A comprehensive review of healthy effects of vegetarian diets.

AIMS: A comprehensive review comparing the effect of vegetarian (V) and non-vegetarian (NV) diets on the major cardiometabolic diseases' outcomes was performed. DATA SYNTHESIS: We performed literature research (up to December 31, 2022) of the evidence separately for vascular disease (VD), obesity (OB), dyslipidemia (Dysl), hypertension (HPT), type 2 diabetes (T2D), metabolic syndrome (MetS), analyzing only cohort studies and randomized controlled studies (RCTs) and comparing the effect of V and NV diets. Cohort studies showed advantages of V diets compared to NV diets on incidence and/or mortality risk for ischemic heart disease, overweight and OB risk. Most cohort studies showed V had lower risk of HPT and lower blood pressure (BP) than NV and V diets had positive effects on T2D risk or plasma parameters. The few cohort studies on the risk of MetS reported mixed results. In RCTs, V diets, mainly low-fat-vegan ones, led to greater weight loss and improved glycemic control than NV diets and in the only one RCT a partial regression of coronary atherosclerosis. In most RCTs, V diets significantly reduced LDL-C levels (but also decreased HDL-C levels) and BP. CONCLUSIONS: In this comprehensive review of the association between V diets and cardiometabolic outcomes, we found that following this type of diet may help to prevent most of these diseases. However, the non-uniformity of the studies, due to ethnic, cultural, and methodological differences, does not allow for generalizing the present results and drawing definitive conclusions. Further, well-designed studies are warranted to confirm the consistency of our conclusions.

Position paper on vegetarian diets from the working group of the Italian Society of Human Nutrition.

BACKGROUND: Interest in vegetarian diets is growing in Italy and elsewhere, as government agencies and health/nutrition organizations are emphasizing that regular consumption of plant foods may provide health benefits and help prevent certain diseases. METHODS AND RESULTS: We conducted a Pubmed search, up to September, 2015, for studies on key nutrients (proteins, vitamin B12, iron, zinc, calcium, vitamin D, and n-3 fatty acids) in vegetarian diets. From 295 eligible publications the following emerged: Vegetarians should be encouraged to supplement their diets with a reliable source of vitamin B12 (vitamin-fortified foods or supplements). Since the plant protein digestibility is lower than that of animal proteins it may be appropriate for vegetarians to consume more proteins than recommended for the general population. Vegetarians should also be encouraged to habitually consume good sources of calcium, iron and zinc - particularly vegetables that are low in oxalate and phytate (e.g. Brassicaceae), nuts and seeds, and calcium-rich mineral water. Calcium, iron, and zinc bioavailability can be improved by soaking, germination, and sour-dough leavening that lower the phytate content of pulses and cereals. Vegetarians can ensure good n-3 fatty acid status by habitually consuming good sources of a-linolenic acid (walnuts, flaxseeds, chia seeds, and their oils) and limiting linoleic acid intake (corn and sunflower oils). CONCLUSIONS: Well-planned vegetarian diets that include a wide variety of plant foods, and a reliable source of vitamin B12, provide adequate nutrient intake. Government agencies and health/nutrition organizations should provide more educational resources to help Italians consume nutritionally adequate vegetarian diets.

Evaluating the environmental impact of various dietary patterns combined with different food production systems.

OBJECTIVE: Recent studies support the hypothesis that plant-based diets are environmentally better than meat-based diets. This study aims to further explore this topic and to compare different environmental impacts resulting from different dietary patterns (omnivorous, vegetarian, vegan) and methods of production (conventional farming and organic agriculture). DESIGN: Three weekly balanced diets, equivalent to one another for energetic and nutrient content, have been planned: an omnivorous one, a vegetarian one and a vegan one. For each one, the Life Cycle Assessment (LCA) method has been applied in order to calculate the environmental impact, expressed in 'points'. INTERVENTIONS: The software we selected to carry out the Inventory Analysis and the Impact Assessment is SimaPro5. The Assessment phase has been conducted using Ecoindicator 99, a damage-oriented method, which analyses the impact according to three large damage categories, each of them subsuming various impact categories.

Lipoprotein abnormalities in patients with extra-coronary arteriosclerosis.

Serum levels of lipids, lipoproteins and apolipoproteins A-I and B were evaluated in 102 patients (75 males and 27 females; ages 58 +/- 8 and 61 +/- 7 years (mean +/- SD), respectively) with arteriosclerosis of the lower limbs of supra-aortic trunks. Compared to findings in 64 healthy, age-matched control subjects, male patients in both groups had significantly higher serum triglyceride levels (+42%, P less than 0.05), while female patients with lower limb arteriosclerosis showed significantly increased cholesterol and triglyceride concentrations (+19%, P less than 0.01 and +82%, P less than 0.05, respectively). LDL-triglycerides were also increased in all patients. HDL-cholesterol was significantly decreased in male patients with arteriosclerosis of the lower limbs (-27%, P less than 0.01) and the supra-aortic trunks (-28%, P less than 0.01), and in females of both groups (-26%, P less than 0.01 and -20%, P less than 0.01, respectively); in terms of percent, HDL2-cholesterol was reduced 2-fold compared to HDL3-cholesterol. Patient apolipoprotein A-I and B levels were unchanged. In male and female patients, correlations between triglycerides and HDL-cholesterol as well as HDL2-cholesterol were negative, but not significant; on the other hand, both correlations were negative and significant in male controls, while only the correlation between triglycerides and HDL2-cholesterol was negative and significant in the female controls. Since HDL-cholesterol, and in particular HDL2-cholesterol, concentrations seem closely related to the intravascular catabolism of triglyceride-rich lipoproteins, the absence of a significant correlation between these parameters in the patients suggests a possible alteration in this metabolic process.

