1 2708 111 EXERCISE IN NEUROMUSCULAR DISORDERS: A PROMISING INTERVENTION. ALTHOUGH PERFORMING EXERCISE STUDIES IN PATIENTS WITH NEUROMUSCULAR DISORDERS (NMD) IS DIFFICULT, THE NUMBER OF RANDOMIZED CONTROLLED TRIALS IS STEADILY INCREASING. THERE IS GROWING EVIDENCE FOR A POSITIVE EFFECT OF AEROBIC EXERCISE IN SEVERAL NMD, ON THE OTHER HAND, THE EVIDENCE FOR THE EFFECT OF STRENGTH TRAINING IS STILL SCARCE. MANY NMD PATIENTS ARE CAPTURED IN A VICIOUS CIRCLE OF PHYSICAL INACTIVITY, AND IT IS IMPORTANT TO LET PATIENTS ADHERE TO AN ACTIVE LIFESTYLE, IN ORDER TO PREVENT FURTHER CHRONIC CARDIOVASCULAR AND MUSCLE DECONDITIONING AND INCREASED CARDIOVASCULAR HEALTH RISKS. EXERCISE HAS TO BE PRESCRIBED AS IF IT IS MEDICINE, IN ORDER TO INCREASE THE ADHERENCE OF PATIENTS AND TO OPTIMIZE THE EFFICACY OF THE INTERVENTION. EXERCISE IN NMD IS SAFE, ALTHOUGH FOR SOME METABOLIC MYOPATHIES THERE IS A CONTRAINDICATION FOR STRENUOUS EXERCISE. IN NMD KNOWN TO AFFECT CARDIAC MUSCLE, IT IS USUALLY SAFE TO EXERCISE, BUT THE CONSULTATION OF A CARDIOLOGIST IS ADVISED. BASED ON RECENT RESEARCH, AN INCREASE IN PHYSICAL ACTIVITY OF MODERATE INTENSITY AND OF SUFFICIENT DURATION, I.E. A PHYSICALLY ACTIVE LIFESTYLE, COULD BE AT LEAST AS EFFECTIVE AND RELEVANT AS PHYSICAL TRAINING. UNDERLYING MECHANISMS OF EFFECT OF EXERCISE COULD BE THE INFLUENCE OF EPIGENETIC MECHANISMS AND THE ANTI-INFLAMMATORY EFFECT OF EXERCISE, BUT FURTHER STUDIES ARE NEEDED TO CONFIRM THESE HYPOTHESES. 2019 2 6087 26 THE EFFECTS OF AEROBIC AND ANAEROBIC EXERCISES ON CIRCULATING SOLUBLE-KLOTHO AND IGF-I IN YOUNG AND ELDERLY ADULTS AND IN CAD PATIENTS. DIFFERENT STUDIES SUPPORT THE NOTION THAT CHRONIC AEROBIC EXERCISES TRAINING CAN INFLUENCE THE CIRCULATING LEVELS OF SOLUBLE-KLOTHO (S-KLOTHO) AND INSULIN-LIKE GROWTH FACTOR 1 (IGF-I). THE EFFECTS OF S-KLOTHO INCLUDE IMPROVING THE QUALITY OF LIFE, ALLEVIATING THE NEGATIVE IMPACT OF AGE ON THE BODY'S WORK CAPACITY, AND POSSIBLY INCREASING LONGEVITY. THIS REVIEW PROVIDES AN OVERVIEW OF THE LATEST FINDINGS IN THIS FIELD OF RESEARCH IN HUMANS. THE DIFFERENT MODES OF DYNAMIC EXERCISE AND THEIR IMPACT ON CIRCULATING LEVELS OF S-KLOTHO AND IGF-I IN YOUNG ADULT ATHLETES, UNTRAINED YOUNG ADULTS, TRAINED HEALTHY OLDER ADULTS, UNTRAINED HEALTHY OLDER ADULTS, AND CORONARY ARTERY DISEASE (CAD) PATIENTS ARE REVIEWED AND DISCUSSED. TOGETHER THESE FINDINGS SUGGEST THAT LONG-LASTING (CHRONIC) AEROBIC EXERCISE TRAINING IS PROBABLY ONE OF THE ANTIAGING FACTORS THAT COUNTERACT THE AGING AND CAD PROCESS BY INCREASING THE CIRCULATING S-KLOTHO AND LOWERING THE IGF-I LEVELS. HOWEVER, FOLLOWING ANAEROBIC EXERCISE TRAINING THE OPPOSITE OCCURS. THE EXACT METABOLIC AND PHYSIOLOGICAL PATHWAYS INVOLVED IN THE ACTIVITY OF THESE WELL-TRAINED YOUNG AND MASTER SPORTSMEN SHOULD BE FURTHER STUDIED AND ELUCIDATED. THE PURPOSE OF THIS REVIEW WAS TO PROVIDE A CLARIFICATION REGARDING THE ROLES OF S-KLOTHO AND INTENSITIES AND DURATIONS OF DIFFERENT EXERCISE ON HUMAN HEALTH. 2017 3 2717 32 EXERCISE: PUTTING ACTION INTO OUR EPIGENOME. MOST HUMAN PHENOTYPES ARE INFLUENCED BY A COMBINATION OF GENOMIC AND ENVIRONMENTAL FACTORS. ENGAGING IN REGULAR PHYSICAL EXERCISE PREVENTS MANY CHRONIC DISEASES, DECREASES MORTALITY RISK AND INCREASES LONGEVITY. HOWEVER, THE MECHANISMS INVOLVED ARE POORLY UNDERSTOOD. THE MODULATING EFFECT OF PHYSICAL (AEROBIC AND RESISTANCE) EXERCISE ON GENE EXPRESSION HAS BEEN KNOWN FOR SOME TIME NOW AND HAS PROVIDED US WITH AN UNDERSTANDING OF THE BIOLOGICAL RESPONSES TO PHYSICAL EXERCISE. EMERGING RESEARCH DATA SUGGEST THAT EPIGENETIC MODIFICATIONS ARE EXTREMELY IMPORTANT FOR BOTH DEVELOPMENT AND DISEASE IN HUMANS. IN THE CURRENT REVIEW, WE SUMMARISE FINDINGS ON THE EFFECT OF EXERCISE ON EPIGENETIC