1 5605 138 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 2 6822 42 [GENDER MEDICINE. SEX- AND GENDER-SPECIFIC ASPECTS OF CLINICAL MEDICINE]. GENDER MEDICINE STUDIES SEX- AND GENDER-BASED DIFFERENCES IN THE DEVELOPMENT AND PREVENTION OF DISEASES, THE AWARENESS AND PRESENTATION OF SYMPTOMS, AND THE EFFECTIVENESS OF THERAPY. GENDER MEDICINE IS PART OF PERSONALIZED MEDICINE, CONSIDERING DIFFERENCES IN BIOLOGICAL AND PSYCHOSOCIAL FACTORS INDIVIDUALLY. THERE ARE DIFFERENCES IN GENES, CHROMOSOMES, HORMONES, AND METABOLISM AS WELL AS DIFFERENCES IN CULTURE, ENVIRONMENT, AND SOCIETY. LIFELONG INTERACTIONS BETWEEN PHYSICAL AND PSYCHOSOCIAL FACTORS WILL INFLUENCE THE HEALTH AND ILL-HEALTH OF MEN AND WOMEN IN DIFFERENT WAYS. EPIGENETIC MODIFICATIONS PROVIDE EVIDENCE OF THE IMPACT OF ENVIRONMENT AND LIFESTYLE DURING VULNERABLE PHASES ON BIOLOGICAL PROCESSES, EFFECTING FUTURE GENERATIONS. MATERNAL LIFESTYLE AND ENVIRONMENTAL FACTORS DURING PREGNANCY CAN IMPACT THE HEALTH OF OFFSPRING IN LATER LIFE ALREADY IN UTERO IN A SEX-SPECIFIC WAY. PAIN, STRESS, AND COPING STYLES DIFFER BETWEEN MEN AND WOMEN. WOMEN EXPERIENCE MORE DRAMATIC PHYSICAL CHANGES DURING THEIR LIFETIME, WHICH ARE ASSOCIATED WITH SPECIFIC BURDENS AND PSYCHOSOCIAL ALTERATIONS. WOMEN WITH MULTIPLE ROLES AND RESPONSIBILITIES SUFFERING FROM STRESS DEVELOP DEPRESSION MORE FREQUENTLY. HOWEVER, MEN ARE OFTEN NOT DIAGNOSED AND TREATED APPROPRIATELY IN CASES OF DEPRESSION OR OSTEOPOROSIS, DISEASES THAT ARE TYPICALLY CONSIDERED "FEMALE." THERE ARE PROMINENT DIFFERENCES BETWEEN MEN AND WOMEN IN MEDICINE REGARDING THE IMMUNE SYSTEM, INFLAMMATION, AND NONCOMMUNICABLE DISEASES SUCH AS OBESITY, TYPE 2 DIABETES, HYPERTENSION, AND CARDIOVASCULAR DISEASE. WOMEN EXPERIENCE MORE OFTEN AUTOIMMUNE DISEASES AND SUFFER MORE FREQUENTLY FROM (CHRONIC) PAIN, NEURODEGENERATIVE CHANGES, AND FUNCTIONAL DISABILITIES. MEN HAVE SHORTER LIFE EXPECTANCY BUT RELATIVELY MORE HEALTHY YEARS OF LIFE, WHICH IS IN GREATER PART ASCRIBED TO PSYCHOSOCIAL DETERMINANTS. STATE-OF-THE-ART CLINICAL MEDICINE COMPRISES INDIVIDUAL RISK FACTORS BASED ON SEX- AND GENDER-SENSITIVE HEALTH PROGRAMS IN ORDER TO IMPROVE THE HEALTH-RELATED QUALITY OF LIFE FOR MEN AND WOMEN. 2014 3 625 32 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 4 6109 31 THE EPIGENETIC AGING, OBESITY, AND LIFESTYLE. THE PREVALENCE OF OBESITY HAS DRAMATICALLY INCREASED WORLDWIDE OVER THE PAST DECADES. AGING-RELATED CHRONIC CONDITIONS, SUCH AS TYPE 2 DIABETES AND CARDIOVASCULAR DISEASE, ARE MORE PREVALENT IN INDIVIDUALS WITH OBESITY, THUS REDUCING THEIR LIFESPAN. EPIGENETIC CLOCKS, THE NEW METRICS OF BIOLOGICAL AGE BASED ON DNA METHYLATION PATTERNS, COULD BE CONSIDERED A REFLECTION OF THE STATE OF ONE'S HEALTH. SEVERAL ENVIRONMENTAL EXPOSURES AND LIFESTYLE FACTORS CAN INDUCE EPIGENETIC AGING ACCELERATIONS, INCLUDING OBESITY, THUS LEADING TO AN INCREASED RISK OF AGE-RELATED DISEASES. THE INSIGHT INTO THE COMPLEX LINK BETWEEN OBESITY AND AGING MIGHT HAVE SIGNIFICANT IMPLICATIONS FOR THE PROMOTION OF HEALTH AND THE MITIGATION OF FUTURE DISEASE RISK. THE PRESENT NARRATIVE REVIEW TAKES INTO ACCOUNT THE INTERACTION BETWEEN EPIGENETIC AGING AND OBESITY, SUGGESTING THAT EPIGENOME MAY BE AN INTRIGUING TARGET FOR AGE-RELATED PHYSIOLOGICAL CHANGES AND THAT ITS MODIFICATION COULD INFLUENCE AGING AND PROLONG A HEALTHY LIFESPAN. THEREFORE, WE HAVE FOCUSED ON DNA METHYLATION AGE AS A CLINICAL BIOMARKER, AS WELL AS ON THE POTENTIAL REVERSAL OF EPIGENETIC AGE USING A PERSONALIZED DIET- AND LIFESTYLE-BASED INTERVENTION. 