The truth is out there …
“How will we really know the truth?”
I didn’t understand the question at first. And so I gave a standard answer … we study lots of individuals, we follow then prospectively, we replicate our findings and then we perform interventional studies to test them.
Yes, and no. “The question was rephrased. Your study (@predicct) does a great job of looking at diet and environmental factors.” (Thanks — we look at diet through a 180 point food frequency questionnaire and a 4 day weighed food diary … stool samples on day 4 to robustly correlate microbiome and diet!). “But it doesn’t capture everything someone eats, nor everything they do. How do we capture … everything … precisely.”
OK … tough questions. And an important challenge. We can and should do more.
The answer is we can’t, not yet, but sometimes we can. I wear a new GPS smart watch for training (a Garmin Fenix 5 for tech geeks). I love it. I have an external heart rate monitor (HRM) for training (running / gym / biking). But it has HRM built in and via Bluetooth it syncs in real-time to my smartphone (Galaxy note 9 — oh boy … now there’s a cool gadget). I can pick up my phone, see my heart rate in real-time, look at today’s average, and my average for the last 1 month (since I got the new watch). And all for ZERO effort.
My phone will also tell me (and you) when I slept, how long for and how deeply. It could tell you (from the tone of my voice, the number of calls I make, the ratio between talking and listening) how I’m feeling. And of course, with a Fitbit or equivalent it will tell you how active I’ve been.
And then we can align with massive environmental datasets — environmental, pollution, meteorological data.
Diet is hard, but perhaps the raw inputs don’t matter do much as detailed analysis of the molecular constituents. Metabolomic profiles of urine / stool may be close enough (and perhaps more important).
So .. the truth is out there and we are deliciously close to tapping into it. Everyone has a smartphone. Well, not everyone. But someone please tell me … what proportion of people across the world with IBD do not have a smartphone???? IBD is fast becoming (/has become) a global pandemic. The increase is strongly associated with urbanisation and affluence. So I suspect (although have to admit do not know) the answer if very few.
Working from this, we can (and with the requisite funding will) utilise the scalable technology and data collection methods we have developed to tackle these questions. For now, it is across the UK. Next we should go global. Not just for numbers (power is king, any statistician will tell you that), but to look for common lifestyle, dietary and microbial triggers across diverse environments.
PREdiCCt is providing the framework for this and I have so much to tell you about the data collection methods we are developing for the benefit of the community — patients and consumers and clinicians. Thank you for your interest. Please stay closely tuned for future developments.s with divergent lifestyles. This would provide utterly compelling evidence for causative factors.
For more information on how to help with the study as a patient or an investor please get in touch!
www.predicct.co.uk (look out for new website coming soon)