Fish and human health: an umbrella review of observational studies.

Fish represents one of the most important dietary sources of omega-3 polyunsaturated fatty acids, which are known to be associated with various health benefits. This study aimed to systematically review existing meta-analyses of observational studies exploring the association between fish intake and various health outcomes. A systematic search of electronic databases was conducted to retrieve a total of 63 studies. Evidence was deemed as possible for the association between higher fish intake and decreased risk of the acute coronary syndrome, liver cancer, and depression, and limited for other outcomes (including age-related macular degeneration, Alzheimer's disease, heart failure, all-cause and coronary heart disease mortality, total and ischaemic stroke) due to heterogeneity between results and potential otherwise inexplicable confounding factors. In conclusion, results from epidemiological studies support the mechanistic effects associated with omega-3 fatty acids from high fish consumption, but evidence needs to be further corroborated with more reliable results.

Total, red and processed meat consumption and human health: an umbrella review of observational studies.

Meat consumption has represented an important evolutionary step for humans. However, modern patterns of consumption, including excess intake, type of meat and cooking method have been the focus of attention as a potential cause of rise in non-communicable diseases. The aim of this study was to investigate the association between total, red and processed meat with health outcomes and to assess the level of evidence by performing a systematic search of meta-analyses of prospective cohort studies. Convincing evidence of the association between increased risk of (i) colorectal adenoma, lung cancer, CHD and stroke, (ii) colorectal adenoma, ovarian, prostate, renal and stomach cancers, CHD and stroke and (iii) colon and bladder cancer was found for excess intake of total, red and processed meat, respectively. Possible negative associations with other health outcomes have been reported. Excess meat consumption may be detrimental to health, with a major impact on cardiometabolic and cancer risk.

Nut and legume consumption and human health: an umbrella review of observational studies.

Consumption of nuts and legumes has been associated with several health benefits. The aim of this study was to systematically review existing meta-analyses of observational studies on nut and legume intake and non-communicable diseases, and assess the level of evidence. Out of the six meta-analyses focussed on legume and 15 on nut intake, a possible association with decreased risk of colorectal adenoma and coronary heart disease was found for higher legume consumption, and a decreased risk of cardiovascular and cancer mortality, colon cancer, hypertension and ischaemic stroke for higher nut consumption. The association between legume consumption and cardiovascular diseases (CVDs), as well as nut consumption and risk of cancer, CVD incidence and all-cause mortality, was deemed as "limited" due to heterogeneity between results and/or potential confounding factors. General benefit towards better health can be observed for nut and legume consumption. Further studies are needed to better elucidate potential confounding factors.

Dairy foods and health: an umbrella review of observational studies.

Evidence on consumption of dairy foods and human health is contradictory. This study aimed to summarize the level of evidence of dairy consumption on various health outcomes. A systematic search for meta-analyses was performed: study design, dose-response relationship, heterogeneity and agreement of results over time, and identification of potential confounding factors were considered to assess the level of evidence. Convincing and probable evidence of decreased risk of colorectal cancer, hypertension and cardiovascular disease, elevated blood pressure and fatal stroke, respectively, was found for total dairy consumption; possible decreased risk of breast cancer, metabolic syndrome, stroke and type-2 diabetes, and increased risk of prostate cancer and Parkinson's disease was also found. Similar, yet not entirely consistent evidence for individual dairy products was reported. Among potential confounding factors, geographical localisation and fat content of dairy have been detected. In conclusions, dairy may be part of a healthy diet; however, additional studies exploring confounding factors are needed to ascertain the potential detrimental effects.

Egg consumption and human health: an umbrella review of observational studies.

Egg consumption has been an area of controversy regarding its impact on human health largely due to the content in cholesterol and its potential role in cardio-metabolic outcomes. This study aimed to summarise the level of evidence of egg consumption on various health outcomes. A systematic search for meta-analyses was performed: study design, dose-response relationship, heterogeneity and agreement of results over time, and identification of potential confounding factors were considered to assess the level of evidence. Results from this umbrella review showed a substantial no association between egg consumption and a number of health outcomes, including cancer, cardiovascular and metabolic disorders. In contrast, evidence of possible beneficial effects toward stroke risk has been found. In conclusions, egg may be part of a healthy diet; however, additional studies exploring confounding factors are needed to ascertain the potential detrimental effects.