2022 5 456 41 APPLYING A LIFE COURSE BIOLOGICAL AGE FRAMEWORK TO IMPROVING THE CARE OF INDIVIDUALS WITH ADULT CANCERS: REVIEW AND RESEARCH RECOMMENDATIONS. IMPORTANCE: THE PRACTICE OF ONCOLOGY WILL INCREASINGLY INVOLVE THE CARE OF A GROWING POPULATION OF INDIVIDUALS WITH MIDLIFE AND LATE-LIFE CANCERS. MANAGING CANCER IN THESE INDIVIDUALS IS COMPLEX, BASED ON DIFFERENCES IN BIOLOGICAL AGE AT DIAGNOSIS. BIOLOGICAL AGE IS A MEASURE OF ACCUMULATED LIFE COURSE DAMAGE TO BIOLOGICAL SYSTEMS, LOSS OF RESERVE, AND VULNERABILITY TO FUNCTIONAL DETERIORATION AND DEATH. BIOLOGICAL AGE IS IMPORTANT BECAUSE IT AFFECTS THE ABILITY TO MANAGE THE RIGORS OF CANCER THERAPY, SURVIVORS' FUNCTION, AND CANCER PROGRESSION. HOWEVER, BIOLOGICAL AGE IS NOT ALWAYS CLINICALLY APPARENT. THIS REVIEW PRESENTS A CONCEPTUAL FRAMEWORK OF LIFE COURSE BIOLOGICAL AGING, SUMMARIZES CANDIDATE MEASURES, AND DESCRIBES A RESEARCH AGENDA TO FACILITATE CLINICAL TRANSLATION TO ONCOLOGY PRACTICE. OBSERVATIONS: MIDLIFE AND LATE-LIFE CANCERS ARE CHRONIC DISEASES THAT MAY ARISE FROM CUMULATIVE PATTERNS OF BIOLOGICAL AGING OCCURRING OVER THE LIFE COURSE. BEFORE DIAGNOSIS, EACH NEW PATIENT WAS ON A DISTINCT COURSE OF BIOLOGICAL AGING RELATED TO PAST EXPOSURES, LIFE EXPERIENCES, GENETICS, AND NONCANCER CHRONIC DISEASE. CANCER AND ITS TREATMENTS MAY ALSO BE ASSOCIATED WITH BIOLOGICAL AGING. SEVERAL MEASURES OF BIOLOGICAL AGE, INCLUDING P16INK4A, EPIGENETIC AGE, TELOMERE LENGTH, AND INFLAMMATORY AND BODY COMPOSITION MARKERS, HAVE BEEN USED IN ONCOLOGY RESEARCH. ONE OR MORE OF THESE MEASURES MAY BE USEFUL IN CANCER CARE, EITHER ALONE OR IN COMBINATION WITH CLINICAL HISTORY AND GERIATRIC ASSESSMENTS. HOWEVER, FURTHER RESEARCH WILL BE NEEDED BEFORE BIOLOGICAL AGE ASSESSMENT CAN BE RECOMMENDED IN ROUTINE PRACTICE, INCLUDING DETERMINATION OF SITUATIONS IN WHICH KNOWLEDGE ABOUT BIOLOGICAL AGE WOULD CHANGE TREATMENT, ASCERTAINING WHETHER TREATMENT EFFECTS ON BIOLOGICAL AGING ARE SHORT-LIVED OR PERSISTENT, AND TESTING INTERVENTIONS TO MODIFY BIOLOGICAL AGE, DECREASE TREATMENT TOXIC EFFECTS, AND MAINTAIN FUNCTIONAL ABILITIES. CONCLUSIONS AND RELEVANCE: UNDERSTANDING DIFFERENCES IN BIOLOGICAL AGING COULD ULTIMATELY ALLOW CLINICIANS TO BETTER PERSONALIZE TREATMENT AND SUPPORTIVE CARE, DEVELOP TAILORED SURVIVORSHIP CARE PLANS, AND PRESCRIBE PREVENTIVE OR AMELIORATIVE THERAPIES AND BEHAVIORS INFORMED BY AGING MECHANISMS. 2021 6 1385 40 DIABETES IN CHILDHOOD CANCER SURVIVORS: EMERGING CONCEPTS IN PATHOPHYSIOLOGY AND FUTURE DIRECTIONS. WITH ADVANCEMENTS IN CANCER TREATMENT AND SUPPORTIVE CARE, THERE IS A GROWING POPULATION OF CHILDHOOD CANCER SURVIVORS WHO EXPERIENCE A SUBSTANTIAL BURDEN OF COMORBIDITIES RELATED TO HAVING RECEIVED CANCER TREATMENT AT A YOUNG AGE. DESPITE AN OVERALL REDUCTION IN THE INCIDENCE OF MOST CHRONIC HEALTH CONDITIONS IN CHILDHOOD CANCER SURVIVORS OVER THE PAST SEVERAL DECADES, THE CUMULATIVE INCIDENCE OF CERTAIN LATE EFFECTS, IN PARTICULAR DIABETES MELLITUS (DM), HAS INCREASED. THE IMPLICATIONS ARE SIGNIFICANT, BECAUSE DM IS A KEY RISK FACTOR FOR CARDIOVASCULAR DISEASE, A LEADING CAUSE OF