I am Sharon Moalem, physician, scientist, and author of Survival of the Sickest, How Sex Works, and Inheritance. AMA!

Well, how does sex work then?

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For maximal success, try to keep interspecies sex to a minimum.

Rule 2?

Be really ridiculously good looking

It's so hard to biologically make a face - which is why we probably equate beauty with symmetry when it comes to faces.

I always thought it was normality. The more average, or the more you look like everyone else, the better looking you are. Any truth to that?

It's all in the symmetry lad.

So that's why we can't stop staring. Faces are shorthand for your biological and environmental pedigree.

can this thread reach all the way around to rule 34?.... sorry about that pun. i suppose if it reaches rule 34 you're doing it wrong.

If you have inherited genes that allow for increased flexibility than well, yes.

Or just expanding on the endless variety of human expression.

damn I've been doing it wrong all along

It's never too late to start trying.

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The fact that our genetic destiny is not completely fixed at birth. That there's so much more fluidity and beauty in all our genomes. And that our genes are listening and being called on to respond, to everything we see, eat, and do.

Is this something that we do through-out our entire lives, or just as we are starting to adapt to an environment at a young age?

It's throughout our lives - there's an amazing photo montage that was in Time magazine a year ago that had comparisons between 'identical' twins, where one had a lot of sun exposure and the other didn't. It either added years or cruelly took them away depending on how much sun they got. But that's where I see the most room for empowerment.

You are aware of the twins and the one being sent to space, correct? I'm excited for the results of that.

No I wasn't was it a Russian Cosmonaut?

Oh they just announced they're going to do it recently!

http://science.nasa.gov/science-news/science-at-nasa/2014/10apr_twins/

Thanks for sharing! I can't wait to see the results. I think they will show the extent to which our environment can change our bodies.

What is the most impactful thing I can do in my life to change my genes (for the better) for my future generations?

Turn off your computer and get outside.

Ok besides that.

Our bodies and the genetics that support them follow the use it or lose it dictum of life. Which means we need to keep moving and challenging our bodies and minds continuously. And that diet likely plays a much bigger role than we ever imagined. I'd say stop counting calories and focus on eating food as unprocessed as possible, your genes will thank you.

Not really a question but I read Survival of the Sickest in school and I absolutely loved it! Thanks for doing this AMA!

Glad to hear, what was it about SoS that you loved?

I loved the history of the bubonic plague! I also thought that the diabetes bit in chapter 2 was really interesting.

There's nothing like the death of 50 million 14th century Europeans to get you interested in biology.

And to remind you that it can happen again, at any time. Mother nature can be one nasty serial killer.

Or economics. The fallout from that enormous hit to the workforce helped lay the foundations for the modern labor economy.

Massive death is super-cool!

There's the hard way and there's the easy way of reducing the population from where we are now.

Would be a shame for things to come apart just as we're finally getting somewhere. History doesn't have to repeat itself, though it more often does.

In my view our diverse set of interests and needs buffer us somewhat against the largely unexpected in this day and age, but I think that as a global people who is unable to keep simple things like our desire to consume or sheer greed or avarice in check it seems a little out there to think that we would be prepared for a large system shock like a new plague or environmental catastrophe that say, ruins crops for a few years straight.

I'm thinking that instead of buffering us against catastrophe that globalization has set the wheels in motion to make it all the more likely to happen.

What's your thoughts on insurance in this country being a mostly disease based, deal with it as it comes system, as apposed to an actual "health care" system?

A great way to turn a profit a the expense of the overall health of a population.

How would Sharon Moalem make love to Sharon Moalem?

How to clone yourself in five not so easy steps: 1) Isolate your DNA 2) Find a human egg and remove DNA 3) Insert your DNA into egg 4) Dash of growth factors and into surrogate womb you go! 5) Press Play on romantic playlist

Introduce me to Sharon and hope for the best.

How much do you hate your parents for naming you Sharon?

For anyone else who sees this and doesn't understand, the person doing the AMA is Mr. Sharon Moalem.

Thanks that's helpful!

It's made for some pretty interesting experiences. First day at school, going to the doctor for a physical, and hearing... "are you here for your sister" a LOT.

I have a question about how we can help our children overcome their genetics. I have 3 kids, their dad was severely bipolar, as were many, many people in his family. Is there anything I can do for my kids to protect them from succumbing to the same fate? Everything I have read puts them at a pretty high risk of inheriting this disorder, especially my son, and I am concerned.

