Anxiety conditions are common and contribute substantially to reduced quality of life and healthcare burden(1). While dietary behaviours may differ by anxiety status(2), evidence linking specific food choices and anxiety—either causally or as consequences of anxiety—remains limited. Nuts are a widely consumed, nutrient-dense food that have been associated with better mental health outcomes such as depression(3), but it is unclear whether nut consumption differs between individuals with and without anxiety. Understanding how anxiety relates to everyday food choices may therefore provide insight into behavioural patterns relevant to prevention, management, and public health messaging.

We conducted a cross-sectional analysis of up to 122,195 UK and US participants from the ZOE PREDICT 3 cohort (ClinicalTrials.gov identifier: NCT04735835) to investigate associations between nut consumption and anxiety disorders. Anxiety status was defined based on self-reported lifetime anxiety disorders, classified according to DSM-5 diagnostic categories. Intake of almonds, walnuts, cashews, pistachios, and total nuts was derived from food frequency questionnaire data and categorised as regular consumption (≥4 g/day) versus non-consumption (0 g/day). Associations were examined using Firth logistic regression models adjusted for sociodemographic factors, lifestyle behaviours, clinical characteristics, and total energy intake. Overall diet quality was additionally controlled for using a modified and rescaled Mediterranean–DASH Intervention for Neurodegenerative Delay (MIND) dietary score from which nut components were removed to avoid overadjustment. To account for multiple testing across nut exposures, false discovery rate (FDR) correction was applied.

Across the cohort, nut consumption was positively associated with overall diet quality, as reflected by higher modified MIND scores (r up to 0.34). After adjustment for diet quality and relevant covariates, consumption of all nut types examined was associated with 9–12% lower odds of lifetime prevalent anxiety. Specifically, individuals with anxiety had lower odds of consuming almonds (n= 89,387; OR=0.91; 95% CI: 0.85–0.98; FDR p = 0.018), cashews (n=87,702; OR=0.90; 95% CI: 0.84–0.97; FDR p = 0.008), pistachios (n=105,144; OR=0.91; 95% CI: 0.83–0.99; FDR p = 0.037), walnuts (n=122,195; OR=0.91; 95% CI: 0.86–0.97; FDR p = 0.007), and total nuts (n=117,651; OR=0.88; 95% CI: 0.81–0.95; FDR p = 0.006), relative to individuals without anxiety. Associations were consistent in direction across nut types and strongest for total nut consumption.

In this large cross-sectional study, individuals with anxiety were less likely to report regular nut consumption compared with those without anxiety, even after accounting for overall diet quality. These findings suggest that anxiety status is associated with differences in eating behaviours, including nut consumption, independent of overall diet quality. While causality and directionality cannot be inferred, the results highlight the importance of considering specific food choices alongside broader dietary patterns when examining diet–mental health relationships.

In the context of the rapidly evolving modern food environment, there is a need for dietary assessment tools to accurately assess current food intake. The objective of this research was to develop and validate a new food frequency questionnaire (FFQ). A 265 item web-based, self-administered FFQ (PREDICT-FFQ-v1) was developed using information from two FFQs and US and UK cohort level data. Over a 1-month period, 68 participants completed the PREDICT-FFQ-v1 and six 24-h recalls (reference tool; Intake24). Relative validity was assessed using Bland–Altman plots, cross-classification food group analysis, and Spearman’s rank correlation for food groups and nutrients. From the Bland–Altman plots, the median bias between the PREDICT-FFQ-v1 and Intake24 were energy (414 kcal (95%CI 289 to 609) (1734 kj (95% CI 1208 to 2549)), carbohydrate (2.3 %EI, 95%CI 0.08 to 3.68), fat (2.5 %EI, 95%CI 0.23 to 3.52), protein (−1.14 %EI, 95% CI −1.64 to −0.23), and fibre (1.86 g/1000 kcal, 95% CI 1.05 to 2.65). Cross-classification by quartiles of diet quality (plant-based diet index) categorised >76% of participants into the same or adjacent quartiles. Correlation coefficients for food groups assessed using both tools ranged from 0.38 (legumes) to 0.78 (meat), and for energy-adjusted nutrients ranged from 0.28 (total fat) to 0.82 (alcohol). The PREDICT-FFQ-v1 captures intakes of foods that are commonly consumed in modern diets, with greater resolution at the food level than previous tools. The PREDICT-FFQ-v1 has acceptable relative validity in comparison to 24-h dietary recall and provides a valuable alternative for assessing dietary intake in nutritional epidemiology.