PREMATURE DEATH IN CHILDHOOD CANCER SURVIVORS. THE UNDERLYING PATHOPHYSIOLOGY OF DM IN CANCER SURVIVORS IS MULTIFACTORIAL. DM DEVELOPS AT YOUNGER AGES IN SURVIVORS COMPARED TO CONTROLS, WHICH MAY REFLECT AN "ACCELERATED AGING" PHENOTYPE IN THESE INDIVIDUALS. THE TREATMENT-RELATED EXPOSURES (I.E., CHEMOTHERAPY, RADIATION) THAT INCREASE RISK FOR DM IN CHILDHOOD CANCER SURVIVORS MAY BE MORE THAN ADDITIVE WITH ESTABLISHED DM RISK FACTORS (E.G., OLDER AGE, OBESITY, RACE, AND ETHNICITY). EMERGING RESEARCH ALSO POINTS TO PARALLELS IN CELLULAR PROCESSES IMPLICATED IN AGING- AND CANCER TREATMENT-RELATED DM. STILL, THERE REMAINS MARKED INTER-INDIVIDUAL VARIABILITY REGARDING RISK OF DM THAT IS NOT EXPLAINED BY DEMOGRAPHIC AND THERAPEUTIC RISK FACTORS ALONE. RECENT STUDIES HAVE HIGHLIGHTED THE ROLE OF GERMLINE GENETIC RISK FACTORS AND EPIGENETIC MODIFICATIONS THAT ARE ASSOCIATED WITH RISK OF DM IN BOTH THE GENERAL AND ONCOLOGY POPULATIONS. THIS REVIEW SUMMARIZES OUR CURRENT UNDERSTANDING OF RECOGNIZED RISK FACTORS FOR DM IN CHILDHOOD CANCER SURVIVORS TO HELP INFORM TARGETED APPROACHES FOR DISEASE SCREENING, PREVENTION, AND TREATMENT. FURTHERMORE, IT HIGHLIGHTS THE EXISTING SCIENTIFIC GAPS IN UNDERSTANDING THE RELATIVE CONTRIBUTIONS OF INDIVIDUAL THERAPEUTIC EXPOSURES AND THE MECHANISMS BY WHICH THEY EXERT THEIR EFFECTS THAT UNIQUELY PREDISPOSE THIS POPULATION TO DM FOLLOWING CANCER TREATMENT. 2023 7 3676 35 INFLAMMATION AND NEUTROPHIL IMMUNOSENESCENCE IN HEALTH AND DISEASE: TARGETED TREATMENTS TO IMPROVE CLINICAL OUTCOMES IN THE ELDERLY. DESPITE INCREASING LONGEVITY, MANY OLD PEOPLE ARE NOT IN GOOD HEALTH. THERE HAS BEEN AN INCREASE IN THE PREVALENCE OF AGE-ASSOCIATED MULTI-MORBIDITY (TWO OR MORE CHRONIC CONDITIONS IN THE SAME PERSON). ALSO, SEVERE INFECTIONS, SUCH AS PNEUMONIA, REMAIN SIGNIFICANT CAUSES OF MORTALITY AND MORBIDITY IN THIS AGING GROUP. MANY CHRONIC HEALTH CONDITIONS SHARE RISK FACTORS SUCH AS INCREASING AGE, SMOKING, A SEDENTARY LIFE STYLE AND BEING PART OF A LOWER SOCIOECONOMIC GROUP. HOWEVER, DESPITE THIS, MULTI-MORBIDITIES OFTEN CO-OCCUR MORE COMMONLY THAN WOULD BE PREDICTED. THIS HAS LED TO THE HYPOTHESIS THAT THEY SHARE COMMON UNDERLYING MECHANISMS. THIS IS AN IMPORTANT CONCEPT, FOR IF IT WERE TRUE, TREATMENTS COULD BE DEVISED WHICH TARGET THESE COMMON PATHWAYS AND IMPROVE A NUMBER OF AGE-ASSOCIATED HEALTH CONDITIONS. MANY CHRONIC ILLNESSES ASSOCIATED WITH MULTI-MORBIDITY AND SEVERE INFECTIONS ARE CHARACTERIZED BY AN ABNORMAL AND SUSTAINED INFLAMMATORY RESPONSE, WITH NEUTROPHILS BEING KEY EFFECTOR CELLS IN THE PATHOLOGICAL PROCESS. STUDIES HAVE DESCRIBED ABERRANT NEUTROPHIL FUNCTIONS ACROSS THESE CONDITIONS, AND SOME HAVE HIGHLIGHTED POTENTIAL MECHANISMS FOR ALTERED CELL BEHAVIOURS WHICH APPEAR SHARED ACROSS DISEASE STATES. IT HAS BEEN SUGGESTED THAT ALTERED FUNCTIONS MAY REPRESENT NEUTROPHIL "SENESCENCE". THIS REVIEW CONSIDERS HOW AND WHY NEUTROPHIL FUNCTIONS CHANGE AS THE CELL AGES, AND HOW AND WHY NEUTROPHIL FUNCTIONS CHANGE AS THE HOST AGES IN HEALTH AND DISEASE AND DISCUSSES WHETHER NEUTROPHIL FUNCTIONS COULD BE TARGETED TO IMPROVE HEALTH OUTCOMES IN OLDER ADULTS. 