An interdisciplinary ageing alliance: cellular metabolism over a life-course in socioeconomic disadvantaged populations

Not everyone ages well, many people live their last years in ill health. People living in more affluent areas live significantly longer than people living in deprived areas, who spend nearly a third of their lives in poor health. This health inequality is even more evident between different ethnic groups, where Asian and Black people in Britain are twice as likely to live in poverty compared with White people.

This inequality can be caused by many factors but one key reason that may unify disadvantaged populations are changes in cellular metabolism, in other words the way cells respond to the sugars and fats we eat. Many common diseases of older age result from changes in the balance of sugars and fats used by cells of the body. Asian people in Britain are twice as likely to live in poverty and their diet could directly alter their cellular metabolism. Therefore, we want to investigate how changes in cell metabolism influence life outcomes. Cellular metabolism is not just related to a person's biology such as the genes that they carry, but is influenced by events before a person is born and during childhood as well as environmental factors. For example, where you live and the availability of fresh food will impact on cellular metabolism. Deprived areas have up to 5 times the number of fast food outlets compared to affluent areas. Also, the ability to exercise, having green spaces and places to walk to are all part and parcel of this apparent health inequality. Therefore, having a full understanding of how changes in cellular metabolism influence health throughout the life course is essential if we are to identify ways of addressing this ageing health inequality.

In order to achieve this, we need to bring together researchers from many different disciplines to investigate the biology of people who are socioeconomically disadvantaged, the nutrition they are exposed to as well as external contributors of health inequality such as housing, geography and the environment. We will then work together to determine collectively how all these things impact cell metabolism and healthy ageing. The lead applicants are based at QMUL in East London and have formed links with other places serving areas of social deprivation across England. It is hoped that this network, put together from many different backgrounds and disciplines, can collectively think of new solutions to tackle the health inequality of ageing.

Life expectancy is increasing but the period spent in good health is not keeping pace. Furthermore, the inequalities in healthy life expectancy are greater when the level of socioeconomic deprivation is taken into account. People living in the most deprived areas can expect to live their last 18 years in ill health compared to 9 years for those in affluent regions. Therefore, the aim of this network is to address the biological cause for this healthy ageing inequality by forming an alliance with other areas in England that also have similar levels of socioeconomic deprivation (yet differing in ethnicity) including Birmingham, Liverpool, Newcastle and Leicester.

A key biological factor underpinning the inequality in healthy ageing seen in socioeconomic disadvantaged populations are changes in cellular metabolism. This is the biochemical processes that generate or use up "energy" that take place within each cell of a living organism. Our hypothesis is that cellular metabolic dysfunction of the ageing cell is dictated by both intrinsic (genetic and pathway-driven) and extrinsic (environmental and epigenetic) mechanisms from an early age. Hence the purpose of this interdisciplinary network is to elucidate such mechanisms and the interaction between such factors.

Bringing together a truly interdisciplinary network made up of biologists, geneticists, clinicians, nutritionists, sports scientists, epidemiologists, geographers, AI and bioinformatic experts, economists, policy makers, urban planners and architects; who together with key stakeholders overseen by an expert advisory panel will the tackle and redress health inequalities to benefit our most disadvantaged communities though an understanding of the deregulation of cell metabolism.