The New Modern Mediterranean Diet Italian Pyramid.

BACKGROUND: Epidemiological studies have established the health benefits associated with the adherence to the MD (Mediterranean Diet), mainly in relation to reducing the risk of developing the non communicable diseases. The MD is a sustainable diet model that respects the environment, promotes the bio-diversity, the local cultural heritages, the social interaction and economic aspects. METHODS: The pyramid is a graphical representation designed to represent the frequencies of consumption and portion sizes of each food according to the Mediterranean model and tradition. The pyramid was developed taking into account the LARN (Reference Intake of nutrients and energy for Italian Population) and the Italian Guidelines for a healthy diet. RESULTS: The frequency of consumption and the portion size recommended are located at the different level of the pyramid. At the base of the pyramid there are the foods that should be consumed every meal and some concepts typical of the Mediterranean culture. In the middle there are foods that should be consumed daily and at the top of the pyramid the foods consumed on a weekly basis. CONCLUSIONS: The new modern MD Italian Pyramid is an important tool to promote the MD and improve the adherence to the MD dietary pattern.

Energy drink consumption in Italian university students: food habits and lifestyle.

OBJECTIVES: The aim of this study was to investigate the consumption of ED (Energy drink) among young people, both alone and in association with alcohol, as well as the food habits and lifestyle of ED consumers. MATERIALS AND METHODS: An anonymous closed-ended questionnaire, was administered to a sample of students. The questionnaire is composed of 30 questions with multiple answers. The students, who come from different regions in Italy, were enrolled at two Italian Universities: Rome and Cagliari. T-test and the analysis of variance (ANOVA) were performed and chi-square test was used to compare observed and expected frequencies. RESULTS: The sample was composed by 618 females and 389 males and revealed statistically significant differences related to the gender in terms of lifestyle and food habits. About 2/3 of the sample has consumed ED at least once. ED consumers in the total sample accounted for 655 students (65,0%). The 41.3% of the females and the 58,8% of males were ED consumers. Habitual consumers represent the 15,8% of the ED consumers, while occasional consumers the 84,2 %. Habitual and occasional consumers show statistically significant differences both for the lifestyle and the food habits. The 72.1% of ED consumers drink ED in association with alcohol (ED-based cocktails). CONCLUSIONS: Our results suggest that would be recommended to inform consumers about the side effects related to an excessive use of ED, particularly when combined with alcohol: indeed, this combination is known to have adverse effects on the cardiovascular system, on the nervous system, leading in particular to sleeping disorders.

The yogurt amino acid profile's variation during the shelf-life.

OBJECTIVE: To analyze the yogurt amino acid profile starting from marketing through the whole shelf-life. The evaluation of the proteolytic activity of Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus salivarius subsp. thermophilus, allows to deduce their vitality during the shelf-life period and within 45 days. METHODS: Three types of full fats yogurts have been analyzed (a) natural white (b) sweet white and (c) whole fruit - in two stages: t0 (first day of shelf-life) and t1 (end of shelf-life). The proteins have been analyzed by the Kjeldahl method and the amino acid profile by HPLC. RESULTS: In natural yogurt a significant increase of the amount of free amino acids has been observed during the period of shelf-life (97%). In the sweetened full fats and fruit yogurt, instead, there is a lower increase of respectively 33% and 39% CONCLUSIONS: In whole milk natural yogurt, based on our data, the proteolytic activity seems to persist during the entire period of the shelf-life and this can be considered an index of bacterial survival, especially of Lactobacillus delbrueckii subsp. bulgaricus during the marketing process.

Mediterranean diet pyramids: towards the Italian model.

There is a long history to the representation of the Mediterranean Diet Pyramid which may be seen as a form of cultural--culinary evolution as each country applies the foods best suited to its national diet. Different Mediterranean Diet pyramids have been designed for the population of Greece, Spain and Italy, tailored for their different food habits. These refer variously to portion sizes and frequency of consumption--daily, weekly and monthly and are not standardized. The 3rd CIISCAM Conference held in Parma, Italy was devoted to highlight the overall biodiversity and nutritional well being values and the sustainable benefits of the Mediterranean diet, recognised as one of the healthiest dietary pattern, and to reduce the rapid erosion of "lifestyle and food habits. It is necessary, therefore, to refer more to a Mediterranean Lifestyle of which diet is only a part. It should include physical and social activity, recreation and rest. It may be possible to construct a Mediterranean food lifestyle index both to assess such a holistic aspect and to correlate with improved morbidity & mortality.

