A Fresh Take on Exposomics: Resiliency Factors That Offset Environmental Risks

It’s very difficult (often impossible) to completely avoid many of the environmental toxins that can cause harm – like air pollution and forever chemicals that contaminate our  water and food supply. But Drs. Bob and Rosalind Wright at Mount Sinai have a hopeful solution to this dilemma. They are pioneering the study of “resiliency factors,” not just “risk factors,” that can offset the risks of harmful exposures. It’s a fresh and welcome take on exposomics that I am very excited to share with you. For instance – did you know that omega-3 intake during pregnancy can protect against the development of asthma in the child, even if the child is exposed to known risk factors for asthma? Or that positive relationships (ones that create a sensitive, positive, caregiving environment) have been shown to potentially mitigate the effects of environmental toxins? As a practitioner, I am always looking to empower patients with real solutions to the health challenges we inevitably face and I hope you enjoy this conversation as much as I did. ~DrKF

A Fresh Take on Exposomics: Resiliency Factors That Offset Environmental Risks

In this episode, we dive deep into exposomics with Drs. Robert and Rosalind Wright from Mount Sinai, pioneering researchers exploring the profound effects of environmental exposures across the lifespan. This episode explores the exposome’s impact on chronic diseases, from Alzheimer’s to asthma, and why clinicians must understand how early-life exposures shape long-term health outcomes.

The Wrights share their groundbreaking research on how prenatal and childhood exposures—like air pollution, lead, and social stress—set the stage for diseases later in life. They discuss epigenetics, gene-environment interactions, and the powerful role of social support in building resilience, offering clinicians new tools for patient care.

If you’re a healthcare provider looking to apply cutting-edge insights into your practice, this episode will expand your understanding of the environmental factors driving disease progression and equip you with actionable strategies to enhance patient outcomes.

In this episode of New Frontiers, learn about:

Dr. Kara Fitzgerald: Hi everybody, welcome to New Frontiers in Functional Medicine where we are interviewing the best minds in functional medicine. On this particular episode, I am thrilled to be introducing you to Drs. Wright, that’s Dr. Rosalind Wright and Dr. Bob Wright. Let me give you their background and we’ll jump into what will undoubtedly be one of our best episodes of the year.

Dr. Kara Fitzgerald: Robert O. Wright, MD, MPH is the Ethel H. Wise Chair of the Department of Environmental Medicine and Climate Science at the Icahn School of Medicine at Mount Sinai. Rosalind Wright, MD, MPH is the Dean of Public Health, Chair of the Department of Public Health and the Horace W. Goldsmith Professor in Children’s Health Research at the Icahn School of Medicine at Mount Sinai. And together they direct the Institute for Climate Change, Environmental Health, and Exposomics. Those of us who’ve been in the functional medicine space for many years have been thinking about the exposome and we think about, you know, in our systems model, how environment is influencing our patients, our patients’ offspring, et cetera, over the course of their life and how it influences the development of disease.

Dr. Kara Fitzgerald: It’s just such an honor to be bringing forward the work of these extraordinary individuals. We will list their bibliography. We’ll list back to the Institute for Exposomic Research and we’ll just give you as much data as we possibly can. I do want to mention that Dr. Robert Wright specifically established programming research in growth, obesity, and social stressors. This is the PROGRESS Longitudinal Birth Cohort. He started this in 2007, along with Harvard and the National Institutes of Health of Mexico. It’s based in Mexico City, and it has collected health outcome data along with social, geospatial, and chemical exposure data starting from birth to age 18. This is the first study to attempt to comprehensively measure the exposome starting in pregnancy. There are well over 100 publications on this particular data set, and I know more are coming.

Dr. Kara Fitzgerald: And then just to talk about Dr. Rosalind Wright, she, among many things, is an internationally recognized expert for her work in environmental exposure assessment, genetics, epigenetics, and psychosocial stress in health outcomes. She directs the PACER Lab, which specifically assesses biological response systems in pregnant women, infants, and children to better understand health risks. So you can see we’ve got an awesome podcast in front of us. First of all, Drs. Wright, either of you can pick up this question, I just want to know how you got into focusing on the exposome and the extraordinary accomplishment of starting an institute dedicated to it.

Dr. Robert Wright, MD: I’m a pediatrician and I did do a fellowship in medical toxicology many years ago at Boston Children’s Hospital and I used to work in the lead clinic. At the time, environmental health really was sort of looking at one factor at a time, in this case, lead poisoning, and if you think about what our environment is, it’s millions of different exposures. If we only study one thing at a time, we would have to do a million studies. Also, real life doesn’t work that way. You’re not just exposed to lead. Children who are exposed to lead are far more likely to live in poverty. They’re far more likely to live in an older house. There’s all these other contextual factors that go along with it that really can’t be captured by just measuring blood lead.

Dr. Robert Wright, MD: So in those early days, I realized that if we really want to understand what’s happening, particularly to children, we have to capture the entirety of their environment and that’s really what the exposome is. The exposome really as a field was sort of invented by Dr. Christopher Wild, who was an epidemiologist at IR, the International Agency for Research and Cancer in France. He actually wrote a paper in 2005 where he proposed that the field of environmental health needed to move away from studying just one chemical or one factor at a time and consider the way genomics was being practiced, because this was shortly after the human genome project was completed, and actually try to measure what he coined the term the exposome, all the environmental factors that a person is exposed to from birth to death.

Dr. Robert Wright, MD: It’s been somewhat expanded since that time. I think he was primarily thinking about chemicals, but those sorts of exposures don’t happen in a vacuum. They happen in different social environments, they happen with different nutritional backgrounds, and even genetic backgrounds. So the field has actually grown since those early days and that’s sort of how exposomics came about. Because I was a pediatrician interested in environment, I liked this idea of trying to understand the holistic world in which children are actually growing up and developing.

Dr. Kara Fitzgerald: Yes, it’s daunting. I want to hear, Rosalind, how you got into it as well, but also little bit about how did you figure out how to wrap your hands around it, wrap your arms around it?

Dr. Rosalind Wright, MD: Yeah. So I’m actually trained as a pulmonary critical care physician. As an intensivist in critical care— And I take care of adults, I’m not a pediatrician. I don’t focus on kids for my clinical life. I fell in love with critical care because I like putting it all together– systems. I do like to think big problems and how they all interact from my clinical side. That’s just always been very appealing to me. When I started doing research in medical school and residency, I was doing all molecular biology. I even spent a year at NIH doing that research as part of the Howard Hughes program during medical school. And then I started seeing patients when I came back and did my clinical rotations, and I started thinking to myself, we’ve really got to put people in this broader holistic perspective to really understand how genes may operate and that it’s really more gene by environment.