2018 8 6346 31 THE ROLE OF EPIGENETICS IN CARDIOVASCULAR HEALTH AND AGEING: A FOCUS ON PHYSICAL ACTIVITY AND NUTRITION. THE CARDIOVASCULAR SYSTEM IS RESPONSIBLE FOR TRANSPORT OF BLOOD AND NUTRIENTS TO TISSUES, AND IS PIVOTAL TO THE PHYSIOLOGICAL HEALTH AND LONGEVITY. EPIGENETIC MODIFICATION IS A NATURAL, AGE-ASSOCIATED PROCESS RESULTING IN HIGHLY CONTEXTUALISED GENE EXPRESSION WITH CLEAR IMPLICATIONS FOR CELL DIFFERENTIATION AND DISEASE ONSET. BIOLOGICAL/EPIGENETIC AGE IS INDEPENDENT OF CHRONOLOGICAL AGE, CONSTITUTING A HIGHLY REFLECTIVE SNAPSHOT OF AN INDIVIDUAL'S OVERALL HEALTH. ACCELERATED VASCULAR AGEING IS OF MAJOR CONCERN, EFFECTIVELY LOWERING DISEASE THRESHOLD. AGE-RELATED CHRONIC ILLNESS INVOLVES A COMPLEX INTERPLAY BETWEEN MANY BIOLOGICAL PROCESSES AND IS MODULATED BY NON-MODIFIABLE AND MODIFIABLE RISK FACTORS. THESE ALTER THE STATIC GENOME BY A NUMBER OF EPIGENETIC MECHANISMS, WHICH CHANGE GENE EXPRESSION IN AN AGE AND LIFESTYLE DEPENDENT MANNER. THIS 'EPIGENETIC DRIFT' IMPACTS HEALTH AND CONTRIBUTES TO THE ETIOLOGY OF CHRONIC ILLNESS. LIFESTYLE FACTORS MAY CAUSE ACCELERATION OF THIS EPIGENETIC "CLOCK", PRE-DISPOSING INDIVIDUALS TO CARDIOVASCULAR DISEASE. NUTRITION AND PHYSICAL ACTIVITY ARE MODIFIABLE LIFESTYLE CHOICES, SYNERGISTICALLY CONTRIBUTING TO CARDIOVASCULAR HEALTH. THEY REPRESENT A POWERFUL POTENTIAL EPIGENETIC INTERVENTION POINT FOR EFFECTIVE CARDIOVASCULAR PROTECTIVE AND MANAGEMENT STRATEGIES. THUS, TOGETHER WITH TRADITIONAL RISK FACTORS, MONITORING THE EPIGENETIC SIGNATURE OF AGEING MAY PROVE BENEFICIAL FOR TAILORING LIFESTYLE TO FIT BIOLOGY - SUPPORTING THE INCREASINGLY POPULAR CONCEPT OF "AGEING WELL". 2018 9 4515 41 MULTI-OMICS APPROACHES FOR PRECISION OBESITY MANAGEMENT : POTENTIALS AND LIMITATIONS OF OMICS IN PRECISION PREVENTION, TREATMENT AND RISK REDUCTION OF OBESITY. INTRODUCTION: OBESITY IS A MULTIFACTORIAL CHRONIC DISEASE THAT CANNOT BE ADDRESSED BY SIMPLY PROMOTING BETTER DIETS AND MORE PHYSICAL ACTIVITY. TO DATE, NOT A SINGLE COUNTRY HAS SUCCESSFULLY BEEN ABLE TO CURB THE ACCUMULATING BURDEN OF OBESITY. ONE EXPLANATION FOR THE LACK OF PROGRESS IS THAT LIFESTYLE INTERVENTION PROGRAMS ARE TRADITIONALLY IMPLEMENTED WITHOUT A COMPREHENSIVE EVALUATION OF AN INDIVIDUAL'S DIAGNOSTIC BIOMARKERS. EVIDENCE FROM GENOME-WIDE ASSOCIATION STUDIES HIGHLIGHT THE IMPORTANCE OF GENETIC AND EPIGENETIC FACTORS IN THE DEVELOPMENT OF OBESITY AND HOW THEY IN TURN AFFECT THE TRANSCRIPTOME, METABOLITES, MICROBIOMES, AND PROTEOMES. OBJECTIVE: THE PURPOSE OF THIS REVIEW IS TO PROVIDE AN OVERVIEW OF THE DIFFERENT TYPES OF OMICS DATA: GENOMICS, EPIGENOMICS, TRANSCRIPTOMICS, PROTEOMICS, METABOLOMICS AND ILLUSTRATE HOW A MULTI-OMICS APPROACH CAN BE FUNDAMENTAL FOR THE IMPLEMENTATION OF PRECISION OBESITY MANAGEMENT. RESULTS: THE DIFFERENT TYPES OF OMICS DESIGNS ARE GROUPED INTO TWO CATEGORIES, THE GENOTYPE APPROACH AND THE PHENOTYPE APPROACH. WHEN APPLIED TO OBESITY PREVENTION AND MANAGEMENT, EACH OMICS TYPE COULD POTENTIALLY HELP TO DETECT SPECIFIC BIOMARKERS IN PEOPLE WITH RISK PROFILES AND GUIDE HEALTHCARE PROFESSIONALS AND DECISION MAKERS IN DEVELOPING INDIVIDUALIZED TREATMENT PLANS ACCORDING TO THE NEEDS OF THE INDIVIDUAL BEFORE THE ONSET OF OBESITY. CONCLUSION: INTEGRATING MULTI-OMICS APPROACHES WILL ENABLE A PARADIGM SHIFT FROM THE ONE SIZE FITS ALL APPROACH TOWARDS PRECISION OBESITY MANAGEMENT, I.E. (1) PRECISION PREVENTION OF THE ONSET OF OBESITY, (2) PRECISION MEDICINE AND TAILORED TREATMENT OF OBESITY, AND (3) PRECISION RISK REDUCTION AND PREVENTION OF SECONDARY DISEASES RELATED TO OBESITY. 