1 1845 164 EFFECTS OF THE MEDITERRANEAN DIET DURING PREGNANCY ON THE ONSET OF ALLERGY IN AT RISK CHILDREN: A STUDY PROTOCOL OF A MULTI-CENTER, RANDOMIZED- CONTROLLED, PARALLEL GROUPS, PROSPECTIVE TRIAL (THE PREMEDI STUDY). INTRODUCTION: MATERNAL DIET DURING PREGNANCY HAS BEEN LINKED TO OFFSPRING ALLERGY RISK AND IT COULD REPRESENT A POTENTIAL TARGET FOR ALLERGY PREVENTION. THE MEDITERRANEAN DIET (MD) IS CONSIDERED ONE OF THE HEALTHIEST DIETARY MODELS. RANDOMIZED-CONTROLLED TRIALS ON THE EFFECT OF MD IN PREVENTING PEDIATRIC ALLERGIC DISEASES ARE STILL NEEDED. METHODS AND ANALYSIS: THE MEDITERRANEAN DIET DURING PREGNANCY STUDY (PREMEDI) WILL BE A 9-MONTH MULTI-CENTER, RANDOMIZED-CONTROLLED, PARALLEL GROUPS, PROSPECTIVE TRIAL. HEALTHY WOMEN (20-35 YEARS) AT THEIR FIRST TRIMESTER OF PREGNANCY AT RISK FOR ATOPY BABY, WILL BE RANDOMLY ALLOCATED TO GROUP 1 (STANDARD OBSTETRICAL AND GYNECOLOGICAL FOLLOW-UP AND NUTRITIONAL COUNSELING TO PROMOTE MD) OR GROUP 2 (STANDARD OBSTETRICAL AND GYNECOLOGICAL FOLLOW-UP ALONE). 138 MOTHER-CHILD PAIR PER GROUP WILL BE NEEDED TO DETECT A REDUCTION IN CUMULATIVE INCIDENCE OF >/=1 ALLERGIC DISEASE AT 24 MONTHS OF AGE. THE PRIMARY STUDY AIM WILL BE THE EVALUATION OF THE OCCURRENCE OF ALLERGIC DISORDERS IN THE FIRST 24 MONTHS OF LIFE. THE SECONDARY AIMS WILL BE THE EVALUATION OF MATERNAL WEIGHT GAIN, PREGNANCY/PERINATAL COMPLICATIONS, GROWTH INDICES AND OCCURRENCE OF OTHER CHRONIC DISORDERS, MOTHER-CHILD PAIR ADHERENCE TO MD AND GUT MICROBIOME FEATURES, BREASTFEEDING DURATION AND BREAST MILK COMPOSITION, EPIGENETIC MODULATION OF GENES INVOLVED IN IMMUNE SYSTEM, AND METABOLIC PATHWAYS IN THE OFFSPRING. ETHICS AND DISSEMINATION: THE STUDY PROTOCOL HAS BEEN APPROVED BY THE ETHICS COMMITTEE OF THE UNIVERSITY OF NAPLES FEDERICO II (NUMBER 283/21) AND IT WILL BE CONDUCTED IN ACCORDANCE WITH THE HELSINKI DECLARATION (FORTALEZA REVISION, 2013), THE GOOD CLINICAL PRACTICE STANDARDS (CPMP/ICH/135/95), THE ITALIAN DECREE-LAW 196/2003 REGARDING PERSONAL DATA AND THE EUROPEAN REGULATIONS ON THIS SUBJECT. THE STUDY HAS BEEN REGISTERED IN THE CLINICAL TRIALS PROTOCOL REGISTRATION SYSTEM. CLINICAL TRIAL REGISTRATION: [HTTP://CLINICALTRIALS.GOV], IDENTIFIER [NCT05119868]. 2022 2 3166 52 GROCERY DELIVERY TO SUPPORT HEALTHY WEIGHT GAIN AMONG PREGNANT YOUNG WOMEN WITH LOW INCOME: PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: EXCESSIVE WEIGHT GAIN DURING PREGNANCY IS ASSOCIATED WITH COMPLICATIONS FOR BOTH THE MOTHER AND HER INFANT INCLUDING GESTATIONAL DIABETES, HYPERTENSIVE DISORDERS, OPERATIVE DELIVERY, AND LONG-TERM OBESITY. A HEALTHY DIET DURING PREGNANCY PROMOTES HEALTHY GESTATIONAL WEIGHT GAIN AND DETERMINES FETAL EPIGENETIC PROGRAMMING IN INFANTS THAT IMPACTS RISK FOR FUTURE CHRONIC DISEASE. OBJECTIVE: THIS PROJECT WILL EXAMINE THE IMPACT OF GROCERY DELIVERY DURING PREGNANCY ON THE WEIGHT, DIET, AND HEALTH OUTCOMES OF YOUNG PREGNANT WOMEN AND THEIR INFANTS. METHODS: A THREE-ARM RANDOMIZED CONTROLLED TRIAL DESIGN WILL BE PERFORMED. A TOTAL OF 855 YOUNG PREGNANT WOMEN, AGED 14-24 YEARS, FROM ACROSS THE STATE OF MICHIGAN WILL BE ENROLLED AND RANDOMIZED EQUALLY INTO THE THREE STUDY ARMS. PARTICIPANTS IN ARM ONE (CONTROL) WILL RECEIVE USUAL CARE FROM THE SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS, AND CHILDREN (WIC); ARM TWO WILL RECEIVE WIC PLUS BIWEEKLY GROCERY DELIVERY; AND ARM THREE WILL RECEIVE WIC PLUS BIWEEKLY GROCERY AND UNSWEETENED BEVERAGE DELIVERY. WEIGHT WILL BE ASSESSED WEEKLY DURING PREGNANCY, AND TOTAL PREGNANCY WEIGHT GAIN WILL BE CATEGORIZED AS ABOVE, BELOW, OR WITHIN GUIDELINES. ADDITIONALLY, DIETARY INTAKE WILL BE ASSESSED AT THREE TIME POINTS (BASELINE, SECOND TRIMESTER, AND THIRD TRIMESTER), AND PREGNANCY OUTCOMES WILL BE EXTRACTED FROM MEDICAL RECORDS. THE APPROPRIATENESS OF PREGNANCY WEIGHT GAIN, DIET QUALITY, AND OCCURRENCE OF POOR OUTCOMES WILL BE COMPARED BETWEEN GROUPS USING STANDARD PRACTICES FOR MULTINOMIAL REGRESSION AND CONFOUNDER ADJUSTMENT. RESULTS: THIS STUDY WAS FUNDED IN APRIL 2021, DATA COLLECTION STARTED IN DECEMBER 2021, AND DATA COLLECTION IS EXPECTED TO BE CONCLUDED IN 2026. CONCLUSIONS: THIS STUDY WILL TEST WHETHER GROCERY DELIVERY OF HEALTHY FOODS IMPROVES WEIGHT, DIET, AND PREGNANCY OUTCOMES OF YOUNG MOMS WITH LOW INCOME. THE FINDINGS WILL INFORM POLICIES AND PRACTICES THAT PROMOTE A HEALTHY DIET DURING PREGNANCY, WHICH HAS MULTIGENERATIONAL IMPACTS ON HEALTH. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT05000645; HTTPS://CLINICALTRIALS.GOV/CT2/SHOW/NCT05000645. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/40568. 