Dr. Rosalind Wright, MD: And then I went after a public health degree and public health training because I thought, how do I learn to measure the environment? And that really is what took me to public health school to think about it from a broader perspective. I was very interested in lung disease as a pulmonologist and asthma was a big epidemic at the time, still is problematic. Everybody was trying to focus on what was driving the epidemic of asthma in this country and globally, and particularly vulnerable populations, inner city, lower income, that kind of thing. And we were looking at traditional physical environmental factors, tobacco smoke, dust, mite, cockroach, air pollution, and it only explained about 15% of what was going on there.

Dr. Rosalind Wright, MD: I’ve always been interested as well in mind-body connections and the link between psychology and medicine and certainly see that play out in patients, that it’s how you emotionally experience your environment also that can trigger asthma, trigger other conditions. And so I became very interested in how do I measure that? How do I measure the social environment and how you emotionally respond to that? And to me, the stress health paradigm and how just as you breathe in an air pollutant or a dust mite allergen and it revs up your immune system and other systems in your body, other neurotransmitter systems, et cetera, when you emotionally experience something that’s out of your control or feels out of control, you experience distress. And you trigger those same alterations in immunity, in autonomic functioning, etc.

Dr. Rosalind Wright, MD: Think about when you get upset and you feel shaky and sweaty and all those things. That’s because your body’s making those neurotransmitters and hormones that are doing this. To me it’s no different than thinking about the social environment and how it might get in there and get biologically embedded. We talk about epigenetics as one mechanism that that happens, but there are lots of ways that happens and lots of things we measure. And that’s what I measure in my Pacer Laboratory, is the different key regulatory response systems that are triggered by these different collective exposures. And to Bob’s point, we knew 20 years ago we needed to measure not just one chemical at a time, but we didn’t have the computational tools and some way to do that on a large scale.

Dr. Rosalind Wright, MD: The reason we could come to develop an institute which includes exposomics, to think about how do we measure the locality or as close to that as we can to find the big drivers in a certain patient population, group, etc. We now have those tools so it’s very exciting.

Dr. Kara Fitzgerald: It’s very exciting. I’m jumping ahead, but I’m assuming you’ll be thinking about, well, I mean, you probably have high throughput technology. Will you be layering AI onto that and just some of the things that we stand on the cusp of, or are using?

Dr. Robert Wright, MD: Yeah, there are some additional challenges to exposomics compared to genomics. Your genome doesn’t change. It’s the same the day you’re conceived as the day you die, but your exposome is changing over time so it’s actually much more of a computational challenge. And it’s also a measurement challenge because you’re not sick today because of something that happened this morning, with the exception of getting hit by a car or a virus.

Dr. Robert Wright, MD: Your health today is more likely a function of things that happened to you months or even years or even decades ago. We now know that childhood is really important for adult health. There’s even evidence that environmental factors that happen when you’re a child might actually predict diseases like schizophrenia or even Alzheimer’s disease, so the risks of all these illnesses actually have their origins in things that are environmental, but when you were a child. But think about the challenge of that. The people who have Alzheimer’s disease today, they were born primarily in the 1940s and some in the 1950s. So how do you go back in time to figure out what happened in their childhood that may actually predict why they got Alzheimer’s disease today? That’s really sort of the real grand challenge of exposomics is how do we actually go back in time to do that?

Dr. Robert Wright, MD: So we’re working on some of that. One of our faculty, Dr. Manish Arora, developed a method that uses teeth. It works great in kids because baby teeth fall out and you actually need the tooth. It isn’t actually something that’s found out in an instrument in a laboratory. Teeth grow like trees so they have growth rings in them and those growth rings, you can attach a calendar date so you can measure chemicals that were in those growth rings. It is possible that if you were doing studies where you had access to brain tissue, so there are studies where people donate their bodies to science, if you could get a tooth, you might be able to reconstruct what happened when someone was a child. But the other thing that we’re doing is we’re trying to make maps. Maps go back in time.

Dr. Robert Wright, MD: If you think about weather and climate, those are actually based on maps and you can actually see, say, where air pollution was in the 1980s. If you know where you live or where your school is or where you work, you have some sense of how much air pollution you’re exposed to back then. What we’re trying to do is actually create maps that go back even farther in time. Unfortunately, if you think about the 1940s and 50s, there were no satellites. Sputnik hadn’t happened yet so those sorts of maps that we create today, which often use satellites are impossible to make from the 1940s and 50s. That’s one of the challenges in exposomics, is actually trying to figure out how to map the exposome back in time when technology was relatively primitive.

Dr. Kara Fitzgerald: I want to ask you some more questions around that and I’m wondering about epigenetics because there’s a historical element to the heritable portion of epigenetics. But Rosalind I wanted to circle back to your work focusing on asthma and the different variables contributing. What did you end up finding? I mean, the big players that we always think of, various common antigens, pollution, smoking, the obvious, and then you thought of stress. I guess the extraordinary thing is that if you pie chart out, everybody’s going to have different size pies depending on what’s going on. But is there anything that you ended up finding that was relatively conclusive?

Dr. Rosalind Wright, MD: Yeah, and the mixture of those things, when you’re looking at them collectively, together or jointly, may be different in a different population. You might see stress in a certain community, neighborhood, group, etc., rises to the top there and you might see air pollution being a big driver over here. Or nutrition being a mitigating factor of all of those things. So it’s important to measure nutrition as well. Think about risk and resiliency factors. We don’t measure just risk factors. We really want to throw in resiliency factors and understand those in the mix as well because you can see if somebody maintains a healthy diet, even in the context of these multiple pollutants that they might be experiencing in their environment, you can see it can be protective.

Dr. Kara Fitzgerald: Yes. That’s absolutely extraordinary.

Dr. Rosalind Wright, MD: Yeah. And that’s exactly what we’re trying to do because that would be very helpful to help put that person back on a healthy trajectory, no matter where they are in the lifespan. Even though we understand previous exposures have impact, what’s your functioning right now? What’s your profile look like right now? And can we tweak this or that and help get you on a better health trajectory? That’s what drove me from taking care of older folks with advanced lung disease in adulthood to go all the way back to the in utero environment and even preconception to start looking at this and doing this work to be able to hopefully prevent disease, not just mitigate existing disease.

Dr. Rosalind Wright, MD: Sometimes you find that if you only look at the air pollution, it seems like that’s the driver. But if you take into account stress, air pollution has an effect only in the communities where there’s low stress. In the high stress community, maybe it’s more the stress or there’s some multiplicative effect of those two things. So if you went in and intervene and just, by policy, decreased air pollution levels, you don’t see too much change in its impact on some of the health outcomes you might be looking at, like asthma. Yeah.

