Valeria del Balzo

How to estimate fat mass in overweight and obese subjects

Background. The prevalence of overweight and obesity is increasing and represents a primary health concern. Body composition evaluation is rarely performed in overweight/obese subjects, and the diagnosis is almost always achieved just considering body mass index (BMI). In fact, whereas BMI can be considered an important tool in epidemiological surveys, different papers stated the limitations of the use of BMI in single individuals. Aim. To assess the determinants of body composition in overweight and obese subjects. Methods. In 103 overweight or obese subjects (74 women, aged 41.5 ± 10 years, and 29 men, aged 43.8 ± 8 years), a multidimensional evaluation was performed including the assessment of body composition using Dual Energy X-Ray Absorptiometry (DXA), anthropometry, bioimpedance analysis (BIA), and biochemical parameters (total cholesterol, triacylglycerol, HDL- and LDL-cholesterol, free fatty acids and glycerol, glucose, insulin, C-reactive protein, plasma acylated and unacylated ghrelin, adiponectin, and leptin serum levels). Results. BMI does not represent the main predictor of FM estimated by DXA; FM from BIA and hip circumference showed a better association with FM from DXA. Moreover, models omitting BMI explained a greater part of variance. These data are confirmed by the predictive value analysis where BMI showed a performance similar to a “coin flip.”

Environmental and economic sustainability of the Mediterranean Diet

Abstract The Mediterranean diet (MD) has been proposed as a healthy dietary pattern for disease prevention. However, little information exists on the cost and on the environmental impact of such a dietary model. We compared the environmental impact and the costs of the current food consumption pattern of the Italian population and the Mediterranean model in order to investigate its overall sustainability. The environmental impact was calculated on the basis of three indexes, i.e. Carbon, Ecological and Water Footprint. The costs (Euro) per person of the MD and of the current Italian household food expenditure were considered on a weekly basis according to the 2013 data from the Observatory prices and tariffs of the Ministry of Economic Development and the service SMS consumers of the Ministry of Agriculture, Food and Forestry. The MD resulted to produce a lower environmental impact than the current food consumption of the Italian population. The monthly expenditure of the MD is slightly higher in the overall budget compared to the current expenditure allocated to food by the Italian population, but there is a substantial difference in the distribution of budget according to the different food groups.

A Consensus Proposal for Nutritional Indicators to Assess the Sustainability of a Healthy Diet: The Mediterranean Diet as a Case Study

Background There is increasing evidence of the multiple effects of diets on public health nutrition, society, and environment. Sustainability and food security are closely interrelated. The traditional Mediterranean Diet (MD) is recognized as a healthier dietary pattern with a lower environmental impact. As a case study, the MD may guide innovative inter-sectorial efforts to counteract the degradation of ecosystems, loss of biodiversity, and homogeneity of diets due to globalization through the improvement of sustainable healthy dietary patterns. This consensus position paper defines a suite of the most appropriate nutrition and health indicators for assessing the sustainability of diets based on the MD. Methods In 2011, an informal International Working Group from different national and international institutions was convened. Through online and face-to-face brainstorming meetings over 4 years, a set of nutrition and health indicators for sustainability was identified and refined. Results Thirteen nutrition indicators of sustainability relating were identified in five areas. Biochemical characteristics of food (A1. Vegetable/animal protein consumption ratios; A2. Average dietary energy adequacy; A3. Dietary Energy Density Score; A4. Nutrient density of diet), Food Quality (A5. Fruit and vegetable consumption/intakes; A6. Dietary Diversity Score), Environment (A7. Food biodiversity composition and consumption; A8. Rate of Local/regional foods and seasonality; A9. Rate of eco-friendly food production and/or consumption), Lifestyle (A10. Physical activity/physical inactivity prevalence; A11. Adherence to the Mediterranean dietary pattern), Clinical Aspects (A12. Diet-related morbidity/mortality statistics; A13. Nutritional Anthropometry). A standardized set of information was provided for each indicator: definition, methodology, background, data sources, limitations of the indicator, and references. Conclusion The selection and analysis of these indicators has been performed (where possible) with specific reference to the MD. Sustainability of food systems is an urgent priority for governments and international organizations to address the serious socioeconomic and environmental implications of short-sighted and short-term practices for agricultural land and rural communities. These proposed nutrition indicators will be a useful methodological framework for designing health, education, and agricultural policies in order, not only to conserve the traditional diets of the Mediterranean area as a common cultural heritage and lifestyle but also to enhance the sustainability of diets in general.