2022 3 6911 28 [TWO GERMAN BIRTH COHORTS: GINIPLUS AND LISAPLUS]. NUMEROUS CHRONIC DISEASES IN CHILDHOOD AND ADULTHOOD HAVE THEIR ORIGINS IN PERINATAL LIFE AND ARE POTENTIALLY INFLUENCED BY TRANS-GENERATIONAL EPIGENETIC PROCESSES. THEREFORE, PROSPECTIVE BIRTH COHORTS CAN SUBSTANTIALLY CONTRIBUTE TO OUR KNOWLEDGE ABOUT THE ETIOLOGY OF DISEASES INCLUDING MODIFIABLE RISK FACTORS. THE TWO POPULATION-BASED GERMAN BIRTH COHORTS GINIPLUS AND LISAPLUS AIM TO DESCRIBE THE NATURAL COURSE OF CHRONIC DISEASES AND INTERMEDIATE PHENOTYPES IN CHILDHOOD AND ITS DETERMINANTS, AND TO IDENTIFY POTENTIAL GENETIC EFFECT MODIFICATIONS. IN THE MID-1990S, 5,991 (GINIPLUS) AND 3,097 (LISAPLUS) HEALTHY, TERM NEWBORNS WERE RECRUITED FOR LONG-TERM FOLLOW-UP IN FOUR REGIONS OF GERMANY. THE FOLLOW-UP RATE FOR THE FIRST 10 YEARS WAS ABOUT 55%. WE ANALYZED THE GROWTH AND DEVELOPMENT OF OVERWEIGHT, INFECTIONS AND ALLERGIC DISEASES, MENTAL AND ORAL HEALTH, METABOLIC AND INFLAMMATORY PARAMETERS AND THE ROLE OF POTENTIAL RISK FACTORS INCLUDING GENETICS. THE RESULTS OF THESE TWO BIRTH COHORTS SUBSTANTIALLY CONTRIBUTE TO THE CURRENT KNOWLEDGE ABOUT THE NATURAL COURSE OF THESE HEALTH PARAMETERS. THESE DATA WERE INCLUDED IN MANY INTERNATIONAL PROJECTS AND CONSORTIA FOR PURPOSES OF INTERNATIONAL COMPARISONS OF PREVALENCE AND CONSISTENCY OF FINDINGS, AND TO INCREASE THE POWER OF THE ANALYSES. 2012 4 5000 33 PERINATAL PROGRAMMING PREVENTION MEASURES. OVER THE PAST 10 YEARS, THERE HAS BEEN OUTSTANDING SCIENTIFIC PROGRESS RELATED TO PERINATAL PROGRAMMING AND ITS EPIGENETIC EFFECTS IN HEALTH, AND WE CAN ANTICIPATE THIS TREND WILL CONTINUE IN THE NEAR FUTURE. WE NEED TO MAKE USE AND APPLY THESE ACHIEVEMENTS TO HUMAN NEURODEVELOPMENT VIA PREVENTION INTERVENTIONS. BASED ON THE CONCEPT OF THE INTERACTION BETWEEN GENOME AND AMBIOME, THIS CHAPTER PROPOSES LOW-COST EASY-IMPLEMENTATION PREVENTIVE STRATEGIES FOR MATERNAL AND INFANT HEALTH INSTITUTIONS.BREASTFEEDING AND HUMAN MILK ADMINISTRATION ARE THE FIRST PREVENTIVE MEASURES, AS HAS BEEN REVIEWED IN THE POLICY STATEMENT OF THE AMERICAN ACADEMY OF PEDIATRICS. ANOTHER STRATEGY IS THE SAFE AND FAMILY-CENTERED MATERNITY HOSPITALS INITIATIVE THAT PROMOTES AND EMPOWERS THE INCLUSION OF THE FAMILIES AND THE RESPECT FOR THEIR RIGHTS, ESPECIALLY DURING PREGNANCY AND BIRTH. (THIS CHANGE OF PARADIGM WAS APPROVED AND IS RECOMMENDED BY BOTH UNITED NATIONS CHILDREN'S FUND, UNICEF, AND PAN AMERICAN HEALTH ORGANIZATION, PAHO.) THEN, THERE IS ALSO AN IMPORTANT EMPHASIS GIVEN TO THE SACRED HOUR-WHICH HIGHLIGHTS THE IMPACT OF BONDING, ATTACHMENT, AND BREASTFEEDING DURING THE FIRST HOUR OF LIFE-THE PAIN PREVENTION AND TREATMENT IN NEWBORNS, THE CONTROL OF THE "NEW MORBIDITY" REPRESENTED BY LATE PRETERM INFANTS, AND FINALLY, THE IMPORTANCE OF AVOIDING INTRAUTERINE AND EXTRAUTERINE GROWTH RESTRICTION. (HOWEVER, THERE ARE NOT YET CLEAR RECOMMENDATIONS ABOUT NUTRITIONAL INTERVENTIONS IN ORDER TO DIMINISH THE POTENTIAL METABOLIC SYNDROME CONSEQUENCE IN THE ADULT.). 2015 5 4809 32 OBESITY PREVENTION. ONCE CONSIDERED A PROBLEM ONLY IN HIGH-INCOME COUNTRIES (HICS), OBESITY HAS BECOME A MAJOR CONTRIBUTOR TO THE GLOBAL DISEASE BURDEN (FINUCANE AND OTHERS 2011; MISRA AND KHURANA 2008). EXCESS ADIPOSITY, PARTICULARLY AROUND THE VISCERAL ABDOMINAL REGION, IS AN IMPORTANT RISK FACTOR FOR MORBIDITY AND MORTALITY FROM TYPE 2 DIABETES, CARDIOVASCULAR DISEASES, AND SOME CANCERS (DANAEI AND OTHERS 2009; WHITLOCK AND OTHERS 2009; WHO 2009). ALTHOUGH SOME STUDIES HAVE SUGGESTED LOWER MORTALITY AMONG OVERWEIGHT OR OBESE PERSONS THAN AMONG HEALTHY-WEIGHT PERSONS (CARNETHON AND OTHERS 2012), THIS OUTCOME HAS NOT BEEN OBSERVED IN STUDIES THAT PROPERLY ACCOUNT FOR THE CONFOUNDING EFFECTS OF SMOKING, PREEXISTING CHRONIC CONDITIONS, AND OTHER BIASES (GLOBAL BMI MORTALITY COLLABORATION 2016; TOBIAS, PAN, AND HU 2014). THE COSTS OF OBESITY AND COMORBID CONDITIONS ARE STAGGERING AS MEASURED BY BOTH HEALTH CARE EXPENDITURES AND QUALITY OF LIFE, UNDERSCORING THE IMPORTANCE OF IMPLEMENTING OBESITY PREVENTION STRATEGIES AND TREATMENT STRATEGIES ON A GLOBAL SCALE. THE CHANGES NEEDED TO REVERSE GLOBAL TRENDS IN OBESITY WILL LIKELY REQUIRE NUMEROUS INTERVENTIONS AND POLICY RECOMMENDATIONS THAT TARGET DIET, LIFESTYLE, ACCESS TO CARE, AND ENVIRONMENTAL RISK FACTORS. IN THIS CHAPTER, WE SUMMARIZE THE GLOBAL BURDEN OF OBESITY AND THE IMPACT OF A SPECTRUM OF OBESITY RISK FACTORS, RANGING FROM SOCIOPOLITICAL AND ECONOMIC FORCES THAT ARE LARGELY BEYOND AN INDIVIDUAL'S CONTROL TO MODIFIABLE LIFESTYLE FACTORS, AND DISCUSS GENETIC AND EPIGENETIC RISKS. WE ALSO REVIEW THE EFFECTIVENESS OF POPULATION-BASED INTERVENTIONS AND POLICIES FOR PREVENTING OBESITY, SOME INDIVIDUAL-LEVEL TREATMENT OPTIONS ACROSS VARIOUS PLATFORMS, AND THE COST-EFFECTIVENESS OF SELECT INTERVENTIONS. 