Whole grain consumption and human health: an umbrella review of observational studies.

Whole grains have been associated with a number of health benefits. We systematically reviewed existing meta-analyses of observational studies and evaluated the level of evidence for their putative effects based on pre-selected criteria. Of the 23 included studies, we found convincing evidence of an inverse association between whole grain consumption and risk of type-2 diabetes and colorectal cancer; possible evidence of decreased risk of colon cancer and cardiovascular mortality with increased whole grain intake, as well as increased risk of prostate cancer. Limited or insufficient evidence was available for all other outcomes investigated. Overall findings are encouraging for a positive effect of whole grain consumption on certain diseases, especially highly prevalent metabolic diseases, however, uncertainty of some negative associations deserves further attention.

Fruit and vegetable consumption and health outcomes: an umbrella review of observational studies.

The aim of this study was to provide a comprehensive evaluation of current evidence on fruit and vegetable consumption and health outcomes. A systematic search for quantitative syntheses was performed. Several criteria, including study design, dose-response relationship, heterogeneity and agreement of results over time, and identification of potential confounding factors, were used to assess the level of evidence. The strongest (probable) evidence was found for cardiovascular disease protection; possible evidence for decreased risk of colon cancer, depression and pancreatic diseases was found for fruit intake; and colon and rectal cancer, hip fracture, stroke, depression and pancreatic diseases was found for vegetable intake. Suggestive and rather limited associations with other outcomes have been found. Evidence of potential confounding by sex and geographical localisation has been reported. Despite findings are consistent enough for hypothesising causation (at least for cardiovascular-related outcomes), further studies are needed to clarify the role of potential confounding factors.

[The control system in the food industry in Italy: warranting the health of consumers and businesses]. / Il sistema dei controlli della filiera alimentare in Italia: garanzia della salute dei consumatori e delle imprese.

The Italian food industry is appreciated worldwide and has undoubtedly brought economic advantages, with exports in 2017 having grown by more than six percentage points, for a volume of almost €32 billion. However, some critical issues exist that require the constant presence of Food and Nutrition Hygiene Services (SIAN) of the Local Health Authorities (LHAs) which, together with other key players, including the Veterinary Services (SV), constitute the backbone of integrated competencies for the protection and promotion of community health. In Italy, controls in the food industry are very complex, involving not only the SIAN and the Veterinary Services of the LHAs (as local competent authority for food safety), but also the Central Inspectorate against frauds, specialized "Carabinieri" Command Departments (NAS AND NAC ), State Forestry Corps, Port Authorities and "Guardia di Finanza", Border Inspection Posts (PIF), Frontier Air Transport Offices (USMAF), the Customs and Monopolies Agency, as well as, for analysis of foods samples, the National Health Institute ("Istituto Superiore di Sanità"), Public Health Laboratories and Experimental Zooprophylactic Institutes. Data published by the Italian Ministry of Health show a decreasing trend in the number of checks carried out by the LHAs, probably due to implementation of increasingly targeted controls, based on risk analysis, and by a progressive reduction of staff. We describe data up to the year 2018, obtained from the survey on the "State of the Art" of the SIAN (structures, staff, activities, etc). In view of the existing complex system of official controls, consumers have a need, often unexpressed, to receive clear information on the quality of food, the ingredients contained in food, and on recent updates regarding food and nutritional safety, in order to make more informed choices and have greater awareness of individual responsibilities for one's health. However, many preventive and health promotion activities implemented by these services remain largely unknown to citizens. The authors believe that all SIANs must take an active role in communication to consumers, so that they receive clear and science-based information, in order to promote informed choices for the protection of their health. This has become increasingly important considering the large number of information channels that do not communicate according to ethical and professional criteria.