A Cross-Sectional Survey on Dietary Supplements Consumption among Italian Teen-Agers

Introduction In the last decades, dietary supplements consumption has increased in the Western world for all age groups. The long-term potentially dangerous effects related to an indiscriminate consumption of dietary supplements are still unknown and are becoming a matter of public health concern. Therefore, the aims of the present study were: to explore the contribution of dietary supplements to micronutrient daily intake, and to evaluate awareness and knowledge about dietary supplements. Methods Participants (age ranging from 14 to 18 years) were recruited among students attending 8 high schools in the province of Frosinone (Italy). An anonymous questionnaire, composed of 12 multiple-choice items, was administered to all the participants. T-test and the analysis of variance (ANOVA) were performed to describe differences between means of the groups, while the chi-square test was used to compare observed and expected frequencies. The logistic regression model, aimed at identifying the characteristics of potential consumers of dietary supplements, Results A total of 686 teenagers (288 males and 398 females, average age: 17,89±0,91 years) participated in the study. The 83,6% of participants affirmed to be aware of dietary supplements. 239 participants consumed dietary supplements: 118 males and 121 females. 49,1% of females consumed dietary supplements less than twice a week, whereas 43,6% of males consumed dietary supplements from 2 to 5 times per week. Statistically significant differences emerged between the genders with respect to the source of information regarding dietary supplements, the perceived indications for their use, and the choice of the store/place to purchase them. Discussion Findings in the present study provide insight into the consumption of dietary supplements among young Italians, highlighting the need to foster further awareness among adolescents about the correct use of dietary supplements, especially in terms of indications and contraindications.

In preparation for the International Symposium on ‘Obesity in the Elderly’

Obesity is a prevalent health problem among the elderly, where it contributes to the early onset of chronic morbidity and functional impairment and is related to premature mortality. The prevalence of sarcopenic obesity also increases with age in each sex. In these subjects, a significantly higher prevalence of physical impairment and disability is found, as well as a higher prevalence of the metabolic syndrome. We observe a natural phenomenon (aging) and a complex worldwide illness (obesity) that should not merely be treated as the sum of the treatments for the elderly and obese. The balance between the potential benefits of treatment interventions, reducing premature morbidity and mortality, and the impact on quality of life in old age may be different between young and adult ages in the case of obesity and needs to be seriously considered.

Dieta, infiammazione e malattie metaboliche

SommarioLa disponibilità di cibo e l’esposizione ad agenti patogeni hanno condizionato l’evoluzione della specie umana favorendo l’acquisizione di un’elevata efficienza nell’accumulare energia e lo sviluppo di un efficace apparato di difesa, rappresentato dal sistema immunitario. Il network che connette funzioni metaboliche e immunitarie si è strutturato in un contesto diverso da quello odierno, cosicché l’attuale l’overload metabolico induce uno stato infiammatorio cronico di basso grado.

Lifestyle, anthropometric and blood chemical parameters in hypercholesterolaemic subjects

Abstract A sample of 60 subjects (36M and 24F) with blood cholesterol above threshold values presents the following characteristics with regard to exposure to CHD risk: because sex is a CHD risk factor, males with an average age of 42.7 years and average serum cholesterol at 263 mg/dl are more exposed also due to lack of physical activity and high blood pressure; females of 41.2 of age on average, with average serum cholesterol of 260 mg/dl and a prevalently android fat distribution are less protected, although in their fertile life, also due to their concomitant sedentary life and smoking habits. In both sexes the level of serum cholesterol is correlated with LDL; no other significant associations among risk factors can be observed. A comparison of the data observed in hypercholesterolaemic subjects with the control group indicates significant variations in LDL, triglycerides and fat mass (p

Food Preferences in the Elderly: Molecular Basis

Abstract A close relationship exists between nutritional status and health in the elderly. Changes in body composition (in particular sarcopenia) together with chronic diseases, multiple medications, cognitive impairment, depression, and social isolation can act synergistically with the decline in digestive, olfactory and salivary functions as well as in hormonal profile, affecting the nutritional status. Senile anorexia may predispose elderly subjects to protein energy malnutrition which is associated with functional impairment (due to impaired muscle function and/or decreased bone mass), comorbidity (related to immune dysfunction, anemia, reduced cognitive function, poor wound healing), delayed recovery from acute events, and increased mortality. Physiological modifications (impairment of gastrointestinal function, modified satiating effects of different macronutrients, downregulation of signaling proteins and hormones) may lead to reduced energy and/or nutrient intake. In particular modifications of chemosensory functions (distortion of tasting and olfactory function) may induce important changes in food preferences in the elderly. Moreover, modifications of clinical and nutritional status (impairment of functional status, cognitive decline) together with motivations and perceived barriers may represent an important determinant of food choices.

Obesità, dieta mediterranea e nutraceutica

SommarioLa Dieta Mediterranea (DM) è ricca di alimenti con proprietà nutraceutiche. L’olio d’oliva è ricco di acidi grassi Ω9

Eating habits and dietary patterns in children with autism

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