1 1710 124 DYSFUNCTIONAL IMMUNOMETABOLIC EFFECTS OF VITAMIN D DEFICIENCY, INCREASED CARDIOMETABOLIC RISK. POTENTIAL EPIDEMIOLOGICAL ALERT IN AMERICA? VITAMIN D DEFICIENCY IS A SERIOUS PUBLIC HEALTH PROBLEM WORLDWIDE THAT AFFECTS NOT ONLY SKELETAL HEALTH, BUT ALSO A WIDE RANGE OF ACUTE AND CHRONIC DISEASES. HOWEVER, THERE IS STILL SKEPTICISM BECAUSE OF THE LACK OF RANDOMIZED, CONTROLLED TRIALS TO SUPPORT ASSOCIATION STUDIES ON THE BENEFITS OF VITAMIN D FOR NON-SKELETAL HEALTH. THIS REVIEW WAS BASED ON ARTICLES PUBLISHED DURING THE 1980-2015 OBTAINED FROM THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS, MEDLINE AND PUBMED, AND FOCUSES ON RECENT CHALLENGES WITH REGARD TO THE DEFINITION OF VITAMIN D DEFICIENCY AND HOW TO ACHIEVE OPTIMAL SERUM 25-HYDROXYVITAMIN D LEVELS FROM DIETARY SOURCES, SUPPLEMENTS, AND SUN EXPOSURE. THE EFFECT OF VITAMIN D ON EPIGENETIC FETAL PROGRAMMING AND REGULATION OF GENES THAT MAY POTENTIALLY EXPLAIN WHY VITAMIN D COULD HAVE SUCH LIFELONG COMPREHENSIVE HEALTH BENEFITS IS REVIEWED. OPTIMIZATION OF VITAMIN D LEVELS IN CHILDREN AND ADULTS AROUND THE WORLD HAS POTENTIAL BENEFITS TO IMPROVE SKELETAL HEALTH AND TO REDUCE THE RISK OF CHRONIC DISEASES, INCLUDING SOME TYPES OF CANCER, AUTOIMMUNE DISEASES, INFECTIOUS DISEASES, TYPE 2 DIABETES MELLITUS, AND SEVERE CARDIOVASCULAR DISORDERS SUCH AS ATHEROTHROMBOSIS, NEUROCOGNITIVE DISORDERS, AND MORTALITY. 2017 2 6725 39 VITAMIN D: NOT JUST BONE METABOLISM BUT A KEY PLAYER IN CARDIOVASCULAR DISEASES. VITAMIN D IS THE FIRST ITEM OF DRUG EXPENDITURE FOR THE TREATMENT OF OSTEOPOROSIS. ITS DEFICIENCY IS A CONDITION THAT AFFECTS NOT ONLY OLDER INDIVIDUALS BUT ALSO YOUNG PEOPLE. RECENTLY, THE SCIENTIFIC COMMUNITY HAS FOCUSED ITS ATTENTION ON THE POSSIBLE ROLE OF VITAMIN D IN THE DEVELOPMENT OF SEVERAL CHRONIC DISEASES SUCH AS CARDIOVASCULAR AND METABOLIC DISEASES. THIS REVIEW AIMS TO HIGHLIGHT THE POSSIBLE ROLE OF VITAMIN D IN CARDIOVASCULAR AND METABOLIC DISEASES. IN PARTICULAR, HERE WE EXAMINE (1) THE ROLE OF VITAMIN D IN DIABETES MELLITUS, METABOLIC SYNDROME, AND OBESITY, AND ITS INFLUENCE ON INSULIN SECRETION; (2) ITS ROLE IN ATHEROSCLEROSIS, IN WHICH CHRONIC VITAMIN D DEFICIENCY, LOWER THAN 20 NG/ML (50 NMOL/L), HAS EMERGED AMONG THE NEW RISK FACTORS; (3) THE ROLE OF VITAMIN D IN ESSENTIAL HYPERTENSION, IN WHICH LOW PLASMA LEVELS OF VITAMIN D HAVE BEEN ASSOCIATED WITH BOTH AN INCREASE IN THE PREVALENCE OF HYPERTENSION AND DIASTOLIC HYPERTENSION; (4) THE ROLE OF VITAMIN D IN PERIPHERAL ARTERIOPATHIES AND ANEURYSMAL PATHOLOGY, REPORTING THAT PATIENTS WITH PERIPHERAL ARTERY DISEASES HAD LOWER VITAMIN D VALUES THAN NON-SUFFERING PAD CONTROLS; (5) THE GENETIC AND EPIGENETIC ROLE OF VITAMIN D, HIGHLIGHTING ITS TRANSCRIPTIONAL REGULATION CAPACITY; AND (6) THE ROLE OF VITAMIN D IN CARDIAC REMODELING AND DISEASE. DESPITE THE MANY OBSERVATIONAL STUDIES AND META-ANALYSES SUPPORTING THE CRITICAL ROLE OF VITAMIN D IN CARDIOVASCULAR PHYSIOPATHOLOGY, CLINICAL TRIALS DESIGNED TO EVALUATE THE SPECIFIC ROLE OF VITAMIN D IN CARDIOVASCULAR DISEASE ARE SCARCE. THE CHARACTERIZATION OF THE IMPORTANCE OF VITAMIN D AS A MARKER OF PATHOLOGY SHOULD REPRESENT A FUTURE RESEARCH CHALLENGE. 2021 3 6718 39 VITAMIN D AND CARDIOVASCULAR DISEASES: CAUSALITY. VITAMIN D REGULATES BLOOD PRESSURE, CARDIAC FUNCTIONS, AND ENDOTHELIAL AND SMOOTH MUSCLE CELL FUNCTIONS, THUS, PLAYING AN IMPORTANT ROLE IN CARDIOVASCULAR HEALTH. OBSERVATIONAL STUDIES REPORT ASSOCIATIONS BETWEEN VITAMIN D DEFICIENCY WITH HYPERTENSION AND CARDIOVASCULAR-RELATED DEATHS. PEER-REVIEWED PAPERS WERE EXAMINED IN SEVERAL RESEARCH DATABASES AS PER THE GUIDELINES OF THE PREFERRED REPORTING ITEMS FOR SYSTEMATIC REVIEWS, USING KEY WORDS THAT ADDRESS THE RELATIONSHIP BETWEEN VITAMIN D AND CARDIOVASCULAR DISEASE. CORRELATIONS AND INTERPRETATIONS WERE MADE CONSIDERING THE RISKS-BENEFITS, BROADER EVIDENCE, AND IMPLICATIONS. THIS REVIEW ANALYZED CURRENT KNOWLEDGE REGARDING THE EFFECTS OF VITAMIN D ON THE CARDIOVASCULAR SYSTEM. 