Having one parent who was bipolar can mean up to a 30% risk for all their children. But DNA here is far from destiny - avoiding trauma and working on life skills to deal with the stressors of life is thought to helpful.

Thanks for your reply. Unfortunately, having a bipolar parent can contribute to the trauma. However, that is a non issue now, and my goal is to help them all learn healthy coping skills. Hopefully, we can beat the odds.

Yes of course. And the fact that they have a parent like yourself that is focusing on resilience techniques will hopefully give them even better odds.

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Seeing patients hands down. There's a special kinship that can evolve with a patient and their family over time, when you're invited along so to speak on their medical odyssey.

So why do you write books, then?

To share the just some of the incredible stories I've encountered over the years. I really believe that we don't give humanity enough credit. We're flawed in many ways - but it's as if we don't spend enough time sharing acknowledging the amount of kindness and resiliency we can exhibit.

I especially see this everyday in working with families that have a rare condition. The love of a parent for their child is something truly awe inspiring and crosses not only cultures but species as well.

Well if he didn't write it , it didn't happen right?

Not outside a very small circle.

Exactly:) Books are the way to spread the word.

I've been inspired by more than a few along the way. Razor's Edge by Somerset Maugham or a more recent one Open City by Teju Cole.

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There's a treasure trove of information we all carry in our genomes. Some of which can save our lives - like a discovering a predisposition to a cancer syndrome like Lynch or BRCA1 - ones that are actionable. Other variations in our genomes like the one you describe in your wife is a little more tricky still today. The danger lies within the problem of what to do with information like that. And much more concerning is that insurance companies can legally discriminate in cases of life and disability insurance in most of the US today.

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With the ease and low cost of genetic testing there's going to be a lot more hacking other people's genomes going on. You could only imagine what people might do with such information. If you're really concerned about your wife and want to get more information regarding the specific mutations she may have inherited may be a good idea to speak to a Genetic Counsellor or Geneticist.

Actually, the ACA should alleviate that need. The whole "no discrimination against pre-existing conditions" bit. I imagine your genome and genetic predispositions would be considered pre-existing.

Yes, you're right but the real concern for many after health insurance, is life and disability which companies are free to discriminate at their leisure in most of the US. It's pretty amazing that we lack such basic protection.

Yep. I was uninsured for 3 years because of a pre-existing health condition. I am THRILLED I have insurance now. But, I also have 4 teens. They are in trouble if I get very ill again, or god forbid kick the bucket. I guess one step at a time?...

So glad to hear that you're insured. I don't want to potentially 'out' your identity in anyway in case someone might be trolling for your personal health info. But some states have protection against genetic discrimination for life and disability. Depending how you feel about insurance in general it may be a good idea to look into it further.

I had cancer. No chance of me getting life insurance where I live. Thankfully, it was not BRCA +, so my kids might have a good chance :)

Sometimes some companies will reconsider if you're more than 5 years out from your diagnosis.

We have recently found out that my husband has a BRCA1 gene deletion. I've been told that we cannot have my children tested until adulthood as there is nothing that can be done for them yet. What if anything can I do to give them their best fighting chance against BRCA1? We have two girls and one boy. (if that matters)

It's great that you're looking to give your children the best fighting chance given the possibility that they inherited changes in their BRCA1 gene. First off, it's not 100% that they inherited the gene from your partner. There's a 50/50 chance that each of your children inherited the BRCA1 with a change. It's important to keep up to date with the numerous studies that are underway right now looking at how things like the pill (oral contraceptives) and other environmental factors can change the risk for developing cancers. We're at a really incredible place of discovery.

Hi! I'm a neuroscience PhD student. I read 'Survival of the Sickest' long ago and it's good to hear you have a new book coming out!

In your opinion, how well are epigenetic mechanisms elucidated? Can you think of any specifically? If every experience affects the amount of DNA methylation and histone acetylation, how are we ever going to be able to apply it to real world situations?

Not well at all. We've only just begun to understand just how much we actually don't understand when it comes to epigenetics. And to add to the complexity of it all there seems to be a lot of tissue specificity - meaning you can't always know what's happening in hard to reach places like the brain.

I really loved Survival of the Sickest-- it's a treasure trove of party trivia and conversation starters. The idea that sunshine reduces cholesterol but it destroys folic acid and hence influenced people's skin colors is really interesting. Do you think that any genetic mutation that were to happen today in humans would provide any visible 'advantage' over others, given how advanced medicine has become?

