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" Having a baby almost killed high school teacher Dawn Manogue \u2014 but not for the reasons you might think. True, she had a difficult, 42-hour labor. But that didn&amp;#039;t explain why, after giving birth in November 2000, she became short of breath, her legs ballooned with fluid, her vision dimmed, and she was too exhausted even to lift her infant. Her ob/gyn said Dawn simply had &amp;quot;new-mommy anxiety.&amp;quot; But within a week, the 32-year-old was back in the hospital with two blood clots in her lungs and an enlarged heart pumping so weakly that it was barely keeping her alive. Doctors at Dawn&amp;#039;s local hospital in Plymouth, MA, ordered a helicopter to rush her to a larger hospital in Boston, where specialists found the problem: peripartum cardiomyopathy, a potentially fatal weakening of the heart muscle associated with pregnancy. Dawn survived the ordeal and was lucky to avoid a heart transplant, but her problems were far from over. When her daughter, Lily, was 3 months old, Dawn noticed that the skin around the baby&amp;#039;s mouth was bluish. The pediatrician detected a murmur he hadn&amp;#039;t heard before, and Dawn felt her blood run cold. Lily was diagnosed with a rare heart defect that required open-heart surgery at just 18 weeks old. &amp;quot;It was the scariest time of my life, much scarier than what had happened to me,&amp;quot; says Dawn, now 41. &amp;quot;Handing my newborn off to the anesthesiologist that day was the hardest thing I&amp;#039;ve ever had to do.&amp;quot; Even though Dawn&amp;#039;s health issues were different from her daughter&amp;#039;s, any medical professional could tell from glancing at the family&amp;#039;s health history that heart trouble is in the genes. Dawn&amp;#039;s father died of congestive heart failure at age 53 after struggling with coronary artery disease for years. &amp;quot;He was sick my whole life,&amp;quot; says Dawn, who grew up in Janesville, WI. During her father&amp;#039;s months-long hospitalizations, she was often shuffled around to relatives&amp;#039; houses. Dawn remembers one poignant moment when, during 11th-grade English class, she realized that her father was in the middle of bypass surgery. &amp;quot;Most of my classmates weren&amp;#039;t worrying about their parents&amp;#039; mortality,&amp;quot; she says. Dawn&amp;#039;s younger sister, Amy, 39, was diagnosed with congenital heart disease at birth, and she had her first of four open-heart surgeries at age 2. &amp;quot;I remember before one surgery, at age 14, she talked about how she was afraid she was going to die,&amp;quot; Dawn says. &amp;quot;She&amp;#039;s lived with that all her life.&amp;quot;  If Dawn&amp;#039;s family had known then what we know now about the havoc our genes can wreak, they might have been spared some of this suffering. And today, we do know so much more about DNA&amp;#039;s considerable impact on our health \u2014 that there are thousands of gene mutations (or changes to our genes passed down from generation to generation) that can predispose us to everything from heart disease and breast cancer to Parkinson&amp;#039;s disease or depression. Knowing which disease markers might be encoded in your DNA could help you escape your health destiny \u2014 and save your life.  But are you taking full advantage of science&amp;#039;s revelations? How do you know which conditions might be lurking in your gene pool and how to protect yourself from them? Slashing your risk for deadly disease starts with a simple conversation among family members. Sit down and inquire about the illnesses and issues that have felled members of your family tree. This information is a powerful resource because it illuminates not only your clan&amp;#039;s genetic makeup (with all the disease-causing mutations it might be harboring) but also your shared environment, diet, and lifestyle \u2014 like whether you grew up near a park or a factory, ate fresh produce or frozen entr\u00E9es, hiked and biked on weekends or mostly watched TV. All of those factors play a part in determining which illnesses, if any, you might face down the road. &amp;quot;That&amp;#039;s the beauty of family history,&amp;quot; says Paula W. Yoon, an epidemiologist in the division for heart disease and stroke prevention at the Centers for Disease Control and Prevention. &amp;quot;It represents your genetic risk in a package. Mapping your family&amp;#039;s medical health history can alert you to screenings you might need as well as motivate you to make diet and lifestyle changes that could prevent \u2014 or at least lessen the ravages of \u2014 the disorders that plagued generations past. &amp;quot;Your genes are not your fate,&amp;quot; says Dean Ornish, M.D., a clinical professor of medicine at the University of California at San Francisco \u2014 even, possibly, when it comes to cancer. In a study Ornish conducted, more than 500 of the genes of men with prostate cancer changed significantly for the better only three months after a healthy lifestyle makeover. &amp;quot;Improving nutrition, fitness, and stress management can &amp;#039;turn off&amp;#039; disease-promoting genes and &amp;#039;turn on&amp;#039; disease-preventing genes,&amp;quot; Ornish says.  