Dr. Kara Fitzgerald: That is absolutely extraordinary. All right. I want to, again, I’m just letting my listeners know that we’ll link to as many of these papers as possible in the show notes so you can do a drill down. Of course, I appreciate it from the bottom of my heart that you’re working on resiliency because that really seems to be sort of… There’s an obsession with studying the toxic influence, which can be heartbreaking. I’m sure at times your work has been incredibly difficult. But when you’re solution-centric, I think that’s helpful. I just want to say that I am a big fan of the work of Dr. Bernhard Hennig out of the University of Kentucky. He’s looked specifically at things like omega-3 fatty acids favorably influencing the inflammatory trajectory of PCBs. I mean, just because of my own background being in nutrition, to see that there are scientists actually paying attention to if you eat these things, you can actually offset these inevitable exposures. So, bravo.

Dr. Rosalind Wright, MD: We found that for asthma, increased omega-3 fatty acid intake in pregnant women can protect against development of asthma in their child even though they’re exposed to some of these other things. Antioxidant intake is another one because a lot of the toxins that we think about, metals, chemicals, air pollutants, they can be pro-oxidizing, so they’re enhancing your oxidative stress in your body. But if you can offset that in some way, nutrition is an important lever, it’s something we can do something about.

Dr. Kara Fitzgerald: I just wanted to say, and then I want to hear about the other resiliency piece, that’s very important, is that it seems to me what you’re ultimately saying is that you enter into the conversation, or you enter into the delivery of care, in the here and now with the variables that are most impactful. So the past exposures and maybe inherited exposures are a piece of the puzzle, but what we can do right now is the biggest. Is that correct?

Dr. Rosalind Wright, MD: You have somebody sitting in front of you, what can we do right now? That’s where we need to take exposomics. The more that you can know about one’s past experiences and exposures and when those might have occurred, the more informed that decision-making process will be at that time. So it’s all important. It doesn’t mean we have to be perfect before we start doing that. It doesn’t mean we have to be able to measure everything from the past. Bob already pointed out the challenges to that but we’re getting to a place where we now understand we need to do that. So we’ll be developing that sort of information more and more. That will be available to us as clinicians as well. But we have to start somewhere.

Dr. Kara Fitzgerald: Yes.

Dr. Robert Wright, MD: I’m a pediatrician so the idea of what’s the past for an adult is the present for a pediatrician. If we understand why particular adults have heart disease or Alzheimer’s disease or lung disease, what was the antecedent cause of that 50, 60 years ago when they were a child? It helps me as a pediatrician to understand what I can do for this child patient in front of me to prevent those diseases later on in life. To be honest, the value of understanding the past also extends to children because I think there’s a lot we need to do as a society to help our children because there’s an epidemic of obesity, there’s an epidemic of poor nutrition and I think one of our bigger fears is what’s going to happen when these children grow up.

Dr. Robert Wright, MD: What we think of today as being a lot of, say, Alzheimer’s disease or heart disease, it may be three or four times higher in the next 30 to 40 years because our children and our grandchildren have experienced things like obesity and learning disabilities at a much higher rate than our generation did. And that’s not due to genetics. Genetics cannot possibly work that fast. It is something in the environment and I think we really need to start to get our hands around that or else we’re going to have a generation of people with really severe chronic diseases at much younger ages than we’ve ever seen.

Dr. Kara Fitzgerald: Yeah, that’s quite extraordinary. I want to get back to you, Rosalind. You wanted to make a resiliency comment and then we’ll come back and talk more about what you just said, Bob, and how we actually look into that and and figure that out.

Dr. Rosalind Wright, MD: Yeah. I think another important buffering system, if you will, or resilience builder, is our social relationships. They counter stress effects— That’s been widely out there in the literature for a long time— but they can also counter toxic effects from these other chemicals that are pushing and pulling on the same stress response systems that psychological stressors do. So we’ve also started looking into that. Depending on where you are in your life cycle, those social relationships might be a little bit different. When you’re talking about infants, and if you want to put people on a healthy trajectory from very early age, think about the caregiving relationship with the infant.

Dr. Rosalind Wright, MD: We’ve actually shown in my laboratory that positive caregiving that’s measured objectively in the laboratory, when you bring in moms and babies together, it does mitigate the effects of psychological stressors that the mother might have experienced during pregnancy, ongoing stressors since the infant has been in the world, and also things like air pollution and other toxins. Because our systems in our body our stress response systems, key regulatory systems I like to call them, because I don’t want people to think it’s only stress that’s pushing and pulling at it. It’s not only psychological stress, it’s these chemical factors as well. So these key regulatory systems, like our hypothalamic pituitary adrenal axis, makes cortisol, which is a big hormone. It’s very important to us to maintain health but if it gets out of whack or out of balance, it can go the other way and contribute to disease and disorders.

Dr. Rosalind Wright, MD: Autonomic nervous system functioning and balance is very important too, but when that goes out of whack, and that can be due to air pollution exposures, it can be due to psychological stress. Even when you’re exposed to lots of these things, because we’re measuring them at the same time, but you have a sensitive, positive caregiving environment, you mitigate the effects of those toxins. So again, that’s something we can do something about. We can educate people. It’s so, so important. But think about your social relationships throughout your life course. The same can happen through there.

Dr. Kara Fitzgerald: And I just want to ask on that question– First of all, it’s extraordinary. So good connection becomes like kale. Good connection becomes like fish oil. You know, it’s like it has the same mechanistic response. I I love it. Sometimes I will tell my patients that, you know, exercise is kale. It’s the new kale. So if you don’t eat kale, get outside and exercise. You can eat another green veggie.

Dr. Rosalind Wright, MD: That’s another good example. Absolutely.

Dr. Kara Fitzgerald: But let me just ask you, you talked specifically about moms and babies, but I think this would be true with any caregiver. Isn’t that correct? Be it…

Dr. Rosalind Wright, MD: That’s absolutely true, whoever your primary caregiver is. And you can think about that in the aged population as well with the caregiving environment there, marriage, couples, your relationship with your significant other, that kind of thing. Pets, connections, there’s so many ways that we bond socially that’s so important. And medicine had really gotten away from that. That is not something that we talked a lot about in medical school but you see it play out over and over in your own life. You see it play out in your patients’ lives and one of the things that I set out to do in my work is, well, let’s show how it really gets in there. Let’s show those skeptics. It does get in there. Right? And people want to see the biology. We all do. We’re scientists. We like to see the biology.

Dr. Rosalind Wright, MD: And then you can talk to patients and the last thing you want them to feel is that you’re telling them it’s all in your head. I’m not saying it’s in your head. You’ve got to be very careful how you talk about it, and I just say hey, it’s no different than breathing in tobacco smoke or other things that you already know could be harmful because it’s affecting these systems as well. So let’s think about how do we make that better? You know?