So glad to hear that like SoS! We're in no way done evolving. The one concerning thing that we may not have the sophist action to deal with is that for the real first time in our history we have the power to select for certain genes at the exclusion of others. At the risk for loss of genetic diversity that can expose things like crops to pests, we're not that different. Except we should know better.

Is it true that if you don't use it you lose it?

In a really big way. It's one of the reasons that astronauts have to spend so much of their time exercising while orbiting the earth. Their bodies don't have to deal with gravity in the same ways. The bones begins to thin and their hearts begin to shrink.

How long did you spend in school?! Dang

A very long time almost 20 years out of high school. And looking back it's amazing that I ended up in genetics, it was my least favorite course in college. I was really really fortunate to have the right mentors at just the right time.

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Start by just reaching out. It's actually amazing who might respond to you with offers of guidance and help. And the adage of it "never really hurts to ask" couldn't be more true. I would not be here writing to you today if it wasn't for a very long list of mentors.

So yes, reach out and see what kind of response you get. And don't limit yourself to a certain 'expert' in your field of interest. For me I had an professor of Entomology (Insect prof) who took me under his wing really early and college and kept me challenged. I know the visual might be strange here, but I think you get the idea.

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Yes! And why not start now? Keep me posted I'd like to hear how things work out for you.

What other science or profession had your interest?

Botany and Apiculture (honey bees) were all at the top of the list at some point. I was always fascinated by what happens when anything gets sick, be it a plant or bug... somewhere along the way the focus changed. For me it was witnessing a family member with a rare disease, that changed the playing field. Medicine became a really personal endeavor at that point.

DNA plays a huge part of genetics and there are certain genetic aspects that are inheritable. With your idea that our genes is constantly changing, doesn't this contradict heredity?

What we inherit plays an enormous role is shaping who we are - but it's what we do with that inheritance that can matter so much more. What's exciting to me is the degree to which we're seeing the inheritance of life experiences in animal experiments. It's very likely that we'll eventually discover that humans can inherit trauma, nurture being encoded as nature , as well.

Which do you think has had the biggest impact on our society in the past 500 years, guns, germs, or steel?

Food.

Sorry that wasn't on your list - germs.

How much of obesity do you think is hereditary? As we eat worse and worse on the Western Diet are we actually passing down more genes for obesity as well as more environmental factors?

So far the jury is still out. I think we're going to discover that a bigger than imaginable part of obesity is going to turn out to be inherited based on what our recent ancestors ate. What we do know is that the genes you inherit can really change what you can and should eat.

What portion, if you had any, caused your biggest writers' block with this book? How did you overcome it, and in general, how did you line the process of writing a scientific book?

Trying to explain science in a way that makes you want to learn more about how the world works - that's always a challenge. Using examples from some of the amazing patients I've met and had the honor of working with in my latest book I think helped to bring the genetics to life.

What frequency of people mistake you for a woman until they google you in order to see your image? You said ask anything.

If no one gives them a heads up than I'd say close to 100%.

Well.. Can I be Spiderman?

Is it the webs or the senses that you're after?

Ah...hmmm.. Yes the increased reflexes make more sense and closer to reality

I wonder how long it will be before we start moving from 'treating' to 'enhancing'. Genetic doping may be closer at hand that we ever imagined.

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To allow yourself the time, patience and pain to continually fall in and out of love of what you feel most called to do in life.

Your books seem great. I'll have to pick some up. :)

Great! Keep me posted.

Dr. Moalem, I'm delighted to see that you're doing this AMA. I would like to take this chance to thank you for inspiring me through your book Survival of The Sickest. I even mentioned it in my college app essay in 2009 and now I'm a medical student :)

That's great! Any thoughts on a specialty yet?

What is your funniest fart story?

Climbing up Mt. Fuji I turned into a human fart machine. Producing more wind that I thought was humanly possibly. It was just one of the unpleasant symptoms of the worst altitude sickness I ever experienced. An example of being weighed down by my genetic inheritance.

Possibly the most impressive fart story

And totally true to boot! I really felt awful for those climbing with me. Let's just say it was one really long climb.

Hahah that's crazy that the difference in altitude actually had an affect on your gas! Must have been some loud and powerful farts haha

Yes it was. But unfortunately they did not help to power my climb.

If only we could harness the power of our own gas, great things could be accomplished

Yes, I can see it now a new wave of energy independence blowing across America.