Type 2 diabetes and cardiovascular disease are serious and increasingly common health problems globally, demanding urgent attention for better prevention and treatment methods. Lifestyle interventions have proven to be an effective way to prevent these diseases, surpassing the effectiveness of some medications, while being cost-efficient, safe, and of broad benefit. However, due to the complexity of human biology, not everyone responds in the same way to such interventions. This presents an important opportunity to personalize prevention and treatment approaches, based on individuals’ unique biological and behavioural characteristics.
The NASCENT project thus began with the aim of investigating how environmental factors and genes interacted with each other to gain greater understanding as to why there was such a wide range of individual responses to treatment and interventions. Through innovative techniques that turn off and on specific genes, we could deepen our understanding of such gene-environment interactions. The NASCENT project focused on integrating genetic and molecular epidemiology, machine learning, innovative clinical trial design, and functional genomics. This integrative programme of research afforded a rare opportunity to provide multiple orthogonal lines of evidence addressing key hypotheses. For example, some of the research in epidemiological studies and clinical trials conducted by our team implicated genes like PPARGC1A as a modifier of the effects of lifestyle on body adiposity and blood glucose and fat levels. Using a novel CRISPR-based approach, we were able to further define the functional basis to these interactions.
The rapid emergence of the SARS-Cov2 virus in late 2019, led me to redirect our efforts towards COVID-19 research. I worked with collaborators in Sweden and the UK to establish the COVID Symptom Study in Sweden; we enrolled 200,000 participants, generating valuable data on COVID-19 incidence and symptoms. By repurposing an app originally designed for tracking daily eating habits (used in one of our earlier ERC projects) to capture self-reported COVID symptoms, we collected data from the UK, US, and Sweden, aiding global public health efforts.
Despite its origins as a research project, the COVID Symptom Study played a crucial role in providing public health leaders with essential epidemiological data during the rapidly evolving pandemic. Our early findings, such as identifying loss of taste and smell as prominent COVID-19 symptoms, significantly contributed to understanding and managing the disease. We also investigated the impact of COVID-19 on specific populations, including healthcare workers, individuals with cancer, and those with diabetes and obesity.
Although the NASCENT project redirected to address the COVID-19 pandemic, and later paused due to the lead investigator's 24-month sabbatical, the work conducted has had a major global impact on precision medicine. This is perhaps most clearly illustrated in the International Consensus Report on Precision Diabetes Medicine (Nature Medicine, 2023), which was chaired by NASCENT’s lead investigator.
