1 4592 123 NATURAL ENVIRONMENTS, NATURE RELATEDNESS AND THE ECOLOGICAL THEATER: CONNECTING SATELLITES AND SEQUENCING TO SHINRIN-YOKU. RECENT ADVANCES IN RESEARCH CONCERNING THE PUBLIC HEALTH VALUE OF NATURAL ENVIRONMENTS HAVE BEEN REMARKABLE. THE GROWING INTEREST IN THIS TOPIC (OFTEN HOUSED UNDER TERMS SUCH AS GREEN AND/OR BLUE SPACE) HAS BEEN OCCURRING IN PARALLEL WITH THE MICROBIOME REVOLUTION AND AN INCREASED USE OF REMOTE SENSING TECHNOLOGY IN PUBLIC HEALTH. IN THE CONTEXT OF BIODIVERSITY LOSS, RAPID URBANIZATION, AND ALARMING RATES OF GLOBAL NON-COMMUNICABLE DISEASES (MANY ASSOCIATED WITH CHRONIC, LOW-GRADE INFLAMMATION), DISCUSSIONS OF NATURAL VIS-A-VIS BUILT ENVIRONMENTS ARE NOT MERELY FODDER FOR INTELLECTUAL CURIOSITY. HERE, WE ARGUE FOR INCREASED INTERDISCIPLINARY COLLABORATION WITH THE AIM OF BETTER UNDERSTANDING THE MECHANISMS-INCLUDING AEROBIOLOGICAL AND EPIGENETIC-THAT MIGHT HELP EXPLAIN SOME OF THE NOTED POSITIVE HEALTH OUTCOMES. IT IS OUR CONTENTION THAT SOME OF THESE MECHANISMS ARE RELATED TO ECODIVERSITY (I.E., THE SUM OF BIODIVERSITY AND GEODIVERSITY, INCLUDING BIOTIC AND ABIOTIC CONSTITUENTS). WE ALSO ENCOURAGE RESEARCHERS TO MORE CLOSELY EXAMINE INDIVIDUAL NATURE RELATEDNESS AND HOW IT MIGHT INFLUENCE MANY OUTCOMES THAT ARE AT THE INTERFACE OF LIFESTYLE HABITS AND CONTACT WITH ECODIVERSITY. 2016 2 1915 27 ENVIRONMENTAL AND OCCUPATIONAL EXPOSURE OF METALS AND FEMALE REPRODUCTIVE HEALTH. UNTAINTED ENVIRONMENT PROMOTES HEALTH, BUT THE LAST FEW DECADES EXPERIENCED STEEP UPSURGE IN ENVIRONMENTAL CONTAMINANTS POSING DETRIMENTAL PHYSIOLOGICAL IMPACT. THE RESPONSIBLE FACTORS MAINLY INCLUDE THE EXPONENTIAL GROWTH OF HUMAN POPULATION, HAVOC RISE IN INDUSTRIALIZATION, POORLY PLANNED URBANIZATION, AND SLAPDASH ENVIRONMENT MANAGEMENT. ENVIRONMENTAL DEGRADATION CAN INCREASE THE LIKELIHOOD OF HUMAN EXPOSURE TO HEAVY METALS, RESULTING IN HEALTH CONSEQUENCES SUCH AS REPRODUCTIVE PROBLEMS. AS A RESULT, RESEARCH INTO METAL-INDUCED CAUSES OF REPRODUCTIVE IMPAIRMENT AT THE GENETIC, EPIGENETIC, AND BIOCHEMICAL LEVELS MUST BE STRENGTHENED FURTHER. THESE METALS IMPACT UPON THE FEMALE REPRODUCTION AT ALL STRATA OF ITS REGULATION AND FUNCTIONS, BE IT DEVELOPMENT, MATURATION, OR ENDOCRINE FUNCTIONS, AND ARE LINKED TO AN INCREASE IN THE CAUSES OF INFERTILITY IN WOMEN. CHRONIC EXPOSURES TO THE HEAVY METALS MAY LEAD TO BREAST CANCER, ENDOMETRIOSIS, ENDOMETRIAL CANCER, MENSTRUAL DISORDERS, AND SPONTANEOUS ABORTIONS, AS WELL AS PRE-TERM DELIVERIES, STILLBIRTHS. FOR EXAMPLE, ENDOMETRIOSIS, ENDOMETRIAL CANCER, AND SPONTANEOUS ABORTIONS ARE ALL CAUSED BY THE METALLOESTROGEN CADMIUM (CD); LEAD (PB) LEVELS OVER A CERTAIN THRESHOLD CAN CAUSE SPONTANEOUS ABORTION AND HAVE A TERATOGENIC IMPACT; TOXIC AMOUNTS OF MERCURY (HG) HAVE AN INFLUENCE ON THE MENSTRUAL CYCLE, WHICH CAN LEAD TO INFERTILITY. IMPACT OF ENVIRONMENTAL EXPOSURE TO HEAVY METALS ON FEMALE FERTILITY IS THEREFORE A WELL-KNOWN FACT. THUS, THE UNDERLYING MECHANISMS MUST BE EXPLAINED AND PERIODICALLY UPDATED, GIVEN THE GROWING EVIDENCE ON THE INFLUENCE OF INCREASING ENVIRONMENTAL HEAVY METAL LOAD ON FEMALE FERTILITY. THE PURPOSE OF THIS REVIEW IS TO GIVE A CONCISE OVERVIEW OF HOW HEAVY METAL AFFECTS FEMALE REPRODUCTIVE HEALTH. 