Diabetes increases the risk of COVID-19 in an altitude dependent manner: An analysis of 1,280,806 Mexican patients

Therapeutic Potential of Green Synthesized Polyherbal Formulated Silver Nanoparticles in Alloxan-Induced Diabetes Mellitus-An In Vivo Strategy

Diabetes mellitus (DM) is a non-communicable, life-threatening syndrome prevalent worldwide. One effective treatment for DM is the medicinal use of green synthesized silver nanoparticles (AgNPs), which are eco-friendly and cost-effective. This study investigates the antidiabetic potential of greensynthesizedAgNPs derived from a polyherbal formulation (PHF). Characterization of PHF-AgNPs included UV-Vis spectroscopy, FTIR, XRD, SEM, and EDX. Diabetes was induced in albino Wistar rats (N = 30, n = 6/group, 150-200 g, 8 weeks old) via intraperitoneal alloxan injection (150 mg). Groups are as follows: 1) untreated control, 2) diabetic control (150 mg/kg b.w. alloxan), 3) glibenclamide (0.5 mg/kg), 4) PHF-AgNPs (10 mg/kg), and 5) PHF-AgNPs (20 mg/kg). Blood glucose levels (BGL) were monitored on days 0, 7, 14, and 21. Blood samples were collected for the liver, kidney, and lipid profile analysis before euthanization. The results showed that PHF-AgNPs had an average size of 20 nm and exhibited significant reductions in BGL, with PHF-AgNPs at both 10 mg/kg and 20 mg/kg demonstrating superior effects compared to glibenclamide. Histopathological analysis revealed tissue regeneration in the liver, kidney, and pancreas, indicating healing of alloxan-induced damage. Additionally, treatment improved liver and kidney function markers, and lipid profiles, with reductions in cholesterol, triglycerides, ALT, AST, and creatinine levels compared to the diabetic control group. These findings suggest that green synthesized PHF-AgNPs effectively improved blood glucose control, body weight, and organ health, positioning them as a promising antidiabetic agent with potential for further clinical development.

Death Risk Response of High-Altitude Resident Populations to COVID-19 Vaccine: A Retrospective Cohort Study

Vásquez-Velásquez, Cinthya, Diego Fano-Sizgorich, and Gustavo F. Gonzales. Death risk response of high-altitude resident populations to COVID-19 vaccine: a retrospective cohort study. High Alt Med Biol. 26:37-44, 2025. Background: Peru had one of the highest mortality rates caused by the coronavirus disease 2019 (COVID-19) pandemic worldwide. Vaccination significantly reduces mortality. However, the effectiveness of vaccination might differ at different altitudinal levels. The study aimed to evaluate the effect modification of altitude on the association between vaccination and COVID-19 mortality in Peru. Methodology: A retrospective cohort, using open access databases of deaths, COVID-19 cases, hospitalizations, and vaccination was obtained from the Peruvian Ministry of Health. Deaths due to COVID-19 were evaluated in vaccinated and nonvaccinated patients. Crude (RR) and adjusted relative risks (aRR) were calculated using generalized linear models of Poisson family with robust variances. Models were adjusted for age, sex, pandemic wave, and Human Development Index. To evaluate the interaction by altitude, a stratified analysis by this variable was performed. The variable altitude was categorized as, 0-499 m (828,298 cases), 500-1,499 m (64,735 cases), 1,500-2,499 m (106,572 cases), and ≥2,500 m (179,004 cases). The final sample studied included 1,362,350 cases. Results: The vaccine showed a considerable reduction of death risk with the second (aRR: 0.41, 95% confidence interval [CI]: 0.38-0.44) and third doses (aRR: 0.21, 95% CI: 0.20-0.23). In the adjusted and interaction model, it can be observed that medium and high altitude present a higher risk of death compared to sea level (aRR: 2.58 and 2.03, respectively). Likewise, the two doses' group presents an aRR:1.22 for medium altitude (1,500-2,499 m) and 1.6 for high altitude (≥2,500 m), compared with low-altitude population, suggesting that the action of vaccination at high altitude is altered by the effect of the altitude itself. Conclusions: Altitude might modify the protective effect of SARS-CoV-2 vaccine against COVID-19 death.