Diets low in diverse fibre-rich plant foods contribute to the rise of chronic disease. The BIOME study (NCT06231706; 6-week parallel randomised controlled trial) in 399 adults (35–65 years; BMI 18·5–40 kg/m2; fibre intake < 20 g/d) investigated a whole-food plant blend containing > 30 ingredients, rich in (poly)phenols, fibre and micronutrients. Participants were randomised (1:1:1) to the blend (30 g/d), an isoenergetic control (bread croutons, 28 g/d) or probiotic (Lactobacillus rhamnosus, 15bn CFU/d). Analysts were blinded to allocation. The primary outcome was change in ‘favourable’ and ‘unfavourable’ gut microbiome species (ZOE Microbiome Health Ranking 2025); secondary outcomes included blood metabolites, symptoms, stool output, anthropometry, hunger, sleep, energy and mood. A crossover sub-study explored postprandial glucose, hunger and mood. Of 349 participants analysed (fifty excluded), self-reported adherence was > 98 %. The 30+ plant blend resulted in more species changing relative abundance at 6 weeks v. control (57 v. 14 species-level genome bins (SGB), P < 0·001) and probiotic (57 v. 4 SGB, P < 0·001). There were no significant between-group differences in microbiome health ranks of significantly changing species (increasing or decreasing). Blend participants self-reported reduced indigestion, constipation, heartburn and flatulence and increased energy v. control (all P < 0·05). Six related but no serious adverse events occurred. In the sub-study, adding the blend to a high-carbohydrate meal (v. meal alone) reduced hunger, increased fullness and energy (3-h incremental AUC, all P < 0·05), with no effect on postprandial glucose. This 30+ plant blend represents a simple strategy to modify gut microbiome composition and benefit gastrointestinal symptoms in healthy adults.

High intakes of ultra-processed foods (UPFs) have been associated with adverse health outcomes including weight gain, cardiometabolic disease and cancer(1,2). However, the limitations of NOVA highlight the need for a novel classification which captures food properties and features of processing that drive these health outcomes. Proposed mechanisms underlying the associations between UPF and health include energy density and hyperpalatability(3,4). Within the US food system, the prevalence of both energy dense and hyperpalatable foods is increasing, and there is moderate overlap between foods identified by each definition(5). The aim of this study was to characterise the energy density and hyperpalatability of foods and habitual diets consumed by UK adults.

Logged dietary data, baseline characteristics and body composition were analysed from ZOE PREDICT 1 UK participants (n= 1001; NCT03479866)(6). Weighted logged dietary data, including more than 12,000 foods (beverages excluded), from participants with ≥2 free-living days (n=891) were included. Energy density (kcal/g) for all foods and participant diets was calculated. Hyperpalatable foods (HPF) were classified using a data-defined definition(7) and percentage energy intake (%EI) from HPFs were calculated. Differences in energy density and hyperpalatability were examined across top and bottom tertiles of energy intake.

In the PREDICT 1 cohort (n=891, 73% females, (mean±SD) age 46±12 years and BMI 26±4.9 kg/m2) 55% of foods were high in energy density (>2 kcal/g), 49% were defined as HPFs and 35% were both energy dense and hyperpalatable. Across participants’ habitual diets (beverages excluded), the average energy density was 2.1±1.0 kcal/g and proportion of energy consumed from HPFs was 48±16 %EI. There was a significant difference across tertiles of energy intake (low versus high) in the energy density of diets (kcal/g) and contribution of energy from HPFs (%EI) (P<0.05 for all).

This analysis provides valuable insights into the energy density and hyperpalatability of habitual diets in the PREDICT 1 cohort, demonstrating overlap between these features. Further work is required to understand the independent and combined role of these factors, and additional proposed mechanisms underlying the negative health effects associated with processing, such as food texture, energy-intake-rate, and additives and non-culinary ingredients. A novel classification should build on NOVA by encompassing the food properties and features of processing that drive adverse health outcomes. Policy makers must consider the role of these factors to ensure nutritionally beneficial and affordable foods are not penalised without appropriate scientific justification.