Computer tailored nutrition education: Mediterranean diet.

Goal of this work is to promote via on-line applications the knowledge of the Italian Weekly Pyramid, which is based on the concept of WI (Well Being Index) as a unit for a correct lifestyle. On the website www.piramideitaliana.it the user can verify his/her weekly lifestyle by participating in a "game" based on the introduction, for seven consecutive days, of food and beverages consumption and time assigned to physical activity. At the end of the seven days it is possible to access the page with an evaluation of dietary habits together with the possible suggestions for a correct lifestyle. On the basis of the data collected through this web game, a statistical analysis has been developed to evaluate the food habits and the level of physical activity. In the period between September 2005-January 2010 16,546 participants have completed the game. The data collected compare actual WI consumption for each food group with the one suggested by the Pyramid. The sample eating pattern appears almost varied; all the food groups were consumed daily, albeit in much lower quantities with regard to the suggested portions. It is pointed out that some differences in the nutritional habits are related to differences in age groups and in the school degree of the sample analyzed. This work highlights the importance of web-based tailored interventions on population food habits: many people can be reached to promote the knowledge of the guidelines leading to a healthy lifestyle.

A systematic review of the literature concerning the relationship between obesity and mortality in the elderly.

INTRODUCTION: Obesity is a risk factor for chronic diseases and premature mortality, but the extent of these associations among the elderly is under debate. The aim of this systematic literature review (SR) is to collate and critically assess the available information of the impact of obesity on mortality in the elderly. METHODS: In PubMed, there are three-hundred twelve papers on the relationship between obesity and mortality among older adults. These papers were analysed on the basis of their abstracts, and sixteen studies were considered suitable for the purpose of the study. It was possible to perform a pooled estimate for aggregated data in three different studies. CONCLUSION: The results of this SR document that an increased mortality in obese older adults. The limitation of BMI to index obesity and the noted protective action of a moderate increase in BMI on mortality are highlighted. Waist circumference is an indicator of central adiposity and potentially as good a risk factor for mortality as BMI in obese elderly adults.

[Obesity and Eating Disorders. Indications for the different levels of care. An Italian Expert Consensus Document]. / Documento di Consensus. Obesità e Disturbi dell'Alimentazione Indicazioni per i diversi livelli di trattamento.

This paper is an Italian Expert Consensus Document on multidimensional treatment of obesity and eating disorders. The Document is based on a wide survey of expert opinion. It presents, in particular, considerations regarding how clinicians go about choosing the most appropriate site of treatment for a given patient suffering from obesity and/or eating disorders: outpatient, partial hospitalization, residential rehabilitation centre, inpatient hospitalization. In a majority of instances obesity and eating disorders are long-term diseases and require a multiprofessional team-approach. In determining an initial level of care or a change to a different level of care, it is essential to consider together the overall physical condition, medical complications, disabilities, psychiatric comorbidity, psychology, behaviour, family, social resources, environment, and available services. We first created a review manuscript, a skeleton algorithm and two rating scales, based on the published guidelines and the existing research literature. As the second point we highlighted a number of clinical questions that had to be addressed in the specific context of our National Health Service and available specialized care units. Then we submitted eleven progressive revisions of the Document to the experts up to the final synthesis that was approved by the group. Of course, from point to point, some of the individual experts would differ with the consensus view. The document can be viewed as an expert consultation and the clinical judgement must always be tailored to the particular needs of each clinical situation. We will continue to revise the Document periodically based on new research information and on reassessment of expert opinion to keep it up-to-date. The Document was not financially sponsored.

Obesity in the elderly.

Obesity is a prevalent health disease among the elderly as it contributes to the early onset of chronic morbidity and functional impairment and is also related to premature mortality. The prevalence of sarcopenic-obesity increases too with age in each sex leading to a significantly higher prevalence of physical impairment and disability, as well as higher prevalence of metabolic syndrome. We observe a natural phenomenon (ageing) and a complex world-wide illness (obesity) that should not be merely treated as the sum of the treatments for the elderly and for the 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 from young and adult age in case of obesity and need to be seriously considered.

[Mediterranean diet and prevention of non-communicable diseases: scientific evidences]. / La dieta Mediterranea nella prevenzione delle patologie cronico-degenerative: evidenze scientifiche.