From surveillance to development of nutritional guidelines.

In Italy, like in most parts of the world, 30% of children and almost 50% of adults are overweight. This condition is one of the causes of non-communicable diseases responsible for over two thirds of DALYs, deaths and costs for healthcare. Current surveys confirm that overweight and obesity are associated with food habits which have changed, in Italy, in the last fifty years. Fewer and fewer people have been following a Mediterranean diet, which is considered an effective diet for the prevention of many diseases. The consumption of fruit, vegetables, legumes, whole cereals, and EVO oil has decreased, while the consumption of food with high energetic density and rich in sugar, salt, and added fat has increased, especially when eating out. Schools and workplaces are the best places to promote healthy food habits and an active lifestyle. The aim is to involve families (including low-income families), educators, and catering services. This type of intervention is not new to the National Health System and has already led to improvements: however, it is still possible to improve the use of resources and coordination between social, educational, and health services bringing the community to become its own health promoter. Health operators have to be more aware of overweight as a health threat. The National Health Plan represents a commitment for Italy, the country hosting EXPO 2015, to fulfill the targets of the «Action Plan European Strategy for the Prevention and Control of Non-communicable Diseases 2012-2016¼ entrusting the Departments of Prevention with the interventions and development of a network of stakeholders.

[Monitoring of heavy metals and trace elements in the air, fruits and vegetables and soil in the province of Catania (Italy)]. / Monitoraggio di metalli pesanti ed oligoelementi in aria, ortofrutta e terreno nella provincia di Catania.

Contamination of fruits and vegetables with heavy metals can result from anthropogenic events (car or factory emissions, poor management of sewage and industrial waste) or from natural events (volcanic activity and geological soil matrix). The chemical and toxicological characteristics of heavy metals can have an impact on human health through several mechanisms. Other metals, on the other hand, are essential for maintenance of physiological and biochemical human processes, are protective against many diseases and must be present in the diet because they cannot be synthesized by the human body. The purpose of this study was to assess the presence of heavy metals and trace elements both in fruit and vegetable products widely consumed in the province of Catania (Sicily, Italy) and in various environmental matrices (air, water and land), and to investigate possible sources of contamination. Fruit and vegetable products (tomatoes, lettuce, spinach, eggplants, potatoes, zucchini, grapes, apples and pears) were sampled (n = 60) from the towns of Adrano, Biancavilla and Mazzarrone. These locations were selected for their geomorphology, climate and cultivation characteristics. Levels of lead, cadmium, nickel, copper, zinc, vanadium and selenium in fruit, vegetables, air and water samples were determined using atomic absorption spectrometer with graphite furnace Perkin-Elmer AAnalyst 800 while soil samples were evaluated by the atomic emission spectrometer Optima 2000 DV Perkin-Elmer. The presence of mercury was evaluated by atomic absorption spectrometry with cold vapor technique. Study results revealed widespread contamination of fruit and vegetables and mainly due to use of fertilizers and to volcanic activity. A strategy targeting the entire food chain is essential for ensuring food safety and consumer protection and maintaining contaminants at levels which are not hazardous to health.

Case series of Chlorophyllum molybdites intoxication in Sicily: an "alien" mushroom species in Europe.

INTRODUCTION: Mushroom poisoning is an important cause of intoxication worldwide. The toxic mechanism remains frequently unknown and the diffusion of non-endemic species may cause the emergence of new syndromes. An example is the widespread of Chlorophyllum molybdites in Sicily. CASE SERIES: Pavia Poison Centre was recently involved in the management of 10 intoxications caused by the ingestion of Chlorophyllum molybdites, which was not considered part of the Italian mycological species. The clinical syndrome was characterized by severe gastrointestinal symptoms. In paediatric or vulnerable patients, it may bring to hypovolemic shock that necessitate intensive support. The possibly confusion with amatoxins-containing mushrooms may complicate the management. CONCLUSIONS: Chlorophyllum molybdites is widespread on the oriental coast of Sicily and it could be confused with "parasol mushrooms". Cooperation between emergency physicians, clinical toxicologist and mycologist, supported by improving of laboratory tests, is essential for the appropriate clinical management. Climate changes and migration flows can interfere with the diffusion of new species and the development of novel syndromes.

