With the development of sensors, apps and other digital alternatives for health monitoring, the individual’s opportunities to work proactively for better health and well-being increase. At the same time, the measurement of many different biomolecular variables (so-called multiomics) enables a deep and comprehensive profiling of human biology.

– Instead of focusing on the treatment of the later stages of the disease, the health care of the future could focus on more proactive and individualized interventions as well as on early detection of diseases. It may sound a bit futuristic, but the technical conditions are already in place, says the study’s lead author Francesco Marabita , researcher at SciLifeLab and the Department of Oncology-Pathology at Karolinska Institutet.

Explores future approaches

The Digital Health Revolution (DHR) project is a multicenter study initiated a few years ago by researchers at the Institute for Molecular Medicine Finland (FIMM) at the University of Helsinki with the aim of exploring and evaluating future approaches in healthcare.

The study lasted 16 months and included 96 people between the ages of 25 and 59 who were enrolled at an occupational health center in Helsinki, Finland. No one had any known, serious illnesses, but some of the participants had risk factors such as high blood pressure, high blood sugar levels or obesity.

The molecular profiling was done in collaboration with researchers from Karolinska Institutet and SciLifeLab. In addition to extensive multiomic analyzes, the repeated data collection included web-based questionnaires, clinical laboratory measurements in blood samples, analysis of the intestinal flora microbiome and activity and sleep data using a smartwatch.

Motivate lifestyle changes

The researchers collected over 20,000 biological samples and more than 53 million primary data points for 558,032 distinct traits. In addition to health surveys and digital health measurements, all participants received regular guidance, to support and motivate lifestyle changes in diet, exercise, stress and mental well-being.

A web-based user interface and a smartwatch provided participants with the type of health data they needed to influence their own health, such as genetic risk scores, blood fats, BMI and level of physical activity. The interpretation of health data was facilitated by a doctor linked to the study, and personal trainers provided continuous guidance both digitally and through personal contact. At the end of the study, 86 percent reported positive lifestyle changes in the form of diet, exercise, sleep and drinking and smoking habits. Participants’ perceptions of improved health were confirmed by the bioinformatics analyzes of molecular variables.

The results showed new and previously unknown links between health risks and molecular factors linked to obesity, diabetes, liver function, immunity, and hormones. The researchers found, for example, that synthetic estrogen (ethinyl estradiol) has a broad and unique effect on metabolites, proteins and physiology.

– Our study provides an increased understanding of human biology and health over time and seems to confirm the possibilities with a data-driven, individualized approach to motivate and monitor the effects of lifestyle changes and proactive health work, says Francesco Marabita.

Transition from health to disease

The method is generally applicable to understand transitions from health to disease. The study did not focus on any particular disease, risk group, type of intervention or biomarker.

– From a care perspective, in the future it would be possible to focus on, for example, people at high risk for diabetes or cardiovascular disease. The cost of molecular profiling is now the biggest clinical challenge for large-scale implementation. As with sequencing of human genome, the cost of advanced laboratory technology can be greatly reduced over time. This study shows that the concept works and can be seen as a preparation for future implementation of data-driven methods in health care, says Francesco Marabita.

The study was funded by the Academy of Finland, Tekes / Business Finland, the Sigrid Jusélius Foundation, the Knut and Alice Wallenberg Foundation.

Publication

“Multiomics and digital monitoring during lifestyle changes reveal independent dimensions of human biology and health” , Francesco Marabita, Tojo James, Anu Karhu, Heidi Virtanen, Kaisa Kettunen, Hans Stenlund, Fredrik Boulund, Cecilia Hellström, Maja Neiman, Robert Mills, Teemu Perheentupa , Hannele Laivuori, Pyry Helkkula, Myles Byrne, Ilkka Jokinen, Harri Honko, Antti Kallonen, Miikka Ermes, Heidi Similä, Mikko Lindholm, Elisabeth Widen, Samuli Ripatti, Maritta Perälä-Heape, Lars Engstrand, Peter Nilsson, Thomas Moritz, Timo Miettinen , Riitta Sallinen, Olli Kallioniemi. Cell Systems , December 1, 2021, doi: 10.1016 / j.cels.2021.11.001.