2022 3 751 25 CARDIOMETABOLIC EFFECTS OF POSTNATAL HIGH-FAT DIET CONSUMPTION IN OFFSPRING EXPOSED TO MATERNAL PROTEIN RESTRICTION IN UTERO. IN RECENT DECADES, THE HIGH INCIDENCE OF INFECTIOUS AND PARASITIC DISEASES HAS BEEN REPLACED BY A HIGH PREVALENCE OF CHRONIC AND DEGENERATIVE DISEASES. CONCOMITANTLY, THERE HAVE BEEN PROFOUND CHANGES IN THE BEHAVIOR AND EATING HABITS OF FAMILIES AROUND THE WORLD, CHARACTERIZING A "NUTRITIONAL TRANSITION" PHENOMENON, WHICH REFERS TO A SHIFT IN DIET IN RESPONSE TO MODERNIZATION, URBANIZATION, OR ECONOMIC DEVELOPMENT FROM UNDERNUTRITION TO THE EXCESSIVE CONSUMPTION OF HYPERCALORIC AND ULTRA-PROCESSED FOODS. PROTEIN MALNUTRITION THAT WAS A HEALTH PROBLEM IN THE FIRST HALF OF THE 20TH CENTURY HAS NOW BEEN REPLACED BY HIGH-FAT DIETS, ESPECIALLY DIETS HIGH IN SATURATED FAT, PREDISPOSING CONSUMERS TO OVERWEIGHT AND OBESITY. THIS PANORAMA POINTS US TO THE ALARMING COEXISTENCE OF BOTH MALNUTRITION AND OBESITY IN THE SAME POPULATION. IN THIS WAY, INDIVIDUALS WHOSE MOTHERS WERE UNDERNOURISHED EARLY IN PREGNANCY AND THEN EXPOSED TO POSTNATAL HYPERLIPIDIC NUTRITION HAVE INCREASED RISK FACTORS FOR DEVELOPING METABOLIC DYSFUNCTION AND CARDIOVASCULAR DISEASES IN ADULTHOOD. THUS, OUR MAJOR AIM WAS TO REVIEW THE CARDIOMETABOLIC EFFECTS RESULTING FROM POSTNATAL HYPERLIPIDIC DIETS IN PROTEIN-RESTRICTED SUBJECTS, AS WELL AS TO EXAMINE THE EPIGENETIC REPERCUSSIONS OCCASIONED BY THE NUTRITIONAL TRANSITION. 2022 4 6348 29 THE ROLE OF EPIGENETICS IN RESPIRATORY HEALTH IN URBAN POPULATIONS IN LOW AND MIDDLE-INCOME COUNTRIES. AS URBANIZATION INCREASES IN LOW- AND MIDDLE-INCOME COUNTRIES (LMICS), URBAN POPULATIONS WILL BE INCREASINGLY EXPOSED TO A RANGE OF ENVIRONMENTAL RISK FACTORS FOR NON-COMMUNICABLE DISEASES. INADEQUATE LIVING CONDITIONS IN URBAN SETTINGS MAY INFLUENCE MECHANISMS THAT REGULATE GENE EXPRESSION, LEADING TO THE DEVELOPMENT OF NON-COMMUNICABLE RESPIRATORY DISEASES. WE CONDUCTED A SYSTEMATIC REVIEW OF THE LITERATURE TO ASSESS THE RELATIONSHIP BETWEEN RESPIRATORY HEALTH AND EPIGENETIC FACTORS TO URBAN ENVIRONMENTAL EXPOSURES OBSERVED IN LMICS USING MEDLINE, PUBMED, EMBASE, AND GOOGLE SCHOLAR SEARCHING A COMBINATION OF THE TERMS: EPIGENETICS, CHRONIC RESPIRATORY DISEASES (CRDS), LUNG DEVELOPMENT, CHRONIC OBSTRUCTIVE AIRWAY DISEASE, AND ASTHMA. A TOTAL OF 2835 ARTICLES WERE OBTAINED, AND 48 ARTICLES WERE INCLUDED IN THIS REVIEW. WE FOUND THAT ENVIRONMENTAL FACTORS DURING EARLY DEVELOPMENT ARE RELATED TO EPIGENETIC EFFECTS THAT MAY BE ASSOCIATED WITH A HIGHER RISK OF CRDS. EPIGENETIC DYSREGULATION OF GENE EXPRESSION OF THE HISTONE DEACETYLASE (HDAC) AND HISTONE ACETYLTRANSFERASE GENE FAMILIES WAS LIKELY INVOLVED IN LUNG HEALTH OF SLUM DWELLERS. RESPIRATORY-RELATED ENVIRONMENTAL EXPOSURES INFLUENCE HDAC FUNCTION AND DEOXYRIBONUCLEIC ACID METHYLATION AND ARE IMPORTANT RISK FACTORS IN THE DEVELOPMENT OF CRD. ADDITIONAL EPIGENETIC RESEARCH IS NEEDED TO IMPROVE OUR UNDERSTANDING OF ASSOCIATIONS BETWEEN ENVIRONMENTAL EXPOSURES AND NON-COMMUNICABLE RESPIRATORY DISEASES. 2019 5 1243 24 CURRENT CONCEPTS IN CHRONIC INFLAMMATORY DISEASES: INTERACTIONS BETWEEN MICROBES, CELLULAR METABOLISM, AND INFLAMMATION. RECENT RESEARCH INDICATES THAT CHRONIC INFLAMMATORY DISEASES, INCLUDING ALLERGIES AND AUTOIMMUNE AND NEUROPSYCHIATRIC DISEASES, SHARE COMMON PATHWAYS OF CELLULAR AND MOLECULAR DYSREGULATION. IT WAS THE AIM OF THE INTERNATIONAL VON-BEHRING-RONTGEN SYMPOSIUM (OCTOBER 16-18, 2014, IN MARBURG, GERMANY) TO DISCUSS RECENT DEVELOPMENTS IN THIS FIELD. THESE INCLUDE A CONCEPT OF BIODIVERSITY; THE CONTRIBUTION OF URBANIZATION, LIFESTYLE FACTORS, AND NUTRITION (EG, VITAMIN D); AND NEW MECHANISMS OF METABOLIC AND IMMUNE DYSREGULATION, SUCH AS EXTRACELLULAR AND INTRACELLULAR RNAS AND CELLULAR AND MITOCHONDRIAL STRESS. EPIGENETIC MECHANISMS CONTRIBUTE FURTHER TO ALTERED GENE EXPRESSION AND THEREFORE TO THE DEVELOPMENT OF CHRONIC INFLAMMATION. THESE NOVEL FINDINGS PROVIDE THE FOUNDATION FOR FURTHER DEVELOPMENT OF PREVENTIVE AND THERAPEUTIC STRATEGIES. 