The relationship of age, sex and prothrombin time related to the severity of COVID-19 patients with diabetes mellitus: a systematic review and meta analysis

Background

SARS-CoV-2 first appeared in Wuhan, China, in December 2019. Looking at the prevalence data in the world and in Indonesia, the highest mortality rate due to COVID-19 involves age, gender and comorbidities such as diabetes mellitus. Severity of the condition also refers to coagulation abnormalities, such as abnormal prothrombin time values.

Methods

This systematic review study and meta-analysis used online literature sourced from PubMed, Science Direct, EBSCO, Cochrane and Google Scholar. The literature used here is literature that has data on age, sex and prothrombin time of COVID-19 patients with diabetes mellitus whose quality is assessed by the NOS (Newcastle-Ottawa Scale) criteria and processing data using Review Manager 5.4.

Results

Out of 8711 literatures that were traced from various search sources, there were 45 literatures that were included in this study. The results of the analysis on age showed the Standardized Mean Difference (SMD) value of 0.45 and P <0.0001 (95% CI: 0.23-0.68), the gender analysis showed an Odds Ratio (OR) value of 3.28 and P = 0.01 (95% CI: 1.26-8.52) and the prothrombin time analysis showed SMD values of 0.41 and P = 0.07 (95%CI = -0.03-0.85).

Conclusion

Patients with COVID-19 who have DM have a higher risk compared to those without DM. Among COVID-19 patients with DM admitted to hospitals, they were older compared to those without DM and prothrombin time values similar but slightly higher in COVID-19 patients with DM.

Identification of common genes and pathways between type 2 diabetes and COVID-19

BACKGROUND

Numerous studies have reported a high incidence and risk of severe illness due to coronavirus disease 2019 (COVID-19) in patients with type 2 diabetes (T2DM). COVID-19 patients may experience elevated or decreased blood sugar levels and may even develop diabetes. However, the molecular mechanisms linking these two diseases remain unclear. This study aimed to identify the common genes and pathways between T2DM and COVID-19.

METHODS

Two public datasets from the Gene Expression Omnibus (GEO) database (GSE95849 and GSE164805) were analyzed to identify differentially expressed genes (DEGs) in blood between people with and without T2DM and COVID-19. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed on the common DEGs. A protein-protein interaction (PPI) network was constructed to identify common genes, and their diagnostic performance was evaluated by receiver operating characteristic (ROC) curve analysis. Validation was performed on the GSE213313 and GSE15932 datasets. A gene co-expression network was constructed using the GeneMANIA database to explore interactions among core DEGs and their co-expressed genes. Finally, a microRNA (miRNA)-transcription factor (TF)-messenger RNA (mRNA) regulatory network was constructed based on the common feature genes.

RESULTS

In the GSE95849 and GSE164805 datasets, 81 upregulated genes and 140 downregulated genes were identified. GO and KEGG enrichment analyses revealed that these DEGs were closely related to the negative regulation of phosphate metabolic processes, the positive regulation of mitotic nuclear division, T-cell co-stimulation, and lymphocyte co-stimulation. Four upregulated common genes (DHX15, USP14, COPS3, TYK2) and one downregulated common feature gene (RIOK2) were identified and showed good diagnostic accuracy for T2DM and COVID-19. The AUC values of DHX15, USP14, COPS3, TYK2, and RIOK2 in T2DM diagnosis were 0.931, 0.917, 0.986, 0.903, and 0.917, respectively. In COVID-19 diagnosis, the AUC values were 0.960, 0.860, 1.0, 0.9, and 0.90, respectively. Validation in the GSE213313 and GSE15932 datasets confirmed these results. The miRNA-TF-mRNA regulatory network showed that TYH2 was targeted by PITX1, PITX2, CRX, NFYA, SREBF1, RELB, NR1L2, and CEBP, whereas miR-124-3p regulates THK2, RIOK2, and USP14.

CONCLUSION

We identified five common feature genes (DHX15, USP14, COPS3, TYK2, and RIOK2) and their co-regulatory pathways between T2DM and COVID-19, which may provide new insights for further molecular mechanism studies.