2023 10 2213 34 EPIGENETIC MODIFICATIONS AS OUTCOMES OF EXERCISE INTERVENTIONS RELATED TO SPECIFIC METABOLIC ALTERATIONS: A SYSTEMATIC REVIEW. BACKGROUND: CHRONIC DISEASES ARISE AS A CONSEQUENCE OF AN UNHEALTHY LIFESTYLE PRIMARILY CHARACTERIZED BY PHYSICAL INACTIVITY AND UNBALANCED DIETS. REGULAR PHYSICAL ACTIVITY CAN IMPROVE HEALTH, AND THERE IS CONSISTENT EVIDENCE THAT THESE IMPROVEMENTS MAY BE THE RESULT OF EPIGENETIC MODIFICATIONS. OBJECTIVE: TO IDENTIFY EPIGENETIC MODIFICATIONSAS OUTCOMES OF EXERCISE INTERVENTIONS RELATED TO SPECIFIC METABOLIC ALTERATIONS. METHODS: THE PREFERRED REPORTING ITEMS FOR SYSTEMATIC REVIEWS AND META-ANALYSES PROTOCOLS (PRISMA-P) METHODOLOGY FOR MANUSCRIPT RESEARCH AND PREPARATION WAS FOLLOWED USING PUBMED AND EBSCO DATABASES FOR LITERATURE REVIEW. OUT OF 2,638 ARTICLES IDENTIFIED, ONLY 34 ARTICLES MET THE INCLUSION CRITERIA. RESULTS: THE SECTIONS OF THE REVIEW WERE ORGANIZED BY METABOLIC ALTERATIONS IN WHICH STUDIES WERE GROUPED ACCORDING TO HEALTHY, DISEASED, AND TRAINED INDIVIDUALS. RESISTANCE EXERCISE IN HUMANS INDUCED EPIGENETIC CHANGES IN PATHWAYS ASSOCIATED WITH ENERGY METABOLISM AND INSULIN SENSITIVITY, CONTRIBUTING TO HEALTHY SKELETAL MUSCLE. ENDURANCE EXERCISE ALSO CAUSED MODIFICATIONS IN BIOMARKERS ASSOCIATED TO METABOLIC ALTERATIONS THROUGH CHANGES IN DNA METHYLATION AND THE EXPRESSION OF SPECIFIC MIRNAS. HOWEVER, BOTH RESISTANCE AND ENDURANCE EXERCISE ARE NECESSARY TO OBTAIN A BETTER PHYSIOLOGICAL ADAPTATION AND A COMBINATION OF BOTH SEEMS TO BE NEEDED TO PROPERLY TACKLE THE INCREASING PREVALENCE OF NON-COMMUNICABLE PATHOLOGIES. CONCLUSION: GIVEN THE HETEROGENEITY AND COMPLEXITY OF THE EXISTING LITERATURE, IT IS CURRENTLY NOT POSSIBLE TO PROPOSE A SPECIFIC RECOMMENDATION ABOUT THE TYPE, INTENSITY, OR DURATION OF EXERCISE THAT COULD BE BENEFICIAL FOR DIFFERENT SUBSETS OF THE POPULATION (HEALTHY, DISEASED, AND/OR TRAINED). NEVERTHELESS, THIS REVIEW HIGHLIGHTS THE IMPORTANCE OF EXERCISE FOR HEALTH AND SHOWS THE NEED TO PERFORM MORE RESEARCH IN THIS EMERGING AREA TO IDENTIFY EPIGENETIC BIOMARKERS THAT COULD SERVE AS INDICATORS OF EXERCISE ADAPTATIONS. 2019 11 3577 39 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 12 4803 25 OBESITY AND MALE INFERTILITY. THE WORLDWIDE PREVALENCE OF OBESITY IS INCREASING AMONG BOTH SEXES, WITH ASSOCIATED IMPACTS ON CHRONIC HEALTH AND MEDICAL COMORBIDITIES. SIMILARLY, THE EFFECTS OF OBESITY ON REPRODUCTIVE HEALTH ARE INCREASINGLY BEING RECOGNIZED. ADIPOSITY IS ASSOCIATED WITH REDUCED FERTILITY IN MEN, WITH A COMPLEX AND MULTIFACTORIAL ETIOLOGY. THE REPORTED EFFECTS OF OBESITY ON SEMEN PARAMETERS AND IMPAIRED FERTILITY ARE CONTRASTING, WITH SOME STUDIES SHOWING A CLEAR REDUCTION IN REPRODUCTIVE OUTCOMES ASSOCIATED WITH INCREASED BODY MASS INDEX, WHILE OTHERS DO NOT SHOW SUCH IMPACTS. THESE CONTROVERSIES MAY BE DUE TO THE COMPLEX PATHOPHYSIOLOGY AND INTERPLAY BETWEEN GONADOTROPINS AND END ORGANS, AS WELL AS GENETIC AND EPIGENETIC CHANGES AND OXIDATIVE STRESS ON MALE FERTILITY AND FUNCTION. THESE DIFFERENT ASPECTS HAVE LED TO HETEROGENEOUS PARTICIPANTS IN STUDIES AND VARYING IMPLICATIONS FOR ASSISTED REPRODUCTIVE OUTCOMES AS WELL AS OFFSPRING HEALTH. TREATMENT MODALITIES TO MANAGE OBESITY INCLUDE LIFESTYLE, MEDICAL, AND SURGICAL OPTIONS, WITH EMERGING AND EFFECTIVE MEDICAL TREATMENTS SHOWING PROMISE IN REPRODUCTIVE OUTCOMES. 