Dr. Kara Fitzgerald: Absolutely extraordinary. You know, there was the Project Ice Storm, Moshe Szyf — You’re familiar with that— demonstrating the emotional stress of that huge ice storm on pregnant moms was as impactful as the physical stress of being in the ice storm in a way that was more impactful. So the physical and emotional really prompted the same outcome, which was an increased incidence of asthma going back to your original, as well as autism.

Dr. Rosalind Wright, MD: Yeah, including asthma and it’s a good example of a natural experiment that you can take advantage of. A natural experience that they’re all having and then they decided they were going to look at pregnant women who experienced that at the time and look at the effects on their children. We take advantage of those natural experiments as well when they come out. COVID was another one. We all experienced COVID. We’ve experienced that in different ways. We’ve experienced that not just by getting the virus and that sort of thing, but schools shut down, kids were away from their social networks, parents were balancing much more, accommodating their kids at home and those kinds of things.This is going to be research going on for a long, long time.

Dr. Kara Fitzgerald: Yes. Yeah. Any comments on that, Bob?

Dr. Robert Wright, MD: I think the social environment is critical across the lifespan. There’s even evidence that if you have social isolation, you’re at much greater risk for Alzheimer’s disease. And yet it’s difficult to understand why we don’t really, as a society or as physicians, take that seriously. We’re very quick to get genetic tests for Alzheimer’s disease, even though they rarely give you any information that’s really actionable. Even if you have some of the variants that may cause Alzheimer’s disease, they don’t cause Alzheimer’s disease in 100% of people, so you’re not really sure what to tell people other than to eat right and to exercise. You can develop Alzheimer’s disease without those genetic variants.

Dr. Robert Wright, MD: But social isolation, which is something you can help people cope with or to coach them to try to actually go to church, go to these social events that may actually get them to interact with people. Those are things that actually can prevent Alzheimer’s disease. And yet in medical practice, we rarely actually think like that. We prefer actually to do molecular tests and we prefer to give medicines and I think if we could think about how we can actually socially integrate people better, I think we would have a much bigger impact.

Dr. Kara Fitzgerald: There’s a radical reshaping that’s starting to happen in functional medicine. We’re small in numbers, but you know, incorporating group visits, incorporating health coaches so there’s a lot of touch points. We did that in our diet and lifestyle intervention, which was hard. It was pretty rigorous. We leaned on nutrition coaches to have frequent touch points with our study participants and probably that’s why we got some reasonable adherence. That connection and that contact.

Dr. Kara Fitzgerald: So I’ve got a bunch of questions. I want to talk about your PROGRESS study, but before I get into that I want to just think a little bit about this through the lens of the clinician, you know, some of the testing that you’re doing, maybe some of the key historical questions that we want to ask. What do you both think? You’re speaking to primarily clinicians here. How do we need to be thinking and analyzing the exposome?

Dr. Robert Wright, MD: I’m going to actually change your question a little bit if that’s okay.

Dr. Kara Fitzgerald: Okay, yeah.

Dr. Robert Wright, MD: There’s a lot of research that looks at whether or not an environmental factor causes a disease. There’s a lot of talk about forever chemicals, PFAS, which are thought to be endocrine disruptors. We think that they cause type two diabetes and ultimately obesity and that’s where most of the research is done. What we really need to think about is there are millions of people with type 2 diabetes and obesity in United States, and they’re getting exposed to PFAS. PFAS may have nothing to do with why they currently have type 2 diabetes, but if you layer PFAS on top of the presence of that disease, what’s it doing? They are essentially a vulnerable population.They are far more likely to have endocrine disruption than a healthy young adult who exercises, who’s exposed to perhaps an even higher dose of PFAS.

Dr. Robert Wright, MD: It may not take as much PFAS in somebody with type 2 diabetes to actually cause a disruption of their disease and maybe make them need a little more insulin. We don’t actually look at these endocrine disrupting chemicals in people with the disease. We don’t look at neurotoxic chemicals in people who have Alzheimer’s disease and yet there may be things we can do that actually may prevent these chemicals from actually making these diseases a little bit worse. And so what I’d like to see clinical medicine do and, also environmental researchers like ourselves, is actually study the impact of these chemicals and these environmental exposures on people who already have a disease. If you look in the literature, that’s almost never done.

Dr. Robert Wright, MD: There are very, very few examples of studies that are looking at the impact of the exposome on people with a disease. It’s almost always to see whether or not the exposome prevents a disease and that’s actually studying it in healthy people and following them to determine whether or not they ultimately get the disease. I think we could actually intervene on people’s behalf if we actually started thinking about whether or not these environmental chemicals are impacting people who already have a disease. That’s in the medical world. That’s not in the public health world. But that’s really not being done right now.

Dr. Rosalind Wright, MD: It also likely affects your response to the treatments that we’re providing for that disease. We think we understand the underlying mechanisms that cause diabetes and what’s going on in the pathology and we have drugs that should disrupt that and prevent complications. But people respond very differently and for a long time we haven’t understood completely why that is right. Asthma, the same way. Some respond very well to the treatments we have and then we have these folks that just don’t seem to be responsive unless we get high levels of toxicity from the drugs that we’re giving them.

Dr. Rosalind Wright, MD: And a lot of that is likely to be your exposomic milieu that we need to know something more about, that’s going to say, well, this person’s living in a high polluted environment, their diet is this, they have a lot of stress. If we can tweak those things and refine some of these things, they might be more responsive to this drug, drug A, or maybe we have to think about a different treatment in the meantime as we adjust those things. I think that’s another way that it’s going to be very important to use exposomics in that context as well. Precision medicine, how do I pick the best drug for you? I need to put you in more of a holistic perspective.

Dr. Robert Wright, MD: Yeah. And in fairness to clinicians, environmental scientists and exposomic scientists almost never do research in people who have a disease so there’s very little data. I think it’s very logical that these exposures would have impacts, say, on diabetes or Alzheimer’s disease, or autism, for that matter.

Dr. Kara Fitzgerald: Right. Of course.

Dr. Robert Wright, MD: But there’s almost no literature on it. I mean, can you imagine a child with autism also typically has pica, meaning they non-food substances so they have much higher rates of say, lead poisoning. I can’t imagine that that lead poisoning isn’t making their autism worse and yet there’s almost no literature on whether or not lead poisoning makes autism worse because you could intervene. That may be somewhere you could prevent further exposure, or in that instance, maybe chelation because there’s lead poisoning, may actually be beneficial to the child. But that’s just not something we’ve done in the world of lead poisoning.