MODIFICATIONS AND THEIR EFFECTS ON GENE EXPRESSION. CURRENT RESEARCH DATA SUGGEST EPIGENETIC MODIFICATIONS (DNA METHYLATION AND HISTONE ACETYLATION) AND MICRORNAS (MIRNAS) ARE RESPONSIVE TO ACUTE AEROBIC AND RESISTANCE EXERCISE IN BRAIN, BLOOD, SKELETAL AND CARDIAC MUSCLE, ADIPOSE TISSUE AND EVEN BUCCAL CELLS. SIX MONTHS OF AEROBIC EXERCISE ALTERS WHOLE-GENOME DNA METHYLATION IN SKELETAL MUSCLE AND ADIPOSE TISSUE AND DIRECTLY INFLUENCES LIPOGENESIS. SOME MIRNAS ARE RELATED TO MAXIMAL OXYGEN CONSUMPTION (VO(2MAX)) AND VO(2MAX) TRAINABILITY, AND ARE DIFFERENTIALLY EXPRESSED AMONGST INDIVIDUALS WITH HIGH AND LOW VO(2MAX). REMARKABLY, MIRNA EXPRESSION PROFILES DISCRIMINATE BETWEEN LOW AND HIGH RESPONDERS TO RESISTANCE EXERCISE (MIR-378, -26A, -29A AND -451) AND CORRELATE TO GAINS IN LEAN BODY MASS (MIR-378). THE EMERGING FIELD OF EXERCISE EPIGENOMICS IS EXPECTED TO PROSPER AND ADDITIONAL STUDIES MAY ELUCIDATE THE CLINICAL RELEVANCE OF MIRNAS AND EPIGENETIC MODIFICATIONS, AND DELINEATE MECHANISMS BY WHICH EXERCISE CONFERS A HEALTHIER PHENOTYPE AND IMPROVES PERFORMANCE. 2014 4 4543 30 MUSCLE DYSFUNCTION IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE: UPDATE ON CAUSES AND BIOLOGICAL FINDINGS. RESPIRATORY AND/OR LIMB MUSCLE DYSFUNCTION, WHICH ARE FREQUENTLY OBSERVED IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) PATIENTS, CONTRIBUTE TO THEIR DISEASE PROGNOSIS IRRESPECTIVE OF THE LUNG FUNCTION. MUSCLE DYSFUNCTION IS CAUSED BY THE INTERACTION OF LOCAL AND SYSTEMIC FACTORS. THE KEY DELETERIOUS ETIOLOGIC FACTORS ARE PULMONARY HYPERINFLATION FOR THE RESPIRATORY MUSCLES AND DECONDITIONING SECONDARY TO REDUCED PHYSICAL ACTIVITY FOR LIMB MUSCLES. NONETHELESS, CIGARETTE SMOKE, SYSTEMIC INFLAMMATION, NUTRITIONAL ABNORMALITIES, EXERCISE, EXACERBATIONS, ANABOLIC INSUFFICIENCY, DRUGS AND COMORBIDITIES ALSO SEEM TO PLAY A RELEVANT ROLE. ALL THESE FACTORS MODIFY THE PHENOTYPE OF THE MUSCLES, THROUGH THE INDUCTION OF SEVERAL BIOLOGICAL PHENOMENA IN PATIENTS WITH COPD. WHILE RESPIRATORY MUSCLES IMPROVE THEIR AEROBIC PHENOTYPE (PERCENTAGE OF OXIDATIVE FIBERS, CAPILLARIZATION, MITOCHONDRIAL DENSITY, ENZYME ACTIVITY IN THE AEROBIC PATHWAYS, ETC.), LIMB MUSCLES EXHIBIT THE OPPOSITE PHENOTYPE. IN ADDITION, BOTH MUSCLE GROUPS SHOW OXIDATIVE STRESS, SIGNS OF DAMAGE AND EPIGENETIC CHANGES. HOWEVER, FIBER ATROPHY, INCREASED NUMBER OF INFLAMMATORY CELLS, ALTERED REGENERATIVE CAPACITY; SIGNS OF APOPTOSIS AND AUTOPHAGY, AND AN IMBALANCE BETWEEN PROTEIN SYNTHESIS AND BREAKDOWN ARE RATHER CHARACTERISTIC FEATURES OF THE LIMB MUSCLES, MOSTLY IN PATIENTS WITH REDUCED BODY WEIGHT. DESPITE THAT SIGNIFICANT PROGRESS HAS BEEN ACHIEVED IN THE LAST DECADES, FULL ELUCIDATION OF THE SPECIFIC ROLES OF THE TARGET BIOLOGICAL MECHANISMS INVOLVED IN COPD MUSCLE DYSFUNCTION IS STILL REQUIRED. SUCH AN ACHIEVEMENT WILL BE CRUCIAL TO ADEQUATELY TACKLE WITH THIS RELEVANT CLINICAL PROBLEM OF COPD PATIENTS IN THE NEAR-FUTURE. 2015 5 2707 24 EXERCISE EFFECTS ON METHYLATION OF ASC GENE. CHRONIC MODERATE EXERCISE HAS BEEN REPORTED TO REDUCE PRO-INFLAMMATORY CYTOKINES. TO ANALYZE THE MOLECULAR MECHANISMS BY WHICH TRAINING EXERTS THESE EFFECTS, THE EPIGENETIC INFLUENCES OF AGE AND EXERCISE ON THE ASC GENE, WHICH IS RESPONSIBLE FOR IL-1BETA AND IL-18 SECRETION, WERE INVESTIGATED BY ASC GENE METHYLATION. FURTHER, THE RELATIONSHIP BETWEEN CARCINOGENESIS AND EXERCISE, AND METHYLATION OF THE P15 TUMOR SUPPRESSIVE GENE WAS ALSO ANALYZED. HIGH-INTENSITY INTERVAL WALKING EXERCISE, CONSISTING OF 3 MIN LOW-INTENSITY WALKING AT 40% OF PEAK AEROBIC CAPACITY FOLLOWED BY A 3 MIN HIGH-INTENSITY WALKING PERIOD ABOVE 70% OF PEAK AEROBIC CAPACITY, WAS CONTINUED FOR 6 MONTHS. PERIPHERAL BLOOD DNA EXTRACTS FROM YOUNG