Healthy lifestyle and Mediterranean-diet: fighting against obesity for healthy aging and cancer prevention

Obesity has nearly tripled since 1975 worldwide, with 39% of adults being overweight in 2016, while 13% were obese. Non-communicable diseases (NCDs) are responsible for 74% of all deaths globally, with cardiovascular diseases accounting for most NCD deaths, followed by cancers, chronic respiratory diseases and diabetes. All the NCDs are related to obesity and most of the risk factors recognized that can be considered preventable: tobacco use, physical inactivity, alcohol abuse and unhealthy diets. The aim of this PhD project is to uncover some links between obesity or overweight and cancer, one of the leading causes for mortality among the NCDs, specifically focusing on breast cancer for the exploratory project of this thesis. Healthy lifestyle, including both healthy diet and physical activity engagement, improve body composition and nutritional status at different levels and can be considered pivotal for cancer and metabolic disease prevention and treatment. In 2010, the Mediterranean diet (MD) was recognized as an Intangible Cultural Heritage of Humanity by the United Nations Educational, Scientific and Cultural Organization (UNESCO). Before and since then, increasing evidence supported the MD as one of the most effective healthy pattern for the prevention of NCDs, raising the scientific attention to a cultural pattern synthetized graphically by an iconic Pyramid. Additionally, Mediterranean lifestyle emphasize together with a healthy dietary pattern, regular physical exercise, which constitutes another key pillar for health promotion.Health-promoting effects of exercise remain poorly understood together with the mechanisms regulating cellular senescence, a state of irreversible growth arrest. Long-term moderate calorie restriction and endurance exercise training can decelerate biological aging, promoting visceral fat loss, reducing inflammation and oxidative stress, helping with prevention of cancer, particularly breast cancer. Moreover, during the years of this project the pandemic outbreak of Sars-Cov2 gave the opportunity to show how obesity, adipose tissue excess and also muscle mass depletion can be important not only for NCDs prevention, but also in the fight against communicable disease. In the end, aiming to fight obesity and cancer, we present the results on metabolic improvements after 2 years of weight management through the implementation of Mediterranean diet in breast cancer survivors, with anexploratory analysis of the dropouts to identify possible predictors that can interfere with a long- term compliance to weight loss protocols.