Adolescent Health and Wellbeing: Current Strategies and Future Trends [1st ed. 2019] 978-3-030-25815-3, 978-3-030-25816-0

Table of contents :
Front Matter ....Pages i-xii
Front Matter ....Pages 1-2
Preventive Primordial Strategies: Times Are Changing (Morena Lari, Irene Traghella, Cristina Vassalle)....Pages 3-18
Fetal Programming of Adult Disease in a Translational Point of View (Francesca Mastorci, Jacopo Agrimi)....Pages 19-34
Physical Activity, Sedentary Behaviour and Mental Health in Young People: A Review of Reviews (María Rodriguez-Ayllon, Fernando Estévez-López, Cristina Cadenas-Sanchez, Luis Gracia-Marco, David R. Lubans, Francisco B. Ortega et al.)....Pages 35-73
Habits and Quality of Diet (Iris Iglesia, Alba Maria Santaliestra-Pasías, Luis Alberto Moreno Aznar)....Pages 75-89
Biochemical Markers in Primordial Prevention: Premises and Promises (Eugène Jansen, Laila Meija)....Pages 91-105
Front Matter ....Pages 107-108
Prenatal and Early Postnatal Influences on Neurodevelopment: The Role of Epigenetics (Veronica Mariotti, Sara Palumbo, Silvia Pellegrini)....Pages 109-129
The Role of Environmental Enrichment on Neurodevelopment: Emotion Regulation in Adolescence as a Model Paradigm (Juste Buneviciute, Jasmine Tatum, Genevieve J. Yang, Timothy R. Rice)....Pages 131-151
Relationship Between Emotions, Sleep and Well-Being (Andrea Zaccaro, Ciro Conversano, Elisa Lai, Angelo Gemignani)....Pages 153-166
Adolescents in the 21st Century: Back to Dialogue from Marked Lives vs Dreamed Lives (Marco Braghero)....Pages 167-202
Front Matter ....Pages 203-204
Adolescence and Social Determinants of Health: Family and Community (Claudia Cappa, Sara Giulivi)....Pages 205-229
The Role of Well-Being in the School of Inclusion (Floriana Battaglia, Lucio Bontempelli)....Pages 231-241
Two-Faced Janus: The Role of Peers in Adolescence (Marta Pozzi, Mario Becciu, Anna Rita Colasanti)....Pages 243-269
Front Matter ....Pages 271-271
Adolescence Between Past and Future (Cesare Porcelli, Angela Palumbo)....Pages 273-284
e-Health Strategies (Ada Potenza, Pierpaolo Di Bitonto, Antonio Ulloa Severino)....Pages 285-309
Images and Perspectives of Play for Children’s and Adolescents’ Well-being (Maria Antonella Galanti)....Pages 311-325
New Perspectives for Multidisciplinary and Integrated Strategies of Adolescent Health and Well-being (Alessandro Pingitore, Luca Bastiani, Cristina Doveri, Gabriele Trivellini, Francesca Mastorci)....Pages 327-343
Back Matter ....Pages 345-352

Citation preview

Adolescent Health and Wellbeing Current Strategies and Future Trends Alessandro Pingitore Francesca Mastorci Cristina Vassalle Editors

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Adolescent Health and Wellbeing

Alessandro Pingitore Francesca Mastorci • Cristina Vassalle Editors

Adolescent Health and Wellbeing Current Strategies and Future Trends

Editors Alessandro Pingitore Clinical Physiology Institute CNR, Via Moruzzi 1 Pisa Italy

Francesca Mastorci Clinical Physiology Institute CNR, Via Moruzzi 1 Pisa Italy

Cristina Vassalle Fondazione G. Monasterio Via Moruzzi 1, 56124 Pisa Italy

ISBN 978-3-030-25815-3    ISBN 978-3-030-25816-0 (eBook) https://doi.org/10.1007/978-3-030-25816-0 © Springer Nature Switzerland AG 2019 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

