From the future of genetics to Seven Psychopaths: An Interview with 'The Sports Gene' author, David Epstein

Further discussion with Sports Illustrated's David Epstein, author of 'The Sports Gene', on everything from gene doping, to the ethics of genetics itself, to Martin McDonagh.

If you didn't check out the first part of my interview with David Epstein, I'd suggest doing so. In the second installment, we talked more about genetics and the philosophical implications. So without further ado...

David Castillo: One of the genes you've discussed is the ApoE4 gene, a gene as many know happens to be associated with an increased risk of brain injury. I'm curious if this is where the application of genetics will help the most, which is as a potential preventative measure against injury?

David Epstein: I wouldn't suggest genetic testing for kids in terms of testing for athletic prowess. But with regard to EpoE4, this is definitely where testing can be useful. Athletes should have the right to access this kind of information. They should have the right to put themselves in harms way if they want to also, but such information should be available.

Now, I don't think we should ever say that we should screen people for ApoE4 on the whole...But that said, it frustrated me in the reporting of the book in talking to doctors who report it as a risk factor for permanent brain damage. And yet they would fail to tell people that the test is available. It's only statistical risk information. It's a risk factor. Just because someone has that gene variant, and ends up playing football or boxing, obviously doesn't mean they will have brain damage. So you can't tell somebody definitively.

It's just risk information. That said the same is true for breast cancer and the BRCA genes and that test is being used like crazy. Obviously, most recently in the Angelina Jolie case. Consider what doctors tell smokers in relation to cardiovascular disease. It doesnt mean they won't get cardiovascular disease for sure. Just that there's an increased risk. So how is this any different? If you stop smoking you won't change your DNA, which is true, but you can change your environment. So with respect to ApoE4 you can choose a different sport, or make a concerted effort to limit the number of hits to the head in practice, or retire earlier, and so forth.

When I asked a small number of athletes if they would be interested in screening for ApoE4 the vast majority of them said yes and understood perfectly well. So I think these tests should be offered, and likewise for the genes that predispose people to torn ligaments, and tendons.

And those actually are being used, like in Australia and South Africa for instance. A number of NFL players are using them as well. Again, it's just risk information. Teams do that anyway when they sign players and consider their injury history.

David Castillo: I'm curious about the implication here. And this is the part where we get into full blown philosophy. So something I know Bill McKibben and others have written about, which is the criticism of this 'posthumanism' movement. Do you think technology has reached this ethical tipping point, and should we be worried about metaphysical risks. I think there's a legitimate question there. If genetics can be used to weed out the genetically flawed, why not actively select for those genetically qualified? Do you think about the potential for this emphasis on genetics to make sports less inclusive?

David Epstein: That's a good question, and an interesting idea. I know that genetics can kind of seem avante garde. There's that scary aspect of selecting people in a very sci-fi way. But then again what could be more like that than the NFL Scouting Combine with numbers literally slapped on players, being measured in front of cameras, with their physical histories being read, and so forth. I'm not sure why genetics would be any more objectionable when you look at that talent circus.

But that issue of sports being a less inclusive one is important and one of the reasons why I think we should be having a society wide discussion because technology doesn't move parallel with public discourse. Technology moves much faster.

Look at when Australia was awarded the Olympics, when China was awarded the Olympics, or Great Britain. Seven years ago they started a talent search because they wanted to win more medals. They don't start the talent search focused on track or basketball; sports that are really globally competitive in other words where tons of people are trying to get into them anyway. Instead they start the talent search aimed at smaller sports, like rowing and all sorts of things like that. And it works like crazy

That's why those countries win so many more medals when they host the Olympics. Australia won 10 times as many medals as the US per capita when they hosted the Olympics because they focused the talent search on the minor sports; the sports that wouldn't be missing those people if so many people were not already gravitating towards them.

Take Great Britain. Helen Glover was the first gold medalist for the home team, as a rower and was identified in this program called Sporting Giants. Sports officials went to schools and clubs measuring people for all sorts of different skeletal traits, predicted how tall they were gonna be, their brachial index which is the ratio of their forearm and the upper arm. Then they found that Helen Glover would fit right into rowing. So they stuck her in rowing 4 years before the Olympics and now she's a national icon for winning the first gold medal for the home team.

To me, this kind of screening, whether it's genetic or physiological, dictates that you will find a bunch of people who will otherwise languish in perhaps the country's most popular sport trying to play soccer when they could become an Olympian in rowing. So naturally if you're vetting people, you're gonna lose some but that happens anyway. I think with talent search and screening ,you have a much better chance of getting people into these smaller sports that they might never have turned their attention to. And maybe that will translate into great success.

I've had a lot of physiological testing on myself and I've realized that I'm most like short track speed skaters in my physiology. Maybe it would have been cool if someone pointed me that way and I would have reaped those rewards instead of sticking with competitive running.

David Castillo: Speaking of the future, especially in thinking about the Biogenesis thing, it's hard not to think about the future of doping itself. There was a story in the NewScientist the other day about this gene called IGF-1 that repairs and bulks muscle, which was used in mice to trigger of production of proteins 10 times more than normal. Is this (gene doping) the future of performance enhancement?

David Epstein: It's hard to say. In one sense, yes, but I think the traditional doping methods work so much better if you're simply smart about it. After all, the testing is still so easy to beat if you're just smart. Simple things like testosterone are so effective so if I'm an athlete I wouldn't be going beyond traditional methods. I would just be doing them smartly. Plus the reputation of anti doping policy far exceeds its capabilities. I mean the rate of false negatives is enormous.