1,25(OH)(2)D AND RELATED EPIGENETIC MODIFICATIONS SUBDUE CELLULAR INFLAMMATION, IMPROVE OVERALL ENDOTHELIAL FUNCTIONS, REDUCE AGE-RELATED SYSTOLIC HYPERTENSION AND VASCULAR RIGIDITY, AND ATTENUATE THE ACTIONS OF THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM. MOST OBSERVATIONAL AND ECOLOGICAL STUDIES SUPPORT 25(OH)VITAMIN D HAVING PROTECTIVE EFFECTS ON THE CARDIOVASCULAR SYSTEM. HOWEVER, THE ASSOCIATION OF VITAMIN D DEFICIENCY WITH CARDIOVASCULAR DISEASES IS BASED PRIMARILY ON OBSERVATIONAL AND ECOLOGICAL STUDIES AND THUS, IS A MATTER OF CONTROVERSY. ADEQUATELY POWERED, RANDOMIZED CONTROLLED CLINICAL TRIAL DATA ARE NOT AVAILABLE TO CONFIRM THESE ASSOCIATIONS. THUS, TO TEST THE HYPOTHESIS THAT CORRECTION OF VITAMIN D DEFICIENCY PROTECTS THE CARDIOVASCULAR SYSTEM, WELL-DESIGNED, STATISTICALLY POWERED, LONGER-TERM CLINICAL TRIALS ARE NEEDED IN PERSONS WITH VITAMIN D DEFICIENCY. NEVERTHELESS, THE AVAILABLE DATA SUPPORT THAT ADEQUATE VITAMIN D SUPPLEMENTATION AND/OR SENSIBLE SUNLIGHT EXPOSURE TO ACHIEVE OPTIMAL VITAMIN D STATUS ARE IMPORTANT IN THE PREVENTION OF CARDIOVASCULAR DISEASE AND OTHER CHRONIC DISEASES. 2018 4 4855 42 OPTIMIZE DIETARY INTAKE OF VITAMIN D: AN EPIGENETIC PERSPECTIVE. PURPOSE OF REVIEW: VITAMIN D HAS RECEIVED GLOBAL ATTENTION BECAUSE OF ITS MANY HEALTH BENEFITS. ALTHOUGH THERE IS GENERAL AGREEMENT ABOUT THE IMPORTANCE OF VITAMIN D FOR BONE HEALTH, THERE REMAINS SKEPTICISM ABOUT THE NONSKELETAL HEALTH BENEFITS OF VITAMIN D. THIS REVIEW WILL NOT ONLY FOCUS ON THE VITAMIN D DEFICIENCY PANDEMIC AND WAYS TO TREAT AND PREVENT VITAMIN D DEFICIENCY BUT WILL ALSO EXPLORE THE EPIGENETIC MECHANISMS OF VITAMIN D THAT COULD HELP EXPLAIN MANY OF THE NONSKELETAL BENEFITS OF ENHANCING VITAMIN D STATUS. RECENT FINDINGS: THE INSTITUTE OF MEDICINE AND THE ENDOCRINE SOCIETY HAVE MADE NEW RECOMMENDATIONS FOR VITAMIN D INTAKE TO PREVENT VITAMIN D DEFICIENCY. VITAMIN D DEFICIENCY IS DEFINED AS A 25-HYDROXYVITAMIN D LEVEL BELOW 20 NG/ML AND VITAMIN D INSUFFICIENCY IS DEFINED AS 21-29 NG/ML. RECENT OBSERVATIONS HAVE SUGGESTED THAT VITAMIN D CAN INFLUENCE EPIGENETICS WHICH MAY HELP EXPLAIN THE NONSKELETAL HEALTH BENEFITS THAT HAVE BEEN REPORTED FOR VITAMIN D. SUMMARY: THERE IS GENERAL AGREEMENT THAT VITAMIN D DEFICIENCY IS A WORLDWIDE HEALTH PROBLEM. THIS IS DUE IN PART TO THE LACK OF APPRECIATION THAT SUNLIGHT IS AN IMPORTANT SOURCE OF VITAMIN D. THERE IS NO DOWNSIDE TO INCREASING VITAMIN D INTAKE AND RECENT OBSERVATIONS SUGGESTING THAT VITAMIN D INFLUENCES EPIGENETICS PROVIDE A NEW INSIGHT FOR THE IMPORTANCE OF VITAMIN D IN UTERO IN REDUCING RISK OF CHRONIC DISEASES LATER IN LIFE. 2012 5 6259 29 THE MOLECULAR MECHANISMS BY WHICH VITAMIN D PREVENTS INSULIN RESISTANCE AND ASSOCIATED DISORDERS. NUMEROUS STUDIES HAVE SHOWN THAT VITAMIN D DEFICIENCY IS VERY COMMON IN MODERN SOCIETIES AND IS PERCEIVED AS AN IMPORTANT RISK FACTOR IN THE DEVELOPMENT OF INSULIN RESISTANCE AND RELATED DISEASES SUCH AS OBESITY AND TYPE 2 DIABETES (T2DM). WHILE IT IS GENERALLY ACCEPTED THAT VITAMIN D IS A REGULATOR OF BONE HOMEOSTASIS, ITS ABILITY TO COUNTERACT INSULIN RESISTANCE IS SUBJECT TO DEBATE. THE GOAL OF THIS COMMUNICATION IS TO REVIEW THE MOLECULAR MECHANISM BY WHICH VITAMIN D REDUCES INSULIN RESISTANCE AND RELATED COMPLICATIONS. THE UNIVERSITY LIBRARY, PUBMED, AND GOOGLE SCHOLAR WERE SEARCHED TO FIND RELEVANT STUDIES TO BE SUMMARIZED IN THIS REVIEW ARTICLE. INSULIN RESISTANCE IS ACCOMPANIED BY CHRONIC HYPERGLYCAEMIA AND INFLAMMATION. RECENT STUDIES HAVE SHOWN THAT VITAMIN D EXHIBITS INDIRECT ANTIOXIDATIVE PROPERTIES AND PARTICIPATES IN THE MAINTENANCE OF NORMAL RESTING ROS LEVEL. APPEALINGLY, VITAMIN D REDUCES INFLAMMATION AND REGULATES CA(2+) LEVEL IN MANY CELL TYPES. THEREFORE, THE BENEFICIAL ACTIONS OF VITAMIN D INCLUDE DIMINISHED INSULIN RESISTANCE WHICH IS OBSERVED AS AN IMPROVEMENT OF GLUCOSE AND LIPID METABOLISM IN INSULIN-SENSITIVE TISSUES. 2020 6 2584 35 EPIGENETICS OF OBESITY. OBESITY IS A METABOLIC DISEASE, WHICH IS BECOMING AN EPIDEMIC HEALTH PROBLEM: IT HAS BEEN RECENTLY DEFINED IN TERMS OF GLOBAL PANDEMIC. OVER THE YEARS, THE APPROACHES THROUGH FAMILY, TWINS AND ADOPTION STUDIES LED TO THE IDENTIFICATION OF SOME CAUSAL GENES IN MONOGENIC FORMS OF OBESITY BUT THE ORIGINS OF THE PANDEMIC OF OBESITY CANNOT BE CONSIDERED ESSENTIALLY DUE TO GENETIC FACTORS, BECAUSE HUMAN GENOME IS NOT LIKELY TO CHANGE IN JUST A FEW YEARS. EPIGENETIC STUDIES HAVE OFFERED IN RECENT YEARS VALUABLE TOOLS FOR THE UNDERSTANDING OF THE WORLDWIDE SPREAD OF THE PANDEMIC OF OBESITY. THE INVOLVEMENT OF EPIGENETIC MODIFICATIONS-DNA METHYLATION, HISTONE TAILS, AND MIRNAS MODIFICATIONS-IN THE DEVELOPMENT OF OBESITY IS MORE AND MORE EVIDENT. IN THE EPIGENETIC LITERATURE, THERE ARE EVIDENCES THAT THE ENTIRE EMBRYO-FETAL AND PERINATAL PERIOD OF DEVELOPMENT PLAYS A