It is infinitely more effective and efficient to focus on preventing diseases, rather than treating them as symptoms arise. Patients will not suffer from consequences such as activity restrictions, time, and medical expenses required for assessments and treatments.
Yet, the current medical system is constructed and often incentivized to treat diseases only after the onset of symptoms, rather than working proactively with a patient to prevent them. In fact, annual national health expenditure in the US is constantly rising, totalling 18% of GDP in 2021. Similar trends can be seen in other countries, such as Germany, France, and Japan. Why are our systems set up to be so reactive and how can we reverse this?
It is easier to define a disease state than a healthy state
It’s not always clear how we can define a patient as healthy. Conversely, we’ve made explicit guidelines around what it means to have a disease. In clinical practice, diseases can be identified by certain symptoms appearing for a patient, or out-of-range biomarkers in their bloodwork. For example, high fasting blood sugar and hemoglobin A1c levels are two of the most common criteria to diagnose diabetes.
However, what it means to be healthy varies from person to person and should not be defined solely by limited measures. Each of us lives a complex life, intertwined with physical stimuli from environmental exposures, medications and exercises, and mental stimuli from social interactions. Thousands of molecules in our body are working together to accommodate daily exposures to these stimuli, and these stimuli also influence how well these molecules work in our body. This makes it difficult to define the optimum state of health in clinical practice because the judgment requires information from multiple sources, not just the results of simple lab tests.
Lack of health data transparency to achieve individual’s healthy state
To be able to take control of our health, we need to know more about our body. However, medical data is often shrouded by medical institutions and hard for patients to access. Additionally, it is often scattered across different clinics and difficult to collate if you move from one place to another.
In recent years, partially driven by COVID-19, there has been stronger emphasis on health data digitization, which ideally makes data gathering and sharing easier. In reality, interoperability among different health organizations is still a big challenge and a centralized location for each individual’s longitudinal medical history is still missing. These gaps in health data visibility make it difficult for patients to define and communicate the state of their health with medical professionals. We are left with the current disease care, instead of health care, because we lack actionable insight into when our health starts shifting toward disease.
Comprehensive molecular tests to help you define your “healthy”
There is an innovative health risk assessment product that can enable us to take better control of our health. Molecular You recently started pilot projects in collaboration with specialized clinics in the United States to offer a comprehensive blood testing that encompasses 250 markers to assess 26 health areas, including cognitive, dietary, and cardiovascular health. The test result and lifestyle recommendations are fully accessible by each client through a mobile app anytime they want to. Medical professionals at the clinics will be reviewing the report with patients so that they can receive tailored advice based on their medical history, current physical assessment, and unique molecular makeup.
Many of the biomarkers tested by Molecular You are precursors of standard clinical markers within a vast network of biochemicals in our body. Some examples of standard clinical markers are lipids, such as cholesterol, for cardiovascular health, and alanine transaminase (ALT) and aspartate transaminase (AST) for liver damage. In a general clinical practice in North America, laboratory tests for these markers are ordered only for specific conditions, despite the fact that comorbidities are common with people with chronic conditions. This can be due to the cost associated with ordering multiple tests to cover the whole body functions and lack of focus on disease prevention. On the contrary, just one blood draw covers the comprehensive list of molecules that are involved in a wide range of organ functions in Molecular You’s tests. With this approach, there is an increased chance of detecting abnormal changes in our body that can be missed by looking at a limited number of clinical markers.
Dynamic data helps you navigate your health journey
The true power of this comprehensive blood test lies in the ability for each of us to track changes in our health over time. Unlike genes, molecular makeup of our blood changes over time, reflecting changes in our lifestyle and medical intervention. By periodically taking a comprehensive blood test, we can gain a granular view of our health and track how our body reacts to certain diets or medications. For example, how iron is metabolized in our body can be different from person to person, not only because of different enzymatic functions but also bioavailability of iron itself. Iron from natural food sources, such as beef liver, is generally absorbed more efficiently than synthetic sources of iron (i.e. supplement pills). Let’s say you have decided to take an iron supplement because your report suggested doing so and your physician agreed. After a few months, the molecular assessment tests can tell you not only about how your body utilizes the extra iron, but also if your whole health is improving.
Data transparency can fuel the shift towards value-based healthcare
To mitigate the rising health care costs the US is shifting toward value-based healthcare from a fee-for-service-based model. In this model, medical professionals are reimbursed for the value of service for patients, which is measured by the improvement of health outcomes. One of the key components of being able to deliver value-based health care is the ability to accurately measure and predict future health risk status, since the inability to spot, predict, and manage health events costs the system tremendous amounts of money. Heart disease and stroke alone costs the system $216 billion per year with $147 billion in lost productivity on the job.
With the integration of molecular blood tests, a brighter and healthier future is ahead of us. It is time to shift how we see our health, from reactively treating symptoms, to looking at it holistically as a whole system because everything is interconnected in the complex web of biochemicals. Now we have a way to understand this network and use it to spot early signs of disease in our hands. This data and our understanding will only get better with the integration of more data and powerful machine learning algorithms. In collaboration with clinics, integration of data from physiological assessments, medical history and molecular tests will help us make sense out of an individual’s biochemical makeup further, leading to new discoveries in biomarkers for disease prediction.
When each of us knows more about how our body is performing through periodical molecular tests and check-ups and health care systems are supporting us to stay healthy, we are truly empowered to achieve longer and healthier lives.
About the author
Mai Yamamoto is a passionate product manager behind Molecular You’s health transparency test solutions, responsible for improving the platforms used by client’s internal staff and clinical collaborators.
She has extensive background as an analytical chemist and data scientist in the field of metabolomics. Her research focused on uncovering mechanisms of complex human diseases for better diagnoses. She led multiple multi-year research projects on chronic digestive disorders as part of her Ph.D. research, focusing on adult irritable bowel syndrome (IBS) and pediatric inflammatory bowel disease (IBD). The integration of metabolomics and microbiome data resulted in multiple publications, showcasing novel insights into these increasingly common, chronic diseases with unknown etiology. Prior to joining Molecular You, she was a member of the International Metabolomics Society.
Resources:
- PLOS ONE paper on multi-omics being more accurate predictor of future disease development (https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0220215)
- Paper on value-based healthcare and action plan for T2D [100 days] (https://journals.sagepub.com/doi/10.1177/0840470420904733)
- Paper on why we care more about disease than health; from a perspective of 1) lack of understanding in health → disease process, 2) too much focus on genetics, 3) additive solution instead of removing the core cause (https://pubmed.ncbi.nlm.nih.gov/36939781/)
- Healthcare cost: US national health expenditure in constant increasing trend, reaching over 18% of GDP in 2021 (https://www.statista.com/statistics/184968/us-health-expenditure-as-percent-of-gdp-since-1960/)
- Similar issue in other countries, such as Germany, France and Japan (https://www.statista.com/statistics/268826/health-expenditure-as-gdp-percentage-in-oecd-countries/)
- Heart disease and associated medical cost in the US: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000558