CONTROL (N=34), OLDER CONTROL (N=153), AND OLDER EXERCISE (N=230) GROUPS WERE THEN ANALYZED BY PYROSEQUENCING FOR DNA METHYLATION. METHYLATION OF ASC DECREASED SIGNIFICANTLY WITH AGE (YOUNG CONTROL VS. OLDER CONTROL, P<0.01), WHICH IS INDICATIVE OF AN AGE-DEPENDENT INCREASE IN ASC EXPRESSION. COMPARED TO THE OLDER CONTROL GROUP, THE DEGREE OF ASC METHYLATION WAS HIGHER IN THE OLDER EXERCISE GROUP (OLDER CONTROL VS. OLDER EXERCISE: P<0.01), AND PRESUMABLY LOWER ASC EXPRESSION. NEITHER EXERCISE NOR AGE AFFECTED THE METHYLATION OF THE P15. IN SUMMARY, CHRONIC MODERATE EXERCISE APPEARS TO ATTENUATE THE AGE-DEPENDENT DECREASE IN ASC METHYLATION, IMPLYING SUPPRESSION OF EXCESS PRO-INFLAMMATORY CYTOKINES THROUGH REDUCTION OF ASC EXPRESSION. 2010 6 5605 31 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 7 3554 29 IMPACT OF ADVANCED GLYCATION END PRODUCTS (AGES) AND ITS RECEPTOR (RAGE) ON CANCER METABOLIC SIGNALING PATHWAYS AND ITS PROGRESSION. CANCER IS A COMPLEX DISEASE WITH A 5-10% HEREDITARY BASE, BUT NUTRITION, LIFESTYLE, AND THE ENVIRONMENT WE ARE EXPOSED TO INFLUENCE 90-95% OF CANCERS. DUE TO RAPID WESTERNIZATION, THE DIET WE CONSUME IS RICH IN ADVANCED GLYCATION END PRODUCTS (AGES). AGES ARE THE HETEROGENEOUS GROUP OF COMPOUNDS FORMED BY NON-ENZYMATIC REACTIONS BETWEEN REDUCING SUGARS AND AMINO GROUPS OF PROTEINS, LIPIDS, AND NUCLEIC ACIDS. ITS IMPLICATION IS CONFIRMED IN MANY CHRONIC CONDITIONS SUCH AS DIABETES, RENAL, CARDIOVASCULAR DISEASES, AND AGING HOWEVER ITS ROLE IN CANCER DEVELOPMENT HAS BEEN UNDERSTUDIED. CANCER CELLS ARE CONTINUOUSLY EXPOSED TO AGES DUE TO THEIR INCREASED PRODUCTION, OWING TO ITS HIGH METABOLIC RATE AND AEROBIC GLYCOLYSIS. AGES ACCUMULATION LED TO GLYCATIVE STRESS WHICH IN TURN STIMULATES OXIDATIVE STRESS AND INFLAMMATION, THROUGH ITS RECEPTOR KNOWN AS RECEPTOR FOR ADVANCED GLYCATION END PRODUCTS (RAGE). RAGE MEDIATES CROSSTALK BETWEEN THE TUMOUR CELLS AND ITS MICROENVIRONMENT COMPONENTS TO INDUCE HYPOXIA, MITOCHONDRIAL DYSFUNCTION, ENDOPLASMIC RETICULUM STRESS, AUTOPHAGY, EPIGENETIC MODIFICATION, AND CANCER STEMNESS. THIS EMPHASIZES AGES AS AN ESSENTIAL DRIVING FACTOR IN DIFFERENT ASPECTS OF CANCER DEVELOPMENT, BUT THE EXACT MOLECULAR MECHANISM HAS TO BE EXPLORED. THUS, THIS REVIEW GIVES AN INSIGHT INTO THE PATHOLOGICAL ROLE OF AGES AT THE BIO-MOLECULAR LEVEL IN THE TUMOURIGENESIS AND PROGRESSION OF CANCER IN TERMS OF THE TUMOUR MICROENVIRONMENT, INVASION, AND METASTASIS. FURTHER, THE COMPILED CLINICAL DATA RELATING TO THE AGE-RAGE AXIS ASSOCIATED WITH DIFFERENT CANCERS AND ITS POTENTIAL INHIBITORS HAVE BEEN DISCUSSED. 2021 8 3613 32 IN UTERO PROGRAMMING AND EARLY DETECTION OF CARDIOVASCULAR DISEASE IN THE OFFSPRING OF MOTHERS WITH OBESITY. THE OFFSPRING OF WOMEN WITH OBESITY DURING THEIR PREGNANCY ARE EXPOSED TO AN ALTERED INTRA-UTERINE ENVIRONMENT. A SUBSEQUENT INFLUENCE ON THE CARDIOVASCULAR DEVELOPMENT DURING FETAL LIFE IS ASSUMED. IN THE PRESENT THEMATIC REVIEW, WE REPORT ON THE CURRENT KNOWLEDGE ABOUT THIS EARLY DEVELOPMENT OF CARDIOVASCULAR DISEASE FROM FETAL LIFE UNTIL ADOLESCENCE. BASED ON ANIMAL STUDIES, DIFFERENT CONTRIBUTING MECHANISMS HAVE BEEN HYPOTHESIZED THAT STILL NEED CONFIRMATION IN HUMAN SUBJECTS. INSULIN RESISTANCE, INCREASED LEVELS OF LEPTIN, CHRONIC INFLAMMATORY STATE, PERTURBATION OF SYMPATHETIC TONE AND EPIGENETIC MODIFICATIONS CONTRIBUTE TO A SUBOPTIMAL NUTRIENT ENVIRONMENT AND CHANGED HEMODYNAMICS. THE ENSUING ABERRANT CARDIOMYOCYTE DEVELOPMENT, IMPAIRED ENDOTHELIAL CELL RELAXATION AND ATHEROGENIC LIPID PROFILE PUT THESE CHILDREN AT RISK FOR THE DEVELOPMENT OF ENDOTHELIAL CELL DYSFUNCTION. INCREASING POSSIBILITIES FOR EARLY DETECTION OF THIS PRELIMINARY STAGE OF ATHEROSCLEROTIC DISEASE OFFER NEW INSIGHTS INTO FUTURE PREVENTION AND TREATMENT STRATEGIES. FUTURE RESEARCH SHOULD FOCUS ON FURTHER UNRAVELING THE EFFECT OF MODERATE INTENSE, AEROBIC EXERCISE. SINCE IT IS USED TO TREAT THE CONDITION IN CHILDREN AND ADOLESCENTS WITH GOOD RESULTS, IT MIGHT BE A CONTRIBUTOR TO TACKLING ENDOTHELIAL CELL DYSFUNCTION AT ITS CRADLE WHEN APPLIED IN EARLY PREGNANCY. 