“The Quantified Self: From Idiosyncratic Hobby

to an Emerging Growth Industry”

Invited Lecture

Science & Technology Discovery Series

Technology Alliance

Seattle, WA

October 10, 2014

Dr. Larry Smarr

Director, California Institute for Telecommunications and Information Technology

Harry E. Gruber Professor,

Dept. of Computer Science and Engineering

Jacobs School of Engineering, UCSD

http://lsmarr.calit2.net1

Abstract

Starting a decade ago I began to increasingly quantify the changes of my body over time. Like

most people I started with tracking my weight, then added diet and exercise apps and gadgets.

But five years ago I began to go deeper - tracking over 100 biomarkers in my blood and stool.

Eventually, I added in sequencing my human genome and my gut microbiome. All of this

transition to Big Data became possible because of continuing technological exponentials. While

my "hobby" seemed quirky to many in the past, an emerging growth industry, based on these

practices, is developing with the goal of sustaining wellness, while fundamentally disrupting the

current "sick care" industry. Simultaneously, research is accelerating in the same field, as

exemplified by Lee Hood's 100 Person Wellness Project, headquartered in Seattle's Institute for

System Biology. As one of the Pioneer 100, I will review some of the project's insights for

personalized action to improve and sustain your health.

Calit2 Has Had a Vision of

“the Digital Transformation of Health” for a Decade

• Next Step—Putting You On-Line!

– Wireless Internet Transmission

– Key Metabolic and Physical Variables

– Model -- Dozens of Processors and 60 Sensors /

Actuators Inside of our Cars

• Post-Genomic Individualized Medicine

– Combine

–Genetic Code

– Body Data Flow

– Use Powerful AI Data Mining Techniques

www.bodymedia.com

The Content of This Slide from 2001 Larry Smarr

Calit2 Talk on Digitally Enabled Genomic Medicine

By Measuring the State of My Body and “Tuning” It

Using Nutrition and Exercise, I Became Healthier

2000

Age

41

2010

Age

61

1999

1989

Age

51

1999

My Decade Long Journey to Being a Quantified Self:

I Arrived in La Jolla in 2000 After 20 Years in the Midwest

I Reversed My Body’s Decline By

Quantifying and Altering

Nutrition, Exercise, Sleep, and Stress

http://lsmarr.calit2.net/repository/LS_reading_recommendations_FiRe_2011.pdf

My Quantifying Experiments Became Public

in Seattle in 2010

I Used a Variety of Emerging Personal Sensors

To Quantify My Body & Drive Behavioral Change

Withings/iPhone-

Blood Pressure

Zeo-Sleep

Azumio-Heart Rate

MyFitnessPal-

Calories Ingested

FitBit -

Daily Steps &

Calories Burned

Withings WiFi Scale -

Daily Weight

Wireless Monitoring

Helped Drive My Exercise Goals

Since Starting November 3, 2011

Total Distance Tracked 3,223 miles = San Diego to Bangor, ME

Total Vertical Distance Climbed 107,000 ft. = 3.7 Mt. Everest

Using Polar Chest Strap

During Elliptical WorkoutsMy Resting Heartrate

Fell from 70 to 40!

The Self-Monitoring Business

Has Reached Market Takeoff

• MyFitnessPal

– 40 Million Users

– Aug 2013 Raised $18M Series A, Led by Kleiner Perkins

• Fitbit

– Has Raised ~$70M

• BodyMedia Was Bought by Jawbone

– For ~$100M

• Zeo Sleep Monitor

– Closed Down in 2013

More Mergers Likely as the Shakeout Continues

In 2013 QS Went Mainstream

Source: Samir Damani, MD Revolution

2014 is the Year of the Sensor Integrated Dashboard

Combined with Coaching

My RevUp! Age Has

Decreased to 60

My Physical Age is 66

Deep Learning Will Provide

Personalized Assistants to Coach Us to Wellness

Where Medicine Coaching is Now

Where Wellness Coaching is Going

The Emergence of P4 Medicine --

Predictive, Preventive, Personalized, Participatory

Systems Biology &

Systems MedicineConsumer-Driven

Social Networks

P4

MEDICINE

Digital Revolution

Big Data

Source: Lee Hood, ISB

How Will the Quantified Consumer

Be Integrated into Healthcare Systems?

