The hesitancy in the nutritional prevention

Abstract

Our letter discusses the concept of 'Nutritional Prevention Hesitancy', comparing it to the well-studied phenomenon of 'Vaccine Hesitancy'. Both hesitancies can be fueled by 'infodemics', the rapid spread of accurate and inaccurate information that can lead to public confusion and mistrust in authoritative sources. Drawing parallels between the two, the text highlights that nutritional prevention hesitancy can result in individuals not adopting evidence-based nutritional strategies, potentially leading to poorer health outcomes. The text emphasizes the critical role of diet in preventing diseases such as heart disease, diabetes, and certain types of cancer, and underscores the need for multifaceted strategies to combat misinformation and promote healthier dietary habits.

The "Nutritional Prevention" within Italy's National Prevention Plan 2020-25

Abstract

Italy's National Prevention Plan 2020-25 is the first to address nutritional prevention, highlighting its importance in combating chronic diseases. This letter discusses the relationship between food safety, nutritional security, and the need for nutritional prevention in the plan. Chronic diseases, such as cardiovascular disease, cancer, and diabetes, are significant public health concerns in Italy, with poor nutrition being a critical risk factor. Incorporating nutritional prevention can promote healthy eating habits, food security and sustainability, reduce healthcare costs, and promote social cohesion and equality. Successful implementation will require cooperation among the government, the private sector, and the civil society to ensure healthier food choices and prevent chronic diseases in Italy.

Effects of a behavioural approach on lifestyle habits in a healthy Italian population: a before-after interventional study

Background

The study aimed to assess the effectiveness of an educational intervention promoting adherence to healthy diet and physical activity.

Study design

Before-after interventional study.

Methods

Participants were healthy volunteers, 18-70 y old, from Bologna. They followed a training course consisting of seven meetings and signed a contract to comply with the promoted habits, verified through questionnaires at the engagement phase (T0), three months later (T1) and one year later (T2).

Results

One hundred, fifty-three subjects were involved, 75.8% were evaluated at T1 and 41.2% at T2. More than 80% of the subjects involved at T1 achieved an improvement of planned goals. Moreover, 77% of T1 compliants retained healthy eating and physical activity at T2.

Conclusions

The proposed pathway of empowerment positively affected nutrition and promotion of physical activity at 3 months after the intervention (T1) and were maintained even after a year. The results appear to be promising for primary prevention across the spectrum of a healthy lifestyle educational approach.

Effects of a behavioural approach on lifestyle habits: a before-after interventional study

Key messages

People are easier involved in empowerment paths aimed at fighting a single disease, for example cancer, but good results can be achieved simultaneously for all non-communicable diseases. Motivational communication for healthy eating, physical activity and stress prevention must become an integral part of the therapeutic diagnostic pathways of cancers and non-communicable diseases.

Effects of a school based intervention to promote healthy habits in children 8-11 years old, living in the lowland area of Bologna Local Health Unit

BACKGROUND

A school based health promotion intervention was performed with the aim of increasing physical activity and improving the dietary habits of primary school pupils, using integrated educational strategies involving schools, families, public bodies, sports associations and public health operators.

METHODS

The intervention concerned 11 classes during 3 school years from 2009-10 (231 third-year school children) to 2011-12 (234 fifth-year school children). Information was collected both before and after the intervention about the dietary habits and the physical activities practised by the children, using the questionnaires of the project !OKkio alla Salute! which were administered to both children and parents. At the same time anthropometric measurements were taken (height, weight, BMI) and motor skills were assessed using standardized tests: Sit & Reach, medicine-ball forward throw, standing long jump, 20 m running speed, and forward roll. At the end of the intervention 12 different expected outcomes were assessed (5 about dietary habits, 5 about motor habits, 1 about anthropometric characteristics, 1 about motor skills).

RESULTS

At baseline, 35.8% of the children show excess weight (23.4% overweight; 12.4% obese); this percentage falls to 29.3% (25.3% overweight; 4% obese) after the intervention (p <0.05). The dietary habits improve from the pre- to the post-intervention: there is a rise in the percentage of children who receive an adequate mid-morning snack (p <0.0001), a fall in the percentage of children who consume snacks and drinks after the dinner (p <0.01), and an increase in the percentage of those who take five or more portions of fruits and vegetables daily. The motor habits do not improve in the same way, since there is the increasing tendency with age to skip from a regular daily practice of physical exercise to favour of the occasional practice of a sport. The motor performances, compared after normalization for modifications due to the process of growth, improve between the third and fifth years of primary school, but with no significant differences. To achieve this objective more focused measures are necessary in the administration of moderate to intense physical exercise.

CONCLUSIONS

The results point to a positive assessment of the intervention, thus highlighting the importance of planning integrated and multisectorial actions in school-based programmes to promote correct dietary and motor habits and for the control of body weight, also involving non scholastic areas.

Feeding health: problems, opportunities, goals

Food security is when all people at all times have access to sufficient, safe, nutritious food to maintain a healthy and active life. On the one hand, the European Union Commission proposes new laws to achieve the highest possible levels of protection for human health and consumer interests in relation to food, plants and biodiversity. On the other hand, International Agencies (WHO, FAO, EU) pay attention to malnutrition and its consequences for health; poor people are usually the ones that suffer the consequences of underfeeding or dietary excess. In Italy, the mission of Food and Nutrition Services (Public Health National Service) is to promote food safety and good nutrition for the population; furthermore, they must pay attention to social equity. Suppressing or reducing their activity would be detrimental for public health and the national economy.

