This August’s record-setting heat waves serve as a reminder to pay special attention to sun and heat exposure.
Many of us already understand that sun exposure can increase one’s risk for certain types of <a href="https://blog.23andme.com/health-traits/new-23andme-report-on-skin-cancer/">skin cancer</a> like melanoma and basal and squamous cell carcinomas. But beyond skin cancer, increased UV radiation and heat can also exacerbate several other health conditions. Learning more about some of these conditions and your genetic likelihood of developing them can help you better protect yourself this summer.
<h6>A Resurgence of Rosacea</h6>
Rosacea is a chronic skin condition that often causes redness, flushing, or visible blood vessels around the nose and cheeks. Symptoms come and go in response to environmental triggers.
<a href="https://www.aad.org/public/diseases/rosacea/triggers/prevent#:~:text=Think%20sun%20protection,30%20or%20higher%20every%20day.">Sun exposure</a> is a common cause of rosacea flare-ups, particularly in the summer. However, basic protection measures – like avoiding midday sun, wearing a hat, and applying a gentle, mineral-based sunscreen – can help lessen symptoms.  
It also helps to be aware of your genetics. Rosacea is likely due to a<a href="https://blog.23andme.com/health-traits/new-report-rosacea/"> confluence of factors</a>, including genetics and inflammation caused by an overactive immune system.
23andMe researchers, in collaboration with academic and industry partners, identified <a href="https://blog.23andme.com/23andme-research/the-genetics-of-rosacea/">two genetic variants</a> associated with rosacea among people of European descent and unearthed <a href="https://blog.23andme.com/23andme-research/new-genetic-associations-for-rosacea-found/">seven gene regions</a> related to rosacea symptom severity.
Current research aims to better understand the condition and identify therapies that can help treat symptoms.
<h6>Weathering Lupus Flare-Ups</h6>
The summer sun can also spell trouble for people with lupus. This chronic autoimmune condition occurs when the body’s immune system attacks its own tissues and organs. The resulting inflammation can affect joints, skin, and various organs. 
Many people with lupus experience photosensitivity and flare-ups after UV exposure. A <a href="https://blog.23andme.com/23andme-research/new-insights-from-lupus-research/">four-year study</a> by 23andMe and Pfizer of 6,000 individuals with lupus found that 67 percent of participants reported skin reactions after sun exposure. 
Dermatologists <a href="https://www.lupus.org/resources/uv-exposure-what-you-need-to-know">recommend</a> a suite of lifestyle modifications that include wearing sunscreen, shading or tinting the windows of your car, and even choosing lightbulbs with lower irradiance.
<h6>Staying Safe this Summer</h6>
Too much UV exposure and too much heat can leave their mark, but with a little knowledge and preparation, you can maximize the last few weeks of the season.

23andMe Blog

23andMe Blog Team

Here Comes the Sun!