KEY ROLE IN THE PROGRAMMING OF ALL HUMAN ORGANS AND TISSUES. THEREFORE, THE MOLECULAR MECHANISMS INVOLVED IN THE EPIGENETIC PROGRAMMING REQUIRE A NEW AND GENERAL PATHOGENIC PARADIGM, THE DEVELOPMENTAL ORIGINS OF HEALTH AND DISEASE THEORY, TO EXPLAIN THE CURRENT EPIDEMIOLOGICAL TRANSITION, THAT IS, THE WORLDWIDE INCREASE OF CHRONIC, DEGENERATIVE, AND INFLAMMATORY DISEASES SUCH AS OBESITY, DIABETES, CARDIOVASCULAR DISEASES, NEURODEGENERATIVE DISEASES, AND CANCER. OBESITY AND ITS RELATED COMPLICATIONS ARE MORE AND MORE ASSOCIATED WITH ENVIRONMENTAL POLLUTANTS (OBESOGENS), GUT MICROBIOTA MODIFICATIONS AND UNBALANCED FOOD INTAKE, WHICH CAN INDUCE, THROUGH EPIGENETIC MECHANISMS, WEIGHT GAIN, AND ALTERED METABOLIC CONSEQUENCES. 2016 7 3577 38 IMPACT OF NUTRITION ON TELOMERE HEALTH: SYSTEMATIC REVIEW OF OBSERVATIONAL COHORT STUDIES AND RANDOMIZED CLINICAL TRIALS. DIET, PHYSICAL ACTIVITY, AND OTHER LIFESTYLE FACTORS HAVE BEEN IMPLICATED IN THE PATHOPHYSIOLOGY OF SEVERAL CHRONIC DISEASES, BUT ALSO IN A LOWER TOTAL MORTALITY AND LONGER LIFE EXPECTANCY. ONE OF THE MECHANISMS IN WHICH DIET CAN REDUCE THE RISK OF DISEASE IS WITH REGARD TO ITS IMPACT ON TELOMERES. TELOMERE LENGTH (TL) IS HIGHLY CORRELATED TO CHRONOLOGICAL AGE AND METABOLIC STATUS. INDIVIDUALS WITH SHORTER TELOMERES ARE AT HIGHER RISK OF CHRONIC DISEASES AND MORTALITY. DIET MAY INFLUENCE TL BY SEVERAL MECHANISMS SUCH AS REGULATING OXIDATIVE STRESS AND INFLAMMATION OR MODULATING EPIGENETIC REACTIONS. THE PRESENT SYSTEMATIC REVIEW AIMS TO EXAMINE THE RESULTS FROM EPIDEMIOLOGIC AND CLINICAL TRIALS CONDUCTED IN HUMANS EVALUATING THE ROLE OF NUTRIENTS, FOOD GROUPS, AND DIETARY PATTERNS ON TL. WE ALSO DISCUSS THE POSSIBLE MECHANISMS OF ACTION THAT INFLUENCE THIS PROCESS, WITH THE PERSPECTIVE THAT TL COULD BE A NOVEL BIOMARKER INDICATING THE RISK OF METABOLIC DISTURBANCES AND AGE-RELATED DISEASES. THE AVAILABLE EVIDENCE SUGGESTS THAT SOME ANTIOXIDANT NUTRIENTS, THE CONSUMPTION OF FRUITS AND VEGETABLES, AND MEDITERRANEAN DIET ARE MAINLY ASSOCIATED WITH LONGER TELOMERES. HOWEVER, MOST OF THE EVIDENCE IS BASED ON HIGH HETEROGENIC OBSERVATIONAL STUDIES AND VERY FEW RANDOMIZED CLINICAL TRIALS (RCTS). THEREFORE, THE ASSOCIATIONS SUMMARIZED IN THE PRESENT REVIEW NEED TO BE CONFIRMED WITH LARGER PROSPECTIVE COHORT STUDIES AND BETTER-DESIGNED RCTS. 2020 8 5605 32 ROUTINE ASSESSMENT AND PROMOTION OF PHYSICAL ACTIVITY IN HEALTHCARE SETTINGS: A SCIENTIFIC STATEMENT FROM THE AMERICAN HEART ASSOCIATION. PHYSICAL INACTIVITY IS ONE OF THE MOST PREVALENT MAJOR HEALTH RISK FACTORS, WITH 8 IN 10 US ADULTS NOT MEETING AEROBIC AND MUSCLE-STRENGTHENING GUIDELINES, AND IS ASSOCIATED WITH A HIGH BURDEN OF CARDIOVASCULAR DISEASE. IMPROVING AND MAINTAINING RECOMMENDED LEVELS OF PHYSICAL ACTIVITY LEADS TO REDUCTIONS IN METABOLIC, HEMODYNAMIC, FUNCTIONAL, BODY COMPOSITION, AND EPIGENETIC RISK FACTORS FOR NONCOMMUNICABLE CHRONIC DISEASES. PHYSICAL ACTIVITY ALSO HAS A SIGNIFICANT ROLE, IN MANY CASES COMPARABLE OR SUPERIOR TO DRUG INTERVENTIONS, IN THE PREVENTION AND MANAGEMENT OF >40 CONDITIONS SUCH AS DIABETES MELLITUS, CANCER, CARDIOVASCULAR DISEASE, OBESITY, DEPRESSION, ALZHEIMER DISEASE, AND ARTHRITIS. WHEREAS MOST OF THE MODIFIABLE CARDIOVASCULAR DISEASE RISK FACTORS INCLUDED IN THE AMERICAN HEART ASSOCIATION'S MY LIFE CHECK - LIFE'S SIMPLE 7 ARE EVALUATED ROUTINELY IN CLINICAL PRACTICE (GLUCOSE AND LIPID PROFILES, BLOOD PRESSURE, OBESITY, AND SMOKING), PHYSICAL ACTIVITY IS TYPICALLY NOT ASSESSED. THE PURPOSE OF THIS STATEMENT IS TO PROVIDE A COMPREHENSIVE REVIEW OF THE EVIDENCE ON THE FEASIBILITY, VALIDITY, AND EFFECTIVENESS OF ASSESSING AND PROMOTING PHYSICAL ACTIVITY IN HEALTHCARE SETTINGS FOR ADULT PATIENTS. IT ALSO ADDS CONCRETE RECOMMENDATIONS FOR HEALTHCARE SYSTEMS, CLINICAL AND COMMUNITY CARE PROVIDERS, FITNESS PROFESSIONALS, THE TECHNOLOGY INDUSTRY, AND OTHER STAKEHOLDERS IN ORDER TO CATALYZE INCREASED ADOPTION OF PHYSICAL ACTIVITY ASSESSMENT AND PROMOTION IN HEALTHCARE SETTINGS AND TO CONTRIBUTE TO MEETING THE AMERICAN HEART ASSOCIATION'S 2020 IMPACT GOALS. 