Dr. Robert Wright, MD: I used to work in the lead clinic at Boston Children’s Hospital and we occasionally saw children with autism. Actually, we saw them at a higher rate than we see the general population because they had pica. But once we would intervene with the family and help them understand where the lead poisoning was coming from so they could reduce the exposure, typically their autism symptoms improved. They didn’t cure the autism, but it actually made the patient and their behaviors be less concerning and also more manageable for the parents. And that’s a real benefit that actually can come out of environmental health and exposomic approaches.

Dr. Kara Fitzgerald: That’s extraordinary. So reducing the lead exposure and did you use chelation in that population?

Dr. Robert Wright, MD: Well, if there was lead poisoning— Sorry, I have to be careful we you talk about chelation and lead poisoning because I don’t believe it’s a cure for autism. But children with autism, some percentage of them get lead poisoning, and that’s a higher percentage of them than in the general population. For those children who have lead poisoning, I think it would be beneficial.

Dr. Kara Fitzgerald: Yes, absolutely. That’s interesting. So just one piece of the puzzle and you observed that. Let’s talk a little bit about synergistic interactions of multiple exposures. Then the exposure threshold drops considerably.

Dr. Rosalind Wright, MD: Right.

Dr. Robert Wright, MD: Yeah, so the concept of potentiation where in toxicology, you can be exposed to a drug at a non-toxic level or a chemical at a non-toxic level, and you can be exposed to a second chemical, also at a non-toxic level, but when they’re combined, they cross a threshold, and that’s called potentiation, which is slightly different than synergy. But that is a clear biological process that we see in toxicology. And that can happen in other types of exposures. One of the key aspects of exposomics is we’re not really just looking at chemicals. We’re looking at chemicals as well as stress. We’re looking at chemicals as well as poor nutrition. We’re looking at chemicals as well as some of the physical environmental factors such as air pollution or climate effects.

Dr. Robert Wright, MD: That actually can be a mixture that can show that same potentiation. And that’s something that’s a very different concept from traditional toxicology and I think what sets exposomics apart from toxicology, which is where potentiation actually was first described.

Dr. Rosalind Wright, MD: Yeah, the field is moving towards mixtures, thinking about complex mixtures. What we’re discovering is you might have you might totally have missed an association between say an air pollution and asthma or other outcome if you only measure one component. But if you take that apart into its pieces and you look at a complex mixture you actually start to find relationships there because of the complex ways that they interact and that’s real world scenarios. We’re not exposed to one thing at a time. It’s all this mixture of things that we’re looking at together.

Dr. Kara Fitzgerald: What do you think about the influence of certain single nucleotide polymorphisms? I know exposomics includes genetics, but you’re moving well, well beyond. There’s a study that comes to mind looking at asthma in a city population, kids with asthma, and there was a higher incidence of a glutathione null mutation. So they weren’t detoxing it as well. Have you looked at that? Do you think that those single nucleotide polymorphisms, certain ones can be impactful? What are your thoughts?

Dr. Robert Wright, MD: Yeah.

Dr. Rosalind Wright, MD: I think if you put it into context of the gene by environment interactions with those, yes. I definitely think you start to get a little closer to what’s driving the asthma in that case or other things.

Dr. Robert Wright, MD: Earlier I gave the example of the genetic variant for Alzheimer’s disease. That’s the APOE4 variant. So if you have one copy of the variant, you have about four to five times the risk of developing Alzheimer’s disease and you might have as much as 15 to 20 times if you have two copies of the variant. But even if you have two copies of the variant, roughly half of those people never develop Alzheimer’s disease. So why is that? It may be that there are environmental factors that also need to be present. So similar to potentiation, if you only have the variant, you don’t cross the threshold. But if you have an environmental factor, which might be lead poisoning, perhaps childhood lead poisoning is the other factor, and then the two of those things combined is why you develop Alzheimer’s disease. You would see in that scenario that having APOE4 by itself isn’t enough to cause Alzheimer’s disease.

Dr. Robert Wright, MD: But if you never measure things like lead poisoning, you just see that half the people develop Alzheimer’s disease and the other half don’t, and you don’t understand what that difference is. That difference is probably some environmental factor that just isn’t being measured in the studies.

Dr. Kara Fitzgerald: Or it could be a high resiliency and really solid lifestyle habits for a lifetime.

Dr. Robert Wright, MD: Yes. And I would definitely counsel anyone who had the APOE4 variant that good nutrition and exercise and also social integration are very important for trying to prevent Alzheimer’s disease in the future.

Dr. Kara Fitzgerald: A colleague of mine, Dr. Dale Bredesen, has been looking specifically at diet and lifestyle in a program that he’s developed in cognitive impairment with pretty cool, extraordinary outcome. It makes me think of the BRCA mutation. When they looked retrospectively at individuals with a BRCA mutation in blood that was banked, the incidence of BRCA-associated cancers was very, very low in decades past. And now it’s a shoe-in if you have that mutation, your likelihood of developing a hormone-sensitive. Yeah.

Dr. Rosalind Wright, MD: Yes, so what changed? The environment changed.

Dr. Kara Fitzgerald: Right.

Dr. Robert Wright, MD: Yeah, it’s always sort of frustrated me that we do a lot of studies on the genetics of say, obesity, and we don’t measure what people are eating or how much exercise they’re doing, which is not an uncommon type of study. It’s impossible for genes to generate matter, so it seems as though there has to be something in the environment that plays a role. Plus, when we were children, obesity was relatively rare. Obesity became very, very common after the turn of the 21st century. In fact, as a pediatrician, I never saw a child with type 2 diabetes until roughly 2004.

Dr. Robert Wright, MD: I actually will never forget the day when I was working in the emergency room and a resident presented a patient to me who had type 2 diabetes and I remember telling him, no, he’s wrong. Children don’t get type 2 diabetes. When I walked into the room and I saw this child, I said, oh, maybe he does have type 2 diabetes, because he was quite heavy. There is something in our society that has changed in the last 30 to 40 years that is creating this epidemic and it cannot possibly be genetics. Genetics cannot work on that time of scale. It’s too fast. And we really need to start thinking about what’s in the environment that’s doing this. We’re looking in the wrong place when we look at genetics of obesity.

Dr. Rosalind Wright, MD: Yeah. And there’s a particular urgency because we know that there’s climate change and climate change effects are going to change air pollution exposures and the distribution of these air pollutants in different areas, temperature changes. It also affects temperature of the oceans and it’s going to affect our diet because it’s changing the balance between good and bad polyunsaturated fatty acids in the fish that we eat because of the warming oceans, et cetera. If you start to scratch the surface and look across these different areas of scholarship that are looking at these things, you start to think to yourself, we’ve really got to get on top of this and understand how these environmental factors are driving it because it’s only going to get worse. Investing in exposomics and tools that we can use to really be able to do that in a nimble way, not take 10 years to do it, but we can actually respond when we do start to see climate effects and severe weather events and wildfires and those sorts of things. So the time is now to really grow this area.

