Lin: The LifeLines study is a large population study (comprises three families generation, N= 165,000), what are the efforts you have done to ensure a good follow-up response rate?
RG: The majority of our participants are very willing to answer questionnaires and come by at one of our research sites. In fact, our participants frequently tell us that they would like to do more! But follow-up response rates are a priority of course. We use several means of communication to ensure compliance of our participants. We contact the participants about a week before they are scheduled to come to our clinics, as a reminder. If participants cannot make the scheduled appointment we find a suitable date and time for them.
Lin: Are there any further developments you would like to do with the LifeLines study?
RG: The world does not stand still, technological advances are made every day. Our participants are becoming increasingly mobile with their smartphones, activity monitors, and other mobile sensors they wear throughout their every day lives. We are investing much of our efforts into becoming part of that movement. From 2018 onwards, when we are going to perform the third screening, probably the world of mobile health technology has again shifted and advanced. When we create this screening it will be innovative and incorporate the available technologies which are at the cutting edge of science and technology at that time.
Lin: With the increasing cases of in-vitro fertilized twins, do you foresee any statistical or biomarkers challenges?
RG: This is a very interesting scientific question to which LifeLines as a resource could be explored. We have statistical experiences related to this topic since LifeLines has a three generation design, with many related participants. LifeLines is a resource for scientists to perform their research on. This particular research question has not yet been investigated on the LifeLines data, but any researcher from anywhere in the world (!) that would like to dive into this is welcome to contact LifeLines about getting access to these data.
Lin: Childhood obesity is increasing in Asia, particularly in China, and the prevalence of diabetes among children has shown to be on the rise.
i. Is the Netherlands experiencing a similar trend?
RG: Yes, prevalence of childhood obesity and diabetes is increasing in the Netherlands as well. This is one of the many topics that researchers can use and are using LifeLines for as a resource to not only note this trend, but to investigate using a very broad spectrum of data which LifeLines has available, to find what could be the cause or the combination of causes for each of the individual children that it concerns. For every child individual there is likely to be a combination of factors that leads to these problems. What LifeLines offers is a very rich source of data and biological samples to explore any and every possible answer to this complex problem.
ii. What are the plausible impacts on life expectancy in the next 10 to 15 years; i.e. year 2025, 2030?
RG: Basically despite these and other problems we are observing a continuously increasing life expectancy. However, although people are living longer they are experiencing more years of living with one or more chronic diseases. LifeLines aims to be the optimal resource for research into Healthy Ageing. LifeLines is enabling researchers to perform studies on the interaction between, for example, genetic background, lifestyle and environmental factors, ultimately resulting in more healthy life years.
Lin: Life expectancy has shown to increase since the discovery of vaccination. However, it has shown to remain stagnant or progress very slowly in the last five to ten years. Are there any reasons for this trend?
RG: The diseases that are now prevented by vaccinations were diseases that were highly morbid, most of them at a young age. By preventing these diseases, more children live through adolescence into adulthood, which increases life expectancy considerably. Also, diseases that are highly morbid are diseases that are more complex, cardiovascular diseases or diabetes for example. Not everyone with the same lifestyle develops the same disease, suggesting a role for other risk factors, such as genetics. A cure is therefore more complex as well; what will you be treating when it’s not quite sure what provoked the onset of this disease in this patient? Such precision medicine (or personalized medicine) is rapidly coming up in preventing, diagnosing and treating diseases.
Lin: Novel technology and medicine have shown to increase the life expectancy in many developed nations but it may be counteracted by chronic diseases, what are the chances that young children born after the millennium will age healthily, and possibly, to the age of 100?
RG: The general expectation is that of the newborns born nowadays at least a third will become a centenarian (live to be a 100 or more years old). As our general populations grows older the developments in medicine over the next decades are expected to focus more on prevention of disease than treatment, and where it concerns treatment, the genetic component in finding the optimum in treatment will become increasingly important. Hereby LifeLines’ main aim is to enable researchers in the field of Healthy Ageing to perform research on complex diseases in order to increase the number of healthy years in life. Many chronic diseases are also known as lifestyle diseases, as they arose in the years of economic prosperity. Preventing these diseases start with a healthy lifestyle.
Lin: What are the improvements that you would like to see in genetic engineering and biotechnology?
RG: The field of Healthy Ageing is a significant step forward into giving a long term vision or goal to which the field of genetics and biotechnology has to move. We hope to see over the next decades that biobanks such as LifeLines enable researchers in a wide array of specialties to be able to perform their research and enable a longer life lived in health for everyone.
Lin: If you are awarded 100 million euros for research work purposes, what will you do with it? Is there a particular discipline or aspect(s) in science that you will like to focus on? And why?
RG: Such budget would allow a real broadening of the data collection in LifeLines. Healthy Ageing is not just the absence of diseases. LifeLines does collect data on societal factors (job, leisure time, engagements, etc) but it would be fascinating to increase this aspect by collecting in-depth data on health related behaviors, social interactions, “happiness” using next generation devices and apps to allow a true day-to-day (or actually minute-to-minute!) assessment of the participant’s physical and mental wellbeing.