2018 9 2881 34 FUTURE PERSPECTIVES OF PERSONALIZED WEIGHT LOSS INTERVENTIONS BASED ON NUTRIGENETIC, EPIGENETIC, AND METAGENOMIC DATA. AS OBESITY HAS BECOME A MAJOR GLOBAL PUBLIC HEALTH CHALLENGE, A LARGE NUMBER OF STUDIES HAVE ANALYZED DIFFERENT STRATEGIES AIMED AT INDUCING A NEGATIVE ENERGY BALANCE AND, CONSEQUENTLY, BODY WEIGHT LOSS. HOWEVER, MOST EXISTING WEIGHT LOSS PROGRAMS ARE GENERALLY UNSUCCESSFUL, SO SEVERAL INTERVENTIONS HAVE BEEN CARRIED OUT TO IDENTIFY PHYSIOLOGIC AND BEHAVIORAL FACTORS CONCERNING THIS VARIABILITY IN ORDER TO IMPLEMENT MORE PERSONALIZED TREATMENT. NOWADAYS, AN INDIVIDUALIZED APPROACH IS BEING PROPOSED THROUGH SO-CALLED PERSONALIZED NUTRITION, WHEREBY NOT ONLY THE PHENOTYPE BUT ALSO THE GENOTYPE IS USED FOR CUSTOMIZED NUTRITION TREATMENT. REGARDING BODY WEIGHT REGULATION, APPROXIMATELY 70 POLYMORPHISMS HAVE BEEN IDENTIFIED IN OR NEAR GENES RELATED TO ENERGY EXPENDITURE, APPETITE, ADIPOGENESIS, INSULIN RESISTANCE, AND LIPID METABOLISM. ALTHOUGH PERSONALIZED NUTRITION REFERS MAINLY TO GENETIC MAKEUP, RECENT ADVANCES IN THE INVESTIGATION OF THE EPIGENOME AND THE MICROBIOME OPEN THE DOOR TO IMPLEMENT MORE PERSONALIZED RECOMMENDATIONS FOR BODY WEIGHT MANAGEMENT. IN THIS CONTEXT, RECENT STUDIES HAVE DEMONSTRATED THE EXISTENCE OF SEVERAL EPIGENETIC MARKERS THAT MAY MODIFY GENE EXPRESSION AND COULD BE INVOLVED IN THE OUTCOME OF WEIGHT LOSS INTERVENTIONS. MOREOVER, DIFFERENT STUDIES HAVE SHOWN THAT DIETARY INTERVENTIONS COULD AFFECT THE COMPOSITION OF GUT MICROBIOTA AND HAVE AN IMPACT ON BODY WEIGHT. THE INTEGRATION OF NUTRIGENETIC, EPIGENETIC, AND METAGENOMIC DATA MAY LEAD TO THE DESIGN OF MORE PERSONALIZED DIETARY TREATMENTS TO PREVENT CHRONIC DISEASES AND TO OPTIMIZE THE INDIVIDUAL'S RESPONSE TO DIETARY INTERVENTIONS. 2015 10 4280 24 MICRONUTRIENTS IN EARLY LIFE AND OFFSPRING METABOLIC HEALTH PROGRAMMING: A PROMISING TARGET FOR PREVENTING NON-COMMUNICABLE DISEASES. CHRONIC NON-COMMUNICABLE DISEASES ARE THE LEADING CAUSE OF MORBIDITY AND MORTALITY WORLDWIDE. DEVELOPING AND IMPLEMENTING EFFECTIVE PREVENTIVE STRATEGIES IS THE BEST WAY TO ENSURE THE OVERALL METABOLIC HEALTH STATUS OF THE POPULATION AND TO COUNTER THE GLOBAL BURDEN OF NON-COMMUNICABLE DISEASES. PREDISPOSITION TO OBESITY AND OTHER NON-COMMUNICABLE DISEASES IS DUE TO A COMBINATION OF GENETIC AND ENVIRONMENTAL FACTORS THROUGHOUT LIFE, BUT THE EARLY ENVIRONMENT, PARTICULARLY THE ENVIRONMENT DURING THE FETAL PERIOD AND THE EARLY YEARS OF LIFE, IS CRUCIAL IN DETERMINING METABOLIC HEALTH, HENCE THE CONCEPT OF 'FETAL PROGRAMMING'. THE ORIGINS OF THIS CAUSAL LINK BETWEEN ENVIRONMENTAL FACTORS AND DISEASE LIE IN EPIGENETIC MECHANISMS. AMONG THE ENVIRONMENTAL FACTORS, DIET PLAYS A CRUCIAL ROLE IN THIS PROCESS. SUBSTANTIAL EVIDENCE DOCUMENTED THE KEY ROLE OF MACRONUTRIENTS IN THE PROGRAMMING OF METABOLIC DISEASES EARLY IN LIFE. RECENTLY, THE EFFECT OF MATERNAL MICRONUTRIENT INTAKE ON OFFSPRING METABOLIC HEALTH IN LATER LIFE EMERGED. THE PURPOSE OF THIS NARRATIVE REVIEW IS TO BRING TO LIGHT AVAILABLE EVIDENCE IN THE LITERATURE ON THE EFFECT OF MATERNAL MICRONUTRIENT STATUS ON OFFSPRING METABOLIC HEALTH AND UNDERLYING EPIGENETIC MECHANISMS THAT DRIVE THIS LINK TO HIGHLIGHT ITS POTENTIAL ROLE IN THE PREVENTION OF NON-COMMUNICABLE DISEASES. 2023 11 1372 38 DEVELOPMENTAL ORIGINS OF METABOLIC DISEASES. ALMOST 2 BILLION ADULTS IN THE WORLD ARE OVERWEIGHT, AND MORE THAN HALF OF THEM ARE CLASSIFIED AS OBESE, WHILE NEARLY ONE-THIRD OF CHILDREN GLOBALLY EXPERIENCE POOR GROWTH AND DEVELOPMENT. GIVEN THE VAST AMOUNT OF KNOWLEDGE THAT HAS BEEN GLEANED FROM DECADES OF RESEARCH ON GROWTH AND DEVELOPMENT, A NUMBER OF QUESTIONS REMAIN AS TO WHY THE WORLD IS NOW IN THE MIDST OF A GLOBAL EPIDEMIC OF OBESITY ACCOMPANIED BY THE "DOUBLE BURDEN OF MALNUTRITION," WHERE OVERWEIGHT COEXISTS WITH UNDERWEIGHT AND MICRONUTRIENT DEFICIENCIES. THIS CHALLENGE TO THE HUMAN CONDITION CAN BE ATTRIBUTED TO NUTRITIONAL AND ENVIRONMENTAL EXPOSURES DURING PREGNANCY THAT MAY PROGRAM A FETUS TO HAVE A HIGHER RISK OF CHRONIC DISEASES IN ADULTHOOD. TO EXPLORE THIS CONCEPT, FREQUENTLY CALLED THE DEVELOPMENTAL ORIGINS OF HEALTH AND DISEASE (DOHAD), THIS REVIEW CONSIDERS A HOST OF FACTORS AND PHYSIOLOGICAL MECHANISMS THAT DRIVE A FETUS OR CHILD TOWARD A HIGHER RISK OF OBESITY, FATTY LIVER DISEASE, HYPERTENSION, AND/OR TYPE 2 DIABETES (T2D). TO THAT END, THIS REVIEW EXPLORES THE EPIDEMIOLOGY OF DOHAD WITH DISCUSSIONS FOCUSED ON ADAPTATIONS TO HUMAN ENERGETICS, PLACENTAL DEVELOPMENT, DYSMETABOLISM, AND KEY ENVIRONMENTAL EXPOSURES THAT ACT TO PROMOTE CHRONIC DISEASES IN ADULTHOOD. THESE AREAS ARE COMPLEMENTARY AND ADDITIVE IN UNDERSTANDING HOW PROVIDING THE BEST CONDITIONS FOR OPTIMAL GROWTH CAN CREATE THE BEST POSSIBLE CONDITIONS FOR LIFELONG HEALTH. MOREOVER, UNDERSTANDING BOTH PHYSIOLOGICAL AS WELL AS EPIGENETIC AND MOLECULAR MECHANISMS FOR DOHAD IS VITAL TO MOST FULLY ADDRESS THE GLOBAL ISSUES OF OBESITY AND OTHER CHRONIC DISEASES. 