2016 6 360 22 AMBIENT AIR POLLUTION AND BIOMARKERS OF HEALTH EFFECT. RECENTLY, THE AIR POLLUTION SITUATION OF OUR COUNTRY IS VERY SERIOUS ALONG WITH THE DEVELOPMENT OF URBANIZATION AND INDUSTRIALIZATION. STUDIES INDICATE THAT THE EXPOSURE OF AIR POLLUTION CAN CAUSE A RISE OF INCIDENCE AND MORTALITY OF MANY DISEASES, SUCH AS CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), ASTHMA, MYOCARDIAL INFARCTION, AND SO ON. HOWEVER, THERE IS NOW GROWING EVIDENCE SHOWING THAT SIGNIFICANT AIR POLLUTION EXPOSURES ARE ASSOCIATED WITH EARLY BIOMARKERS IN VARIOUS SYSTEMS OF THE BODY. IN ORDER TO BETTER PREVENT AND CONTROL THE DAMAGE EFFECT OF AIR POLLUTION, THIS ARTICLE SUMMARIZES COMPREHENSIVELY EPIDEMIOLOGICAL STUDIES ABOUT THE BAD EFFECTS ON THE BIOMARKERS OF RESPIRATORY SYSTEM, CARDIOVASCULAR SYSTEM, AND GENETIC AND EPIGENETIC SYSTEM EXPOSURE TO AMBIENT AIR POLLUTION. 2017 7 363 34 AMBIENT AIR POLLUTION: HEALTH HAZARDS TO CHILDREN. AMBIENT AIR POLLUTION IS PRODUCED BY SOURCES INCLUDING VEHICULAR TRAFFIC, COAL-FIRED POWER PLANTS, HYDRAULIC FRACTURING, AGRICULTURAL PRODUCTION, AND FOREST FIRES. IT CONSISTS OF PRIMARY POLLUTANTS GENERATED BY COMBUSTION AND SECONDARY POLLUTANTS FORMED IN THE ATMOSPHERE FROM PRECURSOR GASES. AIR POLLUTION CAUSES AND EXACERBATES CLIMATE CHANGE, AND CLIMATE CHANGE WORSENS HEALTH EFFECTS OF AIR POLLUTION. INFANTS AND CHILDREN ARE UNIQUELY SENSITIVE TO AIR POLLUTION, BECAUSE THEIR ORGANS ARE DEVELOPING AND THEY HAVE HIGHER AIR PER BODY WEIGHT INTAKE. HEALTH EFFECTS LINKED TO AIR POLLUTION INCLUDE NOT ONLY EXACERBATIONS OF RESPIRATORY DISEASES BUT ALSO REDUCED LUNG FUNCTION DEVELOPMENT AND INCREASED ASTHMA INCIDENCE. ADDITIONAL OUTCOMES OF CONCERN INCLUDE PRETERM BIRTH, LOW BIRTH WEIGHT, NEURODEVELOPMENTAL DISORDERS, IQ LOSS, PEDIATRIC CANCERS, AND INCREASED RISKS FOR ADULT CHRONIC DISEASES. THESE EFFECTS ARE MEDIATED BY OXIDATIVE STRESS, CHRONIC INFLAMMATION, ENDOCRINE DISRUPTION, AND GENETIC AND EPIGENETIC MECHANISMS ACROSS THE LIFE SPAN. NATURAL EXPERIMENTS DEMONSTRATE THAT WITH INITIATIVES SUCH AS INCREASED USE OF PUBLIC TRANSPORTATION, BOTH AIR QUALITY AND COMMUNITY HEALTH IMPROVE. SIMILARLY, THE CLEAN AIR ACT HAS IMPROVED AIR QUALITY, ALTHOUGH EXPOSURE INEQUITIES PERSIST. OTHER EFFECTIVE STRATEGIES FOR REDUCING AIR POLLUTION INCLUDE ENDING RELIANCE ON COAL, OIL, AND GAS; REGULATING INDUSTRIAL EMISSIONS; REDUCING EXPOSURE WITH ATTENTION TO PROXIMITY OF RESIDENCES, SCHOOLS, AND CHILD CARE FACILITIES TO TRAFFIC; AND A GREATER AWARENESS OF THE AIR QUALITY INDEX. THIS POLICY REVIEWS BOTH SHORT- AND LONG-TERM HEALTH CONSEQUENCES OF AMBIENT AIR POLLUTION, ESPECIALLY IN RELATION TO DEVELOPMENTAL EXPOSURES. IT EXAMINES INDIVIDUAL, COMMUNITY, AND LEGISLATIVE STRATEGIES TO MITIGATE AIR POLLUTION. 2021 8 4807 27 OBESITY IN LOW- AND MIDDLE-INCOME COUNTRIES: BURDEN, DRIVERS, AND EMERGING CHALLENGES. WE HAVE REVIEWED THE DISTINCTIVE FEATURES OF EXCESS WEIGHT, ITS CAUSES, AND RELATED PREVENTION AND MANAGEMENT EFFORTS, AS WELL AS DATA GAPS AND RECOMMENDATIONS FOR FUTURE RESEARCH IN LOW- AND MIDDLE-INCOME COUNTRIES (LMICS). OBESITY IS RISING IN EVERY REGION OF THE WORLD, AND NO COUNTRY HAS BEEN SUCCESSFUL AT REVERSING THE EPIDEMIC ONCE IT HAS BEGUN. IN LMICS, OVERWEIGHT IS HIGHER IN WOMEN COMPARED WITH MEN, IN URBAN COMPARED WITH RURAL SETTINGS, AND IN OLDER COMPARED WITH YOUNGER INDIVIDUALS; HOWEVER, THE URBAN-RURAL OVERWEIGHT DIFFERENTIAL IS SHRINKING IN MANY COUNTRIES. OVERWEIGHT OCCURS ALONGSIDE PERSISTENT BURDENS OF UNDERWEIGHT IN LMICS, ESPECIALLY IN YOUNG WOMEN. CHANGES IN THE GLOBAL DIET AND PHYSICAL ACTIVITY ARE AMONG THE HYPOTHESIZED LEADING CONTRIBUTORS TO OBESITY. EMERGING RISK FACTORS INCLUDE ENVIRONMENTAL CONTAMINANTS, CHRONIC PSYCHOSOCIAL STRESS, NEUROENDOCRINE DYSREGULATION, AND GENETIC/EPIGENETIC MECHANISMS. DATA ON EFFECTIVE STRATEGIES TO PREVENT THE ONSET OF OBESITY IN LMICS OR ELSEWHERE ARE LIMITED. EXPANDING THE RESEARCH IN THIS AREA IS A KEY PRIORITY AND HAS IMPORTANT POSSIBILITIES FOR REVERSE INNOVATION THAT MAY ALSO INFORM INTERVENTIONS IN HIGH-INCOME COUNTRIES. 