Although he’s a doctor, Paulo didn’t use 23andMe to learn about his health. He used the services to learn more about where he came from.
 “I didn’t know my biological father so I wondered about my ancestry on my father’s side,” said the hematologist, who is in his 40s.
It wasn’t that Paulo was uninterested in 23andMe’s health offering, he just didn’t expect anything. He knew 23andMe offered health reports and he’d even had a discussion with colleagues about genetic testing in general. The conversation revolved around whether he’d still be interested if it turned out that he had a risk for a condition for which there was no treatment.
“I thought about it before I (used 23andMe), and I’d want to know,” Paulo said. “Because (knowing) would allow me to prepare. But my situation with this result is totally different.”
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Paulo used 23andMe while he was in the United States for an extended period of time for a medical conference. When he opened up his reports a few weeks later he learned that he had an increased risk of developing a little-known condition that, if left undiagnosed and untreated, could lead to congestive heart failure. It was stunning, he said. For some, this might have generated angst, but for Paulo, it was the opposite. The knowledge felt empowering.
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Editor’s Note: We’ve talked to hundreds of people about what they did ‘after the click,’ after they opened up a report and learned about an unknown risk for breast cancer, or lung and liver disease, or cardiac and neurological issues. <o:p></o:p>
The response isn’t one of fear but empowerment.  <o:p></o:p>
Suddenly they and their doctor have information they can use to follow-up on a risk in order to prevent or treat a serious illness. And this is too often for risks they wouldn’t have known of otherwise. <o:p></o:p>
Here is the another in an occasional series about customers who were empowered to take action after learning of a serious health risk through 23andMe. <o:p></o:p>
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“The difference is I could do something about it,” he said. 
Like most doctors, Paulo would much prefer if, instead of treating someone for an illness, he could help prevent them from getting sick in the first place. But to do that you have to know of a risk beforehand. That knowledge would give you and your doctor the chance to take steps that could prevent an illness or mitigate a sickness before it ever develops. That’s the ideal. But it rarely happens that way. The healthcare system is very good at treating an illness but, as yet, not so good at preventing one.
That’s what made Paulo’s result so empowering and turned his story into one about prevention.
After clicking on his 23andMe Hereditary Amyloidosis (TTR-Related) Genetic Health Risk report,* Paulo learned he had the V122I variant.
It’s associated with an increased risk of developing something called TTR-related hereditary amyloidosis. The condition is characterized by a build-up of a protein called transthyretin (TTR) in various organs in the body, including the heart. It&#8217;s notoriously difficult to diagnose and often goes undetected. Left untreated it can lead to congestive heart failure and other symptoms. People with this variant typically do not begin to show symptoms until after the age of 60, and the risk increases with age: One study found that among men over 70 with this variant, the rate of heart failure was 70 percent.
Paulo knew that he should take this information seriously.
After getting his result, he talked to his doctor, who diagnosed his condition after confirmatory testing. He also did some research, learning more about the condition and current treatments, and even looking into clinical trials. In the last few years, new medicines have been developed to treat TTR-related hereditary amyloidosis, and they are widely available and effective. The earlier the diagnosis, the more effective the treatment.
“Now I take the medicine,” he said. “I have an exam each year, and this can help me prevent a very serious condition. It doesn’t get better than that.”
But the outcome isn’t so straightforward for most of those with the variant. Many who carry the variant are unaware of it, just as Paulo had been prior to testing with 23andMe. Most have never even heard of the condition, which is particularly prevalent within the African American and Latino communities (Paulo is Brazilian, and has a mix of African, Indigenous American, and European ancestry). Some stats indicate that up to four percent of African American and one percent of Latinx individuals are at an increased risk for congestive heart failure because they have the variant.
Indeed, about 10 percent of African Americans over the age of 60 with congestive heart failure carry the variant. A recent <a href="https://www.mdpi.com/2075-4426/11/1/49/htm">small study</a> by researchers at Mount Sinai found that genetic testing could help both patients and their doctors treat and prevent TTR-related hereditary amyloidosis. The study identified individuals with the variant through genetic screening (not through 23andMe) within a research cohort in New York City.
A little more than half of those identified as carriers of the V122I variant were African American, and a little under half were Latino. Although none had been diagnosed with TTR-related hereditary amyloidosis, many had early indicators of the condition. None of the participants knew of any family history of TTR-related hereditary amyloidosis. In other words, it’s likely that without testing many would never have learned of their risk.
But one of the biggest takeaways of the study is that, like in Paulo’s case, upon learning they had this pathogenic variant, a majority took action, visiting a cardiologist within eight months. This has given them the opportunity to get earlier treatment for a condition that is under-recognized yet treatable. Early diagnosis is critical, and there are new therapies for it. Getting this information to these individuals early was potentially life-saving.
At least that’s what Paulo believes about his experience using 23andMe.
“In my case, I didn’t have to wait until I had heart problems,” he said. “I can do treatment to prevent it.”
After his condition was confirmed through confirmatory testing, Paulo’s mother tested but she did not have the variant, indicating that he likely inherited the risk variant from his birth father. He is still looking for his birth father, but now in part, he wants to find him to alert him that he may carry the variant that puts him at risk. Maybe his father doesn’t know it and the information could help him too.
“Maybe I can help my dad, whoever he is.”
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*The 23andMe PGS test uses qualitative genotyping to detect select clinically relevant variants in the genomic DNA of adults from saliva for the purpose of reporting and interpreting genetic health risks. It is not intended to diagnose any disease. Your ethnicity may affect the relevance of each report and how your genetic health risk results are interpreted. Each genetic health risk report describes if a person has variants associated with a higher risk of developing a disease, but does not describe a person’s overall risk of developing the disease. The test is  not intended to tell you anything about your current state of health, or to be used to make medical decisions, including whether or not you should take a medication, how much of a medication you should take, or determine any treatment. The TTR-related hereditary amyloidosis genetic health risk report is indicated for reporting of V122I, V30M, and T60A variants in the TTR gene and describes if a person has variants associated with an increased risk of developing TTR-related hereditary amyloidosis.  The majority of the variants included in this report have been most studied in people of African Americans, West African, Portuguese, Northern Swedish, Japanese, Irish, and British descent.

