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Personalized Health:advanced prevention between
wellness and sportProf. Vincenzo ROMANO SPICA
UniversitUniversitUniversitààà degli Studi di Roma degli Studi di Roma degli Studi di Roma “““Foro ItalicoForo ItalicoForo Italico”””Public Health UnitPublic Health UnitPublic Health Unit
Thursday 9th February 2012
GENETICSENVIRONMENT
LIFE STYLES
DISEASE
Multi-factorial model
RISK/PROTECTIVE FACTORS
GENETICSENVIRONMENT
LIFE STYLES
HEALTH
ATHLETIC PERFORMANCE
WELLNESS
Multi-HEALTH/factor model
PROTECTIVE FACTORS
GENETICS ENVIRONMENTLIFE STYLES
ATHLETIC PERFORMANCE
WELLNESS
Black BOX
Safe Management of Genetic Data
In February 2001, two papers provided the first detailed look at the nearly complete sequence of the human genome.
Human Genome Project
Prevention
WellnessHealth Promotion
Jan 2011, an IOC medical commission publication
the contribution of specific genes and molecular markers as related to endurance, strength and power, and responsiveness to specific conditioning programs.
Chapter13: genes and endurance performanceChapter14: genes and strength and power phenotypesChapter15: genes and response to trainingChapter17: the ACE gene and performanceChapter18: the ACTN3 gene and human performanceChapter19: mithocondrial DNA sequence variation and performanceChapter 20-21-22: genes, exercise and metabolism and cardiovascular phenotypes
Environmental agents
Life Styles
Gene
tic
back
grou
nd
Prevention - Health Promotion - Wellness
Integrated approachNBT dedicated volume on Personalised Medicine 2012
Our DB
• Muscolo-scheletal HEALTHSequences, data, SNPs (Cfr. diapo and video)
Software and output (Cfr. diapo and video)
Romano Spica et al. ACTN3 Genotyping by Real-Time PCR in the Italian Population and Athletes Med. Sci. Sports and Exercise, 2005
Heterozygous
Homozygous
Homozygous
Figure 2: ACTN3 Allelic Discrimination
Negative Controls
I A I
H
MZ
(α-actn)Z
(α-actn)Figure 1: Localization of α-actinin2 and
α- actinin3, within the Z line of the sarcomere
Preventive Adapted Physical Activity
Contrasting riskfactorsrelated to sedentary life style
Acting positivelyas an health promoting factor
SEDENTARY
Risk factor
APA
Muscular movement involving an energy consumption
Protective Factor
ABSENCE OF MOVEMENT
(+) incidence/mortality (-)1.9 milions death, world
World Health Day
2002 2012
World Health Day 2012 -7 April"L'attività fisica dovrebbe essere alla base delle abitudini di tutti e perfettamente integrata nella routine quotidiana. “Roberto Bertollini, direttore tecnico dell'OMS Europa Roma, 2002.
National, European Programs ...
Evidence Based Prevention
• Hypertension• Diabetes• Obesity• cardiovascolar• Diseases• Cancer
• POSTURE
• WELLNESS
• AESTHETICS
Torrance B, McGuire CA, Lewanczuk R, McGavock J. Overweight, physical activity and high blood pressure in children: a review of the literature. Vascular health and risk management 2007;3(1):139-149
Hagberg JM, Park JJ, Brown MD. The role of exercise training in the treatment of hypertension: an update. Sports Med 2000;30:193-206
Warburton DER, Nicol CW, Bredin SSD. Health benefits of physical activity: theevidence [review]. CMAJ2006;174(6):801-9.
HYPERTENSION
Rana JS, Li TY, Manson JE, Hu FB. Adiposity Compared With Physical Inactivity and Risk of Type 2 Diabetes in Women. Diabetes Care 2007; 30:53-58
Sigal RJ, Kenny GP, Wasserman DH, Castaneda-Sceppa C, White RD. Physical Activity/Exercise and Type 2 Diabetes. Diabetes Care 2006;29:1433-1438
Knowler WC, Barret Connor E, Fowler SE et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. Diabetes Prevention Program Research Group. N Engl J Med 2002;346(6):393-403
Diabetes Prevention Program Research Group. Role of Insuline Secretion and Sensitivity in the Evolution of Type 2 Diabetes in the Diabetes Prevention Program: effects of lifestyle Intervention and Metformin. Diabetes 2005;54(8); 2404-2414
Tuomilehto J, Lindstrom J, Eriksson JG et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344(18):1343-1350
Yates T, Khunti K, Bull F et al. The role of physical activity in the management of impaired glucose tolerance: a systematic review. Diabetologia 2007;50(6):1116-1126
Ramachandran A, Snehalatha C, Mary S et al. The Indian diabetes prevention programme showes that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia 2006;49:289-297
Marceca M, Romano Spica V, Guerrera C, Montuori E, Suraci C, Visalli N, Frangella C, Pasquarella A, Guasticchi G. L’attività motoria come strategia preventiva in sanità pubblica per il controllo del diabete. XLII Congresso Nazionale SItI. La Prevenzione per la Promozione della Salute e l'Integrazione dei Popoli. 2006;391:74
Hamman RF, Wing RR, Edelstein SL et al. Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care. 2006;29(9):2102-2107
DIABETES
Duvigneaud N, Wijndaele K, Matton L et al. Socio-economic and lifestyle associated with overweight in Flemish adult men and women. BMC Public Health 2007;7:123-131
Wareham N. Physical Activity and obesity prevention. Obesity reviews 2007;8(1): 109-114
Wilding JPH. Treatment strategies for obesity. The international association for the study of obesity. Obesity reviews 2007;8 (1):137-144
Te Velde SJ, De Bourdeaudhuij I, Thorsdottir I et al. Patterns in sedentary and exercise behaviors and associations with overweight in 9-14-year-old boys and girls: a cross-sectional study. BMC Public Health 2007;7:116-121
Bensimhon DR, Kraus WE, Donahue MP. Obesity and physical activity: a review. Am Heart J 2006;151:598-603
Fox KR, Hillsdon M. Physical activity and obesity. Obesity reviews. 2007;8(1);115-121
OBESITY
Franklin BA, Swain DP, Shephard RJ. New insights in the prescription of exercise for coronary patients. J Cardiovasc Nurs 2003;18:116-123
Taylor RS, Brown A, Ebrahim S et al. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med 2004;116:682-692
Myers J, Kaykha A, George S et al. Fitness versus physical patterns in predicting mortality in men. Am J Med 2004;117:912-918
HU FB, Willet WC, Li T et al. Adiposity as compared with physical activity in predicting mortality among women. N Engl J Med 2004;651:2694-703.