2018 9 2738 24 EXPOSOMES TO EXOSOMES: EXOSOMES AS TOOLS TO STUDY EPIGENETIC ADAPTIVE MECHANISMS IN HIGH-ALTITUDE HUMANS. HUMANS ON EARTH INHABIT A WIDE RANGE OF ENVIRONMENTAL CONDITIONS AND SOME ENVIRONMENTS ARE MORE CHALLENGING FOR HUMAN SURVIVAL THAN OTHERS. HOWEVER, MANY LIVING BEINGS, INCLUDING HUMANS, HAVE DEVELOPED ADAPTIVE MECHANISMS TO LIVE IN SUCH INHOSPITABLE, HARSH ENVIRONMENTS. AMONG DIFFERENT DIFFICULT ENVIRONMENTS, HIGH-ALTITUDE LIVING IS ESPECIALLY DEMANDING BECAUSE OF DIMINISHED PARTIAL PRESSURE OF OXYGEN AND RESULTING CHRONIC HYPOBARIC HYPOXIA. THIS RESULTS IN POOR BLOOD OXYGENATION AND REDUCES AEROBIC OXIDATIVE RESPIRATION IN THE MITOCHONDRIA, LEADING TO INCREASED REACTIVE OXYGEN SPECIES GENERATION AND ACTIVATION OF HYPOXIA-INDUCIBLE GENE EXPRESSION. GENETIC MECHANISMS IN THE ADAPTATION TO HIGH ALTITUDE IS WELL-STUDIED, BUT THERE ARE ONLY LIMITED STUDIES REGARDING THE ROLE OF EPIGENETIC MECHANISMS. THE PURPOSE OF THIS REVIEW IS TO UNDERSTAND THE EPIGENETIC MECHANISMS BEHIND HIGH-ALTITUDE ADAPTIVE AND MALADAPTIVE PHENOTYPES. HYPOBARIC HYPOXIA IS A FORM OF CELLULAR HYPOXIA, WHICH IS SIMILAR TO THE ONE SUFFERED BY CRITICALLY-ILL HYPOXEMIA PATIENTS. THUS, UNDERSTANDING THE ADAPTIVE EPIGENETIC SIGNALS OPERATING IN IN HIGH-ALTITUDE ADJUSTED INDIGENOUS POPULATIONS MAY HELP IN THERAPEUTICALLY MODULATING SIGNALING PATHWAYS IN HYPOXEMIA PATIENTS BY COPYING THE MOST SUCCESSFUL EPIGENOTYPE. IN ADDITION, WE HAVE SUMMARIZED THE CURRENT INFORMATION ABOUT EXOSOMES IN HYPOXIA RESEARCH AND PROSPECTS TO USE THEM AS DIAGNOSTIC TOOLS TO STUDY THE EPIGENOME OF HIGH-ALTITUDE ADAPTED HEALTHY OR MALADAPTED INDIVIDUALS. 2021 10 4202 20 METABOLIC SYNDROME IN CHILDREN BORN SMALL-FOR-GESTATIONAL AGE. BEING BORN SMALL-FOR-GESTATIONAL AGE AND A RAPID INCREASE IN WEIGHT DURING EARLY CHILDHOOD AND INFANCY HAS BEEN STRONGLY LINKED WITH CHRONIC DISEASES, INCLUDING METABOLIC SYNDROME, WHICH HAS BEEN RELATED TO INTRAUTERINE LIFE ENVIRONMENT AND LINKED TO EPIGENETIC FETAL PROGRAMMING. METABOLIC SYNDROME INCLUDES WAIST CIRCUMFERENCE >/= 90(TH) PERCENTILE FOR AGE, SEX AND RACE, HIGHER LEVELS OF BLOOD PRESSURE, TRIGLYCERIDES AND FASTING GLUCOSE, AND LOW LEVELS OF HDL-CHOLESTEROL. INSULIN RESISTANCE MAY BE PRESENT AS EARLY AS 1 YEAR OF AGE, AND OBESITY AND/OR TYPE 2 DIABETES ARE MORE PREVALENT IN THOSE BORN SGA THAN THOSE BORN AGA. THE PROGRAMMING OF ADAPTIVE RESPONSES IN CHILDREN BORN SGA INCLUDES AN ASSOCIATION WITH INCREASED BLOOD PRESSURE, CHANGES IN ENDOTHELIAL FUNCTION, ARTERIAL PROPERTIES AND CORONARY DISEASE. EARLY INTERVENTIONS SHOULD BE DIRECTED TO APPROPRIATE MATERNAL NUTRITION, BEFORE AND DURING PREGNANCY, PROMOTION OF BREAST FEEDING, AND PREVENTION OF RAPID WEIGHT GAIN DURING INFANCY, AND TO PROMOTE A HEALTHY LIFESTYLE. 2011 11 1376 24 DEVELOPMENTAL PROGRAMMING OF BODY COMPOSITION: UPDATE ON EVIDENCE AND MECHANISMS. PURPOSE OF REVIEW: A GROWING BODY OF EPIDEMIOLOGICAL AND EXPERIMENTAL DATA INDICATE THAT NUTRITIONAL OR ENVIRONMENTAL STRESSORS DURING EARLY DEVELOPMENT CAN INDUCE LONG-TERM ADAPTATIONS THAT INCREASE RISK OF OBESITY, DIABETES, CARDIOVASCULAR DISEASE, AND OTHER CHRONIC CONDITIONS-A PHENOMENON TERMED "DEVELOPMENTAL PROGRAMMING." A COMMON PHENOTYPE IN HUMANS AND ANIMAL MODELS IS ALTERED BODY COMPOSITION, WITH REDUCED MUSCLE AND BONE MASS, AND INCREASED FAT MASS. IN THIS REVIEW, WE SUMMARIZE THE RECENT