Guangxi Eco-Environmental Health and Aging Study (GEHAS)

PURPOSE: The Guangxi Eco-Environmental Health and Aging Study (GEHAS) was established to investigate the interplay between eco-environmental exposome, multi-omics profiles, and healthy ageing in a multi-ethnic subtropical population. This prospective cohort was designed to address knowledge gaps regarding how eco-environmental and lifestyle factors influence ageing trajectories. PARTICIPANTS: GEHAS enrolled 5645 participants (59.8% women; mean age 62.51 years) from Guilin, Guangxi, at baseline, with Yao and Han participants accounting for 60.3% and 36.2% of the cohort, respectively. Baseline data (2018-2022) included questionnaires, physical examinations, biological specimens (blood, urine, hair and nails). Two subsequently established longevity and circadian rhythm sub-cohorts (n=276 and n=596) underwent multi-omics profiling (genomics, epigenomics, proteomics, metabolomics and exposomics). Follow-up in this open cohort includes active surveys approximately every 5 years and annual passive surveillance through government health registries. FINDINGS TO DATE: Recent analyses highlight that improvements in air quality can mitigate frailty progression in older adults, with DNA methylation emerging as a promising biomarker that captures the biological imprint of environmental policy interventions and ageing dynamics. In parallel, local specialty foods and traditional dietary practices have been implicated as potential contributors to reducing the risk of ageing-related diseases, as demonstrated by multiple studies using baseline data. For instance, oil tea consumption has shown potential protective effects against dyslipidaemia and type 2 diabetes, while region-specific dietary patterns were associated with favourable health outcomes in middle-aged and older adults. Specifically, a dose-dependent association was observed between diets rich in vegetables and mushrooms and enhanced cognitive performance, and antioxidant-rich dietary patterns were found to attenuate biological ageing through modulation of redox homeostasis. Moreover, GEHAS studies also explored the interactions between genetic factors and heavy metal exposures in age-related diseases, underscoring the complex interplay between genetic susceptibility and environmental influences in the ageing process. FUTURE PLANS: GEHAS will continue active follow-up surveys every 5 years, supplemented by annual passive surveillance for morbidity and mortality through health registries. The first active follow-up was initiated in 2023 and will continue until 2026/2027, with subsequent rounds planned thereafter. In addition, targeted sub-cohorts, including longevity and circadian rhythm groups, will undergo repeated assessments to capture long-term changes in health, exposures and biological ageing.