Foreword

Adolescence is an extraordinary, in many aspects, magical age of life in which the perception of oneself changes dramatically; the body is transforming and the quality of relationships is changing, emotions are multiplied and complicated. Probably, the trigger of change is represented by the hormonal tsunami that around age 12–13 begins the physical transformation and the upsetting of the nervous networks of emotional regulation. The sudden moments of excitement or anger, the vertiginous oscillation of humor, and the uncontrolled reactions are the most obvious result. Actually, many imaging studies have shown that the brain of adolescents cannot be considered as an older infant brain or as a younger adult organ; on the contrary, it is a reality in itself, in many ways still mysterious, characterized by great flexibility and an explosive increase in the number of connections between the brain regions. Particularly, during puberty the limbic system that is driving emotions under the hormonal stimulus is strongly activated and rapidly consolidated, while the prefrontal cortex that controls impulsivity matures much later, in general when it reaches the age of 20. Adolescence is therefore, by definition, the age of misalignment of the contrast between instinct and reasoning, between thought and impulsiveness. The brain of adolescents is not, however, a faulty organ and not even an adult “immature” organ; evolution has simply shaped it to function differently from that of a child or of an adult: just a point of passage necessary to move from one stage of life to another. This apparent evolutionary disharmony of the individual, on the one hand, makes teenagers more likely and vulnerable to risk, on the other hand allowing them to adapt more easily to the environment, thereby transforming a fragility into a life, active force. Winnicott provocatively claimed that “Adolescence is a normal ‘disease’; the problem is rather about adults and society, if they are healthy enough to be able to bear it”. Unfortunately, despite these acquisitions have been known for a long time we are increasingly distant from an adolescence that we are led to see very different from that experienced by us adults and usually already reworked or removed. Furthermore, to understand fully the situation experienced by today’s adolescents, it is not enough to refer to one’s own life experience, because society has changed profoundly in

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social organization and interpersonal relationships and the condition of adolescents is the most direct reflection. A greater understanding of adolescents’ way of thinking could help parents, teachers and society in general to distinguish typical attitudes of age from those that are not strictly physiological, but the road ahead seems to be still very long. Even talking about health is not easy. In the past, the concept of health was simple, almost elementary, based on a negative affirmation: “healthy is he who has no illness” or “health is absence of disease”. This simplified conception began to waver in the late nineteenth century when the development of medical sciences allowed recognizing, through new techniques and tools, the existence of pre-­ symptomatic diseases, that is before an affected person realizes it by continuing to consider itself healthy. Moreover, the development of knowledge also in the field of social, political, and economic sciences with their implications for human health has progressively imposed a new conception of health then synthesized into the art. 1 of the WHO Statute. Today, we know that health is a dynamic condition of physical, mental and social well-being and not just a mere absence of illness or infirmity. The impact of the new concept has been enormous in the field of culture, science and health policies. The positive affirmation of health as physical, mental and social well-being of the person, compared to the traditional, negative concept of health as absence of disease, caused a sort of earthquake in the field of medicine, which has been almost exclusively for centuries, with rare exceptions, in the study and diagnosis of diseases and now had to address leading issues as the predisposition and prevention but in particular the promotion of health and good quality of life. But when should we take the preventive educational approach? So far all major public health interventions are proposed only starting from the adult age (from 18 years onwards), i.e. limiting adolescent action to the simple/simplistic correction of wrong habits such as sedentariness, smoking and consumption of alcohol and drugs; all this because ultimately it is still rooted and clearly prevails in our vision the old concept of health as absence of diseases that translates into everyday life in a negativist and sanctioning approach (i.e. “not doing that” or “this is wrong”) rather than positive and growing incentive to well-being. Several studies have shown that exogenous factors, that is external to the individual, that affect human health are numerous but still need to be done within the framework of the correct interpretation. These factors belong to all the components of the total environment, that is, to the physical, chemical, biological, social, economic environment; they continually interact with each other, forming a very complex system of unstable relationships and balances that are difficult to embrace. Not only that, an equally complex system of unstable reactions and equilibrium that affect health depends on endogenous factors, that is, internal to the individual, in turn dependent, only partly from genetic influences. Given the complexity of the issue, it is increasingly necessary to undertake a new multidisciplinary methodological study approach that considers the various

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dynamics in the ecosystems of biological, cultural, psychological, medical, sociological, economic, demographic, behavioral, and political interactions concerning young people. Without all these considerations, what should be done to try to understand the mechanisms that underlie the well-being of an adolescent or, alternatively, how a “non-physiological” malaise can be translated into predisposition to adult-life diseases? Putting together the dual complexity, of adolescent lifetime and that of the concept changed over time of health, could turn out to be a “mission impossible” but the authors of this book, even aware of the enormous difficulties, have bravely decided to throw themselves into this great challenge by engaging in a problem that until today has been faced only partially without a holistic vision, thus creating the basis for a new way of concretely conceiving the proactive, synergistic relationship between science, health, and society. Giorgio Iervasi Clinical Physiology Institute CNR, Via Moruzzi 1 Pisa Italy