Lipid and apoprotein modifications in body builders during and after self-administration of anabolic steroids.

To determine the effects of anabolic steroids on serum lipid and apoprotein levels, 14 white male body builders who self-administered steroids for 2 to 3 months (steroid users) were studied; 10 agreed to screening while they were taking the drugs (ON treatment) and also at about 3 months following their suspension (OFF treatment). Controls consisted of 17 body builders who had never taken steroids (nonusers), and a group of 18 healthy sedentary subjects (controls). During the period of steroid administration, there was a slight reduction in total serum cholesterol, with a marked cholesterol decrease in the high-density lipoprotein (HDL) subfractions HDL2 and HDL3, and a significant reduction in the HDL2 cholesterol/HDL3 cholesterol ratio; the percentage of serum cholesterol transported by low-density lipoproteins (LDL) increased significantly. In addition, a marked apoprotein (apo) A-I reduction in the HDL2 and HDL3 subfractions was observed, as well as an apo A-II decrease that was significant only in the HDL3 subfraction, with an A-I/A-II ratio significantly reduced in both subfractions. Serum apo B was only slightly increased, with a very high B/A-I ratio. Apolipoprotein C-II and E levels showed no modifications, while apo C-III reduced significantly. Lipid and apoprotein values returned to almost normal levels in the OFF treatment period. Findings in the group of nonusers were similar to those in sedentary subjects. These results indicate that anabolic steroids profoundly alter the serum lipid-protein profile, and the changes may be caused in part by the significant differences observed in apoprotein levels.

Evaluation of HDL2 and HDL3 cholesterol by a precipitation procedure in a normal population and in different hyperlipidemic phenotypes.

Gidez et al described a double precipitation method with polyanions to separate high density lipoprotein (HDL) subfractions, using sodium heparin to precipitate very low density lipoprotein (VLDL) and low density lipoprotein (LDL) first, and dextran sulphate 15000 to precipitate HDL2 from total HDL afterwards. This method has shown a very good correlation with the data from the analytical and preparative ultracentrifuge. The aim of this work is to use this method to analyse HDL2 and HLD3 levels in a population living in our district. We studied 163 subjects considered as 'normal' on the basis of anamnestic and clinical evaluation and routine analysis and 47 subjects with familial hyperlipoproteinemia (types IIa, IIb, and IV). The results obtained confirmed both the difference in HDL and particularly HDL2 levels between the sexes which other authors had observed with reference methods, and the significant negative correlation between plasma triglycerides and HDL2 levels. This method may be applied easily, is rather cheap and, therefore, may be used more often in future.

Selective determination of cholesterol in high density lipoprotein subfractions (HDL2 and HDL3) in patients with cerebral and peripheral arteriosclerosis.

Cholesterol levels in high density lipoprotein subfractions (HDL2 and HDL3) were evaluated in 69 patients (55 males, average age +/- SD 58.3 +/- 8.8, and 14 females, average age +/- SD 63.1 +/- 10.3) with extra-coronary arteriosclerosis (lower limbs, supraaortic trunks and both sites), and in 79 healthy age-matched control subjects. HDL cholesterol was significantly reduced in male and female patients. The HDL cholesterol decrease was due to a fall in both HDL2 and HDL3 cholesterols; nonetheless, an analysis of the HDL2-cholesterol/HDL3-cholesterol ratio disclosed that HDL2 cholesterol was the most reduced. Slightly higher plasma cholesterol and triglyceride levels were found in the patients as well as a higher plasma cholesterol/HDL-cholesterol ratio. On the contrary, the HDL2-cholesterol/HDL3-cholesterol ratio was significantly reduced in the patients. These preliminary findings suggest that, as in ischemic heart disease, the HDL cholesterol reduction in cerebral and peripheral arteriosclerosis is also mainly due to a reduction in the HDL2 subfraction. These results also lend further support to the proposal that determination of the HDL subfractions is useful for a better assessment of the risk profile for arteriosclerosis.

Transition to stochastic synchronization in spatially extended systems.

