[Smoking cessation and weight gain]. / Trattamento per la disassuefazione dal fumo ed incremento ponderale.

Cigarette smoking is the single most important preventable cause of death and illness. Smoking cessation is associated with substantial health benefits, but weight gain after smoking cessation is perceived to be a barrier against quitting smoking. The aim of the study was to analyse predictors of weight gain after smoking cessation. The sample included 1067 residents, aged 18-70 years, in a health district of Rome who answered to an anonymous postal questionnaire. Among them 482 were former smokers; 398 provided lifetime histories of both body weight and smoking and were considered in the analysis. 52.5% (49.3% M; 60.5% F) reported weight gain after smoking cessation; among these 25.4% reported a weight gain > or =5 kg. The multivariate logistic regression analysis showed a direct association between female gender (OR 1.9, CI 95% 1.1-3.2), age - 45 years (45-65 years: OR 2.5, CI 95% 1.4-4.4; > 64 years OR 2.1, CI 95% 1.0-4.0), number of cigarettes per day >20/day (OR 3.8, CI 95% 1.3-11.5) and weight gain after smoking cessation. The relevance of weight gain following smoking cessation suggests that health benefits associated with smoking cessation may to some extent be negated by the detrimental effects on health of associated weight gain. Smoking cessation programmes should therefore consider incorporating follow-up support to prevent weight gain; regular measurements of body weight together with dietary indications and increase of physical activity are basic factors to implement in the intervention of smoking cessation.

[Mini Nutritional Assessment (MNA) and nutritional risk in elderly. A proposal of nutritional surveillance system for the Department of Public Health]. / Il Mini Nutritional Assessment (MNA) e la valutazione del rischio nutrizionale in età geriatrica. Proposta di un modello operativo di sorveglianza nutrizionale all'interno del Dipartimento di Prevenzione.

Objective of the study is to present an intervention model to evaluate nutritional risk of institutionalised elderly, suitably with the aims and resources of the Hygiene of Nutrition Services, and to individuate predictive variables of nutritional vulnerability. 237 subjects from the residential homes of ASL RMB were involved in the study; to each subject was administered: a) the Mini Nutritional Assessment (MNA); b) a questionnaire for the analysis of the risk factors. Multivariate logistic regression analysis was performed to evaluate the influence of the risk factors on nutritional status. On the basis of BMI the prevalence of malnutrition is 6.5% and the prevalence of overweight and obesity is respectively 41.6% and 22.9%; on the basis of MNA, 5.1% of the subjects is malnourished and 60.3% at risk for malnutrition. The absence of chewing difficulties (OR 2.94; I.C. 1.46-5.91) and the habit to eat all foods served at meals (OR 2.83; I.C. 1.46-5.91) are associated with a good nutritional status. The age > or = 90 years is a risk factor for malnutrition at the limit of statistical significance (OR 0.44; I.C. 0.14-1.00). Carrying out the MNA resulted easy and quick, confirming the hypothesis for feasibility of this protocol in the Hygiene of Nutrition Services. The results highlight an high nutritional risk of the elderly nursing home residents and the importance of planning programs of nutritional surveillance with particular attention on masticatory function impairments, meal intake and on the oldest subjects among the elderly as a group greatly vulnerable. We believe that these areas are very important in defining public health intervention programs.