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Gene-environment interactions within a precision environmental health framework.

Understanding the complex interplay of genetic and environmental factors in disease etiology and the role of gene-environment interactions (GEIs) across human development stages is important. We review the state of GEI research, including challenges in measuring environmental factors and advantages of GEI analysis in understanding disease mechanisms. We discuss the evolution of GEI studies from candidate gene-environment studies to genome-wide interaction studies (GWISs) and the role of multi-omics in mediating GEI effects. We review advancements in GEI analysis methods and the importance of large-scale datasets. We also address the translation of GEI findings into precision environmental health (PEH), showcasing real-world applications in healthcare and disease prevention. Additionally, we highlight societal considerations in GEI research, including environmental justice, the return of results to participants, and data privacy. Overall, we underscore the significance of GEI for disease prediction and prevention and advocate for integrating the exposome into PEH omics studies.

Humans

The environment of the malnourished child.

The study of the relation of man to his environment in developing countries emphasizes the inevitable need for societies to recognize the true causes of infection, malnutrition, and poverty. The need is for improvement in the quality of human life in less developed nations, a recommendation easy to prescribe but difficult to accomplish. Although our pool of knowledge is incomplete, it is adequate to suggest ways to diminish infection, increase food production, utilize food more efficiently, improve education, and provide systems of justice to protect the classes most in need. The physical environment in tropical and subtropical regions, and the socioeconomic characteristics of the population inhabiting such regions, favor maintenance and transmission of a variety of viruses, bacteria, and parasites that make agricultural progress and social development difficult, and that contribute to poor fetal growth, nutrient wastage, and deficient postnatal physical growth, accounting for most of the childhood morbidity and mortality. In this regard, infections contribute indirectly to the overall food problem in a similar fashion as pests do in terms of food losses and spoilage. The overall effect could be comparable or greater than that resulting from an inadequate capacity to produce or to purchase the food needed. Thus, my objective has been to stress, within the whole environment, the importance of infection and the need to diminish it. Ways to control and prevent infection are readily known. They have to do with education of the population to improve personal and environmental hygiene. Economic investment is necessary to improve housing and water supply systems, waste disposal, and such preventive measures as immunization programs. Although such measures may appear expensive when first implemented, they have long-lasting effects and many require minimal expenditure once they are established. Large segments of the population stand to benefit, and other development interventions can then be introduced. However, these measures should not be implemented singly. They should be accompanied by community development, family planning, social legislation--in other words, the holistic approach to health and welfare. To do otherwise may aggravate the problem by stimulating demographic growth, perpetuating malnutrition and infection, and maintaining underdevelopment.

Agriculture

Coercive measures in health promotion: can they be justified?

Though environmental hazards and lack of medical care continue to threaten the public's health, much recent attention has turned to the role of destructive health-related behavior. If, as Fuchs suggests, changing behavior patterns is the most powerful alternative open to advanced countries in the pursuit of health, the role of the health educator is likely to grow more prominent relative to other health-care professionals. At the same time, that role may change. A campaign to solve the nation's health problems by altering habits of living may require methods which are stronger than the traditional health educator's efforts to facilitate and inform. This paper examines the coercive aspects of some of these possible measures and surveys the moral justifications for a policy of using coercion to bring about the desired changes in health-related behavior. Three such arguments are most plausible: that the coercion is justified by the social benefit; by the benefit to the coerced; and by a right of others in society to prevent the self-destructive individual from placing unfair burdens upon them.

Coercion

Gene by environment interaction effects on the metabolic subtype of Polycystic Ovary Syndrome in Hispanic Community Health Study/Study of Latinos.

Polycystic Ovary Syndrome (PCOS) is a common polygenic endocrine disorder that is heterogenous in clinical presentation across genetic ancestry groups. PCOS is characterized by an array of symptoms such as hyperandrogenism, impaired mental health, and metabolic dysregulation. Studying the interaction of environmental factors (such as diet, physical activity, anxiety, and depression) with genetic variants on PCOS and its subtypes in populations with high cardiometabolic burden, e.g., Hispanic/Latinas, could aid in unraveling pathophysiological and genetic pathways through which PCOS functions. We sought to study gene by environment interactions with PCOS and its metabolic subtype (mPCOS) in a sample of US Hispanic/Latina female adults from the Hispanic Community Heath Study/Study of Latinos. In this large community-based study, we derived PCOS using self-reported condition and menstrual cycle information. We classified females with PCOS as having mPCOS if they had high metabolic impairment (fasting glucose, fasting insulin, or body mass index higher than the 75th percentile). There were 451 individuals with PCOS and 221 of them had mPCOS in our sample. We found that PCOS and mPCOS were significantly associated with hyperglycemia and high triglycerides in this population. While a polygenic risk score derived in European ancestry did not generalize to Hispanic/Latina females with PCOS, we identified the best proxy genetic variants in this population in known PCOS regions and investigated their interactions with four environment variables (diet, physical activity, anxiety and depression). Associations with known PCOS loci were generalized in our study at STAG3L4 and CACNA1G genomic regions. We observed GxE interactions between variants in/near three genes and physical activity on PCOS and mPCOS, including FGGY, FAT1, and PTHLH. Additionally, we noted interactions between diet and a variant in FANCC on PCOS, and diet and a variant near CMAS on both PCOS and mPCOS. We also detected GxE interactions between anxiety and depression and a variant in FGGY on PCOS, and depression and a variant near FBP1 on mPCOS. Our results point to potential protective effects of physical activity in females with PCOS and could inform future research on the mitigating effects of lifestyle management on PCOS genetic risk in Hispanic/Latino populations.

GxE