Caution, “normal” BMI: health risks associated with potentially masked individual underweight—EPMA Position Paper 2021

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.

Association of systemic inflammation indices with visual field loss progression in patients with primary angle-closure glaucoma: potential biomarkers for 3P medical approaches

“…Earlier prediction of glaucoma in patients with a higher risk of VF loss progression would enable the use of different treatment strategies to reduce the economic and clinical burden and avoid secondary effects associated with unnecessary treatments. Actually, systemic inflammation indices alterations are involved in the entire healthcare process of a glaucoma patient, including prediction/prevention, early-stage diagnosis/therapy, and prognostic assessment in the framework of PPPM/3P medicine [75].…”

All around suboptimal health — a joint position paper of the Suboptimal Health Study Consortium and European Association for Predictive, Preventive and Personalised Medicine

“…The following healthcare areas are proposed to strongly benefit from the above proposed measures: Stress overload associated pathologies [ 156 , 158 , 182 – 184 ] Planned pregnancies [ 8 ] Periodontal health [ 185 ] Eye disorders [ 5 ] Inflammatory disorders, wound healing and pain management with associated complications [ 186 , 187 ] Metabolic disorders [ 2 ] Cardiovascular pathologies [ 178 ] Cancers [ 4 ] Stroke, particularly of unknown aetiology and in young individuals [ 7 ] Sleep medicine [ 188 , 189 ] Individually suboptimal body weight [ 185 , 188 ] Sports medicine [ 190 ] Male and female health [ 191 ] Improved individual outcomes under pandemic conditions such as COVID-19 [ 185 , 188 , 192 – 194 ] amongst others [ 30 , 190 , 191 ]. …”

“…Improved individual outcomes under pandemic conditions such as COVID-19 [ 185 , 188 , 192 – 194 ] amongst others [ 30 , 190 , 191 ].…”

Flavonoids against non-physiologic inflammation attributed to cancer initiation, development, and progression—3PM pathways

“…A. Primary healthcare: prediction of relevant suboptimal health conditions such as family (genetic) predisposition, abnormal BMI (both overweight and underweight), abnormal stress reactions, disturbed microcirculation, and delayed healing, among others [171][172][173][174][175]; based on anti-inflammatory properties of flavonoids, corresponding individualized mitigating measures may be considered as follows. Healthy and balanced diet rich in naturally occurring phytochemicals including flavonoids is essential to prevent non-communicable diseases associated with non-physiologic inflammation [55,176,177].…”