We are witnessing a revolution in thinking regarding how epigenetics relates to health and disease. The concept of “we are our genes” has been replaced by “we are what our genes express.” This concept is frameshifting in how health care is considered and delivered. Our diseases then become the downstream events resulting from upstream epigenetic events, which are linked to how the individual lifestyle, environments, diets, stress patterns, toxic exposures, activity patterns, and social interactions impact the epigenome.

To translate this emerging concept into clinical medicine requires personalization. For example, it has been shown that even identical twins with identical genomes have different epigenomes and health and disease patterns resulting from these differences.

We have seen the development of new perspectives on epigenomics, including the concepts of nutritional epigenomics, environmental epigenomics, and behavioral epigenomics—all of these link to the advancement of personalized lifestyle medicine.

Clinically it is now recognized that the impact of the composition of the microbiome on an individual’s health is shaped by the diet, the function of the gastrointestinal and immune system, the function of the hepatic detoxification system, and the sensitivity of receptors on various tissues to “signals” that regulate genetic expression. The application of personalized lifestyle medicine is then dependent upon the evaluation of the individual’s genetics coupled with an understanding of how their lifestyle, diet, environment, and social experiences have epigenetically modified their phenotype. This requires a different type of assessment than the traditional disease-diagnostic focused evaluation.

As 2022 has unfolded, it has become clearer that we are collaborating on the definition of a new chapter in clinical medicine focused on the early assessment of the resultant outcomes from epigenetic alteration linked to lifestyle, environment, and behavioral factors.

The good news from this advancing knowledge is that many of these epigenetic alterations associated with chronic disease are reversible through the application of and adherence to specific personalized lifestyle medicine interventions.

—-Dr. Jeffrey Bland