2017 6 1095 35 COHORT PROFILE: THE EWHA BIRTH AND GROWTH STUDY. WITH THE INTRODUCTION OF LIFE-COURSE EPIDEMIOLOGY, RESEARCHERS REALIZED THE IMPORTANCE OF IDENTIFYING RISK FACTORS IN EARLY LIFE TO PREVENT CHRONIC DISEASES. THIS LED TO THE ESTABLISHMENT OF THE EWHA BIRTH AND GROWTH STUDY IN 2001; THE STUDY IS A PROSPECTIVE BIRTH COHORT DESIGNED TO PROVIDE EVIDENCE OF EARLY LIFE RISK FACTORS FOR A CHILD'S GROWTH AND HEALTH. PARTICIPANTS WERE RECRUITED FROM THOSE WHO VISITED EWHA WOMANS UNIVERSITY MOKDONG HOSPITAL (A TERTIARY HOSPITAL IN SOUTHWEST SEOUL, KOREA) FOR PRENATAL CARE AT 24-28 WEEKS OF GESTATION. IN TOTAL, 891 MOTHERS ENROLLED IN THIS STUDY BETWEEN 2001 AND 2006 AND THEIR OFFSPRING (N=940) WERE FOLLOWED-UP. REGULAR CHECK-UP EXAMINATIONS OF OFFSPRING WERE CONDUCTED AT 3 YEARS, 5 YEARS, AND 7 YEARS OF AGE AND EVERY YEAR THEREAFTER. TO CONSIDER AGE-RELATED HEALTH ISSUES, EXTENSIVE DATA WERE COLLECTED USING QUESTIONNAIRES AND MEASUREMENTS. IN 2021, THE STUDY SUBJECTS WILL REACH 19 YEARS OF AGE, AND WE ARE PLANNING A CHECK-UP EXAMINATION FOR EARLY ADULTHOOD. ABOUT 20 YEARS HAVE PASSED SINCE THE COHORT DATA WERE COLLECTED, AND WE HAVE PUBLISHED RESULTS ON CHILDHOOD HEALTH OUTCOMES ASSOCIATED WITH PRENATAL AND BIRTH CHARACTERISTICS, GENETIC AND EPIGENETIC CHARACTERISTICS RELATED TO CHILDHOOD METABOLISM, THE EFFECTS OF EXPOSURE TO ENDOCRINE DISRUPTORS, AND DIETARY PATTERNS IN CHILDHOOD. RECENTLY, WE STARTED REPORTING ON TOPICS RELATED TO ADOLESCENT HEALTH. THE FINDINGS WILL FACILITATE IDENTIFICATION OF EARLY LIFE RISK FACTORS FOR CHRONIC DISEASES AND THE DEVELOPMENT OF INTERVENTIONS FOR DISEASES LATER IN LIFE. 2021 7 6422 27 THE THIN-FAT PHENOTYPE AND GLOBAL METABOLIC DISEASE RISK. PURPOSE OF REVIEW: THERE HAS BEEN A GREAT DEAL OF INTEREST IN THE THIN-FAT PHENOTYPE EVIDENT IN ASIAN INDIANS AND ITS RISK ASSOCIATIONS IN THE EPIDEMIC OF NONCOMMUNICABLE CHRONIC DISEASE ASSOCIATED WITH IT. THE CAUSE OF THIS PHENOTYPE IS PROBABLY RELATED TO LIFESTYLE AND ENVIRONMENT; HOWEVER, GENOTYPIC AND EPIGENETIC MODIFICATIONS IN UTERO ALSO HAVE BEEN CONSIDERED. RECENT FINDINGS: THE THIN-FAT PHENOTYPE OCCURS WHEN FAT IS ADDED TO AN ALREADY THIN FRAME. THIS MAY OCCUR WITH RURAL-URBAN MIGRATION, WHEN POSITIVE ENERGY BALANCE OCCURS IN A MIGRATING POPULATION WHO WERE PREDOMINANTLY THIN AND PHYSICALLY ACTIVE TO BEGIN WITH. THE ROLE OF THE PRE-EXISTING SKELETAL MUSCLE MASS AND ITS INTERACTION WITH NEWLY DEPOSITED FAT MUST BE CONSIDERED. THE THIN-FAT PHENOTYPE MAY BE PROGRAMMED DURING FETAL GROWTH, BUT THE EVIDENCE FOR THIS PHENOMENON IS STILL NOT COMPLETELY CLEAR. FINALLY, ALTHOUGH THERE IS INCREASED CHRONIC DISEASE MORBIDITY AT LOWER BMI AND YOUNGER AGE IN SOUTH ASIAN POPULATIONS, BMI-RELATED MORTALITY DOES NOT APPEAR TO FOLLOW THIS TREND. SUMMARY: AT PRESENT, THE WEIGHT OF EVIDENCE APPEARS TO LINK THE THIN-FAT PHENOTYPE TO AN ENVIRONMENTAL AND LIFESTYLE PHENOMENON OCCURRING IN PREVIOUSLY THIN PEOPLE. THIS IS PARTICULARLY RELEVANT IN INDIA, GIVEN THE PACE OF TRANSITION OVER THE LAST TWO DECADES. 2011 8 4187 46 METABOLIC AND VASCULAR EFFECT OF THE MEDITERRANEAN DIET. SEVERAL STUDIES INDICATED HOW DIETARY PATTERNS THAT WERE OBTAINED FROM NUTRITIONAL CLUSTER ANALYSIS CAN PREDICT DISEASE RISK OR MORTALITY. LOW-GRADE CHRONIC INFLAMMATION REPRESENTS A BACKGROUND PATHOGENETIC MECHANISM LINKING METABOLIC RISK FACTORS TO INCREASED RISK OF CHRONIC DEGENERATIVE DISEASES. A MEDITERRANEAN DIET (MEDI) STYLE HAS BEEN REPORTED AS ASSOCIATED WITH A LOWER DEGREE OF INFLAMMATION BIOMARKERS AND WITH A PROTECTIVE ROLE ON CARDIOVASCULAR AND CEREBROVASCULAR EVENTS. THERE IS HETEROGENEITY IN DEFINING THE MEDDIET, AND IT CAN, OWING TO ITS COMPLEXITY, BE CONSIDERED AS AN EXPOSOME WITH THOUSANDS OF NUTRIENTS AND PHYTOCHEMICALS. RECENTLY, IT HAS BEEN REPORTED A NOVEL POSITIVE ASSOCIATION BETWEEN BASELINE PLASMA CERAMIDE CONCENTRATIONS AND CARDIOVASCULAR EVENTS AND HOW ADHERENCE TO A MEDITERRANEAN DIET-STYLE MAY INFLUENCE THE POTENTIAL NEGATIVE RELATIONSHIP BETWEEN ELEVATED PLASMA CERAMIDE CONCENTRATIONS AND CARDIOVASCULAR DISEASES (CVD). SEVERAL RANDOMIZED CONTROLLED TRIALS (RCTS) SHOWED THE POSITIVE EFFECTS OF THE MEDI DIET STYLE ON SEVERAL CARDIOVASCULAR RISK FACTORS, SUCH AS BODY MASS INDEX, WAIST CIRCUMFERENCE, BLOOD LIPIDS, BLOOD PRESSURE, INFLAMMATORY MARKERS AND ADHESION MOLECULES, AND DIABETES AND HOW THESE ADVANTAGES OF THE MEDI ARE MAINTAINED IN COMPARISON OF A LOW-FAT DIET. SOME STUDIES REPORTED A POSITIVE EFFECT OF ADHERENCE TO A MEDITERRANEAN DIET AND HEART FAILURE