2017 9 4281 36 MICRONUTRIENTS IN PREGNANCY IN LOW- AND MIDDLE-INCOME COUNTRIES. PREGNANCY IS ONE OF THE MORE IMPORTANT PERIODS IN LIFE WHEN INCREASED MICRONUTRIENTS, AND MACRONUTRIENTS ARE MOST NEEDED BY THE BODY; BOTH FOR THE HEALTH AND WELL-BEING OF THE MOTHER AND FOR THE GROWING FOETUS AND NEWBORN CHILD. THIS BRIEF REVIEW AIMS TO IDENTIFY THE MICRONUTRIENTS (VITAMINS AND MINERALS) LIKELY TO BE DEFICIENT IN WOMEN OF REPRODUCTIVE AGE IN LOW- AND MIDDLE-INCOME COUNTRIES (LMIC), ESPECIALLY DURING PREGNANCY, AND THE IMPACT OF SUCH DEFICIENCIES. A GLOBAL PREVALENCE OF SOME TWO BILLION PEOPLE AT RISK OF MICRONUTRIENT DEFICIENCIES, AND MULTIPLE MICRONUTRIENT DEFICIENCIES OF MANY PREGNANT WOMEN IN LMIC UNDERLINE THE URGENCY TO ESTABLISHING THE OPTIMAL RECOMMENDATIONS, INCLUDING FOR DELIVERY. IT HAS LONG BEEN RECOGNIZED THAT ADEQUATE IRON IS IMPORTANT FOR BEST REPRODUCTIVE OUTCOMES, INCLUDING GESTATIONAL COGNITIVE DEVELOPMENT. SIMILARLY, IODINE AND CALCIUM HAVE BEEN RECOGNIZED FOR THEIR ROLES IN DEVELOPMENT OF THE FOETUS/NEONATE. LESS CLEAR EFFECTS OF DEFICIENCIES OF ZINC, COPPER, MAGNESIUM AND SELENIUM HAVE BEEN REPORTED. FOLATE SUFFICIENCY PERICONCEPTIONALLY IS RECOGNIZED BOTH BY THE PRACTICE OF PROVIDING FOLIC ACID IN ANTENATAL IRON/FOLIC ACID SUPPLEMENTATION AND BY INCREASING NUMBERS OF COUNTRIES FORTIFYING FLOURS WITH FOLIC ACID. OTHER VITAMINS LIKELY TO BE IMPORTANT INCLUDE VITAMINS B12, D AND A WITH THE WATER-SOLUBLE VITAMINS GENERALLY LESS LIKELY TO BE A PROBLEM. EPIGENETIC INFLUENCES AND THE LIKELY INFLUENCE OF MICRONUTRIENT DEFICIENCIES ON FOETAL ORIGINS OF ADULT CHRONIC DISEASES ARE CURRENTLY BEING CLARIFIED. MICRONUTRIENTS MAY HAVE OTHER MORE SUBTLE, UNRECOGNIZED EFFECTS. THE NECESSITY FOR IMPROVED DIETS AND HEALTH AND SANITATION ARE CONSISTENTLY RECOMMENDED, ALTHOUGH THESE ARE NOT ALWAYS AVAILABLE TO MANY OF THE WORLD'S PREGNANT WOMEN. CONSEQUENTLY, SUPPLEMENTATION PROGRAMMES, FORTIFICATION OF STAPLES AND CONDIMENTS, AND NUTRITION AND HEALTH SUPPORT NEED TO BE SCALED-UP, SUPPORTED BY SOCIAL AND CULTURAL MEASURES. BECAUSE OF THE LIFE-LONG INFLUENCES ON REPRODUCTIVE OUTCOMES, INCLUDING INTER-GENERATIONAL ONES, BOTH CLINICAL AND PUBLIC HEALTH MEASURES NEED TO ENSURE ADEQUATE MICRONUTRIENT INTAKES DURING PREGNANCY, BUT ALSO DURING ADOLESCENCE, THE FIRST FEW YEARS OF LIFE, AND DURING LACTATION. MANY ANTENATAL PROGRAMMES ARE NOT CURRENTLY ACHIEVING THIS. WE AIM TO ADDRESS THE NEED FOR MICRONUTRIENTS DURING PREGNANCY, THE IMPORTANCE OF MICRONUTRIENT DEFICIENCIES DURING GESTATION AND BEFORE, AND PROPOSE THE SCALING-UP OF CLINICAL AND PUBLIC HEALTH APPROACHES THAT ACHIEVE HEALTHIER PREGNANCIES AND IMPROVED PREGNANCY OUTCOMES. 2015 10 1 15 ON DECEMBER 5, 2017, THE NATIONAL ACADEMIES OF SCIENCES, ENGINEERING, AND MEDICINE HOSTED A PUBLIC WORKSHOP TITLED NUTRIGENOMICS AND THE FUTURE OF NUTRITION IN WASHINGTON, DC, TO REVIEW CURRENT KNOWLEDGE IN THE FIELD OF NUTRIGENOMICS AS IT RELATES TO NUTRITION. WORKSHOP PARTICIPANTS EXPLORED THE INFLUENCE OF GENETIC AND EPIGENETIC EXPRESSION ON NUTRITIONAL STATUS AND THE POTENTIAL IMPACT OF PERSONALIZED NUTRITION ON HEALTH MAINTENANCE AND CHRONIC DISEASE PREVENTION. THIS PUBLICATION SUMMARIZES THE PRESENTATIONS AND DISCUSSIONS FROM THE WORKSHOP. 