Exploring the neurological exposome for precision prevention of neurodegenerative diseases – the role of diet

BACKGROUND AND AIM: The exposome represents the totality of exposures from conception onwards. Unravelling it requires to simultaneously identify, characterize and quantify exogenous and endogenous exposures and modifiable risk factors that predispose to and predict disease throughout the human life span. METHODS: Exposome science will help us understand the intricate web of relationships between environmental exposures, lifestyle, genetics and disease, contributing significantly to the determination of causal associations between environmental factors and human health. Determination of causality would support targeted interventions towards precision prevention, contributing significantly towards healthy aging. RESULTS:Aging brings a lot of physiological changes, usually accompanied by deterioration in cognitive function as a result of neurological degeneration, mediated by oxidative stress and inflammatory processes. However, this process does not follow a standardized course for all individuals, as a result of multiple factors. These factors include genetic susceptibility, exposure to environmental chemicals, lifestyle aspects such as poor nutrition, excessive alcohol ingestion, lack of exercise and stress, health status (e.g. hypertension or diabetes), as well as exposure to chemicals. Although diet is considered as a major exogenous factor, up-regulation of the inflammatory metabolic pathway and in many cases the oxidative stress pathway is triggered or amplified by other exogenous exposures such as exposure to man-made chemicals. Thus, exploring the role of diet in triggering and accelerating the progression of Alzheimer’s disease, should account for both the beneficial nutrients and the neurotoxicants associated with specific food items. High dimension biology tools based on a combination of omics technologies are able to identify the molecular fingerprints and pathway changes associated with specific dietary patterns, exposure to chemicals inducing oxidative stress (ambient air PM) and neuroinflammation (Hg) and genetic factors (ApoE e4 carriers). CONCLUSIONS:Exposomic analysis of the effect of diet on AD is expected to facilitate the coining and implementation of precision prevention strategies. KEYWORDS: Neurodegenerative outcomes, Exposome, Food/nutrition, Metabolomics