INCIDENCE, WHEREAS SOME RECENT STUDIES, SUCH AS THE PREDIMED STUDY, SHOWED THAT THE INCIDENCE OF MAJOR CARDIOVASCULAR EVENTS WAS LOWER AMONG THOSE ASSIGNED TO MEDI SUPPLEMENTED WITH EXTRA-VIRGIN OLIVE OIL OR NUTS THAN AMONG THOSE ASSIGNED TO A REDUCED-FAT DIET. NEW STUDIES ARE NEEDED TO BETTER UNDERSTAND THE MOLECULAR MECHANISMS, WHEREBY THE MEDDIET MAY EXERCISE ITS EFFECTS. HERE, WE PRESENT RECENT ADVANCES IN UNDERSTANDING THE MOLECULAR BASIS OF MEDDIET EFFECTS, MAINLY FOCUSING ON CARDIOVASCULAR DISEASES, BUT ALSO DISCUSSING OTHER RELATED DISEASES. WE REVIEW MEDDIET COMPOSITION AND ASSESSMENT AS WELL AS THE LATEST ADVANCES IN THE GENOMIC, EPIGENOMIC (DNA METHYLATION, HISTONE MODIFICATIONS, MICRORNAS, AND OTHER EMERGING REGULATORS), TRANSCRIPTOMIC (SELECTED GENES AND WHOLE TRANSCRIPTOME), AND METABOLOMIC AND METAGENOMIC ASPECTS OF THE MEDDIET EFFECTS (AS A WHOLE AND FOR ITS MOST TYPICAL FOOD COMPONENTS). WE ALSO PRESENT A REVIEW OF THE CLINICAL EFFECTS OF THIS DIETARY STYLE UNDERLYING THE BIOCHEMICAL AND MOLECULAR EFFECTS OF THE MEDITERRANEAN DIET. OUR PURPOSE IS TO REVIEW THE MAIN FEATURES OF THE MEDITERRANEAN DIET IN PARTICULAR ITS BENEFITS ON HUMAN HEALTH, UNDERLING THE ANTI-INFLAMMATORY, ANTI-OXIDANT AND ANTI-ATHEROSCLEROTIC EFFECTS TO WHICH NEW KNOWLEDGE ABOUT EPIGENETIC AND GUT-MICROBIOTA RELATIONSHIP IS RECENTLY ADDED. 2019 9 6678 28 USING GENETIC BURDEN SCORES FOR GENE-BY-METHYLATION INTERACTION ANALYSIS ON METABOLIC SYNDROME IN AFRICAN AMERICANS. WITH THE RAPID ADVANCEMENT OF OMICS-BASED RESEARCH, PARTICULARLY BIG DATA SUCH AS GENOME- AND EPIGENOME-WIDE ASSOCIATION STUDIES THAT INCLUDE EXTENSIVE ENVIRONMENTAL AND CLINICAL VARIABLES, DATA ANALYTICS HAVE BECOME INCREASINGLY COMPLEX. RESEARCHERS FACE SIGNIFICANT CHALLENGES REGARDING HOW TO ANALYZE MULTIFACTORIAL DATA AND MAKE USE OF THE FINDINGS FOR CLINICAL TRANSLATION. THE PURPOSE OF THIS ARTICLE IS TO PROVIDE A SCIENTIFIC EXEMPLAR FOR USE OF GENETIC BURDEN SCORES AS A DATA ANALYSIS METHOD FOR STUDIES WITH BOTH GENOTYPE AND DNA METHYLATION DATA IN WHICH THE GOAL IS TO EVALUATE ASSOCIATIONS WITH CHRONIC CONDITIONS SUCH AS METABOLIC SYNDROME (METS). THIS STUDY INCLUDED 739 AFRICAN AMERICAN MEN AND WOMEN FROM THE GENETIC EPIDEMIOLOGY NETWORK OF ARTERIOPATHY STUDY WHO MET DIAGNOSTIC CRITERIA FOR METS AND HAD AVAILABLE GENETIC AND EPIGENETIC DATA. GENETIC BURDEN SCORES FOR EVALUATED GENES WERE NOT SIGNIFICANT AFTER MULTIPLE TESTING CORRECTIONS, BUT DNA METHYLATION AT 2 CPG SITES (DIHYDROOROTATE DEHYDROGENASE CG22381196 PFDR = .014; CTNNA3 CG00132141 PFDR = .043) WAS SIGNIFICANTLY ASSOCIATED WITH METS AFTER CONTROLLING FOR MULTIPLE COMPARISONS. INTERACTIONS BETWEEN THE MARGINALLY SIGNIFICANT CPG SITES AND BURDEN SCORES, HOWEVER, WERE NOT SIGNIFICANT. MORE WORK IS REQUIRED IN THIS AREA TO IDENTIFY INTERMEDIATE BIOLOGICAL PATHWAYS INFLUENCED BY ENVIRONMENTAL, GENETIC, AND EPIGENETIC VARIATION THAT MAY EXPLAIN THE HIGH PREVALENCE OF METS AMONG AFRICAN AMERICANS. THIS STUDY DOES SERVE, HOWEVER, AS AN EXAMPLE OF THE USE OF THE GENETIC BURDEN SCORE AS AN ALTERNATIVE DATA ANALYSIS APPROACH FOR COMPLEX STUDIES INVOLVING THE ANALYSIS OF GENETIC AND EPIGENETIC DATA SIMULTANEOUSLY. 2019 10 14 28 3RD COLLEGE OF PAEDIATRICS AND CHILD HEALTH LECTURE--THE PAST, THE PRESENT AND THE SHAPE OF THINGS TO COME.. THE GROWTH TRENDS OF SINGAPORE CHILDREN SPANNING 5 DECADES ARE REVIEWED, BASED ON 8 ANTHROPOMETRIC STUDIES FROM 1957 TILL 2002. THE HEIGHTS OF PRE-SCHOOL CHILDREN AND SCHOOL AGE CHILDREN APPEAR TO HAVE OPTIMISED ACCORDING TO THEIR GENETIC POTENTIAL, BUT THE WEIGHTS AND BODY MASS INDICES OF CHILDREN STILL APPEAR TO BE INCREASING FROM 6 TO 18 YEARS FOR BOTH SEXES, PROBABLY AS A CONSEQUENCE OF INCREASING AFFLUENCE. THIS TREND IS REFLECTED IN THE INCREASING OBESITY PREVALENCE IN SCHOOL CHILDREN OVER THE PAST 30 YEARS, AND THE CONCOMITANT INCREASED MORBIDITY ASSOCIATED WITH THE METABOLIC SYNDROME, NECESSITATES FURTHER RESEARCH INTO THE CAUSES OF OBESITY. BARKER'S HYPOTHESIS FIRST SUGGESTED THAT CHANGES IN THE INTRA-UTERINE ENVIRONMENT CAN CAUSE FETAL ADAPTATIONS WHICH PERSIST INTO ADULTHOOD, AND ARE RESPONSIBLE FOR MANY CHRONIC DISEASES OF ADULT LIFE. MORE RECENTLY, INTENSE RESEARCH IN THE FIELD OF EPIGENETICS SUGGESTS THAT THE ENVIRONMENT CAN ALSO INFLUENCE THE PHENOTYPE THROUGH GENE EXPRESSION, THROUGH MODIFICATION OF DNA METHYLATION AND HISTONES WHICH, IN TURN, INFLUENCES GENE EXPRESSION. THE CHALLENGE FOR THE FUTURE IS TO DETERMINE IF THERE ARE CLEAR EPIGENETIC CHANGES, WHICH ARE RESPONSIBLE FOR THE INCREASED PREVALENCE OF CHILDHOOD AND ADOLESCENT OBESITY, AND WHETHER THESE CHANGES ARE TRANSMITTED THROUGH GENERATIONS. UNRAVELLING THESE EPIGENETIC MECHANISMS MAY BE THE KEY TO THE PREVENTION OF OBESITY AND THE METABOLIC SYNDROME. 