Preface

With the growing awareness that non-communicable conditions, such as obesity and diabetes, heart disease, and cancers, are impacting adult health status, adolescence is being increasingly recognized as an important period to target programmatic intervention and a sensitive window in which is determined one-third of the total disease burden during adulthood. Following this increasing recognition of the life-course impacts of the unhealthy behaviours in adolescence, the book “Adolescent Health and Wellbeing—Current Strategies and Future Trends” was born as a rib of the AVATAR project, the acronym for “A new purpose for promotion and eVAluation of healTh and well-being Among healthy teenageRs”. This project is based on the idea that the human being is a complex dynamic network in which all the units, organs and systems, work together obtaining a result that is not the simple algebraic sum of the single unit functions, but has global properties that are the expression of their integration. This is particularly true in the context of adolescence, a period of extraordinary changes, in which several factors, including lifestyle habits, emotional status, social context, and cognitive abilities, can influence well-being perception and health status. Two of the keywords of this book are, therefore, well-being and health, despite during adolescence the burden of well-being and health is underestimated/neglected, as this age is considered as a healthy period. However, adolescence may be considered a period of health risk taking: unhealthy behaviours not only affect the health within this period, but also characterize its status later in life, underpinning the need of preventive strategies in terms of prevention of the chronic degenerative diseases that will develop during adulthood. At the same time, adolescence is a dynamic, sensible, and flexible period of knowledge and adaptation to target health interventions, so that adolescents can adopt and maintain positive lifestyle choices to improve their present and future well-being. In this view, strategies, including health-promoting skills, positive health behaviours, and social connection with family, school, and community, are recommended to reduce the likelihood of health-jeopardizing behaviours. Despite this, programs and tools to assess and to enhance resilience, happiness, social involvement, self-esteem, and sociability are lacking. In this context, the book offers a careful and updated review of the discussions about the widespread changes during adolescence from the perspective of promotion, prevention, and intervention, including: (1) the physical, social, cognitive, and emotional changes; (2) the role of environment (schools, families, peers, and the ix

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mass media) in influencing the healthy behaviors of adolescents and young adults; (3) the potential role of e-Health technology in health and behavioral interventions for adolescents, with focus on possible future trends. Pisa, Italy Pisa, Italy  Pisa, Italy 

Alessandro Pingitore Francesca Mastorci Cristina Vassalle

Contents

Part I Primordial Prevention: General Aspects 1 Preventive Primordial Strategies: Times Are Changing���������������������������� 3 Morena Lari, Irene Traghella, and Cristina Vassalle 2 Fetal Programming of Adult Disease in a Translational Point of View������������������������������������������������������������������������������������������������ 19 Francesca Mastorci and Jacopo Agrimi 3 Physical Activity, Sedentary Behaviour and Mental Health in Young People: A Review of Reviews������������������������������������������������������ 35 María Rodriguez-Ayllon, Fernando Estévez-López, Cristina Cadenas-Sanchez, Luis Gracia-Marco, David R. Lubans, Francisco B. Ortega, and Irene Esteban-Cornejo 4 Habits and Quality of Diet�������������������������������������������������������������������������� 75 Iris Iglesia, Alba Maria Santaliestra-Pasías, and Luis Alberto Moreno Aznar 5 Biochemical Markers in Primordial Prevention: Premises and Promises�������������������������������������������������������������������������������� 91 Eugène Jansen and Laila Meija Part II Adolescents’ Mental Health and Well-Being 6 Prenatal and Early Postnatal Influences on Neurodevelopment: The Role of Epigenetics ���������������������������������������������������������������������������� 109 Veronica Mariotti, Sara Palumbo, and Silvia Pellegrini 7 The Role of Environmental Enrichment on Neurodevelopment: Emotion Regulation in Adolescence as a Model Paradigm�������������������� 131 Juste Buneviciute, Jasmine Tatum, Genevieve J. Yang, and Timothy R. Rice 8 Relationship Between Emotions, Sleep and Well-Being ������������������������ 153 Andrea Zaccaro, Ciro Conversano, Elisa Lai, and Angelo Gemignani

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9 Adolescents in the 21st Century: Back to Dialogue from Marked Lives vs Dreamed Lives ���������������������������������������������������� 167 Marco Braghero Part III Adolescence and the Social Determinants of Health 10 Adolescence and Social Determinants of Health: Family and Community���������������������������������������������������������������������������� 205 Claudia Cappa and Sara Giulivi 11 The Role of Well-Being in the School of Inclusion���������������������������������� 231 Floriana Battaglia and Lucio Bontempelli 12 Two-Faced Janus: The Role of Peers in Adolescence������������������������������ 243 Marta Pozzi, Mario Becciu, and Anna Rita Colasanti Part IV The Digital Era in Adolescent’s Health and Well-Being 13 Adolescence Between Past and Future���������������������������������������������������� 273 Cesare Porcelli and Angela Palumbo 14 e-Health Strategies ������������������������������������������������������������������������������������ 285 Ada Potenza, Pierpaolo Di Bitonto, and Antonio Ulloa Severino 15 Images and Perspectives of Play for Children’s and Adolescents’ Well-being �������������������������������������������������������������������������������������������������� 311 Maria Antonella Galanti 16 New Perspectives for Multidisciplinary and Integrated Strategies of Adolescent Health and Well-being�������������������������������������� 327 Alessandro Pingitore, Luca Bastiani, Cristina Doveri, Gabriele Trivellini, and Francesca Mastorci Index�������������������������������������������������������������������������������������������������������������������� 345