Dr. Kara Fitzgerald: If you had to pick your top three or five areas to really change– I know you talk about ultra-processed foods, you’ve published on metal exposures, we’re talking about lead, we’re talking about the experience of stress, you were talking about nutrition and resiliency— What are the major players here that we need to be focusing on? Us as clinicians, with each N of 1 case, and then more broadly, as a society or as a world?

Dr. Robert Wright, MD: Well, it’s sort of counter to the concept of exposomics. That’s a hard question for us to answer because we want to try to make…

Dr. Kara Fitzgerald: They’re all of them, yeah.

Dr. Robert Wright, MD: Well, and to Rosalind’s point, it is this large, very complicated mixture and you also need to sort of layer in life stage. If you’re exposed to something as a child it has a different effect on your body than as an adult. When I teach a class, the example I give is if I’m exposed to a chemical that stunts my growth at age two, it may make me shorter. But if I’m exposed to twice the dose of that chemical at age 30, it’s going to have no effect because I’m not growing anymore. A lot of the complexity is also the way that we develop over time and so we need to be able to understand all the different ways that our environmental factors impact us at different life stages.

Dr. Robert Wright, MD: That’s a very difficult thing to do and it adds layers of complexity to exposomics. So what’s important at age 30, to partly address your question, may not be the same things that are important at age two, or age five, or age 16 and I think that’s the complexity of it.

Dr. Kara Fitzgerald: Okay. So then it just brings us to the practice of individualized medicine for us as clinicians, taking a really good history and teasing out what it is we need to do. I mean, it’s validating to listen to that because we…

Dr. Rosalind Wright, MD: Educating patients, sharing with them the science that these things are affecting your health and then validating for them that emotional distress is just as toxic as these other things. But there are things we can do now. Yes, we know these things are out in our environment. Take a good history. What can we talk about changing that will be valuable to reducing your potential ongoing exposure to these things, and then here are the things that we know can mitigate the effects. What can we think about with nutrition? Are there ways we could enhance your nutrition, exercise, and your social connectedness. I mean, these seem like things that your mother told you, your grandmother. But there’s science behind these things.

Dr. Rosalind Wright, MD: The Surgeon General is talking about how there’s going to be an epidemic of social isolation in this country and it’s going to be a big problem. We need to start thinking about, well, how do we create resources for our patients, help them and educate them on what sorts of things they can do to enhance that? And yes, they have huge health effects. Don’t leave them helpless and hopeless that oh, here’s all these things that you could be exposed to. Well, I can’t move doc. I live in this apartment and I know there are cockroaches and there’s this and there’s that and there’s pollution and there’s crime in the streets. Well, you know, there are things we can do to help maybe get you to move, but in the meantime, what do we do? Here’s what we can do. But just your validation for them that these are health driving factors, things that are building resilience as well as risk factors. And I always talk about resiliency factors at the same time because we know they’re just so important.

Dr. Robert Wright, MD: And there are things we can do as clinicians. We can take an environmental history. You gave an example of some of your patients who grew up on farms. Well, there’s very good literature that pesticide exposure might be a risk factor for Parkinson’s disease. So if you know that about somebody’s history and it’s a little bit different than their occupational history, the things that may have happened to them as a child, maybe if they start complaining about symptoms that sound like a tremor, maybe you’ll start thinking more about Parkinson’s disease in that context. So you can individualize the way you actually interact with patients and get histories and incorporate that information into the clinical care if we understand more about the environment. Particularly the environment that happened to them when they were children, which I think right now we don’t do a very good job at.

Dr. Rosalind Wright, MD: Something you’ve talked about Bob in the past, and I think is a good idea to think about, is just as we have genetic counselors, we may have to train environmental counselors because of the complexity of it. You know, to begin with, to really get it integrated into the clinical practice, and to have those types of ancillary supports where we can do that in a meaningful way given busy clinician schedules and et cetera, et cetera. So that’s an idea you’ve had and you’ve talked about.

Dr. Kara Fitzgerald: Right.

Dr. Robert Wright, MD: Well absolutely. Yeah.

Dr. Kara Fitzgerald: Obviously, organics are fairly, broadly available in the US, although not to certain demographics at all.

Dr. Rosalind Wright, MD: Right. Yeah, so you need to understand who you’re talking to and either have resources for everyone where you can provide those things. You don’t want to make people feel helpless, but as we understand more and more about this, we need to provide that as part of the medical care. That’s why I gravitated more towards public health. Some of the best interventions that are going to help us are really going to be the public health interventions. It won’t necessarily be the one-on-one. We have to do both, but we’re going to need to improve these environments. How do we build better environments as we go forward? How do we mitigate the effects that we’re seeing right now in the environments that we have? There are a lot of challenges. That’s why it takes teams to do this, right? There has to be everybody around the table who’s coming at this from all those different levels to really do this.

Dr. Kara Fitzgerald: Talk to me about the PROGRESS study that you and colleagues started, Bob, in 2007. Many, many, many, many papers have come out of this. Much, much data. What is it and what did you guys discover and what’s happening with it now?

Dr. Robert Wright, MD: Well, it’s an observational study. So we’ve been following children just as they grow up. We started following them when their moms were pregnant with them and we’re looking primarily at things like obesity and brain development and the connection between obesity and brain development. But the idea is that we would do an exposomic study. We tried to measure the social environment as extensively as we could, mostly with questionnaires, but some biomarkers like cortisol, the chemical environment. We’ve been measuring pesticides, metals, plasticizers like phthalates, and bisphenol A. We also measure air pollution. We work with geographers that actually use satellite data to estimate air pollution based on where people live and where their schools are.

Dr. Robert Wright, MD: We’re trying to collect all of that longitudinally over time. Exposomics is a lot easier to do in children because lifetime exposures in a five-year-old only take five years to cover. In us, it’s very, very difficult to go back to the day that we were born, but we’ve been able to do this and we’re finding that air pollution is very important. Stress is very important. And we’re about to publish. We’ve shown that there is a connection between environment, the brain, and eating behaviors, or at least obesity. I can’t say specifically eating behavior, but if you’re exposed to environmental toxicants, some of the effects of those toxicants affect the way that we eat food so they may affect the way that people are impulsive.