That said, there's no question that athletes are going to try something different. I write about Se-Jin Lee in the book, who discovered the myostatin gene, and Lee Sweeney who was the first to use the IGF-1 gene in mice, and both those guys reported that as soon as they posted the results, they were inundated with athletes asking to try it, with no regard for whether it's safe or not. The technology is not that difficult. I think some of the companies working on gene therapy drugs might work with anti doping authorities to tag them in a way that will make them easy to detect

That said, one of the things making it difficult is that genes work in complex networks. But like you said now we know these small number of single genes that have a large effect like IGF-1, Myostatin, the EPO receptor gene, and the human growth hormone releasing hormone gene.

Lee Sweeney told me he was in an anti doping meeting one time. And the guy who was altering IGF-1 genes in mice was talking to another another scientist who stood up and said "we have to accept aging as a natural process and not treat it like it's a disease. When I'm 80 years old and in my wheelchair I'll accept that that's life" and then Lee Sweeney said "And I'll be fine to push your wheelchair when I'm 80". Sweeney is collaborating with doping agencies now but he said that if it's proven safe he is not interested in restricting it anymore. So there are definitely some serious philosophical questions there.

David Castillo: That reminds me of a survey about athletes, who when asked whether or not they would take a wonder drug or pill that would maximize their performance for five years only to then kill them, responded in the affirmative...

David Epstein: One thing about that quiz, because it's a famous survey. First, there are definitely athletes like that. I remember Tim Montgomery, with Balco, said that 'I don't care if I die on the other side of the line if I win that gold medal'. But that survey you're talking about is called the Goldman Question, named after a man named Robert Goldman. But the problem with that survey is that he never published anywhere so it never went to any kind of peer review. Also, he went on to become the head of some weird legalize HGH movement. But when the study was repeated last year in the British Journal of Sports Medicine, called 'The Goldman Question revisited', the results were vastly different. I know it's a very famous anecdote, but there are a lot of reasons to suspect it was never done in a rigorous way.

David Castillo: So now for a general question, but what story in relation to science and sports has your attention now?

David Epstein: I've been interested in brain trauma and sports for awhile but there's something different happening now where I think that the tenor and public discussion on this issue has far exceeded what the actual science says we know. So now the whole CTE issue is an epidemiological finding.

In keeping touch with retired football players, I can tell you that after Junior Seau's death, these guys were sent into a panic. You had guys thinking that if they had a couple of concussions in their career, then if they started having a bad day then maybe they should just shoot themselves.

The media did a really good job in bringing up the awareness, but not necessarily in making it well structured and being able to discuss it in a nuanced way. For one, depression is one of the most treatable illnesses around and I fear that these guys are starting to become desperate when they don't necessarily have to be.

Switching gears, from a genetics standpoint I really want to be alive when we know more about epigeneitcs. I actually wrote a chapter on it, but part of why I ultimately had to delete it had to do with the fact that the science is still so nascent, and to clarify, this is the science of how chemical markers that can attach to genes can turn them on or off.

David Castillo: The return to Larmarckism!

David Epstein: I think clearly now there's Increasing evidence in support of epigenetics. Just look at why identical twins sometimes will have different disease profiles because their epigenomes are different even though their genes are largely the same. I just think that's so fascinating that in some cases, these epigenetic marks that turn genes up or down can be passed to generation.

David Castillo: Well I'm curious about potential examples because this has always fascinated me too. In a recent Scientific American article that talked about this 2011 study in a randomized controlled trial involving 120 people in their 60's and 70's that showed that exercise could increase the size of the hippocampus.Could we call this an example of epigenetics in action?

David Epstein: It could be. Epigenetics aside we know that certain stimulants change your biology whether that's because the epigenetic marks that are attached to genes are changing or not, I don't know. But I think it's reasonable to think that way.

For example when people lift weights if they lift habitually, their myostatin production will actually get turned down, so genes involved in myostatin production get turned down. So is it the body going 'Oh I get it we;re gonna be doing resistance training regularly so I might as well turn this gene down so I can let our muscles accommodate this load.'

So we know that gene expression is changing but nobody's looked to see if that's because epigenetic markers are attaching to the genes and turning it down. But I think it's perfectly reasonable to and likely even but nobody knows for sure.

David Castillo: So there always has to be an off topic question. Real quick, any updates on your Martin McDonagh love? Did you check out Seven Psychopaths?

David Epstein: Of course I did. My girlfriend loved it, which surprised me because usually she's not one for excessive violence. I remember when I first tried to get her to watch a UFC event, and it was when Randy Couture fought Gabriel Gonzaga. When Gonzaga's nose broke, and it started bleeding like a fire hydrant she immediately said ‘yep, ok, I'm not watching this.'

But here's the thing when you're watching McDonagh. It's like being in the French Quarter of New Orleans. You might love it, you might not like it that much, but you know you aren't somewhere else. When you're watching him uou would never confuse McDonagh for another writer, and that's really unique for a writer, especially for major movie theatres. There are very few films that are distributed widely where where you can tell the writer without knowing anymore. I think as the medium becomes more profitable, it becomes more and more conformist so someone like him stands out even more. Even though it wasn't my favorite work of his, I still appreciated it because his voice is so unique. His work gets me out of my comfort zone and gets me to engage with it in a way most films, or most writing simply fails to do.

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