Network analysis-guided drug repurposing strategies targeting LPAR receptor in the interplay of COVID, Alzheimer's, and diabetes

The COVID-19 pandemic caused by the SARS-CoV-2 virus has greatly affected global health. Emerging evidence suggests a complex interplay between Alzheimer's disease (AD), diabetes (DM), and COVID-19. Given COVID-19's involvement in the increased risk of other diseases, there is an urgent need to identify novel targets and drugs to combat these interconnected health challenges. Lysophosphatidic acid receptors (LPARs), belonging to the G protein-coupled receptor family, have been implicated in various pathological conditions, including inflammation. In this regard, the study aimed to investigate the involvement of LPARs (specifically LPAR1, 3, 6) in the tri-directional relationship between AD, DM, and COVID-19 through network analysis, as well as explore the therapeutic potential of selected anti-AD, anti-DM drugs as LPAR, SPIKE antagonists. We used the Coremine Medical database to identify genes related to DM, AD, and COVID-19. Furthermore, STRING analysis was used to identify the interacting partners of LPAR1, LPAR3, and LPAR6. Additionally, a literature search revealed 78 drugs on the market or in clinical studies that were used for treating either AD or DM. We carried out docking analysis of these drugs against the LPAR1, LPAR3, and LPAR6. Furthermore, we modeled the LPAR1, LPAR3, and LPAR6 in a complex with the COVID-19 spike protein and performed a docking study of selected drugs with the LPAR-Spike complex. The analysis revealed 177 common genes implicated in AD, DM, and COVID-19. Protein-protein docking analysis demonstrated that LPAR (1,3 & 6) efficiently binds with the viral SPIKE protein, suggesting them as targets for viral infection. Furthermore, docking analysis of the anti-AD and anti-DM drugs against LPARs, SPIKE protein, and the LPARs-SPIKE complex revealed promising candidates, including lupron, neflamapimod, and nilotinib, stating the importance of drug repurposing in the drug discovery process. These drugs exhibited the ability to bind and inhibit the LPAR receptor activity and the SPIKE protein and interfere with LPAR-SPIKE protein interaction. Through a combined network and targeted-based therapeutic intervention approach, this study has identified several drugs that could be repurposed for treating COVID-19 due to their expected interference with LPAR(1, 3, and 6) and spike protein complexes. In addition, it can also be hypothesized that the co-administration of these identified drugs during COVID-19 infection may not only help mitigate the impact of the virus but also potentially contribute to the prevention or management of post-COVID complications related to AD and DM.

Demographic, Clinical, and Quality of Life Profiles of Older People With Diabetes During the COVID-19 Pandemic: Cross-Sectional Study

BACKGROUND

Diabetes mellitus, one of the main diseases that affects the Brazilian population older than 60 years, is defined as a divergent group of metabolic disorders that present a high level of glycemia (hyperglycemia), causing damage to various organs and systems of the body, including the heart, kidneys, eyes, and nervous system. It is believed that in 2025, in Brazil alone, there will be more than 18.5 million individuals diagnosed with diabetes mellitus. Therefore, it is important to know the individuals' quality of life in the context of life and culture.

OBJECTIVE

This study aimed to assess the demographic, clinical, and quality of life profiles of older adults with diabetes during the COVID-19 pandemic in a university hospital complex in the northern Amazon region.

METHODS

We conducted a cross-sectional, exploratory, noninterventional, descriptive, and analytical study using a nonrandom sample of 54 older people diagnosed with diabetes mellitus at the geriatrics outpatient clinic of the medium and high complexity university hospital in the western Brazilian Amazon between 2020 and 2022. We used 3 instruments, namely, a sociodemographic questionnaire, a clinical conditions questionnaire, and Diabetes-39. Qualitative data were described using absolute and relative frequencies. The Kolmogorov-Smirnov normality test was applied, and the z test was used for inferential analysis. SPSS software (version 27) was used for data analysis, and the significance level was 5%.

RESULTS

Of the 54 interviewees, the majority were women, married, retired, and had a good quality of life. Of these, 48.1% (n=26) were infected by COVID-19, 61.5% (n=16) of whom progressed to long COVID, presenting with fatigue or muscle weakness. As for the quality of life, the "social overload" (P<.001) and "sexual functioning" (P<.001) dimensions had with low scores compared to the "energy and mobility" (P=.005), "diabetes control" (P<.001), and "anxiety and worry" (P<.001) dimensions. Quality of life was negatively impacted in the "anxiety and worry" dimension. Among those affected by COVID-19, most progressed to long COVID; however, there was a lack of data on this theme in the population of older people with diabetes.

CONCLUSIONS

The majority of interviewees progressed to long COVID, with their quality of life negatively impacted in the "anxiety and worry" dimension, reflecting that health actions prioritizing mental health should be implemented by health professionals.