2008 11 1386 39 DIABETES: AN UPDATE ON THE PANDEMIC AND POTENTIAL SOLUTIONS. DIABETES MELLITUS IS A CHRONIC METABOLIC DISEASE WITH DEADLY, DISABLING, AND COSTLY CONSEQUENCES FOR INDIVIDUALS, FAMILIES, COMMUNITIES, AND COUNTRIES. ALTHOUGH THEY ARE PHENOTYPICALLY DISTINCT, DIABETES SUBTYPES (TYPE 1, TYPE 2, GESTATIONAL, AND OTHER FORMS) ARE ALL DEFINED BY ELEVATED BLOOD GLUCOSE LEVELS. APPROXIMATELY 95 PERCENT OF DIABETES CASES WORLDWIDE ARE TYPE 2 DIABETES (PREVIOUSLY KNOWN AS ADULT-ONSET OR NON-INSULIN-DEPENDENT DIABETES), WHICH IS THE FOCUS OF THIS CHAPTER. TYPE 1 DIABETES (PREVIOUSLY KNOWN AS INSULIN-DEPENDENT DIABETES) MOST COMMONLY BEGINS IN CHILDHOOD AND ADOLESCENCE. GESTATIONAL DIABETES REFERS TO ELEVATED BLOOD GLUCOSE LEVELS DURING PREGNANCY AMONG WOMEN WITHOUT PREVIOUS DIABETES AND IS ASSOCIATED WITH FETAL, BIRTHING, AND EARLY CHILDHOOD COMPLICATIONS AS WELL AS HIGHER RISK OF THE MOTHER DEVELOPING POSTGESTATION DIABETES. THE GROWTH OF DIABETES AND ITS IMPACTS HAVE ACCELERATED WORLDWIDE SINCE THE END OF THE TWENTIETH CENTURY (NCD-RISC 2016), LIKELY CORRELATED WITH EXPANSION OF DIABETES RISK FACTORS, ESPECIALLY POPULATION AGING AND OBESITY. DIABETES IS A MULTIFACTORIAL CONDITION. BECAUSE GENETIC, EPIGENETIC, LIFESTYLE, ECONOMIC, AND PSYCHOSOCIAL FACTORS ALL CONTRIBUTE TO THE DEVELOPMENT OF DIABETES (MCCARTHY 2010; STUMVOLL, GOLDSTEIN, AND VAN HAEFTEN 2005), PREVENTING AND MANAGING THE CONDITION REQUIRE ACTION AT POLICY, PROGRAM, CLINICAL PRACTICE, AND INDIVIDUAL LEVELS (HILL AND OTHERS 2013). RELIABLE AND MEANINGFUL ESTIMATES OF BURDENS, RISK FACTORS, AND EFFECTIVENESS AND COST-EFFECTIVENESS OF INTERVENTIONS AS WELL AS EVALUATIONS OF EXISTING POLICIES, ARE LIMITED; DATA ARE ESPECIALLY SCARCE IN LOW- AND MIDDLE-INCOME COUNTRIES (LMICS). THIS CHAPTER FOCUSES ON WHAT CAN AND SHOULD BE DONE TO ADDRESS DIABETES. WE PRESENT THE AVAILABLE DATA REGARDING GLOBAL BURDENS AND TRENDS IN DIABETES; REVIEW AVAILABLE EVIDENCE AND ASSESS THE EFFECTIVENESS AND COST-EFFECTIVENESS OF INTERVENTIONS TO PREVENT, DETECT, AND CONTROL DIABETES; AND REPORT SUMMARY EXPERT OPINIONS REGARDING THE PRIORITY AND FEASIBILITY OF IMPLEMENTING THESE INTERVENTIONS. ASSIMILATING EVIDENCE FROM COUNTRIES AT DIFFERENT INCOME LEVELS, WE PROVIDE GLOBAL PERSPECTIVES ON THE DIABETES PANDEMIC, RECOMMEND PRIORITY INTERVENTIONS, AND IDENTIFY REMAINING DATA GAPS. 2017 12 2799 36 FEED COMPOSITION DIFFERENCES RESULTING FROM ORGANIC AND CONVENTIONAL FARMING PRACTICES AFFECT PHYSIOLOGICAL PARAMETERS IN WISTAR RATS-RESULTS FROM A FACTORIAL, TWO-GENERATION DIETARY INTERVENTION TRIAL. RECENT HUMAN COHORT STUDIES REPORTED POSITIVE ASSOCIATIONS BETWEEN ORGANIC FOOD CONSUMPTION AND A LOWER INCIDENCE OF OBESITY, CANCER, AND SEVERAL OTHER DISEASES. HOWEVER, THERE ARE VERY FEW ANIMAL AND HUMAN DIETARY INTERVENTION STUDIES THAT PROVIDE SUPPORTING EVIDENCE OR A MECHANISTIC UNDERSTANDING OF THESE ASSOCIATIONS. HERE WE REPORT RESULTS FROM A TWO-GENERATION, DIETARY INTERVENTION STUDY WITH MALE WISTAR RATS TO IDENTIFY THE EFFECTS OF FEEDS MADE FROM ORGANIC AND CONVENTIONAL CROPS ON GROWTH, HORMONAL, AND IMMUNE SYSTEM PARAMETERS THAT ARE KNOWN TO AFFECT THE RISK OF A NUMBER OF CHRONIC, NON-COMMUNICABLE DISEASES IN ANIMALS AND HUMANS. A 2 X 2 FACTORIAL DESIGN WAS USED TO SEPARATE THE EFFECTS OF CONTRASTING CROP PROTECTION METHODS (USE OR NON-USE OF SYNTHETIC CHEMICAL PESTICIDES) AND FERTILIZERS (MINERAL NITROGEN, PHOSPHORUS AND POTASSIUM (NPK) FERTILIZERS VS. MANURE USE) APPLIED IN CONVENTIONAL AND ORGANIC CROP PRODUCTION. CONVENTIONAL, PESTICIDE-BASED CROP PROTECTION RESULTED IN SIGNIFICANTLY LOWER FIBER, POLYPHENOL, FLAVONOID, AND LUTEIN, BUT HIGHER LIPID, ALDICARB, AND DIQUAT CONCENTRATIONS IN ANIMAL FEEDS. CONVENTIONAL, MINERAL NPK-BASED FERTILIZATION RESULTED IN SIGNIFICANTLY LOWER POLYPHENOL, BUT HIGHER CADMIUM AND PROTEIN CONCENTRATIONS IN FEEDS. FEED COMPOSITION DIFFERENCES RESULTING FROM THE USE OF PESTICIDES AND/OR MINERAL NPK-FERTILIZER HAD A SIGNIFICANT EFFECT ON FEED INTAKE, WEIGHT GAIN, PLASMA HORMONE, AND IMMUNOGLOBULIN CONCENTRATIONS, AND LYMPHOCYTE PROLIFERATION IN BOTH GENERATIONS OF RATS AND IN THE SECOND GENERATION ALSO ON THE BODY WEIGHT AT WEANING. RESULTS SUGGEST THAT RELATIVELY SMALL CHANGES IN DIETARY INTAKES OF (A) PROTEIN, LIPIDS, AND FIBER, (B) TOXIC AND/OR ENDOCRINE-DISRUPTING PESTICIDES AND METALS, AND (C) POLYPHENOLS AND OTHER ANTIOXIDANTS (RESULTING FROM PESTICIDE AND/OR MINERAL NPK-FERTILIZER USE) HAD COMPLEX AND OFTEN INTERACTIVE EFFECTS ON ENDOCRINE, IMMUNE SYSTEMS AND GROWTH PARAMETERS IN RATS. HOWEVER, THE PHYSIOLOGICAL RESPONSES TO CONTRASTING FEED COMPOSITION/INTAKE PROFILES DIFFERED SUBSTANTIALLY BETWEEN THE FIRST AND SECOND GENERATIONS OF RATS. THIS MAY INDICATE EPIGENETIC PROGRAMMING AND/OR THE GENERATION OF "ADAPTIVE" PHENOTYPES AND SHOULD BE INVESTIGATED FURTHER. 