Susceptibility to infection such as SARS-CoV-2 may be influenced by host genotype. TwinsUK volunteers (n = 3261) completing the C-19 COVID-19 symptom tracker app allowed classical twin studies of COVID-19 symptoms, including predicted COVID-19, a symptom-based algorithm to predict true infection, derived from app users tested for SARS-CoV-2. We found heritability of 49% (32−64%) for delirium; 34% (20−47%) for diarrhea; 31% (8−52%) for fatigue; 19% (0−38%) for anosmia; 46% (31−60%) for skipped meals and 31% (11−48%) for predicted COVID-19. Heritability estimates were not affected by cohabiting or by social deprivation. The results suggest the importance of host genetics in the risk of clinical manifestations of COVID-19 and provide grounds for planning genome-wide association studies to establish specific genes involved in viral infectivity and the host immune response.

A healthy diet is associated with the improvement or maintenance of health parameters, and several indices have been proposed to assess diet quality comprehensively. Twin studies have found that some specific foods, nutrients and food patterns have a heritable component; however, the heritability of overall dietary intake has not yet been estimated. Here, we compute heritability estimates of the nine most common dietary indices utilized in nutritional epidemiology. We analyzed 2590 female twins from TwinsUK (653 monozygotic [MZ] and 642 dizygotic [DZ] pairs) who completed a 131-item food frequency questionnaire (FFQ). Heritability estimates were computed using structural equation models (SEM) adjusting for body mass index (BMI), smoking status, Index of Multiple Deprivation (IMD), physical activity, menopausal status, energy and alcohol intake. The AE model was the best-fitting model for most of the analyzed dietary scores (seven out of nine), with heritability estimates ranging from 10.1% (95% CI [.02, .18]) for the Dietary Reference Values (DRV) to 42.7% (95% CI [.36, .49]) for the Alternative Healthy Eating Index (A-HEI). The ACE model was the best-fitting model for the Healthy Diet Indicator (HDI) and Healthy Eating Index 2010 (HEI-2010) with heritability estimates of 5.4% (95% CI [−.17, .28]) and 25.4% (95% CI [.05, .46]), respectively. Here, we find that all analyzed dietary indices have a heritable component, suggesting that there is a genetic predisposition regulating what you eat. Future studies should explore genes underlying dietary indices to further understand the genetic disposition toward diet-related health parameters.

CVD is the leading cause of death worldwide and, after dementia, is the second biggest cause of death for women. In England, it accounts for one in four of all deaths. Lifestyle modifications represent the primary route both to reduce CVD risk factors and prevent CVD outcomes. Diet constitutes one of the key modifiable risk factors in the aetiology of CVD. We investigated the relationship between nine main dietary indices and a comprehensive range of CVD risk factors in 2590 women from TwinsUK. After adjustment for multiple testing, we found that the Dietary Approaches to Stop Hypertension (DASH) diet was inversely correlated with some of the most common CVD risk factors (BMI, visceral fat (VF), TAG, insulin, homoeostasis model assessment of insulin resistance (HOMA2-IR) and atherosclerotic CVD (ASCVD) risk) with PFDR ranging from 6·28 × 10−7 to 5·63 × 10−4. Similar association patterns were detected across most of the dietary indices analysed. In our post hoc investigation, to determine if any specific food groups were driving associations between the DASH score and markers of cardiometabolic risk, we found that increased BMI, VF, HOMA2-IR, ASCVD risk, insulin and TAG levels were directly correlated with red meat consumption (PFDR ranging from 4·65 × 10−9 to 7·98 × 10−3) and inversely correlated with whole-grain cereal consumption (PFDR ranging from 1·26 × 10−6 to 8·28 × 10−3). Our findings revealed that the DASH diet is associated with a more favourable CVD risk profile, suggesting that this diet may be a candidate dietary pattern to supplement current UK dietary recommendations for CVD prevention.