Prevalence and risk factors of COVID-19 infection, mortality, and post-infection lung fibrosis in patients with type 2 diabetes: a cross-sectional study

OBJECTIVES

The clinical course of coronavirus disease 2019 (COVID-19) infection is often aggressive, with unfavorable outcomes for those with comorbidities such as type 2 diabetes mellitus (T2DM). We aimed to assess the prevalence and risk factors of COVID-19 infection, mortality, and post-infection lung fibrosis in patients with COVID-19 infection who had T2DM.

METHODS

In this cross-sectional study, we included adult patients with T2DM who attended an endocrinology clinic and underwent testing for COVID-19 infection.

RESULTS

Among 1039 included patients, the mean age was 59.5 ± 11.0 years and 429 (41.3%) were men. Overall, 87.1% of patients had received COVID-19 vaccination and 32.3% had confirmed COVID-19 infection. The COVID-19-related mortality was 3.0% and rate of post-COVID-19 lung fibrosis was 19.1%. Vaccination was associated with lower COVID-19-related mortality (odds ratio [OR]: 0.03, 95% confidence interval [CI]: 0.0-0.3) and post-COVID-19 lung fibrosis risk (OR: 0.3, 95% CI: 0.1-0.9).

CONCLUSION

Patients with T2DM exhibited a high prevalence of COVID-19 infection and associated mortality. However, COVID-19 vaccines were beneficial in reducing the risks of COVID-19-related mortality and post-infection lung fibrosis in these patients. COVID-19 vaccines and boosters are recommended for patients with T2DM. Further studies involving larger study populations are necessary to validate these findings.

Disparities in COVID-19 incidence and fatality rates at high-altitude

Background

SARS-CoV-2 has affected every demography disproportionately, including even the native highland populations. Hypobaric-hypoxic settings at high-altitude (HA, >2,500 masl) present an extreme environment that impacts the survival of permanent residents, possibly including SARS-CoV-2. Conflicting hypotheses have been presented for COVID-19 incidence and fatality at HA.

Objectives

To evaluate protection or risk against COVID-19 incidence and fatality in humans under hypobaric-hypoxic environment of high-altitude (>2,501 masl).

Methods

Global COVID-19 data of March 2020-21, employed from official websites of the Indian Government, John Hopkins University, and Worldometer were clustered into 6 altitude categories. Clinical cofactors and comorbidities data were evaluated with COVID-19 incidence and fatality. Extensive comparisons and correlations using several statistical tools estimated the risk and protection.

Results

Of relevance, data analyses revealed four distinct responses, namely, partial risk, total risk, partial protection, and total protection from COVID-19 at high-altitude indicating a mixed baggage and complexity of the infection. Surprisingly, it included the countries within the same geographic region. Moreover, body mass index, hypertension, and diabetes correlated significantly with COVID-19 incidence and fatality rate (P ≤ 0.05).

Conclusions

Varied patterns of protection and risk against COVID-19 incidence and fatality were observed among the high-altitude populations. It is though premature to generalize COVID-19 effects on any particular demography without further extensive studies.

Risk of death, hospitalization and intensive care unit admission by SARS-CoV-2 variants in Peru: a retrospective study

OBJECTIVES

Peru has had the highest death toll from the pandemic worldwide; however, it is not clear what the effects of the different variants on these outcomes are. The study aimed to evaluate the risk of death, hospitalization, and intensive care unit (ICU) admission rates of COVID-19 according to the SARS-CoV-2 variants detected in Peru from March 2020-February 2022.

METHODS

Retrospective study using open-access databases were published by the Peruvian Ministry of Health. Databases of genomic sequencing, death, COVID-19 cases, hospitalization and ICU, and vaccination were used. Crude and adjusted Cox proportional hazards regressions with clustered variances were modeled to calculate the hazard ratio (HR) of outcomes by variant.

RESULTS

Lambda variant had the highest risk of death (HR 1.92, 95% CI 1.37-2.68), whereas the Delta variant had the lowest risk (HR 0.50, 95% CI 0.31-0.82). Mu variant had the highest risk of hospitalization (HR: 2.39, 95% CI 1.56-3.67), Omicron the lowest (HR 0.45, 95%CI 0.23-0.90), and Gamma had the highest ICU admission rate (HR 1.95, 95%CI 1.40-2.71).

CONCLUSION

SARS-CoV-2 variants showed distinctive risks of clinical outcomes, which could have implications for the management of infected persons during the pandemic.