Part I Primordial Prevention: General Aspects

Abstract

Chronic degenerative diseases, including cardiovascular diseases, neurodegenerative diseases, and cancer, are one of the most significant public health challenges facing today’s adolescents, aged 10–24  years, which now account for more than 25% of the worldwide population. Globally, chronic degenerative diseases have remained the leading cause of mortality and morbidity, with clinical signs usually present during adult age. However, early alterations may occur during adolescence, making this period particularly pivotal for implementing preventive interventions (Chap. 1). To date, some projects, mainly related to school environment, have been experimented to target food intake and diet quality as well as physical activity, although much can be further done in this context. Other preventive strategies (especially those regarding psycho-emotional aspects) are mainly directed towards adolescents with mental disorders rather than the healthy ones. However, the World Health Organization defines health as “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”, supporting therefore the necessity of preventive interventions in healthy adolescent population before it is too late. One-third of the total disease burden in adults and two-thirds of premature death are related to behaviours originating early in life (childhood and adolescence). However, in view of the available evidences and according to Foetal Programming Hypothesis, this time window can be extended to include also the prenatal period, in which the development constitutes a critical time for shaping adult behaviour setting the basis for vulnerability or protection to disease in adulthood (Chap. 2). In particular, during adolescence, the existence of modifiable risk factors, namely smoking, alcohol intake, diet, physical activity, obesity, perception of stress, emotional arousal, increases the chances of having a pathological risk profile in adulthood. Nowadays, a large and increasing number of studies have demonstrated that engaging in physical activity and reducing sedentary behaviour

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Part I  Primordial Prevention: General Aspects

(Chap. 3) and in dietary habits (Chap. 4) may enhance young people’s health. This makes it necessary the possible lifestyle monitoring also through biomarkers assessment including nutrition and dietary components (Chap. 5). Therefore, the prevention during this “sensitive window” of age is of the utmost importance for researchers, health professionals, and policymakers for a number of reasons: (1) adolescence is a period of risk taking which can have drastic consequences on adult health; (2) preventive programs during adolescence shape the habits during adulthood; (3) directing adolescence allows for maximal improvement of an individual’s health and that of his/her children.

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Preventive Primordial Strategies: Times Are Changing Morena Lari, Irene Traghella, and Cristina Vassalle

1.1

Introduction

During the past 20  years, the elderly population has increased dramatically in Western countries, making elderly’s care a major public health problem that requires new strategies to improve prognosis, life’s quality, and health costs. Increasing data evidenced that chronic degenerative diseases, including cancer, neurodegenerative disease, and especially cardiovascular (CV) disease, which remain the more frequent cause of morbidity and mortality, may be prevented from early life with adoption of correct lifestyle behaviors [1]. Specifically, promotion of CV health should ideally begin postconception and continue throughout the course of life. To this purpose, the American Heart Association (AHA) introduced as 2020 Strategic Impact Goal the concept of “ideal cardiovascular health” (iCVH): “to improve the cardiovascular health of all Americans by 20% while reducing deaths from cardiovascular diseases and stroke by 20% by 2020” [2]. The definition of iCVH considers the simultaneous extent of four health behaviors concerning smoking habit, body mass index (BMI), physical activity, and diet and includes three health biomarkers (total cholesterol, blood pressure, and fasting glucose) [2] (Fig. 1.1). Nonetheless, as health cannot be defined only as disease absence, but rather a state of complete physical, mental, and social well-being, especially critical in children and adolescents, the inclusion of psychological well-being in the interdisciplinary CV prevention research and strategies should help to develop and test new more effective preventive tools [3].

M. Lari Istituto Comprensivo Don L. Milani, Viareggio, Lucca, Italy I. Traghella · C. Vassalle (*) Fondazione CNR-Regione Toscana G. Monasterio, Pisa, Italy e-mail: [email protected] © Springer Nature Switzerland AG 2019 A. Pingitore et al. (eds.), Adolescent Health and Wellbeing, https://doi.org/10.1007/978-3-030-25816-0_1

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M. Lari et al.

Health

behaviors

Health biomarkers

Never smoking

Total cholesterol < 170 mg/dL

BMI < 85° percentile iCVH

Physical activity ≥60 min/d

Diet emphasizing consumption of fruits, vegetables, fish, whole grains, low sodium and few sugar-laden foods and drinks

Fasting blood glucose