LITERATURE LINKING PRENATAL FACTORS TO FUTURE BODY COMPOSITION AND EXPLORE CONTRIBUTING MECHANISMS. RECENT FINDINGS: MANY PRENATAL EXPOSURES, INCLUDING INTRAUTERINE GROWTH RESTRICTION, EXTREMES OF BIRTH WEIGHT, MATERNAL OBESITY, AND MATERNAL DIABETES, ARE ASSOCIATED WITH INCREASED FAT MASS, REDUCED MUSCLE MASS, AND DECREASED BONE DENSITY, WITH EFFECTS REPORTED THROUGHOUT INFANCY AND CHILDHOOD, AND PERSISTING INTO MIDDLE AGE. MECHANISMS AND MEDIATORS INCLUDE MATERNAL DIET, BREASTMILK COMPOSITION, METABOLITES, APPETITE REGULATION, GENETIC AND EPIGENETIC INFLUENCES, STEM CELL COMMITMENT AND FUNCTION, AND MITOCHONDRIAL METABOLISM. DIFFERENCES IN BODY COMPOSITION ARE A COMMON PHENOTYPE FOLLOWING DISRUPTIONS TO THE PRENATAL ENVIRONMENT, AND MAY CONTRIBUTE TO DEVELOPMENTAL PROGRAMMING OF OBESITY AND DIABETES RISK. 2019 12 3115 24 GEROMETABOLITES: THE PSEUDOHYPOXIC AGING SIDE OF CANCER ONCOMETABOLITES. ONCOMETABOLITES ARE DEFINED AS SMALL-MOLECULE COMPONENTS (OR ENANTIOMERS) OF NORMAL METABOLISM WHOSE ACCUMULATION CAUSES SIGNALING DYSREGULATION TO ESTABLISH A MILIEU THAT INITIATES CARCINOGENESIS. IN A SIMILAR MANNER, WE PROPOSE THE TERM "GEROMETABOLITES" TO REFER TO SMALL-MOLECULE COMPONENTS OF NORMAL METABOLISM WHOSE DEPLETION CAUSES SIGNALING DYSREGULATION TO ESTABLISH A MILIEU THAT DRIVES AGING. IN AN INVESTIGATION OF THE PATHOGENIC ACTIVITIES OF THE CURRENTLY RECOGNIZED ONCOMETABOLITES R(-)-2-HYDROXYGLUTARATE (2-HG), FUMARATE, AND SUCCINATE, WHICH ACCUMULATE DUE TO MUTATIONS IN ISOCITRATE DEHYDROGENASES (IDH), FUMARATE HYDRATASE (FH), AND SUCCINATE DEHYDROGENASE (SDH), RESPECTIVELY, WE ILLUSTRATE THE FACT THAT METABOLIC PSEUDOHYPOXIA, THE ACCUMULATION OF HYPOXIA-INDUCIBLE FACTOR (HIFALPHA) UNDER NORMOXIC CONDITIONS, AND THE SUBSEQUENT WARBURG-LIKE REPROGRAMMING THAT SHIFTS GLUCOSE METABOLISM FROM THE OXIDATIVE PATHWAY TO AEROBIC GLYCOLYSIS ARE THE SAME MECHANISMS THROUGH WHICH THE DECLINE OF THE "GEROMETABOLITE" NICOTINAMIDE ADENINE DINUCLEOTIDE (NAD)(+) REVERSIBLY DISRUPTS NUCLEAR-MITOCHONDRIAL COMMUNICATION AND CONTRIBUTES TO THE DECLINE IN MITOCHONDRIAL FUNCTION WITH AGE. FROM AN EVOLUTIONARY PERSPECTIVE, IT IS REASONABLE TO VIEW NAD(+)-DRIVEN MITOCHONDRIAL HOMEOSTASIS AS A CONSERVED RESPONSE TO CHANGES IN ENERGY SUPPLIES AND OXYGEN LEVELS. SIMILARLY, THE NATURAL ABILITY OF 2-HG TO SIGNIFICANTLY ALTER EPIGENETICS MIGHT REFLECT AN EVOLUTIONARILY ANCIENT ROLE OF CERTAIN METABOLITES TO SIGNAL FOR ELEVATED GLUTAMINE/GLUTAMATE METABOLISM AND/OR OXYGEN DEFICIENCY. HOWEVER, WHEN CHRONICALLY ALTERED, THESE RESPONSES BECOME CONSERVED CAUSES OF AGING AND CANCER. BECAUSE HIFALPHA-DRIVEN PSEUDOHYPOXIA MIGHT DRIVE THE OVERPRODUCTION OF 2-HG, THE INTRIGUING POSSIBILITY EXISTS THAT THE DECLINE OF GEROMETABOLITES SUCH AS NAD(+) COULD PROMOTE THE CHRONIC ACCUMULATION OF ONCOMETABOLITES IN NORMAL CELLS DURING AGING. IF THE SOLE ACTIVATION OF A WARBURG-LIKE METABOLIC REPROGRAMMING IN NORMAL TISSUES MIGHT BE ABLE TO SIGNIFICANTLY INCREASE THE ENDOGENOUS PRODUCTION OF BONA FIDE ETIOLOGICAL DETERMINANTS IN CANCER, SUCH AS ONCOMETABOLITES, THIS UNDESIRABLE TRADE-OFF BETWEEN MITOCHONDRIAL DYSFUNCTION AND ACTIVATION OF ONCOMETABOLITES PRODUCTION MIGHT THEN PAVE THE WAY FOR THE EPIGENETIC INITIATION OF CARCINOGENESIS IN A STRICTLY METABOLIC-DEPENDENT MANNER. PERHAPS IT IS TIME TO DEFINITELY ADOPT THE VIEW THAT AGING AND AGING DISEASES INCLUDING CANCER ARE GOVERNED BY A PIVOTAL REGULATORY ROLE OF METABOLIC REPROGRAMMING IN CELL FATE DECISIONS. 