2023 13 1936 40 ENVIRONMENTAL RISK FACTORS OF TYPE 2 DIABETES-AN EXPOSOME APPROACH. TYPE 2 DIABETES IS ONE OF THE MAJOR CHRONIC DISEASES ACCOUNTING FOR A SUBSTANTIAL PROPORTION OF DISEASE BURDEN IN WESTERN COUNTRIES. THE MAJORITY OF THE BURDEN OF TYPE 2 DIABETES IS ATTRIBUTED TO ENVIRONMENTAL RISKS AND MODIFIABLE RISK FACTORS SUCH AS LIFESTYLE. THE ENVIRONMENT WE LIVE IN, AND CHANGES TO IT, CAN THUS CONTRIBUTE SUBSTANTIALLY TO THE PREVENTION OF TYPE 2 DIABETES AT A POPULATION LEVEL. THE 'EXPOSOME' REPRESENTS THE (MEASURABLE) TOTALITY OF ENVIRONMENTAL, I.E. NONGENETIC, DRIVERS OF HEALTH AND DISEASE. THE EXTERNAL EXPOSOME COMPRISES ASPECTS OF THE BUILT ENVIRONMENT, THE SOCIAL ENVIRONMENT, THE PHYSICO-CHEMICAL ENVIRONMENT AND THE LIFESTYLE/FOOD ENVIRONMENT. THE INTERNAL EXPOSOME COMPRISES MEASUREMENTS AT THE EPIGENETIC, TRANSCRIPT, PROTEOME, MICROBIOME OR METABOLOME LEVEL TO STUDY EITHER THE EXPOSURES DIRECTLY, THE IMPRINTS THESE EXPOSURES LEAVE IN THE BIOLOGICAL SYSTEM, THE POTENTIAL OF THE BODY TO COMBAT ENVIRONMENTAL INSULTS AND/OR THE BIOLOGY ITSELF. IN THIS REVIEW, WE DESCRIBE THE EVIDENCE FOR ENVIRONMENTAL RISK FACTORS OF TYPE 2 DIABETES, FOCUSING ON BOTH THE GENERAL EXTERNAL EXPOSOME AND IMPRINTS OF THIS ON THE INTERNAL EXPOSOME. STUDIES PROVIDED ESTABLISHED ASSOCIATIONS OF AIR POLLUTION, RESIDENTIAL NOISE AND AREA-LEVEL SOCIOECONOMIC DEPRIVATION WITH AN INCREASED RISK OF TYPE 2 DIABETES, WHILE NEIGHBOURHOOD WALKABILITY AND GREEN SPACE ARE CONSISTENTLY ASSOCIATED WITH A REDUCED RISK OF TYPE 2 DIABETES. THERE IS LITTLE OR INCONSISTENT EVIDENCE ON THE CONTRIBUTION OF THE FOOD ENVIRONMENT, OTHER ASPECTS OF THE SOCIAL ENVIRONMENT AND OUTDOOR TEMPERATURE. THESE ENVIRONMENTAL FACTORS ARE THOUGHT TO AFFECT TYPE 2 DIABETES RISK MAINLY THROUGH MECHANISMS INCORPORATING LIFESTYLE FACTORS SUCH AS PHYSICAL ACTIVITY OR DIET, THE MICROBIOME, INFLAMMATION OR CHRONIC STRESS. TO FURTHER ASSESS CAUSALITY OF THESE ASSOCIATIONS, FUTURE STUDIES SHOULD FOCUS ON INVESTIGATING THE LONGITUDINAL EFFECTS OF OUR ENVIRONMENT (AND CHANGES TO IT) IN RELATION TO TYPE 2 DIABETES RISK AND WHETHER THESE ASSOCIATIONS ARE EXPLAINED BY THESE PROPOSED MECHANISMS. 2022 14 1932 36 ENVIRONMENTAL EXPOSURES: AN UNDERRECOGNIZED CONTRIBUTION TO NONCOMMUNICABLE DISEASES. PREVIOUS ATTEMPTS TO DETERMINE THE DEGREE TO WHICH EXPOSURE TO ENVIRONMENTAL FACTORS CONTRIBUTE TO NONCOMMUNICABLE DISEASES (NCDS) HAVE BEEN VERY CONSERVATIVE AND HAVE SIGNIFICANTLY UNDERESTIMATED THE ACTUAL CONTRIBUTION OF THE ENVIRONMENT FOR AT LEAST TWO REASONS. FIRSTLY, MOST PREVIOUS REPORTS HAVE EXCLUDED THE CONTRIBUTION OF LIFESTYLE BEHAVIORAL RISK FACTORS, BUT THESE USUALLY INVOLVE SIGNIFICANT EXPOSURE TO ENVIRONMENTAL CHEMICALS THAT INCREASE RISK OF DISEASE. SECONDLY, EARLY LIFE EXPOSURE TO CHEMICAL CONTAMINANTS IS NOW CLEARLY ASSOCIATED WITH AN ELEVATED RISK OF SEVERAL DISEASES LATER IN LIFE, BUT THESE CONNECTIONS ARE OFTEN DIFFICULT TO DISCERN. THIS IS ESPECIALLY TRUE FOR ASTHMA AND NEURODEVELOPMENTAL CONDITIONS, BUT THERE IS ALSO A MAJOR CONTRIBUTION TO THE DEVELOPMENT OF OBESITY AND CHRONIC DISEASES. MOST CANCERS ARE CAUSED BY ENVIRONMENTAL EXPOSURES IN GENETICALLY SUSCEPTIBLE INDIVIDUALS. IN ADDITION, NEW INFORMATION SHOWS SIGNIFICANT