Epidemiological studies showed that the Mediterranean Diet represents a healthy food model in the maintenance of the state of health and in the improvement of the quality of life. The aim of this study was to define the relation between the Mediterranean Diet and the state of health, particularly the role in the prevention of the non-communicable diseases. A systematic literature review was made, analyzing clinical trials published on PubMed from January 2005 to September 2008 and using, separately or in combination, the key words: "Mediterranean Diet", "Health", "Prevention", "Diabetes", "Lipoproteins", "Cardiovascular Diseases", "Cancer." A total of 16 articles were selected. The studies included 101 to 25623 caucasian participants, of both genders, age between 18 and 80 years. Results were analyzed for the effects of the Mediterranean Diet on Cancer; Metabolic Syndrome and Cardiovascular Diseases, in terms of primary and secondary prevention. The Mediterranean Diet showed benefits on the incidence of cancer in healthy subjects, on the metabolic syndrome both in primary prevention that secondary, modifying numerous variables and about cardiovascular diseases, the Mediterranean Diet reduced the risk of relapse and the mortality by acute coronary syndromes and other cardiovascular causes in high risk patients. First of all the Mediterranean Diet must strongly be considered a correlated food model to the style of life, therefore it need further experimental research to validate the effects of Mediterranean Diet on the state of health.

[A survey on diet manuals in Italian hospitals]. / Indagine conoscitiva sui dietetici ospedalieri.

Hospital catering is very important to counteract the onset of malnutrition due to either undernutrition or overnutrition and for dietetic treatment. The aim of the study was to evaluate nutritional quality of the hospital dietetic manual used in some Italian hospitals and to analyze the role of the institutional Catering Service and of the Department of Clinical Nutrition. A survey has been carried out, in some Italian hospitals, using a questionnaire to point out the characteristics of hospitals, the typology of catering service, of the diets and of the staff of the Department of Clinical Nutrition. Only 22% of the hospitals has answered; three Italian regions (Umbria, Molise, Basilicata) are completely missing; -each hospital has a specific dietetic manual in most cases completely different from structure and nutritional quality point of view; the staff acting in this field is absolutely insufficient in term of numerousness and of professional typologies. Hospital in-patients are not homogeneous as for age, dietary needs and diseases, so it's necessary to treat them with an ad hoc nutritional intervention not established in advance in a dietetic manual; if from an organisation point of view it is necessary to have such a dietetic manual, it has to be based on nutritional guidelines and recommended dietary allowances.

Mediterranean lifestyle: nutritional education on-line.

Our goal is to spread on-line the Italian Weekly Pyramid, a tool designed to convey both portion size and frequency of food intake. The Pyramid is referring to the "Well-being Index" (WI) as a unit for an adequate lifestyle. The user can verify his weekly lifestyle by participating to a "game" based on food/beverages consumption and time assigned to physical activity. The site has been visited by 15920 individuals, of whom 4033 completed the game. Self-selected sample, not representative of the Italian population. The data collected included WI consumption by gender for each food group compared to WI suggested. Statistical data evaluation has been performed with the SPSS inc.13 program, without applying any statistical significance to the results. The sample showed a varied eating pattern; all the food groups were consumed almost daily, albeit in much lower quantities with regards to the suggested WI. Fruit and vegetable consumption was higher in women, while men showed a higher intake of meat and cut meats. The percentage of the participants consuming more WI with respect to the recommended amounts was very low for fruit, vegetable, pasta and bread, while was much higher as regards energy dense food.

Lifestyle and dietary differences in smokers and non-smokers from an Italian employee population.

In a sample of 200 subjects, representative of a population of 1936 civil servants, we tested differences in life style, dietary habits and distribution of risk factors for CHD between smokers and nonsmokers. The two groups (79 smokers) and (121 non-smokers) did not differ significantly by age or sex. The percentage of sedentary subjects, of hypercholesterolaemics and of hypertensives was found to be particularly high among smokers: 67%, 33% and 30% respectively (vs 59%, 27% and 19% in non-smokers). More smokers were obese (11% vs 5%) but mean BMI was the same in smokers/non-smokers but showed a higher fat mass; the association of CHD risk factors indicates only one significant correlation (P < 0.05) between obesity and hypertension. In male smokers, higher values of LDL and triglycerides and lower intake of energy, vitamins C and A are observed and these values are significantly different than those for non-smokers. In women HDL values are higher in non-smokers whereas, in female smokers, the food cholesterol intake is particularly high 271 +/- 295 mg. There are also correlations both for the anthropometric and clinical parameters and for energy and nutrients, indicating that the lifestyle of smokers is less healthy than that of non-smokers. Smokers cat vegetables and fruits less frequently and consume more alcohol than non-smokers, who prefer sweet foods.