Twin researchers face the challenge of accurately determining the zygosity of twins for research. As part of the annual questionnaire between 1999 and 2006, 8,307 twins from the TwinsUK registry were asked to complete five questions (independently from their co-twin) to ascertain their self-perceived zygosity during childhood on up to five separate occasions. This questionnaire is known as the ‘peas in the pod’ questionnaire (PPQ), but there is little evidence of its validation. Answers were scored and classified as monozygotic (MZ), dizygotic (DZ), or unknown zygosity (UZ) and were compared with 4,484 twins with genotyping data who had not been selected for zygosity. Of these, 3,859 individuals (46.5% of those who had a zygosity from PPQ) had zygosity classified by both the PPQ and genotyping. Of the 708 individual twins whose answers meant that they were consistently classed as MZ in the PPQ, 683 (96.5%) were MZ within the genotype data. Of the 945 individual twins consistently classed as DZ within questionnaire, 936 (99.0%) were DZ in the genotype data. Where both twins scored MZ consistently across multiple questionnaires, 99.6% were MZ on genotyping, 99.7% were DZ on genotyping if both twins consistently scored DZ. However, for the initial questionnaire, 88.6% of those scoring as MZ were genotypically MZ and 98.7% DZ. For twin pairs where both scored UZ, 94.7% were DZ. Using the PPQ on a single occasion provided a definitive classification of whether the twin was MZ or DZ with an overall accuracy of 86.9%, increasing to 97.9% when there was a consistent classification of zygosity across multiple questionnaires. This study has shown that the PPQ questionnaire is an excellent proxy indicator of zygosity in the absence of genotyping information.

Low birth weight (LBW) can have an impact on health outcomes in later life, especially in relation to pre-disposition to metabolic disease. Several studies suggest that LBW resulting from restricted intrauterine growth leaves a footprint on DNA methylation in utero, and this influence likely persists into adulthood. To investigate this further, we performed epigenome-wide association analyses of blood DNA methylation using Infinium HumanMethylation450 BeadChip profiles in 71 adult monozygotic (MZ) twin pairs who were extremely discordant for birth weight. A signal mapping to the IGF1R gene (cg12562232, p = 2.62 × 10−8), was significantly associated with birth weight discordance at a genome-wide false-discovery rate (FDR) of 0.05. We pursued replication in three additional independent datasets of birth weight discordant MZ pairs and observed the same direction of association, but the results were not significant. However, a meta-analysis across the four independent samples, in total 216 birth-weight discordant MZ twin pairs, showed a significant positive association between birth weight and DNA methylation differences at IGF1R (random-effects meta-analysis p = .04), and the effect was particularly pronounced in older twins (random-effects meta-analysis p = .008, 98 older birth-weight discordant MZ twin pairs). The results suggest that severe intra-uterine growth differences (birth weight discordance >20%) are associated with methylation changes in the IGF1R gene in adulthood, independent of genetic effects.

Food liking-disliking patterns may strongly influence food choices and health. Here we assess: (1) whether food preference patterns are genetic/environmentally driven; and (2) the relationship between metabolomics profiles and food preference patterns in a large population of twins. 2,107 individuals from TwinsUK completed an online food and lifestyle preference questionnaire. Principle components analysis was undertaken to identify patterns of food liking-disliking. Heritability estimates for each liking pattern were obtained by structural equation modeling. The correlation between blood metabolomics profiles (280 metabolites) and each food liking pattern was assessed in a subset of 1,491 individuals and replicated in an independent subset of monozygotic twin pairs discordant for the liking pattern (65 to 88 pairs). Results from both analyses were meta-analyzed. Four major food-liking patterns were identified (Fruit and Vegetable, Distinctive Tastes, Sweet and High Carbohydrate, and Meat) accounting for 26% of the total variance. All patterns were moderately heritable (Fruit and Vegetable, h 2[95% CI]: 0.36 [0.28; 0.44]; Distinctive Tastes: 0.58 [0.52; 0.64]; Sweet and High Carbohydrate: 0.52 [0.45, 0.59] and Meat: 0.44 [0.35; 0.51]), indicating genetic factors influence food liking-disliking. Overall, we identified 14 significant metabolite associations (Bonferroni p < 4.5 × 10−5) with Distinctive Tastes (8 metabolites), Sweet and High Carbohydrate (3 metabolites), and Meat (3 metabolites). Food preferences follow patterns based on similar taste and nutrient characteristics and these groupings are strongly determined by genetics. Food preferences that are strongly genetically determined (h 2 ≥ 0.40), such as for meat and distinctive-tasting foods, may influence intakes more substantially, as demonstrated by the metabolomic associations identified here.