After the Click, Paulo Protects His Heart

This week, we released a new report (powered by 23andMe Research) on Fibromyalgia for 23andMe+ Premium members.
Fibromyalgia is characterized by chronic pain and tenderness throughout the body. That pain can be intermittent and move to different parts of the body. Fibromyalgia symptoms can also include fatigue, problems sleeping, and difficulty concentrating.
Because of the pain, discomfort, and chronic nature of the condition, people with fibromyalgia often experience depression and anxiety as they cope with their symptoms.
<h6><img loading="lazy" decoding="async" class="aligncenter wp-image-29987 size-large" src="http://35.88.189.111/wp-content/uploads/2022/08/Fibromyalgia-1200x628-1-1024x536.png" alt="" width="1024" height="536" srcset="https://blogcms.23andme.com/wp-content/uploads/2022/08/Fibromyalgia-1200x628-1-1024x536.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Fibromyalgia-1200x628-1-300x157.png 300w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Fibromyalgia-1200x628-1-768x402.png 768w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Fibromyalgia-1200x628-1-880x461.png 880w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Fibromyalgia-1200x628-1-1180x618.png 1180w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Fibromyalgia-1200x628-1.png 1200w" sizes="auto, (max-width: 1024px) 100vw, 1024px" />Understanding Fibromyalgia</h6>
The causes of fibromyalgia are not well understood, but genetics and other factors influence how likely an individual is to develop the condition.
 Researchers believe people with fibromyalgia have higher pain sensitivity. That may reflect differences in the nervous system for these individuals, especially in the brain and spinal cord.
While the exact causes are not understood, certain non-genetic factors are associated with a higher likelihood of developing the condition. A family history of the condition also increases the odds of developing it. It’s also associated with other health conditions, like depression, viral infection, arthritis, and lupus. Stress or trauma also is associated with higher chances of developing fibromyalgia.
 While the condition can affect people of any age, it tends to develop in middle age. It’s estimated that as many as five million people in the U.S. live with fibromyalgia, according to the Centers for Disease Control. Women are more likely to be diagnosed with fibromyalgia, but it’s also believed that the condition is under-diagnosed, especially in men.
<h6>A New Report</h6>
Our new report is powered by data from people who have consented to participate in 23andMe research and uses machine learning techniques to estimate an individual’s likelihood of developing fibromyalgia.
 This estimate is made using a statistical model that includes 13,040 genetic markers and information on an individual’s ethnicity and birth sex. In this <a href="https://permalinks.23andme.com/pdf/23_21-PRSMethodology_May2020.pdf">white paper</a>, you can learn more about the science and methodology behind our new report. 
<h6>Managing and Treating Fibromyalgia</h6>
Although it’s not life-threatening, fibromyalgia can make day-to-day life difficult.
Beyond the symptoms already described like chronic pain and fatigue, people with the condition also may deal with headaches, migraines, irritable bowel syndrome, or even a painful bladder.
Often those with the condition benefit from counseling or participate in support groups as part of a broader effort to manage their fibromyalgia.
In addition, many experts agree that lifestyle habits may help manage symptoms and improve the quality of life for those with fibromyalgia. Regular exercise, good sleep and sleep habits, and stress-reduction or mindfulness techniques have been shown to help manage symptoms.
<h6>Learn More</h6>
23andMe’s new Fibromyalgia report (powered by 23andMe Research) is available to all 23andMe+ Premium members. To view your report, go<a href="https://you.23andme.com/reports/prs.fibromyalgia/"> here</a>.
Not a 23andMe+ Premium member? To become a 23andMe+ Premium member, or to find out more go<a href="https://www.23andme.com/membership/"> here</a>.

New 23andMe+ Premium Report on Fibromyalgia

23andMe’s latest Ancestry Composition update includes three new populations in China, increasing resolution for v5 customers with ancestry from the world’s most populous country. 
With more than 30 detailed ancestry regions in China and 19 in Taiwan, 23andMe was already the best DNA test for people with Chinese ancestry, but there was room for improvement. 
“I had some specific regional matches in China and Taiwan, but my ancestry breakdown — my pie chart — just said 100 percent Chinese, which was a little disappointing since China has much more diversity than that,” said Alison Kung, 23andMe’s Director of Product Management, whose family hails from Taiwan.
Now, with 23andMe’s latest Ancestry Composition update introducing three new populations in China, Alison’s ancestry percentages have been broken down into a combination of ancestries. In her updated report, most of Alison’s Chinese ancestry has been inferred to be from Southern China, with smaller percentages from elsewhere in China.
<div id="attachment_29967" style="width: 1034px" class="wp-caption aligncenter"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-29967" class="size-large wp-image-29967" src="http://35.88.189.111/wp-content/uploads/2022/08/China-by-regional-Pop-Map-1024x714.png" alt="The five Ancestry Composition population regions within China." width="1024" height="714" srcset="https://blogcms.23andme.com/wp-content/uploads/2022/08/China-by-regional-Pop-Map-1024x714.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2022/08/China-by-regional-Pop-Map-300x209.png 300w, https://blogcms.23andme.com/wp-content/uploads/2022/08/China-by-regional-Pop-Map-768x535.png 768w, https://blogcms.23andme.com/wp-content/uploads/2022/08/China-by-regional-Pop-Map-880x613.png 880w, https://blogcms.23andme.com/wp-content/uploads/2022/08/China-by-regional-Pop-Map-1180x823.png 1180w, https://blogcms.23andme.com/wp-content/uploads/2022/08/China-by-regional-Pop-Map.png 1370w" sizes="auto, (max-width: 1024px) 100vw, 1024px" />This map indicates the five Ancestry Composition populations within China, including three new, primarily Han Chinese populations. In the upper left corner, Xinjiang Uygur Autonomous Region is hashed with both green and red to reflect the fact that individuals from this region can have genetic ancestry resembling either Central Asian populations or Northern Chinese &amp; Tibetan populations.  </div>
“I&#8217;m excited I can finally understand how my genetic makeup is broken up between the regions of China, since I was unfamiliar with my family history before they were in Taiwan,” explained Alison.
<a href="https://you.23andme.com/reports/ancestry_composition/">View your updated Ancestry Composition report</a>
Note: Customers with no East Asian ancestry may also see small changes to their Ancestry Composition percentages. Common questions about this update can be found at the end of this article.
<h6>What’s new?</h6>
New populations
In previous versions of Ancestry Composition, there were three populations representing almost all of China’s diverse ancestry: “Chinese” represented the majority Han Chinese population; &#8220;Central Asian&#8221; represented the Uyghur population of western China; and “Chinese Dai” represented the larger Tai ethnolinguistic group that currently lives in parts of China, Burma, Laos, Vietnam, and Thailand. Most Chinese Dai live in southern and western Yunnan Province and are genetically more similar to their Vietnamese neighbors than they are to the Han Chinese. 
With this latest update, the “Chinese” reference population was replaced by three more specific populations: <a href="https://you.23andme.com/reports/ancestry_composition/north_chinese/">Northern Chinese &amp; Tibetan</a>, <a href="https://you.23andme.com/reports/ancestry_composition/south_chinese/">Southern Chinese &amp; Taiwanese</a>, and <a href="https://you.23andme.com/reports/ancestry_composition/southernmost_chinese/">South Chinese</a>.