2018 11 300 24 AIR POLLUTION AND INDOOR SETTINGS. INDOOR ENVIRONMENTS CONTRIBUTE SIGNIFICANTLY TO TOTAL HUMAN EXPOSURE TO AIR POLLUTANTS, AS PEOPLE SPEND MOST OF THEIR TIME INDOORS. HOUSEHOLD AIR POLLUTION (HAP) RESULTING FROM COOKING WITH POLLUTING ("DIRTY") FUELS, WHICH INCLUDE COAL, KEROSENE, AND BIOMASS (WOOD, CHARCOAL, CROP RESIDUES, AND ANIMAL MANURE) IS A GLOBAL ENVIRONMENTAL HEALTH PROBLEM. INDOOR POLLUTANTS ARE GASES, PARTICULATES, TOXINS, AND MICROORGANISMS AMONG OTHERS, THAT CAN HAVE AN IMPACT ESPECIALLY ON THE HEALTH OF CHILDREN AND ADULTS THROUGH A COMBINATION OF DIFFERENT MECHANISMS ON OXIDATIVE STRESS AND GENE ACTIVATION, EPIGENETIC, CELLULAR, AND IMMUNOLOGICAL SYSTEMS. AIR POLLUTION IS A MAJOR RISK FACTOR AND CONTRIBUTOR TO MORBIDITY AND MORTALITY FROM MAJOR CHRONIC DISEASES. CHILDREN ARE SIGNIFICANTLY AFFECTED BY THE IMPACT OF THE ENVIRONMENT DUE TO BIOLOGICAL IMMATURITY, PRENATAL AND POSTNATAL LUNG DEVELOPMENT. POOR AIR QUALITY HAS BEEN RELATED TO AN INCREASED PREVALENCE OF CLINICAL MANIFESTATIONS OF ALLERGIC ASTHMA AND RHINITIS. HEALTH PROFESSIONALS SHOULD INCREASE THEIR ROLE IN MANAGING THE EXPOSURE OF CHILDREN AND ADULTS TO AIR POLLUTION WITH BETTER METHODS OF CARE, PREVENTION, AND COLLECTIVE ACTION. INTERVENTIONS TO REDUCE HOUSEHOLD POLLUTANTS MAY PROMOTE HEALTH AND CAN BE ACHIEVED WITH EDUCATION, COMMUNITY, AND HEALTH PROFESSIONAL INVOLVEMENT. 2021 12 529 21 ASTHMA IN URBAN CHILDREN: EPIDEMIOLOGY, ENVIRONMENTAL RISK FACTORS, AND THE PUBLIC HEALTH DOMAIN. ASTHMA IS THE MOST COMMONLY REPORTED CHRONIC CONDITION OF CHILDHOOD IN DEVELOPED COUNTRIES, WITH 6.5 MILLION CHILDREN AFFECTED IN THE USA. A DISPARATE BURDEN OF CHILDHOOD ASTHMA IS SEEN AMONG SOCIOECONOMICALLY DISADVANTAGED YOUTH, OFTEN CONCENTRATED IN URBAN AREAS WITH HIGH POVERTY RATES. HOST FACTORS THAT PREDISPOSE A CHILD TO ASTHMA INCLUDE ATOPY, MALE GENDER, PARENTAL HISTORY OF ASTHMA, AND ALSO RACE, ETHNICITY, AND GENETIC AND EPIGENETIC SUSCEPTIBILITIES. ENVIRONMENTAL FACTORS, SUCH AS IMPROVED HYGIENE, AMBIENT AIR POLLUTION, AND EARLY LIFE EXPOSURES TO MICROBES AND AEROALLERGENS, ALSO INFLUENCE THE DEVELOPMENT OF ASTHMA. WITH GREATER THAN 90% OF TIME SPENT INDOORS, HOME EXPOSURES (SUCH AS COCKROACH, RODENT, AND INDOOR AIR POLLUTION) ARE HIGHLY RELEVANT FOR URBAN ASTHMA. MORBIDITY REDUCTION MAY REQUIRE FOCUSED PUBLIC HEALTH INITIATIVES FOR ENVIRONMENTAL INTERVENTION IN HIGH PRIORITY RISK GROUPS AND THE ADDITION OF IMMUNE MODULATORY AGENTS IN CHILDREN WITH POORLY CONTROLLED DISEASE. 2016 13 1223 24 CRITICAL REVIEW ON EMERGING HEALTH EFFECTS ASSOCIATED WITH THE INDOOR AIR QUALITY AND ITS SUSTAINABLE MANAGEMENT. INDOOR AIR QUALITY (IAQ) IS ONE OF THE FUNDAMENTAL ELEMENTS AFFECTING PEOPLE'S HEALTH AND WELL-BEING. CURRENTLY, THERE IS A LACK OF AWARENESS AMONG PEOPLE ABOUT THE QUANTIFICATION, IDENTIFICATION, AND POSSIBLE HEALTH EFFECTS OF IAQ. AIRBORNE POLLUTANTS SUCH AS VOLATILE ORGANIC COMPOUNDS (VOCS), PARTICULATE MATTER (PM), SULFUR DIOXIDE (SO2), CARBON MONOXIDE (CO), NITROUS OXIDE (NO), POLYCYCLIC AROMATIC HYDROCARBONS (PAHS) MICROBIAL SPORES, POLLEN, ALLERGENS, ETC. PRIMARILY CONTRIBUTE TO IAQ DETERIORATION. THIS REVIEW DISCUSSES THE SOURCES OF MAJOR INDOOR AIR POLLUTANTS, MOLECULAR TOXICITY MECHANISMS, AND THEIR EFFECTS ON CARDIOVASCULAR, OCULAR, NEUROLOGICAL, WOMEN, AND FOETAL HEALTH. ADDITIONALLY, CONTEMPORARY STRATEGIES AND SUSTAINABLE METHODS FOR REGULATING AND REDUCING POLLUTANT CONCENTRATIONS ARE EMPHASIZED, AND CURRENT INITIATIVES TO ADDRESS AND ENHANCE