2021 13 6730 25 WALK MORE, EAT LESS, DON'T STRESS. UNHEALTHY DIET, OBESITY, LACK OF PHYSICAL ACTIVITY, AND PSYCHOLOGIC STRESS ARE ASSOCIATED WITH INCREASED INFLAMMATION, OXIDATIVE STRESS, INSULIN RESISTANCE, AND DNA METHYLATION, WHICH ARE THE MAIN MECHANISMS OF CHRONIC DISEASES SUCH AS CANCER, HYPERTENSION, DIABETES, CARDIOVASCULAR DISEASE, AND ALZHEIMER'S DISEASE. IT HAS RECENTLY BEEN FOUND THAT HEALTHY DIET AND PHYSICAL ACTIVITY CAN REDUCE INFLAMMATORY MARKERS AND IMPROVE INSULIN SENSITIVITY RESULTING IN BETTER SURVIVORSHIP OUTCOMES IN PATIENTS WITH PROSTATE CANCER. AN "ANTI-INFLAMMATORY" LIFESTYLE, INCLUDING PHYSICAL ACTIVITY, HEALTHY BODY WEIGHT, HEALTHY DIET, AND STRESS REDUCTION, HAS BEEN ASSOCIATED WITH DECREASED CANCER RISK AND PROGRESSION. EPIGENETIC CHANGES DUE TO DNA METHYLATION AND ALTERED GENE EXPRESSION ASSOCIATED WITH UNHEALTHY LIFESTYLE CAN BE MODULATED BY HEALTHY BEHAVIORS. NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH (NCCIH) FOCUSES ON HEALTHY LIFESTYLE, AND IT SUPPORTS RESEARCH ON PSYCHOLOGIC AND PHYSICAL APPROACHES INCLUDING DIETARY SUPPLEMENTS AND PLANT-BASED PRODUCTS, AS WELL AS MIND AND BODY APPROACHES, SUCH AS YOGA, MASSAGE, MEDITATION, MINDFULNESS-BASED STRESS REDUCTION, AND ACUPUNCTURE. SEE RELATED ARTICLE BY LANGLAIS ET AL., P. 1760. 2022 14 1749 24 EARLY LIFE INTERVENTIONS CAN SHAPE AGING. IT IS WELL DOCUMENTED THAT THE ENVIRONMENT OF THE DEVELOPING FETUS, INCLUDING AVAILABILITY OF NUTRIENTS AND PRESENCE OF TOXINS, CAN HAVE MAJOR IMPACT ON ADULT PHENOTYPE, AGE-RELATED TRAITS AND RISK OF CHRONIC DISEASE. THERE IS ALSO ACCUMULATING EVIDENCE THAT POSTNATAL ENVIRONMENT CAN IMPACT ADULT CHARACTERISTICS RELATED TO EVOLUTIONARY FITNESS, HEALTH, AND AGING. TO DETERMINE WHETHER EARLY LIFE HORMONAL INTERVENTIONS CAN ALTER TRAJECTORY OF AGING, WE HAVE EXAMINED THE EFFECTS OF EARLY LIFE GROWTH HORMONE (GH) REPLACEMENT THERAPY IN PROP1(DF) (AMES DWARF) MICE WHICH ARE GH DEFICIENT AND REMARKABLY LONG LIVED. TWICE-DAILY GH INJECTIONS BETWEEN THE AGES OF TWO AND EIGHT WEEKS COMPLETELY NORMALIZED ("RESCUED") A NUMBER OF ADULT METABOLIC CHARACTERISTICS BELIEVED TO CONTRIBUTE TO EXTENDED LONGEVITY OF THESE MUTANTS. IMPORTANTLY, LONGEVITY OF AMES DWARF MICE WAS REDUCED BY EARLY LIFE GH TREATMENT. THIS WAS ASSOCIATED WITH HISTONE H3 MODIFICATIONS. WE CONCLUDE THAT THE TRAJECTORY OF MAMMALIAN AGING CAN BE MODIFIED BY EARLY LIFE INTERVENTIONS. MECHANISTIC LINKS AMONG INTERVENTIONS DURING POSTNATAL DEVELOPMENT, ADULT METABOLIC CHARACTERISTICS, AGING, AND LONGEVITY, APPARENTLY INVOLVE EPIGENETIC PHENOMENA. 2022 15 6127 29 THE EPIGENETIC OVERLAP BETWEEN OBESITY AND MOOD DISORDERS: A SYSTEMATIC REVIEW. (1) BACKGROUND: OBESITY AND MOOD DISORDERS ARE CONSIDERED AS THE MOST PREVALENT MORBIDITIES IN MANY COUNTRIES. WE SUPPOSE THAT EPIGENETIC MECHANISMS MAY INDUCE HIGHER RATES OF OBESITY IN SUBJECTS WHO SUFFER FROM MOOD DISORDERS. IN THIS SYSTEMATIC REVIEW, WE FOCUSED ON THE POTENTIAL ROLES OF DNA METHYLATION ON MOOD DISORDERS AND OBESITY DEVELOPMENT. (2) METHODS: THIS SYSTEMATIC REVIEW WAS CONDUCTED IN ACCORDANCE WITH THE PRISMA STATEMENT AND REGISTERED IN PROSPERO. A SYSTEMATIC SEARCH WAS CONDUCTED IN MEDLINE, SCOPUS, WEB OF SCIENCE, COCHRANE CENTRAL DATABASE, EMBASE, AND CINHAL. WE ALSO CONDUCTED A GREY LITERATURE SEARCH, SUCH AS GOOGLE SCHOLAR. (3) RESULTS: AFTER DEDUPLICATION, WE IDENTIFIED 198 POTENTIALLY RELATED CITATIONS. FINALLY, TEN UNIQUE STUDIES MET OUR INCLUSION CRITERIA. WE HAVE FOUND THREE OVERLAP GENES THAT SHOW SIGNIFICANT DNA METHYLATION CHANGES, BOTH IN OBESITY AND DEPRESSION. PATHWAY ANALYSIS INTERACTION FOR TAPBP, BDNF, AND SORBS2 CONFIRMED THE RELATION OF THESE GENES IN BOTH OBESITY AND MOOD DISORDERS. (4) CONCLUSIONS: WHILE MECHANISMS LINKING BOTH OBESITY AND MOOD DISORDERS TO EPIGENETIC RESPONSE ARE STILL UNKNOWN, WE HAVE ALREADY KNOWN CHRONIC INFLAMMATION INDUCES A NOVEL EPIGENETIC PROGRAM. AS THE RESULTS OF GENE ENRICHMENT, PATHWAYS ANALYSIS SHOWED THAT TAPBP, BDNF, AND SORBS2 LINKED TOGETHER BY INFLAMMATORY PATHWAYS. HYPERMETHYLATION IN THESE GENES MIGHT PLAY A CRUCIAL RULE IN THE CO-OCCURRENCE OF OBESITY AND MOOD DISORDERS. 