2021 12 5377 34 RECENT FINDINGS IN ALZHEIMER DISEASE AND NUTRITION FOCUSING ON EPIGENETICS. ALZHEIMER DISEASE (AD) IS A CHRONIC NEURODEGENERATIVE DISEASE WITH NO EFFECTIVE CURE SO FAR. THE CURRENT REVIEW FOCUSES ON THE EPIGENETIC MECHANISMS OF AD AND HOW NUTRITION CAN INFLUENCE THE COURSE OF THIS DISEASE THROUGH REGULATION OF GENE EXPRESSION, ACCORDING TO THE LATEST SCIENTIFIC FINDINGS. THE SEARCH STRATEGY WAS THE USE OF SCIENTIFIC DATABASES SUCH AS PUBMED AND SCOPUS IN ORDER TO FIND RELATIVE RESEARCH OR REVIEW ARTICLES PUBLISHED IN THE YEARS 2012-2015. BY SHOWING THE LATEST DATA OF VARIOUS NUTRITIONAL COMPOUNDS, THIS STUDY AIMS TO STIMULATE THE SCIENTIFIC COMMUNITY TO RECOGNIZE THE VALUE OF NUTRITION IN THIS SUBJECT. EPIGENETICS IS BECOMING A VERY ATTRACTIVE SUBJECT FOR RESEARCHERS BECAUSE IT CAN SHED LIGHT ON UNKNOWN ASPECTS OF COMPLEX DISEASES LIKE AD. DNA METHYLATION, HISTONE MODIFICATIONS, AND MICRORNAS ARE THE PRINCIPAL EPIGENETIC MECHANISMS INVOLVED IN AD PATHOPHYSIOLOGY. NUTRITION IS AN ENVIRONMENTAL FACTOR THAT IS RELATED TO AD THROUGH EPIGENETIC PATHWAYS. VITAMIN B-12, FOR INSTANCE, CAN ALTER THE ONE-CARBON METABOLISM AND THUS INTERFERE IN THE DNA METHYLATION PROCESS. THE RESEARCH RESULTS MIGHT SEEM AMBIGUOUS ABOUT THE CLINICAL ROLE OF NUTRITION, BUT THERE IS STRENGTHENING EVIDENCE THAT PROPER NUTRITION CAN NOT ONLY CHANGE EPIGENETIC BIOMARKER LEVELS BUT ALSO PREVENT THE DEVELOPMENT OF LATE-ONSET AD AND ATTENUATE COGNITION DEFICIT. NUTRITION MIGHT GROW TO BECOME A PREVENTIVE AND EVEN THERAPEUTIC ALTERNATIVE AGAINST AD, ESPECIALLY IF COMBINED WITH OTHER ANTIDEMENTIA INTERVENTIONS, BRAIN EXERCISE, PHYSICAL TRAINING, ETC. EPIGENETIC BIOMARKERS CAN BE A VERY HELPFUL TOOL TO HELP RESEARCHERS FIND THE EXACT NUTRIENTS NEEDED TO CREATE SPECIFIC REMEDIES, AND PERHAPS THE SAME BIOMARKERS CAN BE USED EVEN IN PATIENT SCREENING IN THE FUTURE. 2016 13 2226 33 EPIGENETIC MODIFICATIONS INDUCED BY NUTRIENTS IN EARLY LIFE PHASES: GENDER DIFFERENCES IN METABOLIC ALTERATION IN ADULTHOOD. METABOLIC CHRONIC DISEASES, ALSO NAMED NONCOMMUNICABLE DISEASES (NCDS), ARE CONSIDERED MULTIFACTORIAL PATHOLOGIES, WHICH ARE DRAMATICALLY INCREASED DURING THE LAST DECADES. NONCOMMUNICABLE DISEASES SUCH AS CARDIOVASCULAR DISEASES, OBESITY, DIABETES MELLITUS, CANCERS, AND CHRONIC RESPIRATORY DISEASES MARKEDLY INCREASE MORBIDITY, MORTALITY, AND SOCIOECONOMIC COSTS. MOREOVER, NCDS INDUCE SEVERAL AND COMPLEX CLINICAL MANIFESTATIONS THAT LEAD TO A GRADUAL DETERIORATION OF HEALTH STATUS AND QUALITY OF LIFE OF AFFECTED INDIVIDUALS. MULTIPLE FACTORS ARE INVOLVED IN THE DEVELOPMENT AND PROGRESSION OF THESE DISEASES SUCH AS SEDENTARY BEHAVIOR, SMOKING, POLLUTION, AND UNHEALTHY DIET. INDEED, NUTRITION HAS A PIVOTAL ROLE IN MAINTAINING HEALTH, AND DIETARY IMBALANCES REPRESENT MAJOR DETERMINANTS FAVORING CHRONIC DISEASES THROUGH METABOLIC HOMEOSTASIS ALTERATIONS. IN PARTICULAR, IT APPEARS THAT SPECIFIC NUTRIENTS AND ADEQUATE NUTRITION ARE IMPORTANT IN ALL PERIODS OF LIFE, BUT THEY ARE ESSENTIAL DURING SPECIFIC TIMES IN EARLY LIFE SUCH AS PRENATAL AND POSTNATAL PHASES. INDEED, EPIDEMIOLOGIC AND EXPERIMENTAL STUDIES REPORT THE DELETERIOUS EFFECTS OF AN INCORRECT NUTRITION ON HEALTH STATUS SEVERAL DECADES LATER IN LIFE. DURING THE LAST DECADE, A GROWING INTEREST ON THE POSSIBLE ROLE OF EPIGENETIC MECHANISMS AS LINK BETWEEN NUTRITIONAL IMBALANCES AND NCDS DEVELOPMENT HAS BEEN OBSERVED. FINALLY, BECAUSE OF THE PIVOTAL ROLE OF THE HORMONES IN FAT, CARBOHYDRATE, AND PROTEIN METABOLISM REGULATION THROUGHOUT LIFE, IT IS EXPECTED THAT ANY HORMONAL MODIFICATION OF THESE PROCESSES CAN IMBALANCE METABOLISM AND FAT STORAGE. THEREFORE, A PARTICULAR INTEREST TO SEVERAL CHEMICALS ABLE TO ACT AS ENDOCRINE DISRUPTORS HAS BEEN RECENTLY DEVELOPED. IN THIS REVIEW, WE WILL PROVIDE AN OVERVIEW AND DISCUSS THE EPIGENETIC ROLE OF SOME SPECIFIC NUTRIENTS AND CHEMICALS IN THE MODULATION OF PHYSIOLOGICAL AND PATHOLOGICAL MECHANISMS. 