IAQ ARE EXPLORED, ALONG WITH THEIR UNIQUE ADVANTAGES AND POTENTIALS. DUE TO THEIR LONGER EXPOSURE TIMES AND PARTICULAR PHYSICAL CHARACTERISTICS, WOMEN AND CHILDREN ARE MORE AT RISK FOR POOR INDOOR AIR QUALITY. BY TRIGGERING MANY TOXICITY MECHANISMS, INCLUDING OXIDATIVE STRESS, DNA METHYLATION, EPIGENETIC MODIFICATIONS, AND GENE ACTIVATION, INDOOR AIR POLLUTION CAN CAUSE A RANGE OF HEALTH ISSUES. LOW BIRTH WEIGHT, ACUTE LOWER RESPIRATORY TRACT INFECTIONS, SICK BUILDING SYNDROMES (SBS), AND EARLY DEATH ARE MORE PREVALENT IN EXPOSED RESIDENTS. ON THE OTHER HAND, THE MAIN CAUSES OF INCAPACITY AND EARLY MORTALITY ARE LUNG CANCER, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, AND CARDIOVASCULAR DISORDERS. IT'S CRUCIAL TO ACKNOWLEDGE ANTICIPATED RESEARCH NEEDS AND IMPLEMENTED EFFICIENT INTERVENTIONS AND POLICIES TO LOWER HEALTH HAZARDS. 2023 14 1942 29 EPIDEMIOLOGY OF LIVER CANCER IN AFRICA: CURRENT AND FUTURE TRENDS. HEPATOCELLULAR CARCINOMA (HCC) IS A DISEASE OF GLOBAL PUBLIC HEALTH SIGNIFICANCE WITH MORTALITY ON THE RISE, DESPITE THE PREVENTABLE NATURE OF ITS RISK FACTORS ESPECIALLY IN AFRICA. IT IS NOW THE SIXTH MOST COMMON CANCER WORLDWIDE, FIFTH IN MALES, AND NINTH IN FEMALES. HCC INCIDENCE AND MORTALITY ARE PREDICTED TO INCREASE IN AFRICAN COUNTRIES CONSTRAINED BY LIMITED RESOURCES TO COMBAT ENDEMIC LEVELS OF VIRAL INFECTION AND SYNERGISTIC ENVIRONMENTAL RISK FACTORS. THE CHANGING NATURE OF HCC ETIOLOGY IS PARTICULARLY ILLUSTRATED HERE WITH THE TRADITIONAL RISK FACTORS LIKE VIRAL HEPATITIS COEXISTING ALONGSIDE HIGH HUMAN IMMUNODEFICIENCY VIRUS (HIV) PREVALENCE AND RAPIDLY INCREASING URBANIZATION THAT HAVE PROMOTED A SHARP INCREASE IN ADDITIONAL RISK FACTORS LIKE COINFECTION, TYPE 2 DIABETES MELLITUS, AND OBESITY. ALTHOUGH THERE ARE SOME DIFFERENCES IN ETIOLOGY BETWEEN NORTH AFRICA AND SUB-SAHARAN AFRICA, RISK FACTORS LIKE CHRONIC VIRAL HEPATITIS B AND C, AFLATOXIN EXPOSURE, AND IRON OVERLOAD PREDOMINATE. AGGRESSIVE HEPATITIS B GENOTYPES, COMBINED WITH HEPATITIS B VIRUS/HEPATITIS C VIRUS/HIV COINFECTIONS AND AFLATOXIN EXPOSURE, PROMOTE A MORE AGGRESSIVE MOLECULAR PHENOTYPE. IN PARALLEL TO A BETTER UNDERSTANDING OF THE MOLECULAR ETIOLOGY OF HCC, POLICY AND PLANNING INITIATIVES TO ADDRESS THE BURDEN OF HCC MUST BE ANCHORED WITHIN THE REALITY OF THE LIMITED RESOURCES AVAILABLE. ESTABLISHMENT AND COORDINATION OF CANCER REGISTRIES ACROSS AFRICA IS NEEDED TO IMPROVE THE QUALITY OF DATA NECESSARY TO GALVANIZE ACTION. PREVENTIVE MEASURES INCLUDING HEPATITIS B VACCINATION PROGRAMS, MEASURES TO PREVENT MATERNAL-TO-CHILD AND CHILD-TO-CHILD TRANSMISSION, DELIVERY OF UNIVERSALLY ACCESSIBLE ANTIRETROVIRAL AND ANTIVIRAL TREATMENTS, AND REDUCTION OF DIETARY AFLATOXIN EXPOSURE CAN CONTRIBUTE MARKEDLY TO REDUCE HCC INCIDENCE. FINALLY, THE DEVELOPMENT OF BIOMARKERS AND NEW THERAPEUTIC INTERVENTIONS WILL NEED A BETTER UNDERSTANDING OF THE UNIQUE GENETIC AND EPIGENETIC CHARACTERISTICS OF HCC ON THE CONTINENT. WE PRESENT A NARRATIVE REVIEW OF HCC IN AFRICA, DISCUSSING PRESENT AND FUTURE TRENDS. 2020 15 6914 21 [VITAMIN D DEFICIENCY IN PREGNANCY AND ITS IMPACT ON THE FETUS, THE NEWBORN AND IN CHILDHOOD]. OBJECTIVE: VITAMIN D DEFICIENCY (VDD) IN PREGNANT WOMEN AND THEIR CHILDREN IS AN IMPORTANT HEALTH PROBLEM WITH SEVERE CONSEQUENCES FOR THE HEALTH OF BOTH. THUS, THE OBJECTIVES OF THIS REVIEW WERE TO REASSESS THE MAGNITUDE AND CONSEQUENCES OF VDD DURING PREGNANCY, LACTATION AND INFANCY, ASSOCIATED RISK FACTORS, PREVENTION METHODS, AND TO EXPLORE EPIGENETIC MECHANISMS IN EARLY FETAL LIFE CAPABLE OF EXPLAINING MANY OF THE NON-SKELETAL BENEFITS OF VITAMIN D (VID). DATA