Share Some Family Medical History and Pass the Cranberry Sauce

Nov. 23, 2010— -- You'll have your turkey, side of stuffing, dab of cranberry sauce and heap of potatoes. But this Thanksgiving as you chow down during the most eating-centric holiday of the year, try to add a little family medical history to the conversation around the dinner table.

As multiple generations gather in one place, "Thanksgiving is a great time to talk about family history," said Dr. Christie Mitchell Ballantyne, director of the Center for Cardiovascular Disease Prevention at Baylor College of Medicine and of cardiology at Methodist DeBakey Heart and Vascular Center. "It's nice to eat turkey together, but if you can help your family's health, that's really great."

Many common diseases have a genetic component, and those family health histories can help doctors identify patients who are at higher risk for such big players as heart disease, diabetes, stroke and certain cancers. And knowing your family's background can open up windows to other health problems that can run through family lineage.

"There is so much interest in genetic or genomic testing as a way of assessing inherited disease risk," said Dr. Richard Besser, ABC News' chief health and medical editor. "However, the best available test right now is free. It's the family history."

Dr. Philip Ades, director of cardiac rehabilitation and preventive cardiology at the University of Vermont College of Medicine, said that he is living proof that family history, once learned, can be overcome.

Ades has an extensive family history of cardiac heart disease. His brother had a heart attack in his 40s, bypass surgery at age 47 and now has nine coronary stents in place. His mother, while she lived until the age of 82, was diagnosed with coronary heart disease and type 2 diabetes in her 50s.

"A family history for coronary heart disease is not a death sentence," said Ades. "Rather, it is a 'call to arms.' Most of the things that we inherit that can cause coronary heart disease are treatable."

Ades is now a runner, cyclist and cross-country skier. While he grew up playing sports and staying active, Ades said that, along the way, he learned a lot about the preventive qualities of exercise.

"It is no coincidence that my brother and mother both had type 2 diabetes while in their early 50s, whereas I, at 59, do not yet have it," said Ades. "I may eventually get it, but I am sure that I postponed the onset.

"Nor is it a coincidence that I am not overweight, whereas most of my extended family is," Ades continued.

Diabetes in the Family

Dr. Gerald Bernstein, director of the Diabetes Management Program at the Gerald J. Friedman Diabetes Institute at Beth Israel Medical Center, said that a conversation about diabetes is certainly a topic that should come up during the holidays, especially when there are multiple generations of family in the same room.

For diabetes in the United States, the numbers are particularly striking.

According to Bernstein, 42.3 percent of the American population over the age of 20 has either prediabetes or type 2 diabetes. That translates to 100 million people, which doesn't even include children or teenagers. In October, the Centers for Disease Control and Prevention predicted that the number of people with diabetes would triple by 2050.

The American Diabetes Association describes a prediabetic person as someone who has blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes.

"I would favor the idea of a discussion, because diabetes affects so many people," said Bernstein. "People should begin to share what their propensity for that risk is."

"If you have a bad family history of diabetes, the good news is that you know the history," said Ballantyne.

Cancer in the Genes

In the age of personalized medicine, Dr. John Pierce, director of the Moores Cancer Center's Cancer Prevention and Control Program, said that cancer treatments often take into account certain family histories and cancer-related genes in the body.

"People don't like talking about cancer, but without knowing the family history, we have to make guesses and work from scratch when deciding if treatments are higher or lower risk for patients," said Pierce. "There are a number of drugs for really high-risk people that can reduce risk, but we only want to give those out if they know they're very high risk."

And that's where family history can play a key role in cancer treatment options.

But it isn't all genes and it isn't all lifestyle. Dr. Daniel Blumenthal, professor and chairman of the department of community health and preventive medicine at Morehouse School of Medicine, said that it is important to note that a person's health usually isn't so clear cut.

"Don't be steered wrong by a negative family history," said Blumenthal. "For instance, even if there's no history of lung cancer or heart disease in your family, it's still a bad idea to smoke."

Preventive Measures

So what should you do when you find out Uncle Harry, grandma and grandpa have health conditions that predispose you to illness?

Doctors say that eating healthy and exercising, along with dropping bad habits like smoking, play a huge role in prevention.

Bernstein said it is important to eat carefully and walk, one way or another, about two miles every day. For people who are out and about, shopping and cooking and cleaning, it is pretty easy to get in those two miles a day, but for those who sit at a desk most of the day, it is important to get that necessary exercise.

"People usually pay a little bit of a price when going on medicine," said Bernstein. "But exercise sensitizes your own body to your own insulin. The longer it takes for diabetes to show up in the body, the shorter a period of time that it will have a negative effect on a person's life."

A Healthier Turkey Day

But how about that turkey and all the fixings on Nov. 25? Thanksgiving isn't the healthiest of days for most people. Ades gave some quick tips from his book, "Eating Well Healthy Heart Cookbook," to help cook a healthier meal.

For one, take off the skin before cooking the turkey. Try cooking the stuffing separate from the carcass and meat drippings, minimize sugars and starches and ditch the gravy.

And, in the spirit of the true Thanksgiving, Bernstein made a historically valid health point: "The Thanksgiving meal should be centered around vegetables anyway, because that's mostly what they ate back then."