Dawn is now using this groundbreaking information to minimize future health risks for her family, which now includes a son that she and her husband adopted from Ethiopia \u2014 she couldn&amp;#039;t bear to risk having another biological child with inherited heart trouble. Dawn and Lily, now 8, follow the American Heart Association&amp;#039;s heart-healthy guidelines, eating a sugar-free, nearly carb-free, low-fat diet with heaps of green vegetables to keep their cholesterol low and their arteries clear. Both mom and daughter exercise most days of the week.  Being open about her near-death experience and her daughter&amp;#039;s surgery has brought Dawn closer to her mother and sister: &amp;quot;They were supportive in a way that people who hadn&amp;#039;t been through that type of thing couldn&amp;#039;t be,&amp;quot; she says. Dawn also has urged Lily to be her own advocate for her health. &amp;quot;That means being educated about your condition, asking questions, and knowing you&amp;#039;re in charge,&amp;quot; Dawn says.  For the past year, Dawn and Lily have served as survivor ambassadors for the American Heart Association, telling their story nationwide. Together the duo deliver this critical message: Disease could very well run in your family \u2014 and it could ruin it, unless you stay vigilant. Even if your family&amp;#039;s medical history isn&amp;#039;t as dramatic as Dawn&amp;#039;s, you still stand to gain serious health protection with a little more self-knowledge: You could stave off bone loss, preserve your vision, prevent miscarriage, boost your mood, improve your quality of life, and ultimately even extend it. Read on to find out how to map your family&amp;#039;s health history and use your DNA to your very best advantage.  Map Your Family&amp;#039;s Health History This free, low-tech tool could just save your life. &amp;quot;Long before the current proliferation of genetic tests, family history was \u2014 and continues to be \u2014 used to diagnose and manage genetic disorders,&amp;quot; says Rodolfo Valdez, Ph.D., an epidemiologist in the Office of Public Health Genomics at the Centers for Disease Control and Prevention. &amp;quot;In many cases, it&amp;#039;s the best indication of disease risk factors in a family.&amp;quot; So grab pen and paper and make a list of relatives \u2014 both living and dead \u2014 on both sides of your family, keeping the maternal and paternal sides separate. Interview your parents, aunts, uncles, and any living grandparents to learn three pieces of information: 1. Any diseases or health conditions your relatives developed, including heart disease or heart attack, cancer (note the type), diabetes, high blood pressure, high cholesterol, osteoporosis, rheumatoid arthritis, Alzheimer&amp;#039;s, Parkinson&amp;#039;s, and glaucoma, to name a few. Be sure to note any rare diseases, such as hemophilia, cystic fibrosis, and sickle-cell anemia. 2. Age when the conditions were diagnosed. 3. Age the relatives died and cause of death. Don&amp;#039;t be surprised if relatives aren&amp;#039;t eager to broach the subject of illnesses lurking in your family&amp;#039;s branches. These questions can trigger painful memories of lost loved ones or of personal traumas and tragedies; your relatives might feel ashamed of family conditions such as alcoholism and mental illness, or they might simply feel that discussing these family secrets is an invasion of privacy. Win them over by explaining your purpose \u2014 to create a record that will help improve the health of the whole family \u2014 and offer to make it available to all relatives. Word your questions carefully, asking about &amp;quot;family members&amp;quot; rather than &amp;quot;you.&amp;quot; Be aware that some relatives will be more comfortable discussing this face-to-face while others would prefer phone, mail, or email. Ask which of these methods suits them best. Once you&amp;#039;ve got some answers, enter them into a chart that clearly outlines your findings, like the one you can  print here . (The American Heart Association also has a family health tree template on its website, americanheart.org; the U.S. Surgeon General offers one at familyhistory.hhs.gov.) Bring a copy to your next checkup to discuss it with your doctor. He&amp;#039;ll let you know whether there are tests you should be getting or lifestyle changes you should be making to keep you as healthy as you can be. Fight Your Genetic Fate! So you&amp;#039;ve got diseases dotting your family tree. Now what? &amp;quot;There&amp;#039;s a lot you can do,&amp;quot; says Dean Ornish, M.D., a clinical professor of medicine at the University of California at San Francisco. The key to building the best defense against your genes lies in lifestyle change. True, we all stand to improve our health if we eat better, exercise regularly, cut our stress level, and boost our social-support systems (that means friends, family, or anyone else you can talk to and lean on in tough times). But if you&amp;#039;re staring down an inherited condition, these good-for-you habits are practically a mandate. &amp;quot;The more things you can change, and the more you change them, the better your health,&amp;quot; Ornish says, even if you&amp;#039;re in pretty good shape to begin with. Start by discussing your family health history (see &amp;quot;Map your family&amp;#039;s health history&amp;quot;) with your physician. He or she