Dr. Robert Wright, MD: There’s some evidence that if you’re more impulsive, you’re more likely to eat food impulsively, which kind of makes sense. There’s also some evidence that your moods may actually affect foods. Like if you have a more depressed state or anxious state, you may eat food. So what we think may be happening is there’s this literature about environmental factors that cause neurotoxicity in children and there’s this literature on environmental factors that cause obesity and they’re almost the exact same environmental factors.

Dr. Robert Wright, MD: What we think is that these two literatures that have been working in parallel, that what’s actually happening is that it’s causing toxicity to the brain and rewiring the way we are impulsive, or our depression state, and that that may be changing the way our children’s eating behaviors are, and that may actually be causing them to gain more weight when they hit adolescence.

Dr. Kara Fitzgerald: So the underpinning to both the obesity as well as the impulsivity is some toxin exposures?

Dr. Robert Wright, MD: To the brain.

Dr. Kara Fitzgerald: To the brain specifically.

Dr. Robert Wright, MD: The brain is mediating the relationship between the environment and obesity, because eating is essentially a behavior. Because of that, we may be craving foods more, and we have less impulse control to decide to not eat.

Dr. Kara Fitzgerald: What toxins have you identified that seem to be associated with this?

Dr. Robert Wright, MD: Air pollution seems to be playing a role in this. And we’re still looking at the data, but air pollution actually is probably having the clearest signal.

Dr. Kara Fitzgerald: Wow, that’s interesting. What about the food itself? I mean, this ultra-processed food. There’s plenty of chemicals in some of the things that we actually call food these days.

Dr. Robert Wright, MD: Yeah. Well, in Mexico, they definitely do eat ultra-processed food. Even though we try to measure everything it’s not something that we actually have good measures on so I can’t say that it’s ultra-processed food. I certainly suspect that ultra-processed foods are playing a role in this, but because we don’t have a specific measure for that, I can’t really say that.

Dr. Kara Fitzgerald: Just for anybody who doesn’t know, that I’m based in Mexico and your PROGRESS study is based in Mexico City, and that’s why you’re mentioning Mexico now, for listeners. But just being in Mexico, I can see that yeah, there’s plenty of ultra-processed food. It doesn’t appear to be to the same extent as in the US. I mean, there’s plenty of stands here just making food all over the place. And that seems to be one of the primary ways people eat or cook at home.

Dr. Robert Wright, MD: It’s complex. My personal opinion, this is just an opinion from having been to Mexico many times, is children in particular drink a lot of soda pop.

Dr. Kara Fitzgerald: Yeah, Coca-Cola is… God. Yeah.

Dr. Robert Wright, MD: And that is in essence an ultra-processed food because there’s dyes in it and there’s very high amounts of fructose in it and I think that is playing a pretty big role, actually, in childhood obesity in Mexico City.

Dr. Kara Fitzgerald: Yeah, I’ve definitely observed that. So I see more home-cooked or home-like cooked foods here. But yeah, that soda often accompanies, almost always. Okay, so you tracked these outcomes and you’ve published many, many, many, many papers on what you’ve identified. You’ve looked at DNA methylation. You’ve actually looked at aging. You’ve used epigenetic clocks and identified accelerated aging in certain cohorts.

Dr. Robert Wright, MD: Yeah, I think one of the aspects of epigenetics that I think ties to the exposome is we have done some work in elderly populations. This was actually done in Boston, where we measured bone lead. Lead accumulates in your bones so we could measure that using something similar to a bone densitometer that can actually measure how much lead is in your bones. We find that there are specific epigenetic marks that actually correlate to the people who have high lead exposure. One of the ways that epigenetics may tie to exposomics in the future is it may actually be able to help us reconstruct environmental exposures from the past.

Dr. Robert Wright, MD: There was actually data— we were involved in this consortium that showed this, but it’s mostly other people’s work— that show that methylation of specific genes actually is a marker of whether not your mother smoked when she was pregnant with you. So it is interesting to us that epigenetics actually may play a role in actually telling us what people were exposed to in the past.

Dr. Kara Fitzgerald: Right, it may be a fairly non-invasive way to get a history, or it may be like the teeth looking at the rings in the trees as it were. Epigenetics might be able to give you some of that history. Right, that would be amazing. Talk a little bit about the autism exposome. We were talking about that off air.

Dr. Robert Wright, MD: There is a lot of evidence that autism is increasing. The increase would be counter to the idea that autism is primarily a genetic disease because genetics cannot operate on that quick of time scale. It is possible that some of the increase is just due to physicians, clinicians, psychologists are screening more for it. But I think what goes against the argument that that’s accounting for all of the increase in autism is that it continues to increase. I think most recent data is it’s somewhere in the range of one in 30 to 40 children that have autism, whereas it was like one in a thousand 30 years ago. It’s clearly become much more common. And so some of it is more screening, but some of it I think is probably real, which means that it’s something in the environment.

Dr. Robert Wright, MD: One of our faculty in the Institute, Manish Arora, developed this method for actually measuring chemicals in teeth and he’s done some work on twins. Most twins who have autism, it’s concordant but there’s occasional twins who have what are called discordant disease. One of them gets autism and one of them does not but they have the exact same genome if they’re monozygotic twins. He’s been able to show that certain environmental metals actually are different in the twin who has autism versus the twin who doesn’t so he’s doing work trying to reconstruct the prenatal exposome and how that relates to the development of autism. Some of that work is done in twins, but some of that work is being done in other studies that they’ve been doing in autism. But that’s primarily his work. His name is Manish Arora.

Dr. Kara Fitzgerald: Okay, we’ll link to some of his work. Also, what metals? Do you know what metals he’s…

Dr. Robert Wright, MD: I know zinc has played a role in some of that and zinc is a nutrient. I don’t want to misquote the study, but I believe it was more that zinc may have been lower in the child that developed autism than the child that didn’t, but I’d have to review the paper to clarify that.

Dr. Kara Fitzgerald: Sure. Allright. Well, we’ll find them. We’ll track them down and link them on our show notes.

Dr. Kara Fitzgerald: What specimen are you collecting in the PROGRESS Study?

Dr. Robert Wright, MD: We are collecting all those samples and Dr. Arora is a collaborator in that so we’re doing some of those measurements and I’m working with him on that but that’s really something that he’s leading.

Dr. Rosalind Wright, MD: Yeah, it’s important to think as you design study research going forward to build biorepositories over time and repeated measures over time, whether you’re doing blood, urine, saliva, hair, teeth, many of these. The placental tissue is very important as well because there’s lots of maternal fetal signaling that goes on that can affect both mom’s health going forward as well as the child as they continue to develop. So I think investments in that area need to happen as well so that we can ask and answer these questions even more rigorously as we go forward.