SOURCE: ORIGINAL AND REVIEW ARTICLES, AND CONSENSUS DOCUMENTS WITH ELEVATED LEVEL OF EVIDENCE FOR VDD-RELATED CLINICAL DECISIONS ON THE HEALTH OF PREGNANT WOMEN AND THEIR CHILDREN, AS WELL AS ARTICLES ON THE INFLUENCE OF VID ON EPIGENETIC MECHANISMS OF FETAL PROGRAMMING OF CHRONIC DISEASES IN ADULTHOOD WERE SELECTED AMONG ARTICLES PUBLISHED ON PUBMED OVER THE LAST 20 YEARS, USING THE SEARCH TERM VITD STATUS, IN COMBINATION WITH PREGNANCY, OFFSPRING HEALTH, CHILD OUTCOMES, AND PROGRAMMING. DATA SYNTHESIS: THE FOLLOWING ITEMS WERE ANALYZED: VID PHYSIOLOGY AND METABOLISM, RISK FACTORS FOR VDD AND IMPLICATIONS IN PREGNANCY, LACTATION AND INFANCY, CONCENTRATION CUTOFF TO DEFINE VDD, THE VARIABILITY OF METHODS FOR VDD DETECTION, RECOMMENDATIONS ON VID REPLACEMENT IN PREGNANT WOMEN, THE NEWBORN AND THE CHILD, AND THE EPIGENETIC INFLUENCE OF VID. CONCLUSIONS: VDD IS A COMMON CONDITION AMONG HIGH-RISK PREGNANT WOMEN AND THEIR CHILDREN. THE ROUTINE MONITORING OF SERUM 25(OH)D3 LEVELS IN ANTENATAL PERIOD IS MANDATORY. EARLY PREVENTIVE MEASURES SHOULD BE TAKEN AT THE SLIGHTEST SUSPICION OF VDD IN PREGNANT WOMEN, TO REDUCE MORBIDITY DURING PREGNANCY AND LACTATION, AS WELL AS ITS SUBSEQUENT IMPACT ON THE FETUS, THE NEWBORN AND THE CHILD. 2015 16 4995 28 PERINATAL ENVIRONMENT AND ITS INFLUENCES ON METABOLIC PROGRAMMING OF OFFSPRING. THE INTRAUTERINE ENVIRONMENT SUPPORTS THE DEVELOPMENT AND HEALTH OF OFFSPRING. PERTURBATIONS TO THIS ENVIRONMENT CAN HAVE DETRIMENTAL EFFECTS ON THE FETUS THAT HAVE PERSISTENT PATHOLOGICAL CONSEQUENCES THROUGH ADOLESCENCE AND ADULTHOOD. THE DEVELOPMENTAL ORIGINS OF THE HEALTH AND DISEASE CONCEPT, ALSO KNOWN AS THE "BARKER HYPOTHESIS", HAS BEEN PUT FORTH TO DESCRIBE THE INCREASED INCIDENCE OF CHRONIC DISEASE SUCH AS CARDIOVASCULAR DISEASE AND DIABETES IN HUMANS AND ANIMALS EXPOSED TO A LESS THAN IDEAL INTRAUTERINE ENVIRONMENT. MATERNAL INFECTION, POOR OR EXCESS NUTRITION, AND STRESSFUL EVENTS CAN NEGATIVELY INFLUENCE THE DEVELOPMENT OF DIFFERENT CELL TYPES, TISSUES AND ORGAN SYSTEMS ULTIMATELY PREDISPOSING THE ORGANISM TO PATHOLOGICAL CONDITIONS. ALTHOUGH THERE ARE A VARIETY OF CONDITIONS ASSOCIATED TO EXPOSURE TO ALTERED INTRAUTERINE ENVIRONMENTS, THE FOCUS OF THIS REVIEW WILL BE ON THE CONSEQUENCES OF STRESS AND HIGH FAT DIET DURING THE PRE- AND PERINATAL PERIODS AND ASSOCIATED OUTCOMES RELATED TO OBESITY AND OTHER METABOLIC CONDITIONS. WE FURTHER DISCUSS POSSIBLE NEUROENDOCRINE AND EPIGENETIC MECHANISMS RESPONSIBLE FOR THE METABOLIC PROGRAMMING OF OFFSPRING. THE PAPER REPRESENTS AN INVITED REVIEW BY A SYMPOSIUM, AWARD WINNER OR KEYNOTE SPEAKER AT THE SOCIETY FOR THE STUDY OF INGESTIVE BEHAVIOR [SSIB] ANNUAL MEETING IN PORTLAND, JULY 2009. 2010 17 2690 28 EVOLUTION OF DOHAD: THE IMPACT OF ENVIRONMENTAL HEALTH SCIENCES. ENVIRONMENTAL EXPOSURES HAVE A SIGNIFICANT INFLUENCE ON THE CHRONIC HEALTH CONDITIONS PLAGUING CHILDREN AND ADULTS. ALTHOUGH THE DEVELOPMENTAL ORIGINS OF HEALTH AND DISEASE (DOHAD) PARADIGM HISTORICALLY HAS FOCUSED ON NUTRITION, AN EXPANDING BODY OF RESEARCH SPECIFICALLY COMMUNICATES THE EFFECTS OF CHEMICAL EXPOSURES ON EARLY-LIFE DEVELOPMENT AND THE PROPAGATION OF NON-COMMUNICABLE DISEASE ACROSS THE LIFESPAN. THIS PAPER PROVIDES AN OVERVIEW OF 20 YEARS OF RESEARCH EFFORTS AIMED AT IDENTIFYING CRITICAL WINDOWS OF SUSCEPTIBILITY TO ENVIRONMENTAL EXPOSURES AND THE SIGNALING CHANGES AND EPIGENETIC INFLUENCES ASSOCIATED WITH DISEASE PROGRESSION. DOHAD GRANTS FUNDED BY THE NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES (NIEHS) IN 1991, 2001 AND 2011 ARE IDENTIFIED BY GRANT-ANALYSIS SOFTWARE, AND EACH PORTFOLIO