Eat your veggies. Exercise daily. Drink plenty of water. This is all good advice for healthy living, focusing on the things you have control over to decrease your risk of a variety of diseases. But often these preventive measures are simply not enough on their own. And in some cases, disease avoidance may not even be entirely within your control.
For example, there are some conditions for which the genetic contribution to disease is so significant that the environment plays only a minor role. In these cases, the healthiest of living would be insufficient to prevent disease. On the other hand, everyone knows about the exposures that have clear correlations with disease, such as smoking and lung cancer, or sun exposure and skin cancer. But what about other, perhaps less potent, environmental exposures? Or even the combination of seemingly mild exposures encountered every day? What impact do they have?
As of now, the answer is still unknown. However, in the last 10 to 15 years, a new area of study has focused on the “exposome.” Coined as an official term in 2005, the exposome is the measure of the totality of your exposures in your lifetime, beginning at conception, and the effect those exposures have on your overall health.
For many years, both the medical profession and the lay public have recognized and acknowledged that overall health is the byproduct of a multitude of factors. These factors certainly include genetic contributions. There are environmental exposures both pre-and post-birth. There are also social determinants of health, which can include your socioeconomic status, your education level and your access to healthcare.
Chirag Patel, an assistant professor of biomedical informatics at Harvard Medical School, is focused on studying the exposome and believes “the key now is to begin to measure [the exposome] in large populations” to determine what correlations with disease are seen.
Seems like a massive topic to study, right? Well, it is. And despite the amazing potential to study disease correlation, the exposome still hasn’t quite hit mainstream scientific research. One reason may be the overwhelming challenge of attempting to quantify a lifetime worth of exposures and environmental influences. But another reason may simply be logistical. “Until recently, we just haven't had the tools to measure the exposome at scale,” explains Patel.
There are studies determining whether it is possible to truly provide a mathematical formulation to capture and calculate exposure. Even if the exact exposures can’t be quantified, the acknowledgment of the environmental impact on disease is important. The hope of many researchers is that by taking into account the exposome, both diagnosis and prevention of disease may be improved. According to Patel, the traditional study of disease “focuses on one exposure at a time (for example, individual dietary nutrients or smoking), and we miss the entirety of the exposome.”
This is especially true for diseases like allergies, which have a multitude of causes — external and internal, genetic and environmental. Because allergies affect so many people, and because studying the exposome requires extremely large data sets, researching these chronic conditions could demonstrate the power of correlating geographically tailored exposome information with disease occurrence.
Seeing this potential, doc.ai launched a digital trial with the intent of using A.I. to predict allergy risk for those suffering from allergies. The study is focused on tracking changes in the participant’s exposome to determine whether there is a correlation with allergy reports. Patel says, “What we are trying to do is retrospectively assess whether the allergy reports are more likely to happen when changes in the exposome occur.”
Studies like this may never be able to determine what causes a specific disease, because the causes are often a result of myriad factors —not solely the exposome. Still, as Patel says, “It is important to realize that common diseases are complex and both genetics and environment play a role, and we have to be better at measuring both.”
Fortunately, doc.ai has made tracking your health information including your exposome, incredibly simple. Within the app, you will find easily identifiable sections where you can input information as it relates to your overall health and wellness. The exposome selection will ask for you to include information like where you live. This geographical information will allow for the assessment of things like pollen counts and air quality as well as how walkable your neighborhood may be. Try it out here!
If studying the exposome allows us to make better correlations between disease and environmental influences, better and more efficient treatment and prevention strategies may also emerge. And just maybe, preventive medicine can move away from blanket statements like “eat your veggies” and “drink more water” to more personally relevant recommendations and plans. But of course, you should still eat your veggies.
If you want to learn more about the exposome and your health, you can also watch Patel's recent TEDxSF talk about decoding human health and diseases.