Health Benefits of Residence at Moderate Altitude Do Not Reduce COVID-19 Mortality

Moderate altitude (1000−2000 m above sea level) residence is emerging as a protective factor from the mortality of various causes, including of cardiovascular diseases. Conversely, mortality from certain respiratory diseases is higher at these altitudes than in lowlands. These divergent outcomes could indicate either beneficial or detrimental effects of altitude on the mortality of COVID-19 that primarily infects the respiratory tract but results in multi-organ damage. Previous epidemiological data indeed suggest divergent outcomes of moderate to high altitude residence in various countries. Confounding factors, such as variations in the access to clinical facilities or selection biases of investigated populations, may contribute to the equivocation of these observations. We interrogated a dataset of the complete population of an Alpine country in the center of Europe with relatively similar testing and clinical support conditions across altitude-levels of residence (up to around 2000 m) to assess altitude-dependent mortality from COVID-19 throughout 2020. While a reduced all-cause mortality was confirmed for people living higher than 1000 m, no differences in the mortality from COVID-19 between the lowest and the highest altitude regions were observed for the overall population and the population older than 60 years as well. Conversely, COVID-19 mortality seems to have been reduced in the very old (>85 years) women at moderate altitudes.

COVID-19 pneumonia in patients with impaired fasting glucose, newly diagnosed diabetes and pre-existing diabetes: a tertiary center experience

COVID-19 infection is known to increase mortality in patients with diabetes. We aim to demonstrate the differences in disease course and clinical outcomes of patients with COVID-19 regarding the presence of impaired fasting glucose, pre-existing diabetes mellitus (DM) or new-onset DM. 236 patients with positive reverse transcription-PCR tests for SARS-CoV-2 were included in this single-center, retrospective observational study between March 2020 and May 2021. Laboratory results, comorbidities, medications and imaging findings were noted. Logistic regression was used to estimate associated factors for admission to the intensive care unit (ICU). 43 patients with normal glucose, 53 with impaired fasting glucose, 60 with newly diagnosed DM, and 80 with pre-existing DM were classified. Patients with pre-existing DM had higher fasting glucose and glycated hemoglobin than the other groups (p<0.001 for all). Patients with newly diagnosed DM were more likely to need dexamethasone 6 mg (p=0.001). In both newly diagnosed diabetes and impaired fasting glucose groups, 250 mg methylprednisolone was needed at higher rates (p=0.002). Newly diagnosed DM had higher rates of intubation (21.6%) and more mortality (20.0%) (p=0.045 and p=0.028, respectively). Mortality and hospitalization in the ICU were lower in the group receiving antidiabetic treatment. The risk of ICU attendance was higher in patients with impaired fasting glucose (HR=1.71, 95% CI: 0.48 to 6.08) and newly diagnosed DM (HR=1.88, 95% CI: 0.57 to 6.17), compared with pre-existing DM and non-diabetics. Newly diagnosed DM and impaired fasting glucose are associated with increased mortality and intubation in inpatients with COVID-19.

Assisting individuals with diabetes in the COVID-19 pandemic period: Examining the role of religious factors and faith communities

With the onset of the coronavirus disease 2019 (COVID-19) pandemic, diabetes management has become more challenging than it has ever been. Studies on the management of diabetes during this time are required. Unfortunately, the lack of information on the potential role of religious factors and faith communities in diabetes management during the COVID-19 era prevents us from fully understanding the issue of diabetes management during the COVID-19 pandemic period. People with chronic conditions such as diabetes may benefit from some form of religious support from faith communities and their ability to cope could be fostered by some religious factors. It is unclear how religious factors and faith communities contribute to diabetes management. In this article, the authors examine how people with diabetes can be aided in the COVID-19 pandemic period from the perspective of religious factors and faith communities. Based on the studies identified, it appears that religious factors and faith communities play an important role in managing diabetes among patients during the COVID-19 pandemic.