Spatially extended dynamical systems, namely coupled map lattices, driven by additive spatio-temporal noise are shown to exhibit stochastic synchronization. In analogy with low-dimensional systems, synchronization can be achieved only if the maximum Lyapunov exponent becomes negative for sufficiently large noise amplitude. Moreover, noise can suppress also the nonlinear mechanism of information propagation, which may be present in the spatially extended system. An example of phase transition is observed when both the linear and the nonlinear mechanisms of information production disappear at the same critical value of the noise amplitude. The corresponding critical properties cannot be estimated numerically with great accuracy, but some general argument suggests that they could be ascribed to the Kardar-Parisi-Zhang universality class. Conversely, when the nonlinear mechanism prevails on the linear one, another type of phase transition to stochastic synchronization occurs. This one is shown to belong to the universality class of directed percolation.

[Controlled trial with ACTH and corticosteroids in patients with cholestatic viral hepatitis]. / Ricerca controllata con ACTH e corticosteroidi in pazienti affetti da epatite virale ad impronta colostatica

Comparison was made between synthetic ACTH (tetracosactide), betamethasone and a normal paradigm (dietary management with glucose solutions, detoxicants and vitamins) over a period at least of 21 days in 27 patients with cholostatic viral hepatitis. Assessment of the clinical and laboratory parameters by means of both covariance and multivariance analysis showed that hormonal therapy offered no significant advantages with respect to the basic treatment protocol.

Diagnostic policies of minor depressive illness by two differently trained groups of general practitioners.

Two homogeneous general practitioner groups were differently trained for approaching minor depressive illness. One group was presented the depression problem in a traditional manner while the other was led to particularly emphasize the importance of the doctor-patient relationship, according to Balint's suggestions. Both groups adopted the same case record form. The structural analysis of diagnostic judgement based on the logistic transformation of recorded data made it possible to evidence several qualitative differences between the groups, probably deriving from the different training.

Heparin-released plasma lipase activities, lipoprotein and apoprotein levels in young adult cyclists and sedentary men.

Serum lipid and lipoprotein levels, apolipoproteins A-I and B, and lipolytic enzyme activities were studied in 14 young male cyclists and in 21 age-matched sedentary controls. While there were no significant differences in serum cholesterol between the two groups, the cyclists showed a significant decrease in serum triglycerides (P less than 0.05) and LDL cholesterol (P less than 0.05) and had significantly higher levels of HDL cholesterol (P less than 0.01) and HDL2 cholesterol (P less than 0.001). Significantly lower serum cholesterol/HDL cholesterol (P less than 0.001) and LDL cholesterol/HDL cholesterol (P less than 0.001) ratios and a significantly higher HDL2 cholesterol/HDL3 cholesterol ratio (P less than 0.001) were observed in the athletes. Serum apolipoprotein B was lower and the Apo B/Apo A-I ratio significantly reduced in the athletes. No significant differences emerged between the two groups in plasma post-heparin lipoprotein lipase activity (LPL) and in hepatic triglyceride lipase activity (HTGL), and there were no correlations between HDL cholesterol and lipolytic enzyme activities. In conclusion, this cross-sectional study may indicate that an aerobic training program such as cycling is associated with an advantageous lipoprotein pattern; some factors other than lipolytic activity may contribute to increase the HDL cholesterol levels in physical training.

Haemostatic function changes in a trial on the secondary prevention of myocardial infarction with sulphinpyrazone.

The trend of some haemostatic parameters was investigated in a series of 186 myocardial infarction patients randomly allocated to sulphinpyrazone and placebo 15-25 days after the myocardial infarction episode in order to ascertain if one or more of these parameters may be considered as forecasting elements. The tests were performed a treatment allocation (basal values) and after 1, 6, and 12 months. In comparison with 44 healthy volunteers, the results have provided striking confirmation of 'hyperactive' platelets in the early phase of myocardial infarction expressed by the shorter bleeding time, increasing plasmatic beta-thromboglobulin, increased platelet factor 4 release and shorter heparin thrombin clotting time, and by the increased platelet sensitivity to threshold concentrations of adenosine diphosphate and collagen. Significant changes in bleeding time, platelet factor 4 release and heparin thrombin clotting time persist at successive testing times. Platelet aggregation by low collagen concentrations was inhibited in the sulphinpyrazone subsample patients.

Quality assessment of transfusion practice in elective surgery.

A program of quality assurance (QA) was adopted to improve blood transfusion practice in elective surgery at a large urban hospital. For this purpose, a cooperative multidisciplinary group was formed, key indicators were identified, and an organization was set up. Data collected by this organization in the 1-year period needed for implementation of the program indicated that blood misuse was common practice. In fact, overrequest, overtransfusion, excessive reconstitution of whole blood (i.e., concurrent transfusion of red cells and fresh-frozen plasma), and underuse of predeposit were found in all ten surgical departments of the hospital. In a pilot study, data were collected from one surgical department during and after the implementation phase of the QA program; comparison of these data showed a postimplementation reduction of about two thirds in overtransfusion, whereas overrequest, reconstitution of whole blood, and predeposit rates remained unchanged. These results prompted continuation of the program in order to reach a definitive evaluation of its effectiveness.