2014 13 1939 31 EPIDEMIOLOGY AND (PATHO)PHYSIOLOGY OF FOLIC ACID SUPPLEMENT USE IN OBESE WOMEN BEFORE AND DURING PREGNANCY. PRECONCEPTION FOLIC ACID SUPPLEMENT USE IS A WELL-KNOWN METHOD OF PRIMARY PREVENTION OF NEURAL TUBE DEFECTS (NTDS). OBESE WOMEN ARE AT A HIGHER RISK FOR HAVING A CHILD WITH A NTD. AS DIFFERENT INTERNATIONAL RECOMMENDATIONS ON FOLIC ACID SUPPLEMENT USE FOR OBESE WOMEN BEFORE AND DURING PREGNANCY EXIST, THIS NARRATIVE REVIEW PROVIDES AN OVERVIEW OF EPIDEMIOLOGY OF FOLATE DEFICIENCY IN OBESE (PRE)PREGNANT WOMEN, ELABORATES ON POTENTIAL MECHANISMS UNDERLYING FOLATE DEFICIENCY, AND DISCUSSES CONSIDERATIONS FOR THE USAGE OF HIGHER DOSES OF FOLIC ACID SUPPLEMENTS. WOMEN WITH OBESITY MORE OFTEN SUFFER FROM AN ABSOLUTE FOLATE DEFICIENCY, AS THEY ARE LESS COMPLIANT TO PERICONCEPTIONAL FOLIC ACID SUPPLEMENT USE RECOMMENDATIONS. IN ADDITION, THEIR DIETARY FOLATE INTAKE IS LIMITED DUE TO AN UNBALANCED DIET (RELATIVE MALNUTRITION). THE ASSOCIATION OF OBESITY AND NTDS ALSO SEEMS TO BE INDEPENDENT OF FOLATE INTAKE, WITH STUDIES SUGGESTING AN INCREASED NEED OF FOLATE (RELATIVE DEFICIENCY) DUE TO DERANGEMENTS INVOLVED IN OTHER PATHWAYS. THE RELATIVE FOLATE DEFICIENCY, AS A RESULT OF AN INCREASED METABOLIC NEED FOR FOLATE IN OBESE WOMEN, CAN BE DUE TO: (1) LOW-GRADE CHRONIC INFLAMMATION (2) INSULIN RESISTANCE, (3) INOSITOL, AND (4) DYSBIOTIC GUT MICROBIOME, WHICH PLAYS A ROLE IN FOLATE PRODUCTION AND UPTAKE. IN ALL THESE PATHWAYS, THE FOLATE-DEPENDENT ONE-CARBON METABOLISM IS INVOLVED. IN CONCLUSION, SCIENTIFIC EVIDENCE OF THE INVOLVEMENT OF SEVERAL FOLATE-RELATED PATHWAYS IMPLIES TO INCREASE THE RECOMMENDED FOLIC ACID SUPPLEMENTATION IN OBESE WOMEN. HOWEVER, THE PHYSIOLOGICAL UPTAKE OF SYNTHETIC FOLIC ACID IS LIMITED AND SIDE-EFFECTS OF UNMETABOLIZED FOLIC ACID IN MOTHERS AND OFFSPRING, IN PARTICULAR VARIATIONS IN EPIGENETIC (RE)PROGRAMMING WITH LONG-TERM HEALTH EFFECTS, CANNOT BE EXCLUDED. THEREFORE, WE EMPHASIZE ON THE URGENT NEED FOR FURTHER RESEARCH AND PRECONCEPTION PERSONALIZED COUNSELING ON FOLATE STATUS, LIFESTYLE, AND MEDICAL CONDITIONS. 2021 14 2408 20 EPIGENETIC REWIRING OF SKELETAL MUSCLE ENHANCERS AFTER EXERCISE TRAINING SUPPORTS A ROLE IN WHOLE-BODY FUNCTION AND HUMAN HEALTH. OBJECTIVES: REGULAR PHYSICAL EXERCISE IMPROVES HEALTH BY REDUCING THE RISK OF A PLETHORA OF CHRONIC DISORDERS. WE HYPOTHESIZED THAT ENDURANCE EXERCISE TRAINING REMODELS THE ACTIVITY OF GENE ENHANCERS IN SKELETAL MUSCLE AND THAT THIS REMODELING CONTRIBUTES TO THE BENEFICIAL EFFECTS OF EXERCISE ON HUMAN HEALTH. METHODS AND RESULTS: BY STUDYING CHANGES IN HISTONE MODIFICATIONS, WE MAPPED THE GENOME-WIDE POSITIONS AND ACTIVITIES OF ENHANCERS IN SKELETAL MUSCLE BIOPSIES COLLECTED FROM YOUNG SEDENTARY MEN BEFORE AND AFTER 6 WEEKS OF ENDURANCE EXERCISE. WE IDENTIFIED EXTENSIVE REMODELING OF ENHANCER ACTIVITIES AFTER EXERCISE TRAINING, WITH A LARGE SUBSET OF THE REMODELED ENHANCERS LOCATED IN THE PROXIMITY OF GENES TRANSCRIPTIONALLY REGULATED AFTER EXERCISE. BY OVERLAPPING THE POSITION OF ENHANCERS WITH GENETIC VARIANTS, WE IDENTIFIED AN ENRICHMENT OF DISEASE-ASSOCIATED GENETIC VARIANTS WITHIN THE EXERCISE-REMODELED ENHANCERS. CONCLUSION: OUR DATA PROVIDE EVIDENCE OF A FUNCTIONAL LINK BETWEEN EPIGENETIC REWIRING OF ENHANCERS TO CONTROL THEIR ACTIVITY AFTER EXERCISE TRAINING AND THE MODULATION OF DISEASE RISK IN HUMANS. 2021 15 6724 29 VITAMIN D: EFFECTS ON PREGNANCY, MATERNAL, FETAL AND POSTNATAL OUTCOMES. A HIGH PREVALENCE OF VITAMIN D DEFICIENCY AND ITS NEGATIVE CONSEQUENCES FOR HEALTH IS IDENTIFIED AS AREA OF PRIMARY CONCERN FOR SCIENTISTS AND CLINICIANS WORLDWIDE. VITAMIN D DEFICIENCY AFFECTS NOT ONLY BONE HEALTH BUT MANY SOCIALLY SIGNIFICANT ACUTE AND CHRONIC DISEASES. OBSERVATIONAL STUDIES SUPPORT THAT PREGNANT AND LACTATING WOMEN, CHILDREN AND TEENAGERS REPRESENT THE HIGH RISK GROUPS FOR DEVELOPING VITAMIN D DEFICIENCY. CURRENT EVIDENCE HIGHLIGHTS A CRUCIAL ROLE OF VITAMIN D IN PROVIDING THE FETAL