Abstract
An increasing interest in a healthy lifestyle raises questions about optimal body weight. Evidently, it should be clearly discriminated between the standardised “normal” body weight and individually optimal weight. To this end, the basic principle of personalised medicine “one size does not fit all” has to be applied. Contextually, “normal” but e.g. borderline body mass index might be optimal for one person but apparently suboptimal for another one strongly depending on the individual genetic predisposition, geographic origin, cultural and nutritional habits and relevant lifestyle parameters—all included into comprehensive individual patient profile. Even if only slightly deviant, both overweight and underweight are acknowledged risk factors for a shifted metabolism which, if being not optimised, may strongly contribute to the development and progression of severe pathologies. Development of innovative screening programmes is essential to promote population health by application of health risks assessment, individualised patient profiling and multi-parametric analysis, further used for cost-effective targeted prevention and treatments tailored to the person. The following healthcare areas are considered to be potentially strongly benefiting from the above proposed measures: suboptimal health conditions, sports medicine, stress overload and associated complications, planned pregnancies, periodontal health and dentistry, sleep medicine, eye health and disorders, inflammatory disorders, healing and pain management, metabolic disorders, cardiovascular disease, cancers, psychiatric and neurologic disorders, stroke of known and unknown aetiology, improved individual and population outcomes under pandemic conditions such as COVID-19. In a long-term way, a significantly improved healthcare economy is one of benefits of the proposed paradigm shift from reactive to Predictive, Preventive and Personalised Medicine (PPPM/3PM). A tight collaboration between all stakeholders including scientific community, healthcare givers, patient organisations, policy-makers and educators is essential for the smooth implementation of 3PM concepts in daily practice.
Highlights
UnderweightOverweight and obesityOverweight parameters are as follows: for females, body mass index (BMI) 25–30 and for males, BMI 26–30.Obesity parameters are as follows: class I—BMI 30–35; class II—BMI 35–40; class III—BMI > 40.According to the World Health Organization (WHO), in 2016, 50 million girls and 74 million boys around the globe were registered as being obese
Emotional abuse and physical abuse are the most present forms of Childhood maltreatment (CM) and adverse childhood experiences (ACE) are not single events but have to be considered chronic and repetitive stressors and limit the resilience and coping capability of affected subjects in a dose–response relationship. These findings are of epidemiological, psychosocial and medical interest as ACE and CM are reported in literature to significantly contribute to the aetiology and manifestation of eating disorders on the one side and on the other side, ACE and CM are hardly considered in these clinical cohorts in the context of personalised diagnostic approach, treatment modalities and relapse prevention
There are evident cumulative systemic effects leading to chronic inflammation including but not restricted to the lasting vasospastic reactions with systemic ischemic-hypoxic effects and involvement of ET-1 and neuro-immune axes, mitochondrial impairments and increased infection susceptibility with poor outcomes such as caused by the cytokine storm reported for COVID-19-infected individuals [19, 22]
Summary
Overweight parameters are as follows: for females, body mass index (BMI) 25–30 and for males, BMI 26–30. Emotional abuse and physical abuse are the most present forms of CM and adverse childhood experiences (ACE) are not single events but have to be considered chronic and repetitive stressors and limit the resilience and coping capability of affected subjects in a dose–response relationship These findings are of epidemiological, psychosocial and medical interest as ACE and CM are reported in literature to significantly contribute to the aetiology and manifestation of eating disorders on the one side and on the other side, ACE and CM are hardly considered in these clinical cohorts in the context of personalised diagnostic approach, treatment modalities and relapse prevention. Flammer syndrome phenotype demonstrating characteristic low body weight and abnormal reactions towards any kind of physical (e.g. cold provocation) and mental stress in affected individuals has been described [7, 8] as being strongly associated with an increased incidence of communicable and non-communicable disorders in this cohort [6, 9,10,11,12,13,14,15]. The most prominent contributing factors and corresponding pathomechanisms are summarised below
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