[The prevention of Ochratossina A (OTA A) in the wine]. / La Prevenzione di Ochratossina A (OTA A) nel vino.

The expansion of global market has recalled more and more the attention of the researchers on the presence of mycotoxins in the foodstuff. Trying to limit the damages to the health and the correlated economic losses the European Community has legislated fixing more restrictive limits for the presence of mycotoxins in the single food products; and, specifically the limits of presence of Ochratoxin A (OTA A) in the wines have been established by the rule EEC 123 / 2005. With the purpose to prevent the formation of OTA á in the wine (from the grape to the bottled product), has been conducted, a study to compare the different techniques currently used, as the Good Agricultural Practices (BPA), the Good Practices of Manufacture (BPF) and the Good Practices of storage (BPS) with the system of Hazard Analysis Critical Control Points (HACCP), nowadays used only from the begin of the phase of processing of the agricultural products. It results that, concerning the BPAs, the application of the System HACCP on the primary production would bring neither some innovation nor qualitative improvement. The comparison among BPF, BPS and HACCP, confirms, instead, as the HACCP allows to individualize a series of additional critical points worth of attention during the process and maintenance of the grapes. Such result is in agreement with the new community rule 852/2004, which, also because the difficulties in the application of the HACCP to the primary production, confirm the necessity to follow, on the field, the hygienic respect of the sanitary measures (see attached one artt. 5- 6). This involves the necessity of an increasing integration and cooperation among different professional workers (as hygienist and agronomist). That kind of cooperation is already in use (from year 2003), within the "progetto fito", started by the AUSL 3 of Catania, with the coordination of the Service Hygiene Food stuff and Nutrition (SIAN).

[Sanitary and nutritional control of the Catania school catering service]. / Controllo Ufficiale e Nutrizionale lungo la filiera della ristorazione scolastica catanese.

Sanitary and nutritional control of meals distributed by school catering services is one of the institutional duties of the Food Hygiene and Nutrition Services (Servizi Igiene Alimenti e Nutrizione - SIAN) of the Local Health Units. In order to carry out this activity properly it is necessary to ask oneself beforehand what the main outcome of control activities should be. The answer to this question can only be that "proper nutrition is essential for healthy growth". Starting from this assumption, control activities performed along the entire chain of the scholastic catering service, starting from the final dish served at school up to the primary producer, were reviewed. The review was carried out by a team of multiprofessionals which included a physician, a prevention technician, a dietician, a biologist, an agronomist and a veterinarian. Preliminary results are extremely positive and show that the multidisciplinary integration of roles entrusted to the coordinators of SIAN is crucial to obtaining the best results.

Pesticides and their metabolites in selected Italian groundwater and surface water used for drinking.

The control of groundwater and surface water quality in relation to the presence of pesticides and their metabolites is a rather complicated task. National and local authorities with the responsibility to guarantee an adequate quality of water cannot rely on international guidelines for monitoring activities. In a national project, forty-three pesticides and pesticide metabolites were selected on the basis of sale, monitoring and physical-chemical data, and investigated from some of the main Italian agricultural areas, susceptible to pesticide contamination. Twelve compounds were found in the tested water samples at levels exceeding the 0.1 µg/L European Union (EU) limit for drinking water (European Directive 98/83/EC). Maximum levels up to 0.62 were determined. Several water samples were characterized by the simultaneous occurrence of pesticides and their metabolites (up to ten). In some samples, the total concentration of pesticides and their metabolites was higher than the EU limit of 0.5 µg/L. Total triazine concentrations up to 1.02 µg/L were found. In all the cases the highest concentrations were well below the respective guideline values defined by the World Health Organization (WHO) for drinking water quality.