Wearables have become the popular way to monitor various health parameters, but researchers are looking to the lowly toilet as a possible future means of obtaining and diagnosing health information. A team of metabolism scientists at the University of Wisconsin-Madison and the Morgridge Institute for Research are seeking to put the tremendous range of metabolic health information contained in urine to work for personalized medicine.

According to an article appearing on the University of Wisconsin-Madison site, 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 had 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?

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A pilot study conducted earlier this year, whose results were published in the November 11 issue of the journal Nature Digital Medicine, found that urine samples  collected over a 10-day period from two subjects yielded extensive data related to health biomarkers. 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 precisely measured.

The two subjects happened 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, data scientist with the Coon Research Group.

Encouraged by the results, the Coon Research Group is designing a toilet that will incorporate a portable mass spectrometer that can recognize the individual and process samples across various subjects. They plan to install the toilet in their research building and expand the user group to a dozen or more subjects.

"We know in the lab we can make these measurements," said Coon in the article. "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 the engineering to make this instrument simple enough and cheap enough. That's where this will either go far or not happen at all."

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 says. It might provide early warning of viral or bacterial outbreaks.

He added that the idea of metascale 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."