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="332" src="https://blogcms.23andme.com/wp-content/uploads/2022/08/Tree-of-Different-Chinese-Ancestry-Regions-1024x332.png" alt="" class="wp-image-29968" srcset="https://blogcms.23andme.com/wp-content/uploads/2022/08/Tree-of-Different-Chinese-Ancestry-Regions-1024x332.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Tree-of-Different-Chinese-Ancestry-Regions-300x97.png 300w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Tree-of-Different-Chinese-Ancestry-Regions-768x249.png 768w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Tree-of-Different-Chinese-Ancestry-Regions-880x285.png 880w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Tree-of-Different-Chinese-Ancestry-Regions-1180x383.png 1180w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Tree-of-Different-Chinese-Ancestry-Regions.png 1600w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
New stories
Our team of product scientists and content writers have curated a selection of vignettes about the genetic histories, cultures, and attractions unique to the three new populations. Find these new stories on the <a href="https://you.23andme.com/reports/ancestry_composition/north_chinese/">Northern Chinese &amp; Tibetan</a>, <a href="https://you.23andme.com/reports/ancestry_composition/south_chinese/">Southern Chinese &amp; Taiwanese</a>, and <a href="https://you.23andme.com/reports/ancestry_composition/southernmost_chinese/">South Chinese</a> population pages. 
 

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="474" src="https://blogcms.23andme.com/wp-content/uploads/2022/08/Cultural-Dive-Image-1024x474.png" alt="" class="wp-image-29969" srcset="https://blogcms.23andme.com/wp-content/uploads/2022/08/Cultural-Dive-Image-1024x474.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Cultural-Dive-Image-300x139.png 300w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Cultural-Dive-Image-768x355.png 768w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Cultural-Dive-Image-880x407.png 880w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Cultural-Dive-Image-1180x546.png 1180w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Cultural-Dive-Image.png 1600w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="511" src="https://blogcms.23andme.com/wp-content/uploads/2022/08/Bejing-Image-1024x511.png" alt="" class="wp-image-29971" srcset="https://blogcms.23andme.com/wp-content/uploads/2022/08/Bejing-Image-1024x511.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Bejing-Image-300x150.png 300w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Bejing-Image-768x384.png 768w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Bejing-Image-880x439.png 880w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Bejing-Image-1180x589.png 1180w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Bejing-Image.png 1600w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
<h6>The scientific details</h6>
A gradient of genetic diversity
More than 90 percent of people in China identify as Han Chinese, but nested within that Han identity are many layers of regional variation. For example, separating the northern Han from the southern Han are vaguely defined, but often deeply felt, geographical, cultural, historical, and linguistic differences. To what extent does their DNA reflect those distinctions?
China’s population history, including extensive migration, complicates the goal of identifying distinct genetic groups in China. A recent <a href="https://www.cell.com/cell/fulltext/S0092-8674(18)31032-8#%20">study</a>, led by a group at BGI-Shenzhen in Guangdong, China, analyzed the population structure of self-described Han Chinese in China. The authors found a gradient of genetic similarity, but they were also able to identify three distinct genetic groups of Han Chinese, color-coded by region in the paper’s supplemental figure 3, shown below. 

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="522" src="https://blogcms.23andme.com/wp-content/uploads/2022/08/AC-Graph-1024x522.png" alt="" class="wp-image-29970" srcset="https://blogcms.23andme.com/wp-content/uploads/2022/08/AC-Graph-1024x522.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2022/08/AC-Graph-300x153.png 300w, https://blogcms.23andme.com/wp-content/uploads/2022/08/AC-Graph-768x392.png 768w, https://blogcms.23andme.com/wp-content/uploads/2022/08/AC-Graph-880x449.png 880w, https://blogcms.23andme.com/wp-content/uploads/2022/08/AC-Graph-1180x602.png 1180w, https://blogcms.23andme.com/wp-content/uploads/2022/08/AC-Graph.png 1600w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
These results are very similar to those identified by 23andMe’s analysis of customers who report recent ancestry from specific regions of China. While most of the individuals in our analysis may identify as Han, we did not limit the analysis to customers who identified this way. 
<a href="https://you.23andme.com/reports/ancestry_composition/">View your updated Ancestry Composition report</a>
<h6>Discover more with 23andMe</h6>
With more than 2,000 geographic regions, mitochondrial and Y-chromosome haplogroups, <a href="https://you.23andme.com/reports/ancestry_composition_hd/?assessment_id=ancestry_composition_hd.achd_admixture_dating">Ancestry Timeline</a>, <a href="https://you.23andme.com/tools/relatives/dna/">advanced DNA comparison</a>, <a href="https://you.23andme.com/family/relatives/">DNA Relatives</a>, and a <a href="https://you.23andme.com/family/tree/">genetic Family Tree</a>, 23andMe offers more specificity, more interactivity, and more to explore. 23andMe&#8217;s Ancestry Composition improves over time as 23andMe adds new populations and regions, offering customers a chance to see more granularity in their results.
23andMe customers can go to their <a href="https://you.23andme.com/ancestry/">Ancestry Overview</a> to start exploring. 
Not yet a customer? Find out more about 23andMe’s ancestry offerings <a href="https://www.23andme.com/dna-ancestry/">here</a>.

