Ben Sima — Health Protocol (One-Page Summary)
Derived from 23andMe v4 genome analysis, March 2026 Refer to genome_analysis.md for full SNP details and evidence tiers
Diet
Pattern: Byzantine Catholic fasting tradition synergy — fish, poultry, vegetables, fruit, rice, legumes, olive oil.
Hard constraints (strong genetic evidence):
- Low saturated fat — APOC3 double-homozygous. Olive oil + fish oil as primary fats. Minimize butter, cheese, coconut oil, fatty red meat.
- No liquid dairy — LCT GG (lactose non-persistent). Hard aged cheese and fermented dairy are borderline. Raw milk may be tolerable (bacterial lactase), but test with hydrogen breath test if curious.
- Eat the big meal at midday — MTNR1B het. Evening carbs hit insulin harder for your genotype. Ideal: large post-workout lunch, light dinner or nothing.
- Morning coffee only — CYP1A2 AC slow metabolizer + ADORA2A het. Half-life 5-8hrs. After noon = still in system at bedtime. Max 2 cups/day; >2 increases MI risk for slow metabolizers.
- No heavily charred meat — NAT2 slow acetylator + 8q24 GG (CRC risk). Slow heterocyclic amine detoxification.
- No alcohol or minimal — AAT Pi*Z carrier + fast ADH1B.
Favorable foods:
- Fatty fish 3-4x/week (salmon, sardines, mackerel)
- Cruciferous vegetables regularly (upregulates weak GSTP1 detox pathway)
- Liver/pâté weekly (preformed vitamin A — BCMO1 double het can’t convert beta-carotene efficiently)
- Simple carbs on training days are fine (fruit, honey, rice) — glycogen cycling in GLUT4 window
- Fermented foods (support FUT2 het microbiome)
Fasting
- OMAD or 2MAD as baseline eating pattern
- Fasting is your primary metabolic lever — PPARG Pro/Pro means exercise alone won’t fix insulin resistance
- Extended fasts (72h) ~4x/year for autophagy (ATG16L1 het = mildly reduced baseline autophagy) and hepatic fat clearance
- More frequent extended fasts acceptable while insulin is still elevated
Exercise
- Z2 endurance is your strongest genetic play — PPARGC1A wildtype (superior mitochondrial biogenesis) + AGT Met/Met + PPARD het
- Bodyweight strength with controlled progressions — ACTN3 RX hybrid, benefits from strength but won’t gain like a power specialist
- Always warm up — COL1A1 het + COL5A1 het = double connective tissue risk. Progress loading slowly. Eccentric tendon strengthening.
- Volume over intensity — IL-6 GG (high producer) = needs adequate recovery between hard sessions
- Don’t skip training — exercise manages psoriasis (SH2B3 TT baseline inflammation), cardiovascular risk (9p21 het), and is your glycogen cycling mechanism
Supplements
| Supplement | Reason | Priority |
|---|---|---|
| Fish oil (2-4g EPA+DHA) | APOC3 trigs + FADS1 het + psoriasis + inflammation | HIGH |
| Vitamin D | VDR het + no dairy (no fortified source) | HIGH |
| Collagen + Vitamin C (pre-training) | COL1A1/COL5A1 double het connective tissue support | MEDIUM |
| Preformed Vitamin A (retinol) | BCMO1 double het (~45% reduced conversion) — or eat liver weekly | MEDIUM |
| B-complex (methylated) | TCN2 het + MTRR het + MTHFR A1298C het — TEST FIRST (MMA + homocysteine in April) | PENDING |
Screening & Monitoring
- Colonoscopy at 45, don’t defer — 8q24 GG homozygous CRC risk (~1.4-1.5x)
- Annual derm check — MC1R R160W het + psoriasis cluster (HLA-C*06:02 het)
- Show dry skin patches to derm — likely subclinical psoriasis, not just dry skin
- Blood pressure monitoring — AGTR1 het (mild angiotensin receptor upregulation)
- April 2026 blood draw — fasting insulin, glucose, trigs, ALT, cystatin C, uric acid, MMA, homocysteine, hsCRP, vitamin D
Pharmacogenomics Card
TELL ANY PRESCRIBING DOCTOR:
| Finding | Clinical Impact |
|---|---|
| *CYP2C9*1/3 — Intermediate Metabolizer | Warfarin: ~25% dose reduction needed. NSAIDs (ibuprofen, naproxen): use lower doses, slower clearance. Losartan: reduced activation. |
| NAT2 — Slow Acetylator | Isoniazid: hepatotoxicity risk at standard doses |
| AAT Pi*Z Carrier (MZ) | Mention if evaluated for liver or lung disease |
| ABCB1 TT — Reduced P-glycoprotein | More drug penetration to brain. Start low on opioids/CNS drugs. |
| CYP2D6: Normal | No action needed |
| CYP2C19: Normal | No action needed |
| SLCO1B1: Wildtype | No statin myopathy risk |
| DPYD: Wildtype | 5-FU safe if ever needed |
Things That Are Fine (Genetic All-Clear)
- ✅ APOE ε3/ε3 — no Alzheimer’s or lipid transport concern
- ✅ Lp(a) wildtype — no elevated lipoprotein(a)
- ✅ PNPLA3 wildtype — liver fat is environmental, not genetic destiny
- ✅ TCF7L2 wildtype — no genetic T2D risk
- ✅ HLA-DQ2/DQ8 negative — celiac ruled out, no gluten concern
- ✅ NOD2 clean — no Crohn’s risk
- ✅ BRCA/Lynch markers clean (common SNPs only)
- ✅ Filaggrin normal — skin barrier intact, dry patches are inflammatory not structural
- ✅ DRD2/OPRM1/DBH wildtype — low general addiction susceptibility
Lifestyle Notes
- 1-2 cigars/week is fine — CHRNA5 het (slight nicotine susceptibility) but frequency is well below dependency threshold. AAT MZ carrier is low risk without inhalation.
- Sleep 7hrs minimum — no DEC2 short-sleep mutation. 6.5hrs is your floor, not surplus. Bright light at 5am wake, restrict light after 8pm.
- Nicotine pouches (3mg) are in safe zone — protective DRD2/OPRM1/MAOA profile. MAOA high-activity means tobacco smoke (with MAOIs) would be extra reinforcing; isolated nicotine doesn’t trigger that.