Investigations into the genetic architecture of diet–disease relationships are particularly relevant today with the global epidemic of obesity and chronic disease. Twin studies have demonstrated that genetic makeup plays a significant role in a multitude of dietary phenotypes such as energy and macronutrient intakes, dietary patterns, and specific food group intakes. Besides estimating heritability of dietary assessment, twins provide a naturally unique, case–control experiment. Due to their shared upbringing, matched genes and sex (in the case of monozygotic (MZ) twin pairs), and age, twins provide many advantages over classic epidemiological approaches. Future genetic epidemiological studies could benefit from the twin approach particularly where defining what is ‘normal’ is problematic due to the high inter-individual variability underlying metabolism. Here, we discuss the use of twins to generate heritability estimates of food intake phenotypes. We then highlight the value of discordant MZ pairs to further nutrition research through discovery and validation of biomarkers of intake and health status in collaboration with cutting-edge omics technologies.

Low weight at birth has previously been shown to be associated with a number of adult diseases such as type 2 diabetes, cardiovascular disease, high blood pressure, and obesity later in life. Genome-wide association studies (GWAS) have been published for singleton-born individuals, but the role of genetic variation in birth weight (BW) in twins has not yet been fully investigated. A GWAS was performed in 4,593 female study participants with BW data available from the TwinsUK cohort. A genome-wide significant signal was found in chromosome 9, close to the NTRK2 gene (OMIM: 600456). QIMR, an Australian twin cohort (n = 3,003), and UK-based singleton-birth individuals from the Hertfordshire cohort (n = 2,997) were used as replication for the top two single nucleotide polymorphism (SNPs) underpinning this signal, rs12340987 and rs7849941. The top SNP, rs12340987, was found to be in the same direction in the Australian twins and in the singleton-born females (fixed effects meta-analysis beta = -0.13, SE = 0.02, and p = 1.48 × 10−8) but not in the singleton-born males tested. These findings provide an important insight into the genetic component of BW in twins who are normally excluded due to their lower BW when compared with singleton births, as well as the difference in BW between twins. The NTRK2 gene identified in this study has previously been associated with obesity.

Although the co-occurrence among symptoms of insomnia, fatigue, and depression has been frequently reported, the etiology of this co-occurrence remains poorly understood. A total of 3,758 adult female twins in the United Kingdom completed a mail-out survey including six questions concerning frequency and severity of symptoms of insomnia, fatigue, and depression. Correlations among the scores of the three symptoms ranged from 0.35 to 0.44. Among various multivariate models we tested, the common-pathway model explained the data best. In the best-fitting model, the common factor was explained approximately equally by genetic and unique environmental factors (49% and 51%, respectively). In addition to the common variance, there was a significant specific variance in each symptom, where unique environmental factors were much larger than genetic factors. These results imply that although there are shared genetic liabilities for the development of symptoms of depression, fatigue, and insomnia, it is environmental experiences that make etiological distinctions among three symptoms.

Strabismus represents a complex oculomotor disorder characterized by the deviation of one or both eyes and poor vision. A more sophisticated understanding of the genetic liability of strabismus is required to guide searches for associated molecular variants. In this classical twin study of 1,462 twin pairs, we examined the relative influence of genes and environment in comitant strabismus, and the degree to which these influences can be explained by factors in common with refractive error. Participants were examined for the presence of latent (‘phoria’) and manifest (‘tropia’) strabismus using cover–uncover and alternate cover tests. Two phenotypes were distinguished: eso-deviation (esophoria and esotropia) and exo-deviation (exophoria and exotropia). Structural equation modeling was subsequently employed to partition the observed phenotypic variation in the twin data into specific variance components. The prevalence of eso-deviation and exo-deviation was 8.6% and 20.7%, respectively. For eso-deviation, the polychoric correlation was significantly greater in monozygotic (MZ) (r = 0.65) compared to dizygotic (DZ) twin pairs (r = 0.33), suggesting a genetic role (p = .003). There was no significant difference in polychoric correlation between MZ (r = 0.55) and DZ twin pairs (r = 0.53) for exo-deviation (p = .86), implying that genetic factors do not play a significant role in the etiology of exo-deviation. The heritability of an eso-deviation was 0.64 (95% CI 0.50–0.75). The additive genetic correlation for eso-deviation and refractive error was 0.13 and the bivariate heritability (i.e., shared variance) was less than 1%, suggesting negligible shared genetic effect. This study documents a substantial heritability of 64% for eso-deviation, yet no corresponding heritability for exo-deviation, suggesting that the genetic contribution to strabismus may be specific to eso-deviation. Future studies are now needed to identify the genes associated with eso-deviation and unravel their mechanisms of action.