<h6>Common Questions</h6>
1) How did you identify these populations? 
To begin building our reference panel, we selected research-consented 23andMe customers who indicated in their Family Origins survey that all four of their grandparents were born in the same Chinese province. 
Next, we identified groups of individuals who share higher levels of DNA with each other than they do with others in the analysis. These genetic groups became our reference groups for this feature. We compare customers&#8217; DNA to the DNA of individuals within these reference groups.
2) Can customers who tested on earlier genotyping chips see this update?
Customers who tested on older versions of the genotyping chip will need to upgrade to the latest genotyping chip to receive updated results. To find your genotyping chip version, go to your 23andMe profile <a href="https://you.23andme.com/user/">settings</a>, and scroll to the bottom of the personal information section to where it says “Genotyping chip versions.” Customers on our latest chip will see “version 5.” <a href="https://you.23andme.com/chip-upgrade/">Learn more</a> about chip upgrades. This latest Ancestry Composition update includes three new populations in China and is available to customers who tested with 23andMe using the v5 chip (i.e., those genotyped on our latest genotyping chip, called “v5”). All v5 customers’ Ancestry Composition results will be recalculated as part of this update, including customers without East Asian ancestry. Customers without East Asian ancestry should not expect to see significant changes to their ancestry percentages. 23andMe’s latest Ancestry Composition update includes three new populations in China, increasing resolution for v5 customers with ancestry from the world’s most populous country.
3) What does “Northern Chinese AND Tibetan” ancestry mean? Does this mean I have ancestry from both populations listed in the population name? 
This reference population includes individuals whose grandparents were born in Tibet, as well as individuals whose grandparents were born in one of China’s northern provinces. If you have some “Northern Chinese &amp; Tibetan” ancestry in your Ancestry Composition results, this does not necessarily mean you have ancestry from both of these regions, though it is possible. Instead, it could mean that you have ancestry from just one of these regions. You may see more detail in your results that can help shed light on your geographic ancestry — specific provinces to which we were able to trace your ancestry. 
4) My results used to say “East Asian &amp; Indigenous American,” but they no longer do. What changed? 
With this update, Indigenous American ancestry is no longer grouped with East Asian ancestry. What does this mean? Previously, people with either East Asian or Indigenous American ancestry would see those ancestries grouped together under an umbrella category called “East Asian &amp; Indigenous American.” These ancestries were grouped together in our Ancestry Composition algorithm to accommodate shared ancestry that resulted from the migrations into the Americas from Asia that began around 23,000 years ago. 
However, Indigenous American ancestry is almost always distinguishable from East Asian ancestry and, following recent algorithm improvements reducing the amount of nonspecific ancestry in customers’ results, we’ve separated Indigenous American ancestry into its own category.  While this change better reflects how these populations think about their ancestry today, customers who previously had some “Broadly East Asian &amp; Indigenous American” ancestry may now see some or all of that ancestry identified as “unassigned” by the Ancestry Composition algorithm. Customers with Broadly East Asian &amp; Indigenous American ancestry typically had less than 0.5% of this ancestry. 
<a href="https://www.23andme.com/ancestry-composition-guide/">Read more</a> about how the Ancestry Composition algorithm works.
5) If I have ancestry from an ethnic minority in China, will I also have updated results? 
You will still receive updated results, but our algorithms are not granular enough to distinguish these minority populations at this time. It’s likely that the large majority of individuals in the reference populations identify as Han Chinese, but ethnic minorities in China were not excluded in this analysis.
6) I don’t have Chinese ancestry. Will my results change with this update? 
It’s possible customers with no Chinese ancestry will see small changes to their Ancestry Composition results. All customers who tested on version 5 of the genotyping chip will be recalculated with this update, though many customers’ percentages may remain the same.