2020 16 4198 25 METABOLIC PROFILING DISTINGUISHES THREE SUBTYPES OF ALZHEIMER'S DISEASE. THE CAUSE OF ALZHEIMER'S DISEASE IS INCOMPLETELY DEFINED, AND NO TRULY EFFECTIVE THERAPY EXISTS. HOWEVER, MULTIPLE STUDIES HAVE IMPLICATED METABOLIC ABNORMALITIES SUCH AS INSULIN RESISTANCE, HORMONAL DEFICIENCIES, AND HYPERHOMOCYSTEINEMIA. OPTIMIZING METABOLIC PARAMETERS IN A COMPREHENSIVE WAY HAS YIELDED COGNITIVE IMPROVEMENT, BOTH IN SYMPTOMATIC AND ASYMPTOMATIC INDIVIDUALS. THEREFORE, EXPANDING THE STANDARD LABORATORY EVALUATION IN PATIENTS WITH DEMENTIA MAY BE REVEALING. HERE I REPORT THAT METABOLIC PROFILING REVEALS THREE ALZHEIMER'S DISEASE SUBTYPES. THE FIRST IS INFLAMMATORY, IN WHICH MARKERS SUCH AS HS-CRP AND GLOBULIN:ALBUMIN RATIO ARE INCREASED. THE SECOND TYPE IS NON-INFLAMMATORY, IN WHICH THESE MARKERS ARE NOT INCREASED, BUT OTHER METABOLIC ABNORMALITIES ARE PRESENT. THE THIRD TYPE IS A VERY DISTINCTIVE CLINICAL ENTITY THAT AFFECTS RELATIVELY YOUNG INDIVIDUALS, EXTENDS BEYOND THE TYPICAL ALZHEIMER'S DISEASE INITIAL DISTRIBUTION TO AFFECT THE CORTEX WIDELY, IS CHARACTERIZED BY EARLY NON-AMNESTIC FEATURES SUCH AS DYSCALCULIA AND APHASIA, IS OFTEN MISDIAGNOSED OR LABELED ATYPICAL ALZHEIMER'S DISEASE, TYPICALLY AFFECTS APOE4-NEGATIVE INDIVIDUALS, AND IS ASSOCIATED WITH STRIKING ZINC DEFICIENCY. GIVEN THE INVOLVEMENT OF ZINC IN MULTIPLE ALZHEIMER'S-RELATED METABOLIC PROCESSES, SUCH AS INSULIN RESISTANCE, CHRONIC INFLAMMATION, ADAM10 PROTEOLYTIC ACTIVITY, AND HORMONAL SIGNALING, THIS SYNDROME OF ALZHEIMER'S-PLUS WITH LOW ZINC (APLZ) WARRANTS FURTHER METABOLIC, GENETIC, AND EPIGENETIC CHARACTERIZATION. 2015 17 3648 36 INCREASED RELATIVE ABUNDANCE OF RUMINOCCOCUS IS ASSOCIATED WITH REDUCED CARDIOVASCULAR RISK IN AN OBESE POPULATION. BACKGROUND: OBESITY IS A COMPLEX DISEASE WITH UNDERLYING GENETIC, ENVIRONMENTAL, PSYCHOLOGICAL, PHYSIOLOGICAL, MEDICAL, AND EPIGENETIC FACTORS. OBESITY CAN CAUSE VARIOUS DISORDERS, INCLUDING CARDIOVASCULAR DISEASES (CVDS), THAT ARE AMONG THE MOST PREVALENT CHRONIC CONDITIONS IN QATAR. RECENT STUDIES HAVE HIGHLIGHTED THE SIGNIFICANT ROLES OF THE GUT MICROBIOME IN IMPROVING THE PATHOLOGY OF VARIOUS DISEASES, INCLUDING OBESITY. THUS, IN THIS STUDY, WE AIMED TO INVESTIGATE THE EFFECTS OF DIETARY INTAKE AND GUT MICROBIAL COMPOSITION IN MODULATING THE RISK OF CVD DEVELOPMENT IN OBESE QATARI ADULTS. METHODS: WE ENROLLED 46 ADULT SUBJECTS (18-65 YEARS OF AGE) WHO WERE CLASSIFIED BASED ON THEIR CVD RISK SCORES, CALCULATED USING THE FRAMINGHAM FORMULA, INTO A CVD NO-RISK GROUP (SCORE OF <10%, N = 36) AND CVD RISK GROUP (SCORE OF >/=10%, N = 10). FOR EACH STUDY SUBJECT, WE MEASURED THE GUT MICROBIAL COMPOSITION WITH A 16S RDNA SEQUENCING METHOD THAT TARGETED THE V3-V4 REGION USING ILLUMINA MISEQ, AND THEIR NUTRITIONAL STATUS WAS RECORDED BASED ON 24-H DIETARY RECALL. DIETARY INTAKE, BACTERIAL TAXA SUMMARY, DIVERSITY INDEX, MICROBIAL MARKERS, PATHWAY ANALYSIS, AND NETWORK CORRELATION WERE DETERMINED FOR THE STUDY SUBJECTS. RESULTS: THE CVD RISK GROUP SHOWED A LOWER INTAKE OF VITAMIN D, REDUCED RELATIVE ABUNDANCE OF GENERA RUMINOCOCCUS AND BIFIDOBACTERIUM, NO CHANGE IN BACTERIAL DIVERSITY, AND HIGHER LEVELS OF TAURINE, HYPOTAURINE, AND LIPOIC ACID METABOLISM THAN THE CVD NO-RISK GROUP. BESIDES, THE RELATIVE ABUNDANCE OF GENUS RUMINOCOCCUS WAS POSITIVELY CORRELATED WITH THE INTAKE OF PROTEIN, MONOUNSATURATED FAT, VITAMIN A, AND VITAMIN D. CONCLUSION: TAKEN TOGETHER, OUR RESULTS SUGGEST THAT THE GENUS RUMINOCOCCUS COULD BE USED AS A MICROBIAL MARKER, AND ITS REDUCED RELATIVE ABUNDANCE COULD MEDIATE THE RISK OF CVDS IN THE OBESE QATARI POPULATION. 2022 18 844 32 CHILDHOOD ALLERGY DISEASE, EARLY DIAGNOSIS, AND THE POTENTIAL OF SALIVARY PROTEIN BIOMARKERS. ALLERGIC DISEASE HAS RISEN TO EPIDEMIC PROPORTIONS SINCE THE LAST DECADE AND IS AMONG THE MOST COMMON NONCOMMUNICABLE, CHRONIC DISEASES IN CHILDREN AND ADOLESCENTS WORLDWIDE. ALLERGIC DISEASE USUALLY OCCURS IN EARLY LIFE; THUS, EARLY BIOMARKERS OF ALLERGIC SUSCEPTIBILITY ARE REQUIRED FOR PREVENTIVE MEASURES TO HIGH-RISK INFANTS WHICH ENABLE EARLY INTERVENTIONS TO DECREASE ALLERGIC SEVERITY. HOWEVER, TO DATE, THERE IS NO RELIABLE GENERAL OR SPECIFIC ALLERGY PHENOTYPE DETECTION METHOD THAT IS EASY AND NONINVASIVE FOR CHILDREN. MOST REPORTED ALLERGIC PHENOTYPE DETECTION METHODS ARE INVASIVE, SUCH AS THE SKIN PRICK TEST (SPT), ORAL FOOD CHALLENGE (OFC), AND BLOOD TEST, AND MANY INVOLVE NOT READILY ACCESSIBLE BIOLOGICAL SAMPLES, SUCH AS CORD BLOOD (CB), MATERNAL BLOOD, OR NEWBORN VERNIX. SALIVA IS A BIOLOGICAL SAMPLE THAT HAS GREAT POTENTIAL AS A BIOMARKER MEASUREMENT AS IT CONSISTS OF AN ABUNDANCE OF BIOMARKERS, SUCH AS GENETIC MATERIAL AND PROTEINS. IT IS EASILY ACCESSIBLE, NONINVASIVE, COLLECTED VIA A PAINLESS PROCEDURE, AND AN EASY BEDSIDE SCREENING FOR REAL-TIME MEASUREMENT