From One to One Billion Data Points Defining Me:

Big Data Coming to the Electronic Medical Record (EMR)

Billion: My Full DNA,

MRI/CT Images

Million: My DNA SNPs,

Zeo, FitBit

Hundred: My Blood VariablesOne:

My WeightWeight

Blood

Variables

SNPs

Human & Microbial Genome

Today’s EMR

Tomorrow’s EMR

Visualizing 5-10 Year Time Series of 150 Blood & Stool

Variables Led Me to Discover a Chronic Disease

Calit2 64 megapixel VROOM

Early Adopting MDs Are Creating Partnerships

with Their Quantified Patients

• “The 100 participants will be guided on this 9-month

journey by a coach and when necessary,

be referred to their own health care practitioners.”

• The data sets that will be evaluated include:

– Self-Tracking Devices

– Medical History, Traits, Lifestyle

– Blood, Urine, Saliva

– Gut Microbiome

– Whole Genome Sequencing

There are 8760 Hours in a Year

One of These Hours You Are With a Doctor…

The Other 8759 Hours Are Up to You!

https://pioneer100.systemsbiology.net/

Will Grow to 1000, then 10,000

I Titrate My Supplements by Measuring

The Amounts Inside of My Red Blood Cells

Increase Cu

Decrease Mg

Maintain Dose

Test Results from Genova Diagnostics,

Via Lee Hood’s Pioneer 100 Program

Healthcare Must Include a Vast Amount

of Microbial Information That is Not in Today’s Medicine

Inclusion of the Microbiome

Will Radically Change Medicine

99% of Your

DNA Genes

Are in Microbe Cells

Not Human Cells

Your Body Has 10 Times

As Many Microbe Cells As Human Cells

The Cost of Sequencing a Human Genome

Has Fallen Over 10,000x in the Last Ten Years

This Has Enabled Sequencing of

Both Human and Microbial Genomes

Using Supercomputing Allows Comparison of

the Relative Abundance of 200 Gut Microbe Species

Calit2 VROOM-FuturePatient Expedition

Comparing 3 LS Time Snapshots (Left)

with Healthy, Crohn’s, UC (Right Top to Bottom)

Using Microbiome Profiles to Survey 155 Subjects

for Unhealthy Candidates

Comparison Across the Pioneer 100 Gut Microbiomes

Allows For Early Detection of Deviation From Health

Only 6 With Bacteriodetes <20%

A Few With High %

Proteobacteria

or Verrucomicrobia

Inexpensive Consumer 16S Time Series of Microbiome

Allows Similar Analysis Through Ubiome

Data source: LS (Yellow Lines Stool Samples);

Sequencing and Analysis Ubiome

There is a Huge New Field of Products Coming

Which Enable You to “Garden” Your Microbiome

“I would like to lose the language of warfare,”

said Julie Segre, a senior investigator at

the National Human Genome Research Institute.

”It does a disservice to all the bacteria

that have co-evolved with us

and are maintaining the health of our bodies.”

Will Medical Foods Provide New Tools

for Altering Gut Microbiome?

Everything I Discussed Can Be Done by Startups -

Outside of the Traditional Medical Complex

Blood Variable Time Series Stool Variable Time Series

MicrobiomeTime SeriesHuman Genetic Variations

World’s Youngest Female Billionaire

Aims to Disrupt the Medical Testing Industry

A Looming Disruption In Healthcare Systems

From Personalized Medicine

• Citizens Create Vast Datasets Outside of EMRs

• Post-“Watson” Personalized Coaches

• Doctors Must Partner with Super-Informed Patients

• Increased Use of Supplements and Medical Foods

• From Treating Sickness to Maintaining Wellness

Thanks to Our Great Team!

UCSD Metagenomics Team

Weizhong Li

Sitao Wu

Calit2@UCSD

Future Patient Team

Jerry Sheehan

Tom DeFanti

Kevin Patrick

Jurgen Schulze

Andrew Prudhomme

Philip Weber

Fred Raab

Joe Keefe

Ernesto Ramirez

JCVI Team

Karen Nelson

Shibu Yooseph

Manolito Torralba

SDSC Team

Michael Norman

Mahidhar Tatineni

Robert Sinkovits

UCSD Health Sciences Team

William J. Sandborn

Elisabeth Evans

John Chang

Brigid Boland

David Brenner