23andMe Increases Resolution of Chinese Ancestry Inference

A new genetic study identified five regions in the human genome associated with susceptibility to pneumonia, a leading cause of death worldwide.
Published in the journal<a href="https://www.nature.com/articles/s41467-022-31473-3"> Nature Communications</a>, the study also found a surprising link between the risk of pneumonia and psychiatric conditions, such as schizophrenia, bipolar disorder, and major depression.
There are several types of pneumonia, but the most common involve bacterial or viral infection in the lungs. The condition can be deadly for those most physically vulnerable, particularly the elderly and young children. Many of those hospitalized for COVID-19 also end up having to be treated for pneumonia.
<h2>Five Genetic Regions</h2>
This study was led by researchers at the University of Newcastle in Australia. It included data from over half a million individuals and is believed to be the largest genomic study of pneumonia ever done. The research included data from 23andMe customers who consented to participate in research and data from the<a href="https://www.finngen.fi/en"> FinnGen</a> consortium.
The researchers identified five genetic regions associated with pneumonia. Some previously identified associations within human leukocyte antigen (HLA) genes were among those. 
The HLA genes are the hundreds of genes on chromosome 6 that regulate the body’s immune system. The HLA gene also regulates the response to invading pathogens like viruses and bacteria. 
<h2>Role of Inflammation</h2>
The team also found three new associations in genes related to inflammation and immunity and another new association in the gene MUC5AC. The gene is in a cluster of genes that regulate the production of mucin proteins in the body. Mucin proteins make up mucus, the substance that lubricates and protects the lining of the airways, digestive tract, and reproductive system. The up-regulation of MUC5AC may exacerbate pneumonia by inducing inflammation in the airways.
According to the researchers, the link between the genetic risk for pneumonia and psychiatric conditions may be related to inflammation.
“I think it&#8217;s surprising, but in some ways, it’s not, as there are thought to be inflammatory risks for mental illness,”<a href="https://www.newcastle.edu.au/newsroom/featured/pneumonia-risk-signals-potential-for-precision-medicine"> said Murray Cairns,</a> one of the paper’s co-authors and a principal investigator at the University of Newcastle’s HMRI Precision Medicine Research Program. “(Inflammation) is a well-known risk factor for psychiatric illness, so it&#8217;s potentially a risk shared between those disorders.”
The researchers acknowledge that much more must be done to understand the link between pneumonia and mental illness. However, in the paper, they hypothesize that the connection may be related to HLA genes and either their overreaction, inflammation, or inadequate response to an infection.
Understanding the role of this link with inflammation and the genetic associations for pneumonia could help researchers look for new treatments.
Find the complete study in the journal<a href="https://www.nature.com/articles/s41467-022-31473-3"> Nature Communications.</a>

A New Genetic Study on Pneumonia

A very large genetic study of insomnia has identified hundreds of genes associated with the condition that is also linked to such things as depression, anxiety, schizophrenia, as well as metabolic disorders.
The scientists who worked on the study suggest that the breadth of those links likely indicates that there are different genetic subtypes for the condition. It’s estimated that as many as<a href="https://pubmed.ncbi.nlm.nih.gov/28348990/"> 30 percent of adults</a> have insomnia, which is defined as an inability to fall asleep at least three times a week over several months.
<h6>Large Study </h6>
Published in the journal Nature Genetics the<a href="https://www.nature.com/articles/s41588-022-01124-w"> study</a> included data from more than 2.3 million people, more than half a million of whom reported having insomnia and the remaining 1.8 million without the condition who were used in this research as controls. 
This study almost doubled the size of the previous largest genome-wide association <a href="https://blog.23andme.com/23andme-research/genetics-of-insomnia-more-similar-to-psychiatric-conditions-than-to-other-sleep-traits/">study on insomnia</a> that was conducted by some of the same scientists. Danielle Posthuma, a professor at Vrije University in Amsterdam, again led it at Vrije University in Amsterdam.
Posthuma and her co-authors explained in this paper that the current work suggests that &#8220;for extremely polygenic traits such as insomnia, increasing sample size does lead to an increase in detected (single nucleotide polymorphisms), loci, genes, and pathways, providing more confidence in existing and novel mechanisms.&#8221;
<h6>Many Genes Involved</h6>
At the same time, the additional data in this study did not improve the predictive power for insomnia. This is in part due to the highly polygenic nature of insomnia, meaning that there are many, many genetic variants associated with the condition that have yet to be identified. Insomnia is estimated to be the third most polygenic trait behind major depressive disorder and educational attainment, according to the researchers for this study.
The study identified 289 genes involved in insomnia, but that total still only explains about 10 percent of the heritability of the condition. Some of the genes associated with insomnia appeared linked to metabolic or psychiatric conditions.
Other studies indicate that about<a href="https://pubmed.ncbi.nlm.nih.gov/18979946/"> three-quarters of adults</a> with depression suffer from insomnia. 
23andMe does not have a genetic health report on insomnia, but it does have a collection of reports on such things as <a href="https://www.23andme.com/topics/wellness/deep-sleep/">Deep Sleep</a>, <a href="https://www.23andme.com/topics/wellness/sleep-movement/">Sleep Movement</a>, and Wake Time in a “sleep hub” meant to look at how your genetics may play a role in the quality of your sleep.
You can read the full insomnia study in<a href="https://www.nature.com/articles/s41588-022-01124-w"> Nature Genetics.</a>

New Genetic Study on Insomnia

In late 2020, 23andMe launched a genetic study of systemic sclerosis, a rare autoimmune disease that results in the hardening and thickening of the skin and other organs.
Within 18 months, we’ve met our goal of recruiting more than 1,500 individuals with systemic sclerosis to participate in this study. We did this through online recruitment and with help from a collaboration with the Scleroderma Research Foundation, and our drug discovery collaboration partner GSK, who provided funding and expertise. 
&nbsp;