OF THE ONGOING HUMAN PHYSIOLOGICAL SYSTEM. ALL THESE ADVANTAGES EMPHASISE SALIVA AS A VERY PROMISING DIAGNOSTIC CANDIDATE FOR THE DETECTION AND MONITORING OF DISEASE BIOMARKERS, ESPECIALLY IN CHILDREN. FURTHERMORE, PROTEIN BIOMARKERS HAVE THE ADVANTAGES AS MODIFIABLE INFLUENCING FACTORS RATHER THAN GENETIC AND EPIGENETIC FACTORS THAT ARE MOSTLY NONMODIFIABLE FACTORS FOR ALLERGIC DISEASE SUSCEPTIBILITY IN CHILDHOOD. SALIVA HAS GREAT POTENTIAL TO REPLACE SERUM AS A BIOLOGICAL FLUID BIOMARKER IN DIAGNOSING CLINICAL ALLERGY. HOWEVER, TO DATE, SALIVA IS NOT CONSIDERED AS AN ESTABLISHED MEDICALLY ACCEPTABLE BIOMARKER. THIS REVIEW CONSIDERS WHETHER THE SALIVA COULD BE SUITABLE BIOLOGICAL SAMPLES FOR EARLY DETECTION OF ALLERGIC RISK. SUCH TOOLS MAY BE USED AS JUSTIFICATION FOR TARGETED INTERVENTIONS IN EARLY CHILDHOOD FOR DISEASE PREVENTION AND ASSISTING IN REDUCING MORBIDITY AND MORTALITY CAUSED BY CHILDHOOD ALLERGY. 2021 19 4808 28 OBESITY MANAGEMENT: AT THE FOREFRONT AGAINST DISEASE STIGMA AND THERAPEUTIC INERTIA. OBESITY IS A COMPLEX CHRONIC RELAPSING DISEASE, RESULTING FROM THE INTERACTION BETWEEN MULTIPLE ENVIRONMENTAL, GENETIC AND EPIGENETIC CAUSES, AND SUPPORTED BY CHANGES IN THE NEUROENDOCRINE MECHANISMS REGULATING ENERGY BALANCE AND BODY WEIGHT. ADIPOSE TISSUE DYSFUNCTION CONTRIBUTES TO OBESITY-RELATED COMPLICATIONS. HOWEVER, THE PREVALENT NARRATIVE ABOUT THE CAUSES AND MECHANISMS OF OBESITY REMAINS A MUCH MORE SIMPLISTIC ONE, BASED ON THE FALSE ASSUMPTION THAT INDIVIDUALS CAN FULLY CONTROL THEIR BODY WEIGHT THROUGH APPROPRIATE BEHAVIOURAL CHOICES. ACCORDING TO THIS NARRATIVE, OBESITY IS SIMPLY REVERSIBLE "PERSUADING" THE PATIENT TO FOLLOW HEALTHIER AND MORE VIRTUOUS INDIVIDUAL BEHAVIOURS (MORAL JUDGEMENT). THIS PERSISTENT NARRATIVE FORMS THE DEEP ROOT OF THE STIGMATISATION OF PEOPLE WITH OBESITY AT THE INDIVIDUAL LEVEL AND CREATES A CLEAR DISCREPANCY ON HOW OBESITY PREVENTION AND CURE ARE DESIGNED IN COMPARISON WITH THE CASE OF OTHER NON-COMMUNICABLE CHRONIC DISEASES (CLINICAL STIGMA). THE PROMOTION OF SYSTEMIC PREVENTIVE MEASURES AGAINST OBESITY IS NOT SUPPORTED AT A POLITICAL AND SOCIAL LEVEL BY THE PERSISTENCE OF A NARRATIVE OF OBESITY AS THE SIMPLE CONSEQUENCE OF INDIVIDUAL FAILURES AND LACK OF WILLPOWER. THE SIMPLISTIC NARRATIVE OF OBESITY AS A SELF-IMPOSED CONDITION WITH AN EASY WAY-OUT ("EAT LESS AND MOVE MORE") CREATES A CLEAR DISCREPANCY ON HOW OBESITY IS MANAGED BY HEALTH CARE SYSTEMS IN COMPARISON WITH OTHER NCDS. THE OVER-ESTIMATION OF THE EFFICACY OF THERAPEUTIC INTERVENTION SOLELY BASED ON PATIENTS EDUCATION AND LIFESTYLE MODIFICATION IS RESPONSIBLE OF THERAPEUTIC INERTIA IN HEALTH CARE PROFESSIONALS AND IN CLINICAL GUIDELINES, LIMITING OR DELAYING THE ADOPTION OF MORE EFFECTIVE THERAPEUTIC STRATEGIES, LIKE ANTI-OBESITY MEDICATIONS AND BARIATRIC SURGERY. IN CONCLUSION, THE PERSISTENCE OF A NARRATIVE DESCRIBING OBESITY AS A SELF-INDUCED EASILY REVERSIBLE CONDITION HAS PROFOUND CONSEQUENCES ON HOW OBESITY PREVENTION AND MANAGEMENT ARE BUILD, INCLUDING THE DESIGN AND IMPLEMENTATION OF OBESITY MANAGEMENT GUIDELINES AND A TENDENCY TO THERAPEUTIC INERTIA.LEVEL OF EVIDENCE: NO LEVEL OF EVIDENCE. 2022 20 1927 25 ENVIRONMENTAL EPIGENOMICS AND DISEASE SUSCEPTIBILITY. KEYSTONE SYMPOSIA ON MOLECULAR AND CELLULAR BIOLOGY. THE GROVE PARK HOTEL & SPA, ASHVILLE, NC, USA, 27 MARCH-1 APRIL 2011. THE MAIN OBJECTIVE OF THIS CONFERENCE WAS TO PROVIDE SOLID EVIDENCE THAT ENVIRONMENTAL EXPOSURES DURING EARLY DEVELOPMENT CAN AFFECT FAITHFUL REPRODUCTION OF INDIVIDUAL PARENTAL EPIGENOMES WITHOUT CHANGING DNA SEQUENCE IN THE OFFSPRING. NO DOUBT, THIS IMPORTANT GOAL HAS BEEN SUCCESSFULLY ACHIEVED OWING TO THE HIGH QUALITY OF PRESENTED EPIDEMIOLOGICAL AND EXPERIMENTAL STUDIES AND ENGAGING DISCUSSIONS OF MANY YET TO BE PUBLISHED RESULTS. COMPELLING DATA SUGGESTED A STRONG CAUSAL LINK BETWEEN PRENATAL VULNERABILITY OF FUTURE PARENTAL EPIGENOMES TO DAMAGING ENVIRONMENTAL FACTORS AGGRAVATED BY ABNORMAL SOCIO-CULTURAL CONDITIONS (INCLUDING, FOR INSTANCE, MALNUTRITION AND CHRONIC STRESS) AND THE ALARMING RISK OF DEVELOPING HERITABLE COMPLEX MEDICAL CONDITIONS LATER IN LIFE, SUCH AS ASTHMA, AUTISM, CANCER, CARDIOVASCULAR DISEASE, DIABETES, OBESITY, SCHIZOPHRENIA AND A WHOLE RANGE OF RARE NEUROMUSCULAR PATHOLOGIES. IT WAS CONCLUDED THAT MODERN EPIGENETIC RESEARCH PROMISES TO MARKEDLY IMPROVE OUR ABILITY TO DIAGNOSE, PREVENT AND TREAT THESE AND OTHER PATHOLOGICAL CONDITIONS OF HUMANS. HOWEVER, THE COMPLEX HERITABILITY PATTERN OF 'EPIGENETIC SYNDROMES' ALSO INTRODUCES UNIQUE LEGAL AND ETHICAL ISSUES THAT WERE DISCUSSED AT THE END OF THIS OUTSTANDING MEETING. 2011