2019 14 5076 30 PHYSIOLOGICAL AND ENVIRONMENTAL FACTORS AFFECTING CANCER RISK AND PROGNOSIS IN OBESITY. OBESITY RESULTS FROM A CHRONIC EXCESSIVE ACCUMULATION OF ADIPOSE TISSUE DUE TO A LONG-TERM IMBALANCE BETWEEN ENERGY INTAKE AND EXPENDITURE. AVAILABLE EPIDEMIOLOGICAL AND CLINICAL DATA STRONGLY SUPPORT THE LINKS BETWEEN OBESITY AND CERTAIN CANCERS. EMERGING CLINICAL AND EXPERIMENTAL FINDINGS HAVE IMPROVED OUR UNDERSTANDING OF THE ROLES OF KEY PLAYERS IN OBESITY-ASSOCIATED CARCINOGENESIS SUCH AS AGE, SEX (MENOPAUSE), GENETIC AND EPIGENETIC FACTORS, GUT MICROBIOTA AND METABOLIC FACTORS, BODY SHAPE TRAJECTORY OVER LIFE, DIETARY HABITS, AND GENERAL LIFESTYLE. IT IS NOW WIDELY ACCEPTED THAT THE CANCER-OBESITY RELATIONSHIP DEPENDS ON THE SITE OF CANCER, THE SYSTEMIC INFLAMMATORY STATUS, AND MICRO ENVIRONMENTAL PARAMETERS SUCH AS LEVELS OF INFLAMMATION AND OXIDATIVE STRESS IN TRANSFORMING TISSUES. WE HEREBY REVIEW RECENT ADVANCES IN OUR UNDERSTANDING OF CANCER RISK AND PROGNOSIS IN OBESITY WITH RESPECT TO THESE PLAYERS. WE HIGHLIGHT HOW THE LACK OF THEIR CONSIDERATION CONTRIBUTED TO THE CONTROVERSY OVER THE LINK BETWEEN OBESITY AND CANCER IN EARLY EPIDEMIOLOGICAL STUDIES. FINALLY, THE LESSONS AND CHALLENGES OF INTERVENTIONS FOR WEIGHT LOSS AND BETTER CANCER PROGNOSIS, AND THE MECHANISMS OF WEIGHT GAIN IN SURVIVORS ARE ALSO DISCUSSED. 2023 15 1409 27 DIETARY INTERVENTIONS AND NUTRITIONAL FACTORS IN THE PREVENTION OF PEDIATRIC ASTHMA. ASTHMA IS THE MOST FREQUENT CHRONIC DISEASE IN CHILDREN, AND ITS PATHOGENESIS INVOLVES GENETIC, EPIGENETIC, AND ENVIRONMENTAL FACTORS. THE RAPID RISE IN THE PREVALENCE OF ASTHMA REGISTERED OVER THE LAST FEW DECADES HAS STRESSED THE NEED TO IDENTIFY THE ENVIRONMENTAL AND MODIFIABLE FACTORS ASSOCIATED WITH THE DEVELOPMENT OF THE DISEASE. IN PARTICULAR, THERE IS INCREASING INTEREST IN THE ROLE OF MODIFIABLE NUTRITIONAL FACTORS SPECIFIC TO BOTH THE PRENATAL AND POST-NATAL EARLY LIFE AS, DURING THIS TIME, THE IMMUNE SYSTEM IS PARTICULARLY VULNERABLE TO EXOGENOUS INTERFERENCES. SEVERAL DIETARY FACTORS, INCLUDING MATERNAL DIET DURING PREGNANCY, THE DURATION OF BREASTFEEDING, THE USE OF SPECIAL MILK FORMULAS, THE TIMING OF THE INTRODUCTION OF COMPLEMENTARY FOODS, AND PRENATAL AND EARLY LIFE SUPPLEMENTATION WITH VITAMINS AND PROBIOTICS/PREBIOTICS, HAVE BEEN ADDRESSED AS POTENTIAL TARGETS FOR THE PREVENTION OF ASTHMA. IN THIS REVIEW, WE OUTLINE RECENT FINDINGS ON THE POTENTIAL ROLE OF PRENATAL AND PERINATAL DIETARY AND NUTRITIONAL INTERVENTIONS FOR THE PRIMARY PREVENTION OF PEDIATRIC ASTHMA. MOREOVER, WE ADDRESSED UNMET NEEDS AND AREAS FOR FUTURE RESEARCH IN THE PREVENTION OF CHILDHOOD-ONSET ASTHMA. 2020 16 6716 29 VITAMIN A: TOO GOOD TO BE BAD? VITAMIN A IS A MICRONUTRIENT IMPORTANT FOR VISION, CELL GROWTH, REPRODUCTION AND IMMUNITY. BOTH DEFICIENCY AND EXCESS CONSUMING OF VITAMIN A CAUSE SEVERE HEALTH CONSEQUENCES. ALTHOUGH DISCOVERED AS THE FIRST LIPOPHILIC VITAMIN ALREADY MORE THAN A CENTURY AGO AND THE DEFINITION OF PRECISE BIOLOGICAL ROLES OF VITAMIN A IN THE SETTING OF HEALTH AND DISEASE, THERE ARE STILL MANY UNRESOLVED ISSUES RELATED TO THAT VITAMIN. PROTOTYPICALLY, THE LIVER THAT PLAYS A KEY ROLE IN THE STORAGE, METABOLISM AND HOMEOSTASIS OF VITAMIN A CRITICALLY RESPONDS TO THE VITAMIN A STATUS. ACUTE AND CHRONIC EXCESS VITAMIN A IS ASSOCIATED WITH LIVER DAMAGE AND FIBROSIS, WHILE ALSO HYPOVITAMINOSIS A IS ASSOCIATED WITH ALTERATIONS IN LIVER MORPHOLOGY AND FUNCTION. HEPATIC STELLATE CELLS ARE THE MAIN STORAGE SITE OF VITAMIN A. THESE CELLS HAVE MULTIPLE PHYSIOLOGICAL ROLES FROM BALANCING RETINOL CONTENT OF THE BODY TO MEDIATING INFLAMMATORY RESPONSES IN THE LIVER. STRIKINGLY, DIFFERENT ANIMAL DISEASE MODELS ALSO RESPOND TO VITAMIN A STATUSES DIFFERENTLY OR EVEN OPPOSING. IN THIS REVIEW, WE DISCUSS SOME OF THESE CONTROVERSIAL ISSUES IN UNDERSTANDING VITAMIN A BIOLOGY. MORE STUDIES OF THE INTERACTIONS OF VITAMIN A WITH ANIMAL GENOMES AND EPIGENETIC SETTINGS ARE ANTICIPATED IN THE FUTURE. 2023 17 6204 33 THE INFLUENCE OF EPIGENETICS AND INFLAMMATION ON CARDIOMETABOLIC RISKS. CARDIOMETABOLIC DISEASES INCLUDE METABOLIC SYNDROME, OBESITY, TYPE 2 DIABETES MELLITUS, AND HYPERTENSION. EPIGENETIC MODIFICATIONS PARTICIPATE IN CARDIOMETABOLIC DISEASES THROUGH SEVERAL PATHWAYS, INCLUDING INFLAMMATION, VASCULAR DYSFUNCTION, AND INSULIN RESISTANCE. EPIGENETIC MODIFICATIONS, WHICH ENCOMPASS ALTERATIONS TO GENE EXPRESSION WITHOUT MUTATING THE DNA SEQUENCE, HAVE GAINED MUCH ATTENTION IN RECENT YEARS, SINCE THEY HAVE BEEN CORRELATED WITH CARDIOMETABOLIC DISEASES AND MAY BE TARGETED FOR THERAPEUTIC INTERVENTIONS. EPIGENETIC MODIFICATIONS ARE GREATLY INFLUENCED BY