COVID-19 and diabetes: Association intensify risk factors for morbidity and mortality

Diabetes is a condition that affects a large percentage of the population and it is the leading cause of a wide range of costly complications. Diabetes is linked to a multi-fold increase in mortality and when compared to non-diabetics, the intensity and prevalence of COVID-19 ailment among diabetic individuals are more. Since its discovery in Wuhan, COVID-19 has grown rapidly and shown a wide range of severity. Temperature, lymphopenia, non-productive cough, dyspnoea, and tiredness are recognized as the characteristic of individuals infected with COVID-19 disease. In COVID-19 patients, diabetes and other related comorbidities are substantial predictors of disease and mortality. According to a recent study, SARS-CoV-2 (the virus responsible for covid-19 disease) may also lead to direct pancreatic harm, which could aggravate hyperglycemia and potentially cause the establishment of diabetes in formerly non-diabetic individuals. This bidirectional association of COVID-19 and diabetes load the burden on health care professionals throughout the world. It is recommended that gliptin medications be taken moderately, blood glucose levels must be kept under control, ACE inhibitors should be used in moderation, decrease the number of avoidable hospitalizations, nutritional considerations, and some other prevention measures, such as immunization, are highly recommended. SARS-CoV-2 may cause pleiotropic changes in glucose homeostasis, which could exacerbate the pathophysiology of pre-existing diabetes or result in new disease processes.

Associations between COVID-19 testing status, non-communicable diseases and HIV status among residents of sub-Saharan Africa during the first wave of the pandemic

BACKGROUND

This study determined if non-communicable disease status, HIV status, COVID-19 status and co-habiting were associated with COVID-19 test status in sub-Saharan Africa.

METHODS

Data of 5945 respondents age 18-years-old and above from 31 countries in sub-Saharan Africa collected through an online survey conducted between June and December 2020, were extracted. The dependent variable was COVID-19 status (testing positive for COVID-19 and having symptoms of COVID-19 but not getting tested). The independent variables were non-communicable disease status (hypertension, diabetes, cancer, heart conditions, respiratory conditions, depression), HIV positive status, COVID-19 status (knowing a close friend who tested positive for COVID-19 and someone who died from COVID-19) and co-habiting (yes/no). Two binary logistic regression models developed to determine associations between the dependent and independent variables were adjusted for age, sex, employment, sub region and educational status.

RESULTS

Having a close friend who tested positive for COVID-19 (AOR:6.747), knowing someone who died from COVID-19 infection (AOR:1.732), and living with other people (AOR:1.512) were significantly associated with higher odds of testing positive for COVID-19 infection, while living with HIV was associated with significantly lower odds of testing positive for COVID-19 infection (AOR:0.284). Also, respondents with respiratory conditions (AOR:2.487), self-reported depression (AOR:1.901), those who had a close friend who tested positive for COVID-19 infection (AOR:2.562) and who knew someone who died from COVID-19 infection (AOR:1.811) had significantly higher odds of having symptoms of COVID-19 infection but not getting tested.

CONCLUSION

Non-communicable diseases seem not to increase the risk for COVID-19 positive test while cohabiting seems to reduce this risk. The likelihood that those who know someone who tested positive to or who died from COVID-19 not getting tested when symptomatic suggests there is poor contact tracing in the region. People with respiratory conditions and depression need support to get tested for COVID-19.

Considerations regarding the relationship between Fitness, Wellness and Healthy Lifestyle

Introduction. Currently, the crises triggered by the pandemic, in the fields of health, freedom of movement, economic, with impact in the social and cultural spheres, bring back today the practical applicability of the concepts of fitness and wellness. Material and method. In our study we will refer to the effects of the pandemic on health (everyone's well-being), to see how they accentuated the negative effects of the risks that specialists linked to sedentary lifestyle; increased stress; static anti-physiological positions for prolonged periods of time, which result in cardiovascular disease, metabolic syndrome and even cancer, to which is added an irrational diet. We will also refer to the relationship between the quality of life of people and the need to find the most effective ways to combat the negative effects of risk factors, by overcoming the obstacles posed by the financial situation and cultural patterns both in terms of lifestyle, as well as the eating behavior of people from different backgrounds. Results and discussions. We are of the opinion that specialists must go in their approaches, from the cultural understanding of man, to find ways to individualize the means of intervention so as to achieve the proposed objectives. The framework could be, for children and adolescents - the reorganization of school physical education, and for young people and adults - leisure activities, in which the emphasis could be falls on the concepts of Fitness and Wellness, with a beneficial effect on quality of life and personal satisfaction. Conclusion In this context, we believe that it is necessary to reconsider the need to make the population aware of the formation of a healthy lifestyle. The means could be physical fitness, wellness, rational nutrition and recovery according to the effort made, their benefits can have a major impact on health and prolong life expectancy. Keywords: Fitness, Wellness, Health, Physical education, cultural perspectives,