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="210" height="210" src="https://blogcms.23andme.com/wp-content/uploads/2020/11/Scleroderma-Feed-Icon@3x.png" alt="" class="wp-image-28608" srcset="https://blogcms.23andme.com/wp-content/uploads/2020/11/Scleroderma-Feed-Icon@3x.png 210w, https://blogcms.23andme.com/wp-content/uploads/2020/11/Scleroderma-Feed-Icon@3x-150x150.png 150w" sizes="auto, (max-width: 210px) 100vw, 210px" /></figure>
 
<h6>Recruiting to Study the genetics of systemic sclerosis</h6>
Simply reaching our recruitment goal so quickly is an important milestone.
Like many rare diseases — defined as conditions that affect<a href="https://rarediseases.info.nih.gov/about"> fewer than 200,000</a> individuals in the United States — there is currently no cure or effective treatment for systemic sclerosis. And like many rare diseases, the rarity of this condition makes it challenging for scientists to study. As with many of the more than 7,000 known rare diseases, it is often difficult to find enough people with a rare disease, or enough who are able to participate in research studies. Historically, research on these conditions has been limited and slow.
23andMe’s unique research model allows for online recruitment and participation, which makes it that much easier.
<h6>A snapshot of our research participants</h6>
While there is still much work to do, we want to mark this recruitment milestone. And as we close our recruitment and begin this next phase of the study, we’re sharing a little bit about those participating in our research.
In all, 1,594 people living with systemic sclerosis consented to participate in our research. Although we haven’t yet begun the study, we’ve begun to characterize the cohort of research participants and we’ve already learned a little bit from them.
The condition is more common among women; indeed, 95 percent of the participants in our study are female. We’ve learned that the median age of onset of symptoms among our participants is 35 for those with what’s called primary Raynaud’s phenomenon. For onset of other systemic sclerosis symptoms, the median age of onset is 38 among those participating in 23andMe’s study. 
Raynaud’s phenomenon is the most common symptom for those with systemic sclerosis.  It’s characterized by what’s called vasospasms or spasms of the blood vessels that are triggered by cold temperatures or stress. This can lead to discoloration of the fingers, numbness and pain. In some cases, it can also lead to ulcers on the fingers. (Just note that people who do not have systemic sclerosis can also develop Raynaud’s.)
&nbsp;

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="584" height="598" src="https://blogcms.23andme.com/wp-content/uploads/2022/08/Sscl-Bar-Graph.png" alt="" class="wp-image-29978" srcset="https://blogcms.23andme.com/wp-content/uploads/2022/08/Sscl-Bar-Graph.png 584w, https://blogcms.23andme.com/wp-content/uploads/2022/08/Sscl-Bar-Graph-293x300.png 293w" sizes="auto, (max-width: 584px) 100vw, 584px" /></figure>
 
<h6>Most Common Symptoms</h6>
To give readers a sense of how difficult systemic sclerosis can be for those living with it, we&#8217;re sharing some of the most common symptoms reported by our participants.
Almost half of participants, 48 percent, have had sores or ulcers on their fingers. Another serious symptom is called “interstitial lung disease,” essentially scarring of the lungs, and 30 percent of participants reported having this. Lung scarring can make it harder to breathe and get oxygen into your bloodstream.
About 14 percent of participants reported having pulmonary arterial hypertension, or high blood pressure caused by restrictive blood flow in the lungs. Finally, about 3 percent of participants reported having one of the most serious complications from systemic sclerosis, renal crisis, which can lead to renal failure or congestive heart failure. 
<h6>Studying the Genetics of Systemic Sclerosis</h6>
As our researchers begin the hard work of this study, they continue to focus on the goal that this work will generate genetic insights for potential treatments.
This study will allow our researchers to study systemic sclerosis at scale and allow those living with this condition to participate in research that could provide invaluable insight that may lead researchers to a future treatment discoveries.
While we know that about 70 percent of rare diseases are genetic, there is so much we don’t know about these conditions. Only about 5 percent of all rare diseases have approved treatments. But by working to uncover new genetic insights to conditions like systemic sclerosis, we hope to add to the list of approved treatments to address this unmet need. 
With the additional consent of participants in the study, we plan  to share the data from this study with qualified researchers from academia or biotech labs through the Database of Genotype and Phenotypes (<a href="https://www.ncbi.nlm.nih.gov/gap/">dbGaP</a>). This  repository is sponsored by the <a href="https://www.nih.gov/">National Institutes of Health (NIH)</a>. The NIH’s dbGaP archives and distributes data from studies investigating the relationship of genotype and phenotype in humans.

Recruitment Goal Met for Systemic Sclerosis Genetic Study

A new genetic study suggests drinking coffee during pregnancy does not negatively affect birthweight, nor does it increase the risk of a miscarriage, stillbirth, or premature birth.  
The<a href="https://academic.oup.com/ije/advance-article/doi/10.1093/ije/dyac121/6605011?login=false#358171832"> study</a>, by researchers at the University of Queensland in Australia and the University of Oslo, counters the advice often given during pregnancy to avoid caffeine. That advice was based on observational studies that did not separate coffee drinking from the harmful effects of behaviors like smoking, drinking alcohol, or poor nutrition.  