ENVIRONMENTAL FACTORS, SUCH AS DIET, PHYSICAL ACTIVITY, CIGARETTE SMOKING, AND POLLUTION. SOME MODIFICATIONS ARE HERITABLE, INDICATING THAT THE BIOLOGICAL EXPRESSION OF EPIGENETIC ALTERATIONS MAY BE OBSERVED ACROSS GENERATIONS. MOREOVER, MANY PATIENTS WITH CARDIOMETABOLIC DISEASES PRESENT WITH CHRONIC INFLAMMATION, WHICH CAN BE INFLUENCED BY ENVIRONMENTAL AND GENETIC FACTORS. THE INFLAMMATORY ENVIRONMENT WORSENS THE PROGNOSIS OF CARDIOMETABOLIC DISEASES AND FURTHER INDUCES EPIGENETIC MODIFICATIONS, PREDISPOSING PATIENTS TO THE DEVELOPMENT OF OTHER METABOLISM-ASSOCIATED DISEASES AND COMPLICATIONS. A DEEPER UNDERSTANDING OF INFLAMMATORY PROCESSES AND EPIGENETIC MODIFICATIONS IN CARDIOMETABOLIC DISEASES IS NECESSARY TO IMPROVE OUR DIAGNOSTIC CAPABILITIES, PERSONALIZED MEDICINE APPROACHES, AND THE DEVELOPMENT OF TARGETED THERAPEUTIC INTERVENTIONS. FURTHER UNDERSTANDING MAY ALSO ASSIST IN PREDICTING DISEASE OUTCOMES, ESPECIALLY IN CHILDREN AND YOUNG ADULTS. THIS REVIEW DESCRIBES EPIGENETIC MODIFICATIONS AND INFLAMMATORY PROCESSES UNDERLYING CARDIOMETABOLIC DISEASES, AND FURTHER DISCUSSES ADVANCES IN THE RESEARCH FIELD WITH A FOCUS ON SPECIFIC POINTS FOR INTERVENTIONAL THERAPY. 2023 18 6781 48 [BREATHING: AMBIENT AIR POLLUTION AND HEALTH - PART III]. THE THIRD PART OF THE DGP STATEMENT INTRODUCES THE CURRENT BODY OF KNOWLEDGE ON LESS STUDIED HEALTH OUTCOMES ASSOCIATED WITH EXPOSURE TO AMBIENT AIR POLLUTION: THE NEGATIVE IMPACT ON METABOLISM LEADING TO IMPAIRED GLUCOSE TOLERANCE AND DIABETES AS WELL AS CONTRIBUTION TO THE DEVELOPMENT OF NEURODEGENERATIVE DISORDERS AND DELAYED COGNITIVE FUNCTION IN CHILDREN. FURTHERMORE, PRENATAL EXPOSURE AND ADVERSE EFFECTS ON MOTHER AND CHILD ARE ADDRESSED. FINALLY, THE CURRENTLY DISCUSSED BIOLOGICAL MECHANISMS UNDERLYING VARIOUS HEALTH EFFECTS ASSOCIATED WITH EXPOSURE TO AIR POLLUTION ARE DESCRIBED.DIFFERING, BUT OFTEN COMPLEMENTARY BIOLOGICAL MECHANISMS CREATE THE BASIS FOR THE DIVERSE HEALTH OUTCOMES CAUSED BY AIR POLLUTION. OXIDATIVE STRESS AND A SUBCLINICAL INFLAMMATORY RESPONSE IN THE LUNGS AND ON A SYSTEMIC LEVEL ("LOW-GRADE SYSTEMIC INFLAMMATION") ARE CONSIDERED TO BE KEY MECHANISMS. THEY PROMOTE SECONDARY ALTERATIONS IN THE BODY, SUCH AS VASCULAR OR METABOLIC PROCESSES, AND MAY ALSO RESULT IN THE CURRENTLY STUDIED EPIGENETIC PHENOMENA OR NEUROINFLAMMATION. IN THIS CONTEXT, THE HEALTH SIGNIFICANCE OF SOLUBLE PARTICULATE MATTER AND THE ROLE OF ULTRAFINE PARTICLES TRANSLOCATED ACROSS BIOLOGICAL MEMBRANES INTO BLOOD VESSEL AND TRANSPORTED VIA THE CIRCULATION TO SECONDARY TARGET ORGANS, SUCH AS LIVER, BRAIN OR THE FETUS, ARE INTENSIVELY DISCUSSED.DIABETES IS ONE OF THE LEADING CHRONIC DISEASES WORLDWIDE, WITH A PREVALENCE OF ALMOST 14 % IN GERMANY. ALTHOUGH LIFESTYLE FACTORS ARE THE MAIN CAUSES, CURRENT EVIDENCE SUGGESTS THAT LONG-TERM EXPOSURE TO AIR POLLUTION MAY ADDITIONALLY INCREASE THE RISK FOR TYPE 2 DIABETES. SUPPORTING EVIDENCE FOR A CAUSAL ROLE OF AIR POLLUTION IS PROVIDED BY STUDIES ADDRESSING THE REGULATION OF THE BLOOD GLUCOSE LEVELS IN METABOLICALLY HEALTHY PARTICIPANTS, INSULIN SENSITIVITY, OR PREGNANCY-RELATED DIABETES. EXPERIMENTAL STUDIES PROVIDE FURTHER SUPPORT FOR PLAUSIBLE BIOLOGICAL MECHANISMS. HOWEVER, PROSPECTIVE STUDIES ARE NEEDED TO GAIN MORE EVIDENCE, TAKING MULTIPLE LIFESTYLE AND ENVIRONMENTAL FACTORS, SUCH AS GREEN SPACE AND NOISE, AND AN IMPROVED INDIVIDUAL EXPOSURE ASSESSMENT INTO ACCOUNT.THE AGING POPULATION HAS AN INCREASED RISK OF NEURODEGENERATIVE DISEASES. FIRST STUDIES POINT TOWARDS A CONTRIBUTION OF CHRONIC EXPOSURE TO AIR POLLUTION, SPECIFICALLY BY PARTICULATE MATTER. SEVERAL STUDIES REPORT ITS ASSOCIATION WITH DECREASED NEUROCOGNITIVE CAPACITY OR AN INCREASED PREVALENCE OF DEMENTIA OR ALZHEIMER'S DISEASE IN ADULTS. HOWEVER, THE STUDIES ARE INHOMOGENEOUS REGARDING DESIGN, EXPOSURE AND OUTCOME, LEADING TO INCONSISTENT RESULTS. WITH RESPECT TO THE INFLUENCE ON NEUROCOGNITIVE DEVELOPMENT OF CHILDREN, FIRST STUDIES SUGGEST AN ASSOCIATION BETWEEN THE LEVEL OF AIR POLLUTION, E. G. AT SCHOOL, AND DELAYED COGNITIVE DEVELOPMENT.EVEN THOUGH THE EVIDENCE FOR THE DIFFERENT BIOLOGICAL ENDPOINTS DURING PREGNANCY IS STILL HETEROGENEOUS, THE STUDIES GENERALLY POINT TOWARDS AN ADVERSE IMPACT OF AIR POLLUTION ON THE MATERNAL AND FETAL ORGANISMS. THE STRONGEST EVIDENCE EXISTS FOR LOW BIRTH WEIGHT, WITH SMALL EFFECT SIZES OF ONLY SOME GRAMS, AND FOR A HIGHER INCIDENCE OF REDUCED BIRTH WEIGHT (< 2500 G). AN INCREASED RISK FOR GESTATIONAL HYPERTENSION AND PREECLAMPSIA UNDERSCORES THE POSSIBLE IMPACT OF EXPOSURE TO AIR POLLUTION ON THE MATERNAL ORGANISM. HOWEVER, THE CURRENT BODY OF EVIDENCE DOES NOT YET ALLOW A FINAL CONCLUSION ON THE INFLUENCE OF INTRAUTERINE EXPOSURE TO AIR POLLUTION REGARDING EARLY CHILDHOOD LUNG FUNCTION AND DEVELOPMENT OF ALLERGIES, PARTICULARLY IN LIGHT OF THE FACT THAT IT IS HARD TO DISTINGUISH IN EPIDEMIOLOGICAL STUDIES BETWEEN THE EFFECTS OF PRE- AND POSTNATAL EXPOSURE. 