Finding out about the illnesses that lurk in your family tree can give you vital clues about your own health risks, provide important information for your doctor and help you discover what you should be doing now to protect yourself and the rest of your family for the future. These are some of the essential questions you need to be able to answer…

By Anne Montague

What can you do?
The good news is that it's not all down to your genes. Even with a family history of osteoporosis, taking protective measures can tip the balance in your favour.

● Take regular weight-bearing exercise - jogging, stair climbing, heavy gardening, racket sports, step aerobics or dancing.

● Don't smoke and eat a healthy, low-salt, calcium-rich diet, without too much caffeine and fizzy drinks.

● Talk to your GP about DXA scanning if you think you're at risk - or break a bone after a minor fall and haven't been investigated for osteoporosis.

● To find out more about the condition, call the National Osteoporosis Society on 0845 450 0230 or visit www.nos.org.uk

Type 2 diabetes runs in families – the closer the family member, the higher your risk. If one parent has the condition, you have a 15% chance of developing it. If both are affected, your risk rises to 75%. But there are controllable factors, too – being overweight and having a large waist increases your risk. Being over 40, high blood pressure, a history of heart attack or stroke, gestational diabetes while pregnant and polycystic ovarian syndrome while being overweight increase your risk, too.

What can you do?
Researchers at the US Diabetes Prevention Program have found that basic lifestyle changes can delay or even prevent the development of diabetes.

• Try to lose 5–10% of your body weight if you’re overweight – it can cut your risk of developing diabetes by more than half.

• Exercise – it can lower your risk by up to 64%.

• Eat healthily – include a low glycaemic index starchy carbohydrate such as wholegrain bread, wholemeal pasta or basmati rice with each meal, cut down on salt and fat, and watch your portion sizes.

• Ask your GP for a test if you are over 40, have a family history of diabetes or any two of the risk factors listed above.

• Contact Diabetes UK (0845 120 2960; www.diabetes.org.uk) for more information.

Having a close relative with glaucoma quadruples your own risk of developing it. Glaucoma is a painless progressive condition and the leading cause of preventable blindness in the UK. You're unlikely to notice symptoms in the early stages, as the less affected eye compensates for the damaged one, but, if treated early, the condition can be effectively controlled.

What can you do?

• Have an annual glaucoma test after the age of 35 if you have a family history of the condition. Others should have a test every two years from the age of 40.

• Contact the International Glaucoma Association (01233 648170; www.iga.org.uk).

Bowel cancer is common, so having a case in the family doesn’t necessarily increase your own risk. Your risk is raised, however, if you have several close relatives (a parent or sibling) with bowel cancer, or one or more close relatives diagnosed before the age of 45. Around 5% of bowel cancers are caused by inherited conditions known as FAP (familial adenomatous polyposis) and HNPCC (hereditary non-polyposis colorectal cancer). Ask your family about other cancers, too – breast, ovarian, uterine and stomach cancers can run together in families.

 What can you do?

The national bowel cancer screening programme is being rolled out nationwide, and will offer screening to people aged 60–69. If your doctor thinks you’re at higher risk, you may be offered earlier screening.

• Stay active – it may halve the risk.

• Eat more fruit, vegetables and oily fish, and cut back on fatty foods and red and processed meat.

• Contact Bowel Cancer UK on 0870 850 6050 or visit www.bowelcanceruk.org.uk.

If family members developed heart disease early – under 55 for a father or brother, under 65 for a mother or sister – your risk is automatically increased. ‘This may be because of an inherited tendency to high blood pressure, high cholesterol or it may be because of unknown genetic factors,’ says Cathy Ross, cardiac nurse specialist at the British Heart Foundation (www.bhf.org.uk). ‘If relatives developed heart disease later in life you need to look at underlying factors such as diet, smoking, lack of exercise and being overweight, too, as lifestyle habits tend to be passed down as well.’

 
What can you do?

• Alert your doctor if you have a strong family history of heart disease.

• Make lifestyle changes to help reduce your risk. ‘Everyone can take protective action like stopping smoking, reducing fat intake, losing weight and taking more exercise,’ says Cathy Ross.

