IMMEDIATE aims to investigate and explore the diet-microbiome-immunometabolism-axis as a sensor for health-to-disease transition and evaluate strategies to maintain an individual’s well-being. Chronic inflammation is the major root of most diseases. Understanding of this process preceding organ dysfunction or damage and identification of biomarkers in the pre-symptomatic stage and risk but also resilience factors of health-to-disease transition will enable targeted and personalized interventions to prevent irreversible organ damage. Metabolites of gut microbiota are key messengers between diet, microbiota and host, maintaining the balance of pro- and anti-inflammation. Our study takes advantage of cutting-edge omics technologies available within the IMMEDIATE consortium in conjunction with available clinical data and biospecimens from ongoing observational studies, enrolling “healthy” subjects and individuals in the pre-disease stage but with largely distinct environmental and dietary modulators, including a cohort of kidney transplant recipients in whom renal function has been “reset to baseline”. The identification of clinical and omics-derived biomarkers will – by employing AI algorithms - yield a personalized risk / resilience score of chronic inflammation and thus a better prediction of an individual’s risk of transition towards disease. A proof-of-concept intervention study with the anti-inflammatory microbe Akkermansia muciniphila will be conducted to test whether deflections of the microbiome-metabolite-immune axis can be reverted on the biomarker level but also with respect to clinical outcomes and overall well-being. Mobile apps developed by the IMMEDIATE consortium in collaboration with patient organizations tracking numerous lifestyle-related measures and providing guidance and feedback on these aspects will empower individuals to adopt and integrate these knowledge-based health interventions into their own lives, hereby self-managing their own health.

Shift work is an independent risk factor for the development of overweight and obesity. As shift workers represent a huge target group throughout many sectors in Europe obesity and associated diseases stress national health systems. Unhealthy food choices (snacking, high sugar intake, preferences for spicy and sweet-fatty foods) were reported for this group, which are likely the main causes for becoming obese. The underlying mechanisms for these changed eating patterns remain to be resolved. Potential explanations are alterations in metabolic health conditions (e.g. microbiome and inflammation), taste perception and circadian misalignment. Empirically proven solutions are urgently needed to benefit national health systems and reduce the development of obesity and increase the wellbeing of shift workers in the EU. This project aims to identify mechanisms and environmental and lifestyle factors leading to obesity in shift workers and to develop and evaluate products and strategies with consideration of the behavioural and relational level to support healthy eating patterns. The project will focus on both healthcare (female dominated) and industrial workers (male dominated), two major sectors where working in shifts is common. We will combine existing and new knowledge on nutritional, behavioural, perceptual and physiological determinants of (un)healthy food choices in a cross-section trial and consider personal needs and wishes. Based on the latter results, promising strategies, technical solutions and products will be developed and tested within the target group in specific interventions. During all steps, stakeholders (health work organisations, shift workers` representatives, companies, policy makers and scientists) will be involved. With the results, new insights in the nutrition-related mechanisms involved in the development of obesity among shift workers will be identified and tailored strategies benefitting shift workers and employers will be developed.