will assess your personal risk for various diseases and then recommend the proper screenings (including genetic tests if necessary) as well as key diet and lifestyle changes to customize a disease-prevention plan that&amp;#039;s right for you. Read on to see just how powerfully a lifestyle makeover can affect your risk of developing these common hand-me-down conditions. DIABETES If it runs in your family: If a parent or sibling has the disease, get a glucose tolerance test by age 30 \u2014 to measure glucose (sugar) levels in your blood and how well your body handles it. Same goes if you have a body-mass index (BMI) over 25 or have other risk factors, like high blood pressure or high cholesterol. If not: Get tested every three years after age 45. Lower your risk:   The Harvard Health Professionals Follow-Up Study of more than 40,000 men showed that those who ate more fruits, vegetables, whole grains, fish, and chicken had a lower risk of diabetes than those who ate a more traditional Western meat-and-potatoes diet.  Aim to get moving every day: Just one sweat session can lower blood sugar for 72 hours, and regular moderate workouts can improve blood sugar levels by 10 to 20 percent, according to Ornish.  Don&amp;#039;t forget to de-stress: A 2007 World Health Organization study found that women who were depressed, tense, and angry nearly doubled their risk of developing diabetes over 15 years.   HEART DISEASE If it runs in your family: You&amp;#039;re at higher risk if one or more first-degree relatives developed heart disease at a young age (your mother or sister before age 65 or your father or brother before age 55) or has high cholesterol or high blood pressure. In that case, get your blood pressure checked annually beginning at age 18 and your cholesterol tested every five years starting at age 20. Smoking and having diabetes also put you at risk. If you do show symptoms such as high blood pressure, your doctor may give you any of nearly a dozen tests, including electrocardiogram (EKG), MRI, chest X-ray, nuclear imaging, and coronary angiography.  If not: Get your blood pressure checked yearly from age 18 and your cholesterol by age 40 (35 for men). Lower your risk:   In a German study, a diet with only 20 percent of calories coming from fat (as opposed to the generally recommended 30 percent), combined with exercise, reversed heart disease in nearly 40 percent of patients.  While American Heart Association recommends at least 30 to 60 minutes of moderately intense physical activity most days, studies show that simply walking 20 to 30 minutes a day can lower your risk of dying from heart disease by up to 40 percent.  Manage your emotions: Feeling depressed, angry, hostile, and tense can constrict your arteries, make your blood clot faster, cause irregular heartbeats, and encourage buildup of artery-clogging plaque.   OSTEOPOROSIS If it runs in your family: Having first-degree relatives (that is, a sibling or a parent) with osteoporosis or its precursor, osteopenia, means you should head in for a bone-density scan called the DEXA (dual energy X-ray absorptiometry) by age 60. A new tool called FRAX, which should be available in the United States by the end of the year, will allow doctors to punch your risk factors into a computer program and see your fracture risk over the next 10 years.  If not: Go in for testing at age 65. Nongenetic risk factors include weighing less than 127 pounds, smoking, significant alcohol use, having an eating disorder, and long-term use of corticosteroid medications. If any of those apply to you, talk to your doctor about earlier screening. Lower your risk:   Building muscle builds bone. Women in a Tufts University study who lifted weights for 40 minutes twice a week for a year regained bone mass, grew physically stronger, improved their balance and flexibility, and were so energized by their workouts that they became 27 percent more active in general.  High-impact exercise also has, well, a high impact! In a California State Polytechnic University study, women who did step aerobics three times a week for six months had greater gains in leg, spine, and heel bone density than women who did weight training alone.  You still need calcium \u2014 1,200 to 1,500 mg a day \u2014 vitamin C (five daily servings of fruits and veggies), magnesium, and vitamin D (aim for 400 to 800 International Units, IUs, daily). Minimize red meat and salt, both of which cause bones to lose calcium.   COLON CANCER  If it runs in your family: If you have a family history of colorectal cancer or inflammatory bowel disease, you should be screened starting 10 years before your youngest relative developed the disease. Your doctor will determine which colorectal screening method is right for you. It may involve a fecal occult blood test (which detects blood in the stool that can&amp;#039;t be seen by the naked eye), flexible sigmoidoscopy (which uses a viewing tube to check the large intestine for cancer, abnormal growths, and ulcers), or colonoscopy (which uses a viewing tube with a tiny TV camera to examine the entire colon). Your doctor might consider genetic testing if you have two first-degree relatives with colon cancer (especially if one got it before age 50), or if colon cancer has affected both sides of your family.  