Association studies, comparing elite athletes with sedentary controls, have reported a number of genes that may be related to athlete status. The present study reports the first genome wide linkage scan for athlete status. Subjects were 4488 adult female twins from the TwinsUK Adult Twin Registry (793 monozygotic [MZ] and 1000 dizygotic [DZ] complete twin pairs, and single twins). Athlete status was measured by asking the twins whether they had ever competed in sports and what was the highest level obtained. Twins who had competed at the county or national level were considered elite athletes. Using structural equation modeling in Mx, the heritability of athlete status was estimated at 66%. Seven hundred DZ twin pairs that were successfully genotyped for 1946 markers (736 microsatellites and 1210 SNPs) were included in the linkage analysis. Identical-by-descent probabilities were estimated in Merlin for a 1 cM grid, taking into account the linkage disequilibrium of correlated SNPs. The linkage scan was carried out in Mx using the -approach. Suggestive linkages were found on chromosomes 3q22-q24 and 4q31-q34. Both areas converge with findings from previous studies using exercise phenotypes. The peak on 3q22-q24 was found at the SLC9A9 gene. The region 4q31-q34 overlaps with the region for which suggestive linkages were found in two previous linkage studies for physical fitness (FABP2 gene; Bouchard et al., 2000) and physical activity (UCP1 gene; Simonen et al., 2003). Future association studies should further clarify the possible role of these genes in athlete status.

One thousand and seventy three pairs of adult monozygotic (MZ) twins and 895 pairs of same sex adult dizygotic (DZ) twins from the United Kingdom (UK) completed the Humor Styles Questionnaire: a 32-item measure which assesses two positive and two negative styles of humor. MZ correlations were approximately twice as large as DZ correlations for all four humor styles, and univariate behavioral genetic model fitting indicated that individual differences in all of them can be accounted for entirely by genetic and nonshared environmental factors, with heritabilities ranging from .34 to .49. These results, while perhaps not surprising, are somewhat at odds with a previous study that we conducted in North America (Vernon et al., in press) in which genetic factors contributed significantly to individual differences in the two positive humor styles, but contributed far less to the two negative styles, variance in which was instead largely due to shared and nonshared environmental factors. We suggest that differences between North American and UK citizens in their appreciation of different kinds of humor may be responsible for the different results obtained in these two studies.

The purpose of the present study was to determine if a general factor of personality (GFP) could be extracted from the six dimensions of the HEXACO model and four factors of trait emotional intelligence. Participants were 1,192 pairs of twins (666 MZ pairs, 526 DZ pairs) between the ages of 19 to 86 years, who completed the Trait Emotional Intelligence Questionnaire — Short Form and the HEXACO Personality Inventory — Revised. Principal components analysis yielded a strong GFP accounting for 33% of the variance, on which all variables with the exception of honesty-humility from the HEXACO showed moderate to large loadings. Behavioral genetic (BG) analyses revealed that individual differences in the GFP were entirely attributable to additive genetic and non-shared environmental factors — results that are in accord with previous BG analyses of a GFP. The present study adds to the body of evidence in support of a heritable GFP but an alternative perspective is also discussed.

The UK Adult Twin Registry was started in 1993 and consists of approximately 10,000 monozygotic (MZ) and dizygotic (DZ) adult Caucasian twins aged 16 to 85 years from all over the United Kingdom, plus some parents and siblings. It now incorporates previous twin registries from the Institute of Psychiatry and Aberdeen University. This is a volunteer sample recruited by successive media campaigns without selecting for particular diseases or traits. All twins receive a series of detailed disease and environmental questionnaires. The majority of twins have been assessed in detail clinically at several time points for several hundred phenotypes related to common diseases or intermediate traits. The focus to date has been primarily in 5 areas — cardiovascular, metabolic, musculoskeletal, ophthalmologic diseases as well as the aging process. Over 3000 DZ twins have had a 10cM genome-wide scan performed and 5000 twins tagged for over 200 candidate genes allowing both linkage and association studies. The resource has led to many successful and innovative research projects particularly in common age-related diseases, and has led to collaborations with over 80 groups worldwide.