Erikssen G. Physical fitness and changes in mortality: The survival of the fittest. Sports Med 2001;31(8):571-576
Erikssen G, Liestol K, Bjornholt J et al. Changes in physical fitness and changes in mortality. Lancet 1998;352:759-762
Hewitt JA, Whyte GP, Moreton M et al. The effects of a graduated aerobic exercise programme on cardiovascular disease risk factors in the NHS workplace: a randomised controlled trial. J Occup Med Toxicol. 2008; 3: 7.
CARDIUVASCULAR DISEASES
Colditz GA, Cannuscio CC, Frazier AL. Physical activity and reduced risk of colon cancer: implications for prevention. Cancer Causes Control 1997;8:649-667
Sesso HD, Paffenbarger RS Jr, Lee IM. Physical activity and breast cancer risk in the College Alumni Health Study(United States). Cancer Causes Control 1998;9:433-439
Tardon A, Jin Lee W, Delgado-Rodriguez M, et al. Leisure-time physical activity and lung cancer: a meta-analysis. National Institutes of Health 2005;16(4): 389-397
Friedenreich CM, Thune I, Brinton LA, Albanes D. Epidemiologic issues related to the association between physical activity and breast cancer. Cancer (Phila.) 1998;83:600-610
Gammon MD, John EM, Britton JA. Recreational and occupational physical activities and risk of breast cancer. J Natl Cancer Inst 1998;90:100-117
Lattika P, Pukkala E, Vihko V. Relationship between the risk of breast cancer and physical activity. Sports Med 1998;26:133-143
Lee IM, Manson JE, Ajani U, Paffenbarger RSJr, Hennekens CH, Buring JE. Physical activity and risk of colon cancer: the Physicians’ Health Study (United States). Cancer Causes and Control 1997;8(4):568-574
Valenti M, Porzio G, Aielli F et al. Physical Exercise and Quality of Life in Breast Cancer Survivors. Int J Med Sci 2008;5(1):24-28
Lee IM. Physical activity and cancer prevention: data from epidemiologic studies. Med Sci Sports Exerc. 2003;35:1823-1827
Adamsen L, Midtgaard J, Rorth M, et al. Feasibility, physical capacity, and health benefits of a multidimensional exercise program for cancer patients undergoing chemotherapy. Support Care Cancer 2003;2:707-716
McNeely ML, Campbell KL, Rowe BH, et al. Effects of exercise on breast cancer patients and survivors: a systematic
CANCER
Laessoe U, Hoeck HC , Simonsen O, Sinkjaer T, and Voigt M. Fall risk in an active elderly population – can it be assessed? J Negat Results Biomed. 2007; 6: 2
Kovacs EJ, Birmingham TB, Forwell L, Litchfield RB. Effect of training on postural control in figure skaters: a randomized controlled trial of neuromuscular versus basic off-ice training programs. Clin J Sport Med. 2004 Jul;14(4):215-24
Lauritzen JB, Schwarz P, Lund B, McNair P, Transbol I. Changing incidence and residual lifetime risk of common osteoporosisrelated fracture. Osteo Intl 1993;3 127-32
Park H, Kim KJ, Komatsu T, Park SK, Mutoh Y. Effect of combined exercise training on bone, body balance, and gait ability: a randomized controlled study in community-dwelling elderly women. J Bone Miner Metab. 2008;26(3)):
Macedo LG, Latimer J, Mahe CG et al. Motor control or graded activity exercises for chronic low back pain? A randomised controlled trial. BMC Musculoskeletal Disorders 2008, 9:65.
O’Loughlin JL, Robitaille Y, Boivin J-F, Suissa S. Incidence of and risk factors for falls and injourios falls among the community dwelling elderly. Am J Epid 1993; 137: 342-54
Judge JO, Lindsey C, Underwood M, Winsemius D. Balance improvements in older women: effects of exercise training. Phys Ther. 1993 Apr;73(4):254-62; discussion 263-5
POSTURE
EQUILIBRIUMAxes and Symmetry
AESTHETICS
Physical ActivityDiet
Life Styles
Advanced Molecular Biology...
But, ... Most Sofisticated, Most predictive, Most effective ...
Biomarker
http://webstorage.mediaon.it/media/2009/04/63368_372964_Mexico_Fat_7045718_medium.jpg
IND
IVID
UA
LISE
DGE
NET
ICS
-FAM
ILIA
RITY
POSTU
RAO
THER
DIET
PHYSICAL ACTIVITYENVIRONMENT
LIFE STYLES
WELLNESS
MUSCLE
• Prevention (I, II, III)• Exercise/Other (HBP, ..)
INDIVIDUAL RESPONSE
DKJJ
Between High Tech and Tradition...... Same questions new approaches
Ref.:www.wikigiene.it