• Have your blood pressure and cholesterol checked. If you’re over 40, ask your GP for a heart disease risk assessment.

Breast cancer is now so common that having someone in the family with the disease doesn’t necessarily mean your risk is increased. In fact, more than 80% of women who develop breast cancer have no family history of the disease, and only around five in every 100 breast cancers are related to a known, inherited breast cancer gene. So if your granny died from breast cancer at 80, your risk is probably the same as anyone else’s. It’s only if you have a strong family history that your risk is raised – broadly, that means two close family members diagnosed under the age of 50, three close family members under 60 or four close family members at any age. Ask about ovarian cancer as well, as the two can run together in families.

What can you do?

• Talk to your GP if you’re worried, who can refer you to a specialist if necessary.

• Try not to put off screening appointments – especially if you’re over 50.

• Be aware – check breasts and armpits for any unusual lumps, thickening or skin changes and look for changes in the size or appearance of the breasts or nipples. Report any concerns to your doctor.

• Stay active. Just half an hour’s exercise each day can cut your risk by 40%.

• Keep your alcohol intake low. Your risk increases by 7% if you have a drink every day, rising to 14% if you have two a day.

• Maintain a healthy weight. Gaining weight as an adult and being overweight after menopause increases your risk of breast cancer. Losing even a bit of the excess weight can help.

• If you want to find out more, visit www.breakthrough.org.uk.

Admitting to any kind of mental illness is still taboo for many people, says Professor Ann Mortimer, consultant psychiatrist at the University of Hull. ‘You might hear phrases like “she suffered with nerves”, but do try and find out if there’s any history of depression, schizophrenia or bipolar disorder or any drug and alcohol problems, as these can run in families,’ she explains. It’s thought that many genes are involved – and that a combination of genes and environmental factors such as difficult life events can tip people over into illness.

What can you do?

• Talk to your GP. ‘Depression can manifest itself in physical symptoms, so knowing your family history can help your doctor,’ says Professor Mortimer.

• Seek support from a counsellor or your doctor if things start to get on top of you. Don’t wait until you reach a crisis.

• Avoid known risks: if one of your parents had an alcohol problem, for example, be careful about how much you drink.

• Make sensible lifestyle choices – get plenty of sleep, exercise regularly, eat a healthy balanced diet and make sure you allow yourself time to relax.

• To find out more, visit The Royal College of Psychiatrists' website: www.rcpsych.ac.uk.

A health tree is just a family tree with health information – it provides a visual reference for you and your doctor. If you need help compiling it, visit www.familyhistory.hhs.gov

 DO

• Go back two generations – three if you can. Talk to your parents and other close relatives.

• Include the age at diagnosis – this helps determine the risk for many conditions.

• Note down ethnic or racial characteristics.

• ‘Some groups are at higher risk of certain conditions,’ says Dr Catti Moss of the Royal College of General Practitioners. ‘South Asians have a higher risk of diabetes and heart disease, Ashkenazi Jewish women are at higher risk of breast cancer and Afro-Caribbeans have a higher risk of stroke, raised blood pressure and glaucoma.’

• Offer to share information with other family members.

 DON’T

• Guess. ‘People often get it wrong and accuracy is important,’ says Dr Moss.

• Try to interpret the information yourself. Discuss it with your doctor who can advise you if you need to investigate further.

• Push people to give information they’re not comfortable talking about – and always stress that you will respect their privacy.

• Panic if you discover worrying trends. Genetic inheritance is just one factor – controllable factors like your diet and lifestyle may be just as, if not more, important. For instance, Cancer Research UK says that only 5–10% of cancers are caused by genes, while around two thirds are linked to lifestyle.

• Death certificates may provide useful information. Contact your local registry office, or obtain a copy from the General Register Office at www.gro.gov.uk/gro/content/certificates.

• Adopted? You have a legal right to a copy of your birth certificate. You can also register on the Adoption Contact Register on www.gro.gov.uk/gro that you want to contact your birth parents.