2019 19 625 30 BIOLOGICAL AGE AND ENVIRONMENTAL RISK FACTORS FOR DEMENTIA AND STROKE: MOLECULAR MECHANISMS. SINCE THE DEVELOPMENT OF ANTIBIOTICS AND VACCINATION, AS WELL AS MAJOR IMPROVEMENTS IN PUBLIC HYGIENE, THE MAIN RISK FACTORS FOR MORBIDITY AND MORTALITY ARE AGE AND CHRONIC EXPOSURE TO ENVIRONMENTAL FACTORS, BOTH OF WHICH CAN INTERACT WITH GENETIC PREDISPOSITIONS. AS THE AVERAGE AGE OF THE POPULATION INCREASES, THE PREVALENCE AND COSTS OF CHRONIC DISEASES, ESPECIALLY NEUROLOGICAL CONDITIONS, ARE RAPIDLY INCREASING. THE DELETERIOUS EFFECTS OF AGE AND ENVIRONMENTAL RISK FACTORS, DEVELOP CHRONICALLY OVER RELATIVELY LONG PERIODS OF TIME, IN CONTRAST TO THE RELATIVELY RAPID DELETERIOUS EFFECTS OF INFECTIOUS DISEASES OR ACCIDENTS. OF PARTICULAR INTEREST IS THE HYPOTHESIS THAT THE DELETERIOUS EFFECTS OF ENVIRONMENTAL FACTORS MAY BE MEDIATED BY ACCELERATION OF BIOLOGICAL AGE. THIS HYPOTHESIS IS SUPPORTED BY EVIDENCE THAT DIETARY RESTRICTION, WHICH UNIVERSALLY DELAYS AGE-RELATED DISEASES, ALSO AMELIORATES DELETERIOUS EFFECTS OF ENVIRONMENTAL FACTORS. CONVERSELY, BOTH AGE AND ENVIRONMENTAL RISK FACTORS ARE ASSOCIATED WITH THE ACCUMULATION OF SOMATIC MUTATIONS IN MITOTIC CELLS AND EPIGENETIC MODIFICATIONS THAT ARE A MEASURE OF "BIOLOGICAL AGE", A BETTER PREDICTOR OF AGE-RELATED MORBIDITY AND MORTALITY THAN CHRONOLOGICAL AGE. HERE WE REVIEW EVIDENCE THAT ENVIRONMENTAL RISK FACTORS SUCH AS SMOKING AND AIR POLLUTION MAY ALSO DRIVE NEUROLOGICAL CONDITIONS, INCLUDING ALZHEIMER'S DISEASE, BY THE ACCELERATION OF BIOLOGICAL AGE, MEDIATED BY CUMULATIVE AND PERSISTENT EPIGENETIC EFFECTS AS WELL AS SOMATIC MUTATIONS. ELUCIDATION OF SUCH MECHANISMS COULD PLAUSIBLY ALLOW THE DEVELOPMENT OF INTERVENTIONS WHICH DELAY DELETERIOUS EFFECTS OF BOTH AGING AND ENVIRONMENTAL RISK FACTORS. 2022 20 6088 40 THE EFFECTS OF ASSISTED REPRODUCTION TECHNOLOGIES ON METABOLIC HEALTH AND DISEASEDAGGER. THE INCREASING PREVALENCE OF METABOLIC DISEASES PLACES A SUBSTANTIAL BURDEN ON HUMAN HEALTH THROUGHOUT THE WORLD. IT IS BELIEVED THAT PREDISPOSITION TO METABOLIC DISEASE STARTS EARLY IN LIFE, A PERIOD OF GREAT SUSCEPTIBILITY TO EPIGENETIC REPROGRAMMING DUE TO ENVIRONMENTAL INSULTS. ASSISTED REPRODUCTIVE TECHNOLOGIES (ART), I.E., TREATMENTS FOR INFERTILITY, MAY AFFECT EMBRYO DEVELOPMENT, RESULTING IN MULTIPLE ADVERSE HEALTH OUTCOMES IN POSTNATAL LIFE. THE MOST FREQUENTLY OBSERVED ALTERATION IN ART PREGNANCIES IS IMPAIRED PLACENTAL NUTRIENT TRANSFER. MOREOVER, CONSEQUENT INTRAUTERINE GROWTH RESTRICTION AND LOW BIRTH WEIGHT FOLLOWED BY CATCH-UP GROWTH CAN ALL PREDICT FUTURE OBESITY, INSULIN RESISTANCE, AND CHRONIC METABOLIC DISEASES. IN THIS REVIEW, WE HAVE FOCUSED ON EVIDENCE OF ADVERSE METABOLIC ALTERATIONS ASSOCIATED WITH ART, WHICH CAN CONTRIBUTE TO THE DEVELOPMENT OF CHRONIC ADULT-ONSET DISEASES, SUCH AS METABOLIC SYNDROME, TYPE 2 DIABETES, AND CARDIOVASCULAR DISEASE. DUE TO HIGH PHENOTYPIC PLASTICITY, ART PREGNANCIES CAN PRODUCE BOTH OFFSPRING WITH ADVERSE HEALTH OUTCOMES, AS WELL AS HEALTHY INDIVIDUALS. WE FURTHER DISCUSS THE SEX-SPECIFIC AND AGE-DEPENDENT METABOLIC ALTERATIONS REFLECTED IN ART OFFSPRING, AND HOW THE DEGREE OF INTERFERENCE OF A GIVEN ART PROCEDURE (FROM MILD TO MORE SEVERE MANIPULATION OF THE EGG) AFFECTS THE OCCURRENCE AND DEGREE OF OFFSPRING ALTERATIONS. OVER THE LAST FEW YEARS, STUDIES HAVE REPORTED SIGNS OF CARDIOMETABOLIC ALTERATIONS IN ART OFFSPRING THAT ARE DETECTABLE AT A YOUNG AGE BUT THAT DO NOT APPEAR TO CONSTITUTE A HIGH RISK OF DISEASE AND MORBIDITY PER SE. THESE ABNORMAL PHENOTYPES COULD BE EARLY INDICATORS OF THE DEVELOPMENT OF CHRONIC DISEASES, INCLUDING METABOLIC SYNDROME, IN ADULTHOOD. THE EARLY DETECTION OF METABOLIC ALTERATIONS COULD CONTRIBUTE TO PREVENTING THE ONSET OF DISEASE IN ADULTHOOD. SUCH EARLY INTERVENTIONS MAY COUNTERACT THE RISK FACTORS AND IMPROVE THE LONG-TERM HEALTH OF THE INDIVIDUAL. 2021