Periodic Reporting for period 4 - LONGITOOLS (Dynamic longitudinal exposome trajectories in cardiovascular and metabolic non-communicable diseases)
Reporting period: 2024-07-01 to 2025-06-30
Despite medical advances, more than half a billion people around the world continue to be affected by cardiovascular diseases. Efforts continue to focus heavily on treatment, yet many of the risks come from the environment around us. Environmental factors represent a major opportunity to change the course of disease by addressing modifiable risk factors. Pollution, poor diet, limited access to green space, unsafe housing, and chronic stress all increase metabolic and cardiovascular risk, especially for people living in difficult conditions. The problem will not go away on its own, and due to the constant interplay between population health and the environment, the challenges for societies continue to grow. We need to shift our focus - not only treating illness but preventing it, by addressing what shapes health across our lives: the exposome. The exposome is a collective term for the physical, chemical, environmental and social influences on our health. This includes the environmental factors we are exposed to throughout life, from the food we eat and the air we breathe to noise, our built environment and access to green space, social interactions, and lifestyle choices. Unlike traditional research that focuses on how a single exposure affects a single disease, exposomics takes a holistic view. It draws on data from multiple sources to examine how combinations of environmental exposures interact and evolve to influence health outcomes. The field of exposome research has been growing intensively over the past 20 years and even more so during the European Human Exposome Network (EHEN) era. To date, the Exposome and the Exposomics fields consider the environmental causes of diseases and the discovery approach as their key components. It aims to complement human genomics using similar tools, ambitions and scale to boost the European ambition in precision medicine and prevention.The Global Exposome Forum community linking the International Human Exposome Network (IHEN; Europe) and the Network for Exposomics (NEXUS; U.S.A.) reached consensus in defining the human exposome as “the totality of environmental exposures that we are exposed to throughout our lifetime, starting from conception and pregnancy” […] “The human exposome refers to the integrated compilation of all the physical, chemical, biological and psycho-social factors, and their interactions, which have an impact on biology and health” (source IHEN website visited on 25.08.2025). The specificity of LongITools within the ‘EHEN landscape’ was to work on the ‘lifetime’ exposure. We built, and (re-)used repeated measures of exposome and health data across Europe to understand how exposome measures interplay over time, influencing our risk of developing cardiovascular diseases, obesity and type 2 diabetes. The work conducted during the 66 months of the project considered, whenever possible, the following concepts: (i) FAIR data and reproducible methods for a healthier Europe; (ii) Questioning the mechanisms of action underlying the association between the physical, social and lifestyle factors and the epidemic of cardiovascular and metabolic non-communicable diseases; (iii) Critical windows for gene by environment interplay; (iv) Health trajectories.
The project impacr was measured by
Scientific impact
• LongITools research teams have created impact through the development of knowledge and scientific publications. By the end of the project, a total of 167 peer-reviewed open access publications have been published, and more publications will still be published post-project. See also the Life-course Publications Map on the LongITools website (https://longitools.org/publications(opens in new window)).
• Participated in 138 scientific conferences;
• Organisation of 11 scientific conferences;
• 25 activities organised jointly with other EU projects;
• Teaching and training in various academic subjects and in many different places;
• Harmonisation of exposome-based cohorts and clinical studies;
• Collaboration and leading with international research consortia in Epigenetics (e.g. PACE consortium).
Societal impact (reaching the civil society):
• 23 blog posts;
• Social media coverage on X and LinkedIn;
• 15 press releases which were often picked up by national and/or international media, including newspapers, online publications, national news etc.
(Socio-) Economic impact (directly measurable):
• About 70 people (doctoral and post-doctoral researchers and staff other than researchers) have been funded at least partly for varying lengths of time by the project.
• Advanced career paths.
• Created market opportunities for SMEs.
• Increased the use and accessibility of data, providing opportunities for others to benefit from it.
Scientific impact
• LongITools research teams have created impact through the development of knowledge and scientific publications. By the end of the project, a total of 167 peer-reviewed open access publications have been published, and more publications will still be published post-project. See also the Life-course Publications Map on the LongITools website (https://longitools.org/publications(opens in new window)).
• Participated in 138 scientific conferences;
• Organisation of 11 scientific conferences;
• 25 activities organised jointly with other EU projects;
• Teaching and training in various academic subjects and in many different places;
• Harmonisation of exposome-based cohorts and clinical studies;
• Collaboration and leading with international research consortia in Epigenetics (e.g. PACE consortium).
Societal impact (reaching the civil society):
• 23 blog posts;
• Social media coverage on X and LinkedIn;
• 15 press releases which were often picked up by national and/or international media, including newspapers, online publications, national news etc.
(Socio-) Economic impact (directly measurable):
• About 70 people (doctoral and post-doctoral researchers and staff other than researchers) have been funded at least partly for varying lengths of time by the project.
• Advanced career paths.
• Created market opportunities for SMEs.
• Increased the use and accessibility of data, providing opportunities for others to benefit from it.
Together, the partners of the LongITools consortium take pride in the project's accomplishments. First and foremost, we have contributed to moving forward the exposome paradigm. Through joint efforts, we have provided robust evidence that the ambient environment, including air quality, noise levels and built spaces, relates to the risk of somatic diseases, including obesity, type 2 diabetes, hypertension, myocardial infarction, atrial fibrillation and mental health conditions, such as depression and anxiety disorders. The associations are complex in nature, but they show comparable effects (or absence of effects) in the studied populations in Finland, the Netherlands, the UK, France, Italy and Norway. One level of the complexity that LongITools aimed to tackle was to better understand how the risk associated with adverse environmental exposures accumulates through the life-course and how this influences health trajectories or changes in health status across the life-course by studying the effect in multiple generations and age-groups of Europeans. A second level of complexity was to reduce the dimensionality of the data to clarify the concepts behind the exposome; indeed, populations are exposed to a mixture of risks that relate to each other (e.g. traffic noise and air pollution). Multiple studies in LongITools have tried to target this by focusing either on the concepts of exposome profiles, exposome scores and joint effects on health outcomes, while other works were engaged to decipher precise exposures such as traffic noise, air pollution, and green spaces. The latter have further questioned the biological changes associated factors to the exposures, including changes in the epigenome, transcriptome and metabolome. A third level of complexity that LongITools addressed was that of causal relationships and exposure-triggered mechanisms. We built projects upon life-course and econometric models to characterise the pathways linking the exposome to the risk of obesity, via molecular factors, and questioned how this may be altered by targeted health policies. The fourth challenge was to integrate exposome AI-based prediction into a personal health risk assessment system, including a new mobile app and the LongITools Environmental Hub, based in people's homes. Finally, we targeted the communication, dissemination and exploitation of the results to relevant stakeholders, increasing the impact of the project's results. A final policy briefing was produced at the end of the project, providing recommendations to policymakers, offering the potential to improve the health of EU citizens and their environments.