ASSOCIATIONS BETWEEN CARDIOVASCULAR DISEASES AND DIABETES AND EXPOSURE TO ENVIRONMENTAL CHEMICALS PRESENT IN AIR, FOOD, AND WATER. THESE RELATIONSHIPS LIKELY REFLECT THE COMBINATION OF EPIGENETIC EFFECTS AND GENE INDUCTION. ENVIRONMENTAL FACTORS CONTRIBUTE SIGNIFICANTLY MORE TO NCDS THAN PREVIOUS REPORTS HAVE SUGGESTED. PREVENTION NEEDS TO SHIFT FOCUS FROM INDIVIDUAL RESPONSIBILITY TO SOCIETAL RESPONSIBILITY AND AN UNDERSTANDING THAT EFFECTIVE PREVENTION OF NCDS ULTIMATELY RELIES ON IMPROVED ENVIRONMENTAL MANAGEMENT TO REDUCE EXPOSURE TO MODIFIABLE RISKS. 2013 15 5072 33 PHYSICAL EXERCISE POSITIVELY INFLUENCES BREAST CANCER EVOLUTION. BREAST CANCER IS ONE OF THE MOST COMMONLY DIAGNOSED TYPES OF CANCER IN WOMEN. ITS PATHOGENESIS INVOLVES GENETIC, HORMONAL, AND ENVIRONMENTAL FACTORS. A LARGE BODY OF EVIDENCE INDICATES THAT PHYSICAL ACTIVITY HAS POSITIVE EFFECTS ON EVERY ASPECT OF BREAST CANCER EVOLUTION, INCLUDING PREVENTION, MEDICAL TREATMENT, AND AFTERCARE CLINICAL SETTINGS. THUS, DIFFERENT TYPES OF EXERCISE CAN INFLUENCE THE PREVENTION AND PROGRESSION OF THE DISEASE THROUGH SEVERAL COMMON MECHANISMS, SUCH AS REDUCTION OF INSULIN RESISTANCE AND IMPROVEMENT OF IMMUNITY AND CARDIOVASCULAR FUNCTION. FURTHERMORE, ACUTE AND CHRONIC SYMPTOMS OF BREAST CANCER, SUCH AS CACHEXIA, MUSCLE MASS LOSS, FATIGUE, CARDIOTOXICITY, WEIGHT GAIN, HORMONE ALTERATIONS, BONE LOSS, AND PSYCHOLOGIC ADVERSE EFFECTS, MAY ALL BE FAVORABLY INFLUENCED BY REGULAR EXERCISE. WE REVIEW THE RELATION OF INTENSITY AND DURATION OF EXERCISE WITH POTENTIAL PATHOPHYSIOLOGIC PATHWAYS, INCLUDING OBESITY-RELATED HORMONES AND SEX STEROID HORMONE PRODUCTION, OXIDATIVE STRESS, EPIGENETIC ALTERATIONS SUCH AS DNA HYPOMETHYLATION, AND CHANGES IN TELOMERE LENGTH, WITHIN THE CONTEXT OF THE BENEFICIAL EFFECTS OF EXERCISE. THE POTENTIAL ROLE OF EXERCISE IN REDUCING THE INTENSITY OF THE ADVERSE EFFECTS THAT RESULT FROM BREAST CANCER AND ANTICANCER TREATMENT IS ALSO DISCUSSED. 2017 16 2881 33 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 17 5183 34 PREMATURE AGING IN CHILDHOOD CANCER SURVIVORS. PROGRESS IN MEDICINE HAS INCREASED THE SURVIVAL TIME OF CHILDREN SUFFERING FROM CANCER; >80% OF PATIENTS SURVIVE FOR AT LEAST 5 YEARS FROM THE END OF TREATMENT. HOWEVER, THERE ARE LATE EFFECTS OF ANTICANCER THERAPY, WHICH ACCOMPANY THIS SUCCESS. TWO-THIRDS OF CHILDHOOD CANCER SURVIVORS (CCSS) HAVE AT LEAST ONE LATE EFFECT (ANY SIDE EFFECTS OR COMPLICATIONS OF ANTICANCER TREATMENT THAT APPEAR MONTHS TO YEARS AFTER THE COMPLETION OF TREATMENT), E.G. ENDOCRINOPATHIES, CARDIOVASCULAR DISEASES OR SUBSEQUENT CANCERS, AND HALF OF THESE LATE EFFECTS ARE SERIOUS OR LIFE THREATENING. THESE LATE CONSEQUENCES OF CHILDHOOD CANCER TREATMENT POSE A SERIOUS HEALTH, SOCIAL AND ECONOMIC PROBLEM. A COMMON MECHANISM FOR DEVELOPING A NUMBER OF LATE EFFECTS IS THE ONSET OF PREMATURE BIOLOGICAL AGING, WHICH IS ASSOCIATED WITH THE EARLY ONSET OF CHRONIC DISEASES AND DEATH. CELLULAR SENESCENCE IN CANCER SURVIVORS IS CAUSED BY THERAPY THAT CAN INDUCE CHROMOSOMAL ABERRATIONS, MUTATIONS, TELOMERE SHORTENING, EPIGENETIC ALTERATIONS AND MITOCHONDRIAL DYSFUNCTIONS. THE MECHANISMS OF ACCELERATED AGING IN CANCER SURVIVORS HAVE NOT YET BEEN FULLY CLARIFIED. THE MEASUREMENT OF BIOLOGICAL AGE IN SURVIVORS CAN HELP IMPROVE THE UNDERSTANDING OF AGING MECHANISMS AND IDENTIFY RISK FACTORS FOR PREMATURE AGING. HOWEVER, TO THE BEST OF OUR KNOWLEDGE, NO SINGLE MARKER FOR THE EVALUATION OF BIOLOGICAL OR FUNCTIONAL AGE IS KNOWN, SO IT IS THEREFORE NECESSARY TO MEASURE THE CONSEQUENCES OF ANTICANCER TREATMENT USING COMPLEX ASSESSMENTS. THE PRESENT REVIEW PRESENTS AN OVERVIEW OF PREMATURE AGING IN CCSS AND OF THE MECHANISMS INVOLVED IN ITS DEVELOPMENT, FOCUSING ON THE ASSOCIATION OF SENESCENCE AND LATE EFFECTS. 