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="681" src="https://blogcms.23andme.com/wp-content/uploads/2018/10/coffee-beans-1024x681.jpg" alt="" class="wp-image-26590" srcset="https://blogcms.23andme.com/wp-content/uploads/2018/10/coffee-beans-1024x681.jpg 1024w, https://blogcms.23andme.com/wp-content/uploads/2018/10/coffee-beans-300x199.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2018/10/coffee-beans-768x511.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2018/10/coffee-beans-880x585.jpg 880w, https://blogcms.23andme.com/wp-content/uploads/2018/10/coffee-beans-1180x784.jpg 1180w, https://blogcms.23andme.com/wp-content/uploads/2018/10/coffee-beans.jpg 1256w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
<h6>Randomized Stidy</h6>
But in this study the researchers focused solely on the effects of drinking coffee. 
 They used data from several sources, including UK Biobank and from 23andMe customers who consented to participate in research. Ideally, the researchers would have isolated the effects of drinking coffee by doing a randomized trial. This would have required recruiting a very large group of pregnant women and then requiring some to drink coffee, and the others would not be allowed to drink coffee. Then researchers would monitor the effect on their pregnancies. For several reasons, that study design is not feasible in this case. So instead, the researchers used Mendelian randomization to mimic a randomized trial. They did this by first looking at genetic variants associated with drinking coffee and then seeing if they also affect pregnancy outcomes.
Using this genetic analysis, the researchers found no causation between drinking coffee during pregnancy and pregnancy risks for miscarriage, stillbirth, or premature birth. 
<h6>Moderation</h6>
At the same time, the study only looked at a handful of adverse pregnancy outcomes, leaving the possibility that drinking coffee could affect other aspects of a baby’s development.
“For that reason, we don’t recommend a high intake during pregnancy, but a low or moderate consumption of coffee,”<a href="https://www.uq.edu.au/news/article/2022/06/genes-reveal-coffee-safe-during-pregnancy"> said Dr. Gunn-Helen Moen</a>, a lead researcher for the study.
This research used genetic data from the Coffee and Caffeine Genetics Consortium, the<a href="https://www.ukbiobank.ac.uk/"> UK Biobank</a>, the<a href="http://www.bristol.ac.uk/alspac/"> Avon Longitudinal Study of Parents and Children</a>, and customers from 23andMe who consented to participate in research.
The study was published in the<a href="https://dx.doi.org/10.1093/ije/dyac121"> International Journal of Epidemiology</a>.

New Study Suggests Coffee During Pregnancy May Be OK After All

A new genetic study may help those looking for ways to avert some of the troubling side effects of a common medication used to treat Parkinson’s disease.
Parkinson’s is sometimes treated with medication that increases dopamine activity in the brain. In some patients, that triggers impulsivity, such as compulsive gambling, shopping, eating, or hyper-sexuality.
<img loading="lazy" decoding="async" class="alignright size-medium wp-image-7843" src="https://blog-api.23andme.com/wp-content/uploads/2010/11/cartoon-pills-300x285.png" alt="" width="300" height="285" srcset="https://blogcms.23andme.com/wp-content/uploads/2010/11/cartoon-pills-300x285.png 300w, https://blogcms.23andme.com/wp-content/uploads/2010/11/cartoon-pills.png 478w" sizes="auto, (max-width: 300px) 100vw, 300px" />
<h2>Impulse Control Disorder </h2>
In a study published in the journal<a href="https://onlinelibrary.wiley.com/doi/10.1002/acn3.51569"> Annals of Clinical and Translational Neurology,</a> researchers have identified genetic variants in Parkinson’s patients at risk for that problem. Using genetic modeling could help identify patients who are more likely to develop impulse control disorder due to prescribed dopaminergic medications. 
Using machine learning and statistical techniques, the team was able to create a risk model to identify those at the highest risk. 
In the paper, the researchers suggest that this might ultimately be used to make it easier for physicians treating those with Parkinson’s disease to identify those who should be prescribed an alternative to medication that increases dopamine activity, like levodopa.
<h2>Risk Models for Drug Interactions</h2>
The study used data from about 5,700 individuals with Parkinson’s disease. Most of the data came from 23andMe Parkinson’s research participants who consented to participate, with the remainder coming from two other research cohorts, one at the University of Pennsylvania and the other at the Parkinson’s Progression Markers Initiative. 
The research involved two major steps. The first looked at genetic variants associated with impulse control disorder in people with Parkinson’s. Once they identified these variants, researchers used machine learning and statistical techniques to create a risk model. This helped them identify individuals who were more likely to develop impulse control disorder if the prescribed medication affected the dopamine activity in their brains.
In evaluating the model, the researchers said it performed better than similar <a href="https://www.nature.com/articles/s41397-021-00260-6">pharmacogenetic models</a> already used in prescribing anti-platelet drugs.
While dopaminergic drugs are very important and effective in treating motor control issues in Parkinson’s patients, impulse control disorder side effects are relatively common. In this study, n 20-30 percent of those treated with dopaminergic drugs experienced impulse control disorder.  
Applying this pharmacogenetic approach could be effective at identifying those individuals better served by using an alternative to dopaminergic medications. One of those alternatives is the drug levodopa, the researchers said.

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