LIFE-SUPPORT SYSTEM AND FETUS DEVELOPMENT, INCLUDING IMPLANTATION, PLACENTAL FORMATION, INTRA- AND POSTPARTUM PERIODS. HYPOVITAMINOSIS D DURING PREGNANCY IS ASSOCIATED WITH A HIGHER INCIDENCE OF PLACENTAL INSUFFICIENCY, SPONTANEOUS ABORTIONS AND PRETERM BIRTH, PREECLAMPSIA, GESTATIONAL DIABETES, IMPAIRED FETAL AND CHILDHOOD GROWTH, INCREASED RISK OF AUTOIMMUNE DISEASES FOR OFFSPRINGS. POTENTIAL MECHANISMS FOR THE OBSERVED ASSOCIATIONS CONTAIN METABOLIC, IMMUNOMODULATORY AND ANTIINFLAMMATORY EFFECTS OF VITAMIN D. EPIGENETIC MODIFICATIONS IN VITAMIN D-ASSOCIATED GENES AND FETAL PROGRAMMING ARE OF PARTICULAR INTEREST. THE CONCEPT OF PREVENTING VITAMIN D DEFICIENCY IS ACTIVELY DISCUSSED, INCLUDING SUPPLEMENTATION IN DIFFERENT ETHNIC GROUPS, REQUIRED DOSES, TIME OF INITIATION AND THERAPY DURATION, INFLUENCE ON GESTATION AND CHILDBIRTH. AN ADEQUATE SUPPLY OF VITAMIN D DURING PREGNANCY IMPROVES THE MATERNAL AND FETAL OUTCOMES, SHORT AND LONG TERM HEALTH OF THE OFFSPRING. STILL CURRENT DATA ON RELATIONSHIP BETWEEN MATERNAL VITAMIN D STATUS AND PREGNANCY OUTCOMES REMAINS CONTROVERSIAL. THE LARGE OBSERVATIONAL AND INTERVENTIONAL RANDOMIZED CONTROL TRIALS ARE REQUIRED TO CREATE EVIDENCE-BASED GUIDELINES FOR THE SUPPLEMENTATION OF VITAMIN D IN PREGNANT AND LACTATING WOMEN. 2018 16 2801 26 FEMALE OBESITY: SHORT- AND LONG-TERM CONSEQUENCES ON THE OFFSPRING. THE WORLDWIDE PREVALENCE OF OBESITY HAS RISEN OVER THE PAST FEW DECADES AND WOMEN ARE CURRENTLY MORE LIKELY THAN EVER TO ENTER PREGNANCY OBESE. PRE-PREGNANCY OBESITY AND EXCESSIVE GESTATIONAL WEIGHT GAIN INCREASE MISCARRIAGE RATES AND OBSTETRIC AND NEONATAL COMPLICATIONS, WHICH RESULT IN A LOWER HEALTHY LIVE BIRTH RATE. IN ADDITION TO ITS NEGATIVE CONSEQUENCES FOR THE MOTHER, OBESITY HAS BEEN SHOWN TO BE AN IMPORTANT RISK FACTOR FOR CHRONIC ILLNESSES, SUCH AS CARDIOVASCULAR DISEASE, METABOLIC SYNDROME AND TYPE 2 DIABETES IN THE ADOLESCENCE AND ADULTHOOD OF THE OFFSPRING. MOREOVER, MATERNAL OBESITY CAUSES PSYCHOLOGICAL PROBLEMS, PHYSICAL DISABILITIES AND HIGHER HEALTHCARE COSTS. FETAL PROGRAMMING OF METABOLIC FUNCTION INDUCED BY OBESITY, THROUGH PHYSIOLOGICAL AND/OR EPIGENETIC MECHANISMS, MAY HAVE AN INTERGENERATIONAL EFFECT AND COULD, THUS, PERPETUATE OBESITY IN THE NEXT GENERATION. IN ORDER TO BREAK THIS VICIOUS CIRCLE AND AVOID SERIOUS SHORT- AND LONG-TERM NEGATIVE OUTCOMES FOR BOTH MOTHERS AND FETUSES, THE PREVENTION AND ADEQUATE MANAGEMENT OF OBESITY AND GESTATIONAL WEIGHT GAIN ARE ESSENTIAL. 2013 17 2711 15 EXERCISE TRAINING ALTERS THE GENOMIC RESPONSE TO ACUTE EXERCISE IN HUMAN ADIPOSE TISSUE. AIM: TO DETERMINE THE GENOMIC MECHANISMS BY WHICH ADIPOSE TISSUE RESPONDS TO ACUTE AND CHRONIC EXERCISE. METHODS: WE PROFILED THE TRANSCRIPTOMIC AND EPIGENETIC RESPONSE TO ACUTE EXERCISE IN HUMAN ADIPOSE TISSUE COLLECTED BEFORE AND AFTER ENDURANCE TRAINING. RESULTS: ALTHOUGH ACUTE EXERCISES WERE PERFORMED AT SAME RELATIVE INTENSITIES, THE MAGNITUDE OF TRANSCRIPTOMIC CHANGES AFTER ACUTE EXERCISE WAS REDUCED BY ENDURANCE TRAINING. DNA METHYLATION REMODELING INDUCED BY ACUTE EXERCISE WAS MORE PROMINENT IN TRAINED VERSUS UNTRAINED STATE. WE FOUND AN OVERLAP BETWEEN GENE EXPRESSION AND DNA METHYLATION CHANGES AFTER ACUTE EXERCISE FOR 32 GENES PRE-TRAINING AND SIX POST-TRAINING, NOTABLY AT ADIPOCYTE-SPECIFIC GENES. CONCLUSION: TRAINING STATUS DIFFERENTIALLY AFFECTS THE EPIGENETIC AND TRANSCRIPTOMIC RESPONSE TO ACUTE EXERCISE IN HUMAN ADIPOSE TISSUE. 