2023 18 6781 49 [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 1388 30 DIABETIC PATIENTS WITH CHRONIC KIDNEY DISEASE: NON-INVASIVE ASSESSMENT OF CARDIOVASCULAR RISK. THE PREVALENCE AND BURDEN OF DIABETES MELLITUS AND CHRONIC KIDNEY DISEASE ON GLOBAL HEALTH AND SOCIOECONOMIC DEVELOPMENT IS ALREADY HEAVY AND STILL RISING. DIABETES MELLITUS BY ITSELF IS LINKED TO ADVERSE CARDIOVASCULAR EVENTS, AND THE PRESENCE OF CONCOMITANT CHRONIC KIDNEY DISEASE FURTHER AMPLIFIES CARDIOVASCULAR RISK. THE CULMINATION OF TRADITIONAL (MALE GENDER, SMOKING, ADVANCED AGE, OBESITY, ARTERIAL HYPERTENSION AND DYSLIPIDEMIA) AND NON-TRADITIONAL RISK FACTORS (ANEMIA, INFLAMMATION, PROTEINURIA, VOLUME OVERLOAD, MINERAL METABOLISM ABNORMALITIES, OXIDATIVE STRESS, ETC.) CONTRIBUTES TO ADVANCED ATHEROSCLEROSIS AND INCREASED CARDIOVASCULAR RISK. TO DECREASE THE MORBIDITY AND MORTALITY OF THESE PATIENTS DUE TO CARDIOVASCULAR CAUSES, TIMELY AND EFFICIENT CARDIOVASCULAR RISK ASSESSMENT IS OF HUGE IMPORTANCE. CARDIOVASCULAR RISK ASSESSMENT CAN BE BASED ON LABORATORY PARAMETERS, IMAGING TECHNIQUES, ARTERIAL STIFFNESS PARAMETERS, ANKLE-BRACHIAL INDEX AND 24 H BLOOD PRESSURE MEASUREMENTS. NEWER METHODS INCLUDE EPIGENETIC MARKERS, SOLUBLE ADHESION MOLECULES, CYTOKINES AND MARKERS OF OXIDATIVE STRESS. IN THIS REVIEW, THE AUTHORS PRESENT SEVERAL NON-INVASIVE METHODS OF CARDIOVASCULAR RISK ASSESSMENT IN PATIENTS WITH DIABETES MELLITUS AND CHRONIC KIDNEY DISEASE. 2021 20 2955 30 GENETIC AND EPIGENETIC FACTORS INFLUENCING CHRONIC KIDNEY DISEASE. CHRONIC KIDNEY DISEASE (CKD) HAS BECOME A SERIOUS PUBLIC HEALTH PROBLEM BECAUSE OF ITS ASSOCIATED MORBIDITY, PREMATURE MORTALITY, AND ATTENDANT HEALTHCARE COSTS. THE RISING NUMBER OF PERSONS WITH CKD IS LINKED WITH THE AGING POPULATION STRUCTURE AND AN INCREASED PREVALENCE OF DIABETES, HYPERTENSION, AND OBESITY. THERE IS AN INHERITED RISK ASSOCIATED WITH DEVELOPING CKD, AS EVIDENCED BY FAMILIAL CLUSTERING AND DIFFERING PREVALENCE RATES ACROSS ETHNIC GROUPS. PREVIOUS STUDIES TO DETERMINE THE INHERITED RISK FACTORS FOR CKD RARELY IDENTIFIED GENETIC VARIANTS THAT WERE ROBUSTLY REPLICATED. HOWEVER, IMPROVEMENTS IN GENOTYPING TECHNOLOGIES AND ANALYTIC METHODS ARE NOW HELPING TO IDENTIFY PROMISING GENETIC LOCI AIDED BY INTERNATIONAL COLLABORATION AND MULTICONSORTIA EFFORTS. MORE RECENTLY, EPIGENETIC MODIFICATIONS HAVE BEEN PROPOSED TO PLAY A ROLE IN BOTH THE INHERITED SUSCEPTIBILITY TO CKD AND, IMPORTANTLY, TO EXPLAIN HOW THE ENVIRONMENT DYNAMICALLY INTERACTS WITH THE GENOME TO ALTER AN INDIVIDUAL'S DISEASE RISK. GENOME-WIDE, EPIGENOME-WIDE, AND WHOLE TRANSCRIPTOME STUDIES HAVE BEEN PERFORMED, AND OPTIMAL APPROACHES FOR INTEGRATIVE ANALYSIS ARE BEING DEVELOPED. THIS REVIEW SUMMARIZES RECENT RESEARCH AND THE CURRENT STATUS OF GENETIC AND EPIGENETIC RISK FACTORS INFLUENCING CKD USING POPULATION-BASED INFORMATION. 2014