Researchers to design toilet that could collect health data

Where on one side wearable, smart technologies are changing the way people monitor their health, a low-tech commodity, toilets are proving to outperform them all.

That's the conclusion of a team of metabolism scientists at the University of Wisconsin-Madison and the Morgridge Institute for Research, who are working to put the tremendous range of metabolic health information contained in urine to work for personalised medicine.

Urine contains a virtual liquid history of an individual's nutritional habits, exercise, medication use, sleep patterns, and other lifestyle choices.

Urine also contains metabolic links to more than 600 human conditions, including some of the major killers such as cancer, diabetes and kidney disease.

The team has two essential questions. First, can frequent monitoring and testing of urine samples glean useful real-time information about an individual's health?

And second, can a technology platform be adapted to toilets that can make the collection process simple, accurate and affordable?

They received some promising answers to the first question in a small pilot study conducted this year, the results of which were published in the issue of the journal -- Nature Digital Medicine.

Two research subjects consistently collected all urine samples over a 10-day period, submitted those samples for tests with both gas chromatography and mass spectrometry for a complete readout of metabolic signatures.

The two subjects also happen to be lead authors on the paper: Joshua Coon, the Thomas and Margaret Pyle Chair at the Morgridge Institute and UW-Madison professor of biomolecular chemistry and chemistry; and Ian Miller, a data scientist with the Coon Research Group.

The samples do indeed contain a remarkable health fingerprint that follows the ebbs and flows of daily life.

For example, the subjects kept records of coffee and alcohol consumption, and the biomarkers with a known connection to both those drinks were abundantly measured.

One subject took acetaminophen, which was measured in urine by a spike in ion intensity. The metabolic outputs from exercise and sleep also could be measured with precision.

"We know in the lab we can make these measurements," said Coon. "And we're pretty sure we can design a toilet that could sample urine. I think the real challenge is we're going to have to invest in engineering to make this instrument simple enough and cheap enough. That's where this will either go far or not happen at all."

While the pilot experiment didn't examine health questions, many possibilities exist.

For example, testing could show how an individual metabolises certain types of prescription drugs, in ways that could be healthy or dangerous.

Also, as the population gets older with more stay-at-home care, urine tests would indicate whether medications are being taken properly and having their intended effect.

Coon also believes the "smart toilet" concept could have major population health implications, not unlike the National Institutes of Health "All of Us" human genome database.

"If you had tens of thousands of users and you could correlate that data with health and lifestyle, you could then start to have real diagnostic capabilities," he said. It might provide early warning of viral or bacterial outbreaks.

Coon, who runs the National Centre for Quantitative Biology of Complex Systems, said the idea of meta-scale urine testing has intrigued him for some time.

"Josh mentioned this at a group meeting one time and it was met with laughter," Miller recalled. "I thought, you know, I kind of like the idea. I already track a lot of this stuff in my everyday life."

"So we went out and bought a couple of coolers and started collecting," added Coon.