Dr. Robert Wright, MD: Biobanks are also a way to get back in time. One of our faculty has used dried blood spots. Every child born in the United States gets a test for metabolic diseases and that has to happen within the first week of life that the dried blood spot collection occurs. Most public health departments do it for free. Some of them, like the state of California and the state of Michigan, actually save them and they’re sometimes available for research. And she’s actually shown that she can measure metabolomic signatures in the dry blood spots that actually predict later on instead of childhood cancer.

Dr. Rosalind Wright, MD: Yeah. By screening hundreds of metabolic factors, not just one or two at a time.

Dr. Kara Fitzgerald: Right. Very interesting.

Dr. Rosalind Wright, MD: And then using machine learning or AI tools. It’s necessary to have those types of tools available to do that kind of computation.

Dr. Robert Wright, MD: Biobanks are very, very, very valuable and being able to have data on someone from when they were a child is extraordinarily valuable because so much of our health as adults is really predicated on things that happened to us as a child. So the more we can actually start to create these biobanks, we may be able to use them one day clinically if we had these sorts of biobanks. I mean, it’d be wonderful if we were to at least be given the option to store your dry blood spots so that a clinician in the future might be able to run a test on it. I think it would be relatively simple to do, actually, and dry blood spots don’t have to be frozen. So I don’t think they would be as expensive to store as say a blood sample would be.

Dr. Kara Fitzgerald: Right, right. Yeah, that makes a ton of sense. It makes so much sense. Give me a little bit on the cancer exposome and then we’ll wrap up. What’s the focus there.

Dr. Rosalind Wright, MD: More work needs to be done on exposomics and cancer. Bob was talking about the blood spots that are available on kids at birth and Dr. Lauren Petrick, who’s also in the Department of Climate Science, Environmental Health and Exposomics, she used those blood spots to look at risk factors for childhood leukemia and following kids who went on to develop or not develop leukemia and was able to use metabolomic profiling to find some signatures there. So that just exemplifies the utility of those spot cards.

Dr. Kara Fitzgerald: Sure. Yeah, it makes a lot of sense.

Dr. Robert Wright, MD: And some of our faculty are using big data models of air pollution to look at its relationship to cancer using, say, medicare databases so that we can actually see whether or not there’s sort of co-localization of higher areas of air pollution where people live at higher rates of cancer. So it’s another area that we’re looking at.

Dr. Rosalind Wright, MD: Yeah, but more work needs to be done. So it’s good to highlight cancer because there really hasn’t been a lot of work in that area.

Dr. Kara Fitzgerald: So we’re in our home stretch. Are there any final words that you’d like to say as we wrap up here?

Dr. Robert Wright, MD: I think environment is starting to come into its own as a field and I think exposomics is going to drive a lot of that and I think it’s going to play a big role in our understanding of why people get sick or why other people are healthy. I think information is power and the exposome is really about understanding your environment so that you can make informed choices and decide whether or not you want to be exposed to this or to that. Right now, it’s very difficult to avoid air pollution. It’s very difficult to avoid chemicals and products and I think in the future, people are going to want this information. I think exposomics is going to grow because of that.

Dr. Kara Fitzgerald: Yeah, absolutely. Well, Drs. Wright, thank you so much for making time for me today. I really appreciate your expertise and sharing with the functional medicine space here on New Frontiers.

Dr. Rosalind Wright, MD: It’s been wonderful talking, so thanks for having us.

Dr. Robert Wright, MD: Thank you very much. Thanks for having us. Take care.

Dr. O. Robert Wright is the Ethel H. Wise Chair of Environmental Medicine and Climate Science at Mount Sinai. He trained at Northwestern, Brown, and Harvard in Pediatrics, Toxicology, and Environmental Epidemiology. Dr. Wright co-founded the Mount Sinai Institute for Exposomic Research and established the PROGRESS cohort, which tracks health and environmental exposures from birth to age 18. His research focuses on linking exposomics and phenomics with life stages to understand the developmental origins of disease.

Dr. Rosalind Wright is Dean for Public Health at Icahn School of Medicine and Co-Director of the Institute for Climate Change, Environmental Health, and Exposomics. An internationally recognized leader in environmental health research, her work focuses on how environmental and social factors influence chronic disease risks, including neurodevelopment, obesity, and respiratory health. Dr. Wright directs the PACER laboratory and has been continuously funded by the NIH for over 23 years. She is a pioneer in exposomics, particularly in understanding how early-life exposures shape lifelong health outcomes, and mentors the next generation of clinical scientists.

Dr. Rosalind J. Wright, MD, MPH

Robert O. Wright, MD, MPH

Icahn School of Medicine at Mount Sinai Institute for Climate Change, Environmental Health, and Exposomics

Study: The Programming Research in Obesity, GRowth, Environment and Social Stress (PROGRESS) Cohort

Physiological Assessment of Children’s Environmental Risk Laboratory (PACER Lab

Dr. Christopher Wild

Study: Complementing the genome with an “exposome”: the outstanding challenge of environmental exposure measurement in molecular epidemiology

Dr. Manish Arora known for his work on biomarkers—using human teeth to reconstruct the timing of exposure to harmful chemicals and essential nutrients.

Study: Influence of nutrition in PCB-induced vascular inflammation

Study: Prenatal polyunsaturated fatty acids and child asthma: Effect modification by maternal asthma and child sex

Project Ice Storm

Moshe Szyf

Study: GSTP1 and TNF Gene Variants and Associations between Air Pollution and Incident Childhood Asthma: The Traffic, Asthma and Genetics (TAG) Study

Dr. Dale Bredesen

Dr. Lauren Petrick, PhD

Study: Untargeted metabolomics of newborn dried blood spots reveals sex-specific associations with pediatric acute myeloid leukemia

Podcast: Smart, Actionable Strategies for Childhood Resilience, with Dr. Elisa Song

Podcast: Add Superfoods and Epinutrients to Any Diet Using Broths and Tonics

Blog: Ultra-Processed Foods Spell Disaster for Longevity

Podcast: Are You a Fast Metabolizer of Omega Fatty Acids? Lessons from a Legend.

Podcast: Latest Research Data on Diet & Other Interventions for Multiple Sclerosis with Dr. Terry Wahls

Podcast: Tackling Alzheimer’s Disease Head On – the Inspiring Work of Dr. Heather Sandison

DrKF Clinic: Patient consults with DrKF physicians including Younger You Concierge

Bio Age Lab Test

Bio Age Self Assessment Quiz

Younger You Group Program

Younger You book

Better Broths and Healing Tonics book

Interview: Past, Present, and Future of “Biological Aging” with Dr. Fitzgerald

Video Blog: Does Multivitamin Use Increase Mortality Risk?

Podcast: Decoding Aging: The Science Of Cellular Rejuvenation With Dr. Vittorio Sebastiano

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