If not: Get a colorectal cancer screening by age 50; ask your doc which method is best for you. Lower your risk:   A large European study showed that a diet high in fruits, vegetables, and whole grains reduced colon cancer by 25 percent.  Bone up on calcium. Women with a higher intake of the mineral suffer less colorectal cancer, according to a study by the National Institutes of Health.  Pop a vitamin D supplement containing as much as 2,000 IUs. A new study in the Annals of Epidemiology suggests that raising vitamin D levels could cut colon cancer deaths in half.  Keep moving: A 2008 study found that people who were highly active lowered their risk of developing colon cancer by 30 to 40 percent.  BREAST CANCER, OVARIAN CANCER If they run in your family: If you have relatives who were afflicted with either breast or ovarian cancer before age 50, talk to your doctor about genetic testing, which will look for changes in genes such as BRCA1 and BRCA2 (though only an estimated 5 to 10 percent of breast cancer is inherited through these genes).  If not: Get a mammogram every year after age 40.  Lower your risk:   According to a review of more than 60 studies, women who exercise regularly can lower their risk of breast cancer by 20 to 30 percent. In a study from the University of Northern Colorado, women reduced their likelihood of developing the disease by working out for at least an hour a week.  Sideline red meat, full-fat dairy, animal fats, and simple carbs and fill your plate instead with fruits, vegetables, fiber, omega-3-rich fish (such as salmon), and soy products.  Skip the cocktails: Research from Kaiser Permanente on 70,000 women showed that one to two alcoholic drinks per day bumped up breast cancer risk by 10 percent. Three or more drinks increased the risk by 30 percent.  Curious About Genetic Testing? Read This First Proceed with caution if you opt to try one of the many new at-home genetic testing kits \u2014 like those from companies such as 23andMe and Navigenics \u2014 which promise to unlock the secrets of your DNA using only a gob of your spit and anywhere from 79 to 2,500 of your dollars. Some scan for about 100 genes to find tidbits ranging from your risk for Parkinson&amp;#039;s to your chances of developing psoriasis; others scan only for genes linked to specific illnesses such as breast and colon cancer, Alzheimer&amp;#039;s, and celiac disease. Still others promise to trace your ancestry, determine paternity, predict your chances of going bald \u2014 or even your perfect love match. Cracking your genetic code with just a cheek swab sounds like the stuff of sci-fi movies \u2014 and is, potentially, an extraordinary leap for personalized medicine. But some tests are more accurate than others, and the results can be incomplete, misleading, and confusing, says Steve Keiles, president of the National Society of Genetic Counselors. To illustrate the potential for confusion, Keiles tells the story of a colleague who took DNA tests by three companies to assess his risk of heart attack \u2014 and got three different results. &amp;quot;The reality is there&amp;#039;s more that&amp;#039;s unknown than known about the genome,&amp;quot; Keiles says, &amp;quot;and we&amp;#039;re only looking at a very small percentage of it.&amp;quot;  Bottom line: Your doctor is the best person to determine, based on your family history, whether you need genetic testing. If you do, you&amp;#039;ll probably want a geneticist or a genetic counselor to help you interpret the complex results. (Ask your doctor for a referral.) Is Your Health History a Mystery? If you&amp;#039;re adopted, orphaned, or estranged from your family, tracing a family health history is not so simple. But there are options. If you&amp;#039;re adopted, ask the adoption agency to show you any health or medical records in your file. &amp;quot;If nothing else, you&amp;#039;re likely to learn your ethnicity, which can point to specific risk factors,&amp;quot; Keiles says. If you&amp;#039;re descended from Ashkenazi Jews (originally from Eastern or Central Europe), for example, you&amp;#039;re more susceptible to hereditary forms of breast, ovarian, and colorectal cancer. If you have a parent who is Chinese, you&amp;#039;re twice as likely to have a gene mutation that can lead to Parkinson&amp;#039;s disease.  Adoptees, as well as orphans and those estranged from their families, can also try at-home DNA testing. Genetic genealogical testing \u2014 a Y-DNA testing for men and mtDNA testing for men and women \u2014 can pinpoint the likely region of the oldest ancestors down your mother&amp;#039;s all-female line and/or your father&amp;#039;s all-male line. &amp;quot;You can learn, with around 99 percent accuracy, whether you&amp;#039;re originally Western European, Eastern European, African, Scandinavian, Asian, or Native American,&amp;quot; says Katherine Hope Borges, founding director of the International Society of Genetic Genealogy (ISOGG). Since women don&amp;#039;t have a Y chromosome for a Y-DNA test, you can trace your all-male line by having your father or brother (by the same father) tested. Go to familytreedna.com, ethnoancestry.com, or dnaheritage.com to get started; to learn more or to consult a genetic genealogist, visit isogg.org. "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.redbookmag.com/body/health-fitness/advice/a5232/preventing-hereditary-diseases/>