2018 18 2805 31 FETAL MALNUTRITION AND LONG-TERM OUTCOMES. EPIDEMIOLOGICAL STUDIES HAVE SHOWN THAT LOWER BIRTHWEIGHT IS ASSOCIATED WITH A WIDE RANGE OF ADVERSE OUTCOMES IN LATER LIFE, INCLUDING POORER 'HUMAN CAPITAL' (SHORTER STATURE, LOWER COGNITIVE PERFORMANCE), INCREASED RISK FACTORS FOR LATER DISEASE (HIGHER BLOOD PRESSURE AND REDUCED GLUCOSE TOLERANCE, AND LUNG, KIDNEY AND IMMUNE FUNCTION), CLINICAL DISEASE (DIABETES, CORONARY HEART DISEASE, CHRONIC LUNG AND KIDNEY DISEASE), AND INCREASED ALL-CAUSE AND CARDIOVASCULAR MORTALITY. HIGHER BIRTHWEIGHT IS ASSOCIATED WITH AN INCREASED RISK OF CANCER AND (IF CAUSED BY GESTATIONAL DIABETES) OBESITY AND DIABETES. THE 'DEVELOPMENTAL ORIGINS OF HEALTH AND DISEASE' HYPOTHESIS PROPOSES THAT FETAL NUTRITION HAS PERMANENT EFFECTS ON GROWTH, STRUCTURE AND METABOLISM ('PROGRAMMING'). THIS IS SUPPORTED BY STUDIES IN ANIMALS SHOWING THAT MATERNAL UNDER- AND OVERNUTRITION DURING PREGNANCY CAN PRODUCE SIMILAR ABNORMALITIES IN THE ADULT OFFSPRING. COMMON CHRONIC DISEASES COULD POTENTIALLY BE PREVENTED BY ACHIEVING OPTIMAL FETAL NUTRITION, AND THIS COULD HAVE ADDITIONAL BENEFITS FOR SURVIVAL AND HUMAN CAPITAL. RECENT FOLLOW-UP OF CHILDREN BORN AFTER RANDOMIZED NUTRITIONAL INTERVENTIONS IN PREGNANCY PROVIDES WEAK EVIDENCE OF BENEFICIAL EFFECTS ON GROWTH, VASCULAR FUNCTION, LIPID CONCENTRATIONS, GLUCOSE TOLERANCE AND INSULIN RESISTANCE. ANIMAL STUDIES INDICATE THAT EPIGENETIC PHENOMENA MAY BE AN IMPORTANT MECHANISM UNDERLYING PROGRAMMING, AND THAT NUTRITIONAL INTERVENTIONS MAY NEED TO START PRECONCEPTIONALLY. 2013 19 788 17 CELLULAR ALLOSTATIC LOAD IS LINKED TO INCREASED ENERGY EXPENDITURE AND ACCELERATED BIOLOGICAL AGING. STRESS TRIGGERS ANTICIPATORY PHYSIOLOGICAL RESPONSES THAT PROMOTE SURVIVAL, A PHENOMENON TERMED ALLOSTASIS. HOWEVER, THE CHRONIC ACTIVATION OF ENERGY-DEPENDENT ALLOSTATIC RESPONSES RESULTS IN ALLOSTATIC LOAD, A DYSREGULATED STATE THAT PREDICTS FUNCTIONAL DECLINE, ACCELERATES AGING, AND INCREASES MORTALITY IN HUMANS. THE ENERGETIC COST AND CELLULAR BASIS FOR THE DAMAGING EFFECTS OF ALLOSTATIC LOAD HAVE NOT BEEN DEFINED. HERE, BY LONGITUDINALLY PROFILING THREE UNRELATED PRIMARY HUMAN FIBROBLAST LINES ACROSS THEIR LIFESPAN, WE FIND THAT CHRONIC GLUCOCORTICOID EXPOSURE INCREASES CELLULAR ENERGY EXPENDITURE BY APPROXIMATELY 60%, ALONG WITH A METABOLIC SHIFT FROM GLYCOLYSIS TO MITOCHONDRIAL OXIDATIVE PHOSPHORYLATION (OXPHOS). THIS STATE OF STRESS-INDUCED HYPERMETABOLISM IS LINKED TO MTDNA INSTABILITY, NON-LINEARLY AFFECTS AGE-RELATED CYTOKINES SECRETION, AND ACCELERATES CELLULAR AGING BASED ON DNA METHYLATION CLOCKS, TELOMERE SHORTENING RATE, AND REDUCED LIFESPAN. PHARMACOLOGICALLY NORMALIZING OXPHOS ACTIVITY WHILE FURTHER INCREASING ENERGY EXPENDITURE EXACERBATES THE ACCELERATED AGING PHENOTYPE, POINTING TO TOTAL ENERGY EXPENDITURE AS A POTENTIAL DRIVER OF AGING DYNAMICS. TOGETHER, OUR FINDINGS DEFINE BIOENERGETIC AND MULTI-OMIC RECALIBRATIONS OF STRESS ADAPTATION, UNDERSCORING INCREASED ENERGY EXPENDITURE AND ACCELERATED CELLULAR AGING AS INTERRELATED FEATURES OF CELLULAR ALLOSTATIC LOAD. 2023 20 4080 25 MATERNAL LIFESTYLE INTERVENTIONS: TARGETING PRECONCEPTION HEALTH. ABOUT ONE-THIRD OF WOMEN OF REPRODUCTIVE AGE ARE OBESE, PREDISPOSING BOTH MOTHER AND BABY TO UNFAVOURABLE PREGNANCY OUTCOMES AND INITIATING AN INTERGENERATIONAL CYCLE OF CHRONIC METABOLIC DISORDERS. HERE WE SUMMARISE RECENT RESEARCH ON THE INFLUENCE OF MATERNAL METABOLIC HEALTH ON OFFSPRING SUSCEPTIBILITY TO FUTURE CARDIOMETABOLIC DISEASES. CURRENT PRIMARY LIFESTYLE APPROACHES (I.E., DIET AND EXERCISE INTERVENTIONS) TO HALT THE SUCCESSION OF INHERITED AND EPIGENETIC METABOLIC ABNORMALITIES HAVE MET WITH LIMITED SUCCESS DUE TO LATE IMPLEMENTATION, POOR ADHERENCE, AND/OR GENERIC GUIDELINES. IN OUR OPINION, SUCH INTERVENTIONS MUST COMMENCE PRIOR TO CONCEPTION TO IMPROVE BOTH MATERNAL AND CHILD HEALTH OUTCOMES, WITH NEW APPROACHES URGENTLY NEEDED TO INCREASE ADHERENCE TO PRIMARY LIFESTYLE CHANGES AMONG REPRODUCTIVE-AGE WOMEN. 2020