A new framework called 'adaptive health' could transform how doctors treat and prevent disease by monitoring how chemical modifications to genes change over time and using that data to intervene before illness strikes. An international team of researchers, including scientists from Mohamed Bin Zayed University of Artificial Intelligence (MBZUAI), published their vision in Nature Genetics, arguing that large-scale analysis of patients' genomes and epigenomes could enable a shift from reactive medicine to proactive, personalized prevention.

Unlike your DNA sequence, which remains largely fixed from birth, your epigenome is dynamic. It changes constantly in response to diet, stress, aging, physical activity, and environmental chemicals. These chemical modifications act like switches that turn genes on and off, controlling whether they are active or dormant. The key insight is that many epigenetic changes can be reversed.

"The epigenome consists of chemical modifications that influences gene expression, making genes more or less active," explained Eduardo Beltrame, co-author of the article and assistant professor of Computational Biology at MBZUAI.

Eduardo Beltrame, Assistant Professor of Computational Biology at MBZUAI

Translating adaptive health into a working healthcare system requires linking genetic profiles, epigenetic data, clinical records, environmental exposure information, and health outcomes across large populations over extended periods. This kind of integrated data collection is rare globally, but the UAE is uniquely positioned to pioneer this approach.

What Infrastructure Does the UAE Have to Support This Vision?

The UAE has assembled an ecosystem of resources and institutions that few countries can match. Central to this effort is the Emirati Genome Program (EGP), one of the world's largest population genomics initiatives. Nearly 1 million Emirati citizens have undergone whole-genome sequencing, and more than 100,000 have been sequenced using Oxford Nanopore Technologies (ONT) long-read sequencing, a technique that can detect certain epigenetic modifications like DNA methylation while reading long stretches of DNA.

Beyond genomics, the UAE benefits from complementary programs and organizations:

• Human Phenotype Project (HPP): Started profiling patients in 2026, collecting comprehensive data about medical history, nutrition, sleep habits, microbiome composition, and genetics to create a detailed picture of individual health profiles.
• M42 Healthcare Organization: Based in Abu Dhabi, M42 runs the EGP, manages hospitals across the UAE, and leads advanced environmental exposure monitoring to track how external factors affect health.
• Malaffi National Health Information Exchange: Provides longitudinal health data and patient outcomes across the UAE's entire healthcare system, enabling researchers to track health trajectories over time.

This convergence of genomic data, phenotypic information, environmental monitoring, and clinical records creates what researchers call a "unique mix of resources, research institutions, and population characteristics" that enables adaptive health implementation.

How Does Long-Read Sequencing Enable Better Epigenetic Understanding?

Oxford Nanopore long-read sequencing is critical to the adaptive health vision because it can distinguish between epigenetic changes that are inherited versus those caused by environmental factors. This distinction matters enormously for intervention. Inherited epigenetic marks may be harder to reverse, while acquired changes caused by diet, stress, or pollution can potentially be modified through behavioral or environmental interventions.

"ONT long-read sequencing can in theory be applied to human populations to identify genes and variants that are responsible for disease and epigenetic changes together at the same time," noted Andrew Feinberg, Bloomberg Distinguished Professor at Johns Hopkins University and co-author of the Nature Genetics article.

Andrew Feinberg, Bloomberg Distinguished Professor at Johns Hopkins University

Recent research led by Feinberg and David Threadgill, Distinguished Professor at Texas A&M University, used ONT long-read sequencing to examine DNA segments in the mouse genome. Their findings revealed that some epigenetic marks can be inherited in ways that break the century-old understanding of inheritance rules established by Gregor Mendel, suggesting that epigenetic inheritance is more complex and nuanced than previously understood.

What Would Adaptive Health Actually Look Like in Practice?

The adaptive health framework moves beyond static risk prediction toward what researchers call "actionable, mechanistically grounded intervention." Rather than telling a patient "you have a 40% risk of heart disease based on your genes," an adaptive health system would continuously monitor epigenetic changes, identify which ones are harmful, and recommend specific interventions to reverse them.

For example, if a patient's epigenome shows signs of harmful changes linked to poor diet or smoking, doctors could intervene early with targeted recommendations before disease develops. The system would track whether those interventions actually reverse the epigenetic changes, creating a feedback loop that personalizes treatment to each individual's biology.

"We want to understand the maladaptive epigenetic states and how we can restore them back to the healthy state," said Eduardo Beltrame. "We're excited about the UAE's potential for groundbreaking translational health research, the role MBZUAI is playing in the application of AI to analyze health data, and the potential impact this could have for patients."

Eduardo Beltrame, Assistant Professor of Computational Biology at MBZUAI

Implementing this vision requires artificial intelligence to analyze population-level health data at scale. MBZUAI researchers, including Beltrame and Eran Segal, Dean of the Biological and Life Sciences Division and Professor of Computational Biology at MBZUAI, are developing AI tools to process the massive datasets generated by genomic sequencing, phenotypic profiling, and clinical records.

Steps to Implement Adaptive Health in Healthcare Systems

• Establish Genomic Baselines: Sequence large populations to identify genetic variants and baseline epigenetic patterns, creating a reference dataset for comparison and risk stratification.
• Integrate Clinical Data: Link genomic and epigenetic profiles to electronic health records, environmental exposure data, and lifestyle information to create comprehensive patient profiles.
• Deploy AI Analysis: Use machine learning models to identify patterns in epigenetic changes, predict which modifications are harmful, and recommend interventions tailored to individual biology.
• Monitor and Iterate: Continuously track whether interventions reverse harmful epigenetic changes, using real-world outcomes to refine predictions and recommendations over time.

The UAE's infrastructure positions it to become a global leader in this emerging field. Shahrukh Hashmi, another co-author of the Nature Genetics article and Adjunct Professor of Personalized Medicine at MBZUAI, emphasized the importance of this integrated approach: "A crucial advantage to the EGP is the integration of genomics with the Malaffi national health information exchange along with M42, a global, technology-enabled healthcare organization, and cutting-edge universities including MBZUAI, Khalifa University, and NYU Abu Dhabi".

The adaptive health framework represents a fundamental shift in how medicine approaches disease. Rather than waiting for illness to develop and then treating it, healthcare systems could use continuous epigenetic monitoring and AI-driven analysis to prevent disease before it starts. For patients, this could mean earlier interventions, more personalized treatment, and better health outcomes. For researchers, it opens new avenues for understanding how genes, environment, and behavior interact to shape health across entire populations.