IS ANALYZED FOR EXPOSURES, DISEASE ENDPOINTS, WINDOWS OF EXPOSURE, STUDY DESIGN AND IMPACT ON THE FIELD BASED ON PUBLICATION DATA. RESULTS SHOW THAT THE 1991 AND 2001 PORTFOLIOS COMPRISED METALS, PCBS AND AIR POLLUTANTS; HOWEVER, BY 2011, THE PORTFOLIO HAS EVOLVED TO INCLUDE OR EXPAND THE VARIETY OF ENDOCRINE DISRUPTORS, PESTICIDES/PERSISTENT ORGANIC POLLUTANTS AND METALS. AN ASSORTMENT OF BRAIN-HEALTH ENDPOINTS IS MOST TARGETED ACROSS THE PORTFOLIOS, WHEREAS REPRODUCTION AND CANCER INCREASE STEADILY OVER THE SAME TIME PERIOD, AND NEW ENDPOINTS LIKE OBESITY ARE INTRODUCED BY 2011. WITH MOUNTING EVIDENCE CONNECTING EARLY-LIFE EXPOSURES TO LATER-LIFE DISEASE, WE CONCLUDE THAT IT IS CRITICAL TO EXPAND THE ORIGINAL DOHAD CONCEPT TO INCLUDE ENVIRONMENTAL CHEMICAL EXPOSURES, AND TO CONTINUE A RESEARCH AGENDA THAT EMPHASIZES DEFINING SENSITIVE WINDOWS OF EXPOSURE AND THE MECHANISMS THAT CAUSE DISEASE. 2015 18 4809 28 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 19 167 27 ABNORMAL PLACENTATION ASSOCIATED WITH INFERTILITY AS A MARKER OF OVERALL HEALTH. INFERTILITY AND THE FERTILITY TREATMENTS UTILIZED ARE ASSOCIATED WITH ABNORMAL PLACENTATION LEADING TO ADVERSE PREGNANCY OUTCOMES RELATED TO PLACENTATION, INCLUDING PRETERM BIRTH, LOW BIRTH WEIGHT, PLACENTA ACCRETE AND PLACENTA PREVIA. THIS MAY BE DUE TO THE UNDERLYING GENETICS PREDISPOSING TO INFERTILITY OR THE EPIGENETIC CHANGES ASSOCIATED WITH THE FERTILITY TREATMENTS UTILIZED, AS SPECIFIC DISEASE STATES LEADING TO INFERTILITY ARE AT INCREASED RISK OF ADVERSE OUTCOMES, INCLUDING PLACENTAL ABRUPTION, FETAL LOSS, GDM, AND OUTCOMES RELATED TO PLACENTATION, AS WELL AS THE TREATMENTS UTILIZED INCLUDING IN VITRO FERTILIZATION (IVF) AND NIFT (NON-IVF FERTILITY TREATMENT). PLACENTATION DEFECTS, LEADING TO ADVERSE MATERNAL AND FETAL OUTCOMES, WHICH ARE MORE PRONOUNCED IN THE INFERTILE POPULATION, OCCUR DUE TO CHANGES IN TROPHOBLAST INVASION, VASCULAR DEFECTS, CHANGES IN THE ENVIRONMENTAL MILIEU, CHRONIC INFLAMMATION AND OXIDATIVE STRESS. THESE SIMILAR PROCESSES ARE RECOGNIZED AS MAJOR CONTRIBUTORS TO LIFELONG RISK OF CARDIOVASCULAR AND METABOLIC DISEASE FOR BOTH THE MOTHER AND HER OFFSPRING. THUS, ABNORMAL PLACENTATION, FOUND TO BE MORE PREVALENT IN THE INFERTILE POPULATION, MAY BE THE KEY TO BETTER UNDERSTAND HOW INFERTILITY AFFECTS OVERALL AND LONG TERM HEALTH. 2017 20 1222 22 CRITICAL MOMENTS IN PRESCHOOL OBESITY: THE CALL FOR NURSES AND COMMUNITIES TO ASSESS AND INTERVENE. THIRTY YEARS AGO OBESITY WAS RARELY SEEN IN CHILDREN BUT IS NOW DESCRIBED AS A WORLD WIDE PANDEMIC. PREVIOUS RESEARCH HAS FOCUSED ON SCHOOL AGE CHILDREN; HOWEVER, RESEARCHERS HAVE NOW IDENTIFIED CRITICAL MOMENTS OF DEVELOPMENT DURING UTERINE LIFE AND EARLY INFANCY WHERE NEGATIVE FACTORS OR INSULTS COULD CAUSE PERMANENT CHANGES IN THE STRUCTURE AND FUNCTION OF TISSUES AND LEAD TO EPIGENETIC CHANGES. OBESITY IN PRESCHOOL CHILDREN CAN CAUSE PREMATURE AND LONG TERM CHRONIC HEALTH PROBLEMS; HAS BEEN ASSOCIATED WITH ACADEMIC AND SOCIAL DIFFICULTIES IN KINDERGARTEN CHILDREN; DIFFICULTY WITH SOCIAL RELATIONSHIPS; INCREASED FEELINGS OF SADNESS, LONELINESS AND ANXIETY; AND NEGATIVE SELF IMAGE IN CHILDREN AS YOUNG AS 5 YEARS OF AGE. THE IMPORTANCE OF IDENTIFYING CHILDREN UNDER THE AGE OF FIVE WITH OBESITY AND ASSOCIATED RISKS IS IMPORTANT YET LESS THAN HALF OF HEALTH PROFESSIONALS INTERVENE IN CASES OF PRESCHOOL OBESITY. THIS PAPER EXPLORES THE CONCERNS AROUND ANTENATAL AND PRESCHOOL OBESITY AND THE CHALLENGES FOR NURSES AND MIDWIVES IN ASSESSING AND PROVIDING APPROPRIATE INTERVENTIONS FOR CHILDREN AND FAMILIES IN COMMUNITY SETTINGS. 2011