Into the Exposome
Into the Exposome
LF34 | The UK's Quantum Longevity Initiative embraces a model of aging that is holistic, collaborative and ambitious. Bravo!
The UK’s National Innovation Centre for Ageing (NICA) yesterday hosted a hybrid event, called ‘Quantum Healthy Longevity': Healthy People, Planet and Growth’. It was laudably bold in scope and scale. The team behind the ‘Quantum’ push are aiming to position the UK as the leader in a global ecosystem around a seismic shift in longevity. They’re aiming to integrate ESG, add in new metrics of health, reduce inequalities and link to the climate crisis. Too often people work in siloes, and this team seems determined to break them down. The video of the session is below:
One speaker, Professor Paul Shiels from Glasgow University, gave a fascinating presentation in which he laid out the staggering burden and opportunity around healthy aging and the framework they’re using to analyse it, the “exposome”.
Pointing to statistics suggesting a disease burden of non-communicable disease of $47 trillion dollars from 2010 to 2030, and a $1 trillion / year cost of socioeconomic inequalities in health, Professor Shiels made a strong case for shifting from a reactive, biomedical model (today’s system) to a proactive, preventative, bio-psycho-social model. He illustrated this with a model of a car - it’s possible to fix individual components when things are running smoothly, but at some stage the system breaks down and you can’t put things back together.
The exposome is made of you where you live, how you live, how you interact with others and what you eat, among other things. It shifts the focus for population health to things outside the clinical setting and crucially much earlier in life. Interestingly (how did they get the data…?) he said “who you share a bed with before you’re aged 5” was a significant factor in determining your later life cardiovascular health.
The takeaway is that from whatever your starting point with your genome and epigenome, how they interplay with your environment over your life course determines your age-related health.
Remarkably, according to Dr Shiels, three factors of the exposome - air pollution, tobacco smoke & diet - account for 50% of mortality globally.
He went on to share additional biological insights and interesting concepts such as ‘antaganostic pleiotropy’. This is genes deliver traits that are good for you in early years turn but turn out to not be good for you in later years (generally after you’ve stopped reproducing). One example is that higher testosterone levels in men can be good for young men, but those same elevated levels could be a risk factor for prostate cancer.
Am excited to see where this exploration into the exposome leads - if it can focus attention of a fragmented industry on thinking about prevention, international collaboration and the broader ecosystem, it’ll be doing the world, and its ageing populations, a valuable service.