Microbial quality of drinking water from microfiltered water dispensers

A comparison was made between the microbial quality of drinking water obtained from Microfiltered Water Dispensers (MWDs) and that of municipal tap water. A total of 233 water samples were analyzed. Escherichia coli (EC), enterococci (ENT), total coliforms (TC), Staphylococcus aureus, Pseudomonas aeruginosa and heterotrophic plate count (HPC) at 22 °C and 37 °C were enumerated. In addition, information was collected about the principal structural and functional characteristics of each MWD in order to study the various factors that might influence the microbial quality of the water. EC and ENT were not detected in any of the samples. TC were never detected in the tap water but were found in 5 samples taken from 5 different MWDs. S. aureus was found in a single sample of microfiltered water. P. aeruginosa was found more frequently and at higher concentrations in the samples collected from MWDs. The mean HPCs at 22 °C and 37 °C were significantly higher in microfiltered water samples compared to those of the tap water. In conclusion, the use of MWDs may increase the number of bacteria originally present in tap water. It is therefore important to monitor the quality of the dispensed water over time, especially if it is destined for vulnerable users.

[Improving dietary habits in the effective prevention of excess weight and obesity]

The new research survey "Okkio alla salute", conducted in children in the 3rd year of elementary school, has confermed the worrisome phenomenon of the high number of obese and overweight children. Therefore, it is necessary, also in light of the few available resources, to fight back against this phenomenon that has been demonstrated to be a cause of disabling illnesses in adults. There must therefore be collaboration between Departments of Prevention and Hygiene and Nutrition services (SIAN) to build valid and efficient pathways. In this presentation we describe some national projects carried out by various local health agencies to address this health problem.

[Survey on sports practice and physical activity of primary school children living in the area of Bologna Local Health Unit in relation with some individual and environmental variables]

A randomized stratified sample of 522 children attending the third class of primary schools within the area of Bologna Local Health Unit was analysed for physical activity and sports practice. Information about the children's habits and availability of facilities for physical and sports activities were collected by means of structured questionnaires completed by children (507 respondents), parents (491), reference teachers for physical education (26) and class teachers (46) during the school year 2006-07. At the same time, the children's heights and weights were measured in order to calculate BMI values. Regular sports activity is practised by 80.1% of children (males: 82.4%, females: 77.6%), with significant diferences between genders only in children with at least one non-Italian parent (M>F, p < 0.05); the practice of sports is influenced by the area of residence (metropolitan > plain and hills, p < 0.05) and nationality (Italians > non-Italians, p < 0.01). Children with at least one actively sports practising parent are involved more frequently in sports activities (p < 0.001). In free time, sedentary activities are prevalent for both sports-practising children and not. However children not involved in regular sports activities tend to practise outdoor physical activities with a frequency significantly higher than children involved in sports (17.3% vs 10.4% of respondents). The percentage of completely sedentary children, who stated that they practise neither sports nor physical activity in their free time, is 7.3% (metropolitan area: 4.5%, hills: 8.7%, plain: 10.6%). The prevalence of overweight is 24.4%, of obesity 9.7%, with a better distribution of BMI values in the metropolitan area where there is the highest occurrence of positive conditions and behaviours: availability of sports facilities, the highest prevalence of sports practice, and the lowest prevalence of completely sedentary children.

[The commitment of the SIAN in the prevention of the obesity]

One of the main objectives of the National Plan of Prevention is prevention of overweight and obesity. The realization of such plan has been submitted at ASL level mostly to the Food and Nutrition Hygiene Services (SIAN) according to their competences, as well specified by the decree of October 16th 1998, which deals with the collective nutritional prevention and overseeing. In the following sections we present the experiences of some SIANs considered meaningful in order to offer a survey, along the whole country, of what already realised about prevention of the obesity and promotion of correct life styles.

Risk of infection associated with microbiological quality of public swimming pools in Bologna, Italy

Twelve public swimming pools in Bologna (Emilia-Romagna region, Italy) were investigated for the microbiological quality of water and surfaces of the pool edges, showers and changing rooms. At the same time a cross-sectional study was carried out on the health of 238 users (bathers) compared with 238 controls who practised sports other than swimming. Data regarding duration and frequency of exposure, behaviour and recent medical history were gathered by means of a questionnaire. All participants also underwent a medical examination. Compliance of the pool water to the microbiological standards set by Italian regulations was generally good; compliance was total when free chlorine residual was within the recommended limits. However, when analysis was extended to the various surfaces, potentially pathogenic bacteria such as P. aeruginosa and C. albicans were isolated. Eye burning and diarrhoea were the only declared symptoms and verrucas the only diagnosed disease showing statistically significant differences between bathers and controls. Verrucas tended to increase in proportion to exposure. Athlete's foot had a very high prevalence among both bathers (34 %) and controls (27.3%) and controls (27%). The environmental and epidemiological investigations both confirmed the risk of infection, mainly associated with the contamination of surfaces.

[Trends in blood lead levels in the population of the city of Bologna]

The aim of this study was to evaluate the blood lead levels in a sample of Bologna's population, 12 years after the previous screening campaign carried out in 1984. The investigated sample was divided, as in 1984, by age, sex, occupational exposure and selected life style factors. The blood lead levels presented a sharp reduction in comparison with the values observed in the previous study. In 1996, the 50 degrees, 90 degrees and 98 degrees percentile of blood lead were 50 micrograms/l, 90 micrograms/l and 140 micrograms/l whereas in 1984 they were 129 micrograms/l, 242 micrograms/l and 329 micrograms/l, respectively. Possibly, this result is related to a lower level of environmental lead pollution as a result of the increasing use of unleaded gasoline in new cars.

[Air pollution and health risk communication]

The risk communication processes concerning atmospheric pollution and health effects in Modena, Reggio Emilia and Bologna, are described from the public health service point of view. The description includes the chronological developments, the principal events which influenced, or have been influenced by these risk communication processes, their most significant and critical aspects. Finally the air quality evaluation and its impact on risk communication is discussed.