1
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Rotolo O, Zinzi I, Veronese N, Cisternino AM, Reddavide R, Inguaggiato R, Leandro G, Notarnicola M, Tutino V, De Nunzio V, De Leonardis G, Guerra V, Donghia R, Fucilli F, Licinio R, Mastrosimini A, Rinaldi CCM, Daddabbo T, Giampaolo N, Iacovazzi PA, Giannico S, Caruso MG. Women in LOVe: Lacto-Ovo-Vegetarian Diet Rich in Omega-3 Improves Vasomotor Symptoms in Postmenopausal Women. An Exploratory Randomized Controlled Trial. Endocr Metab Immune Disord Drug Targets 2020; 19:1232-1239. [PMID: 31132980 DOI: 10.2174/1871530319666190528101532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 04/10/2019] [Accepted: 04/11/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVES In the postmenopausal period, most women suffer vasomotor symptoms (VMS). It is well-known that VMS can worsen the quality of life. Diet seems to play a relevant role in the development of VMS, but the effect of diet on VMS is mainly limited to observational studies, and analyses of nutritional supplements. The aim of this study was thus to determine the efficacy of a lactoovo- vegetarian (LOVe) diet rich in omega-3 fatty acids vs. a lacto-ovo-vegetarian diet rich in EVO (extra-virgin olive oil) in reducing VMS frequency in postmenopausal women. METHODS A two-arms (lacto-ovo-vegetarian diet with EVO vs. lacto-ovo-vegetarian diet rich in omega-3) randomized-controlled trial with a follow-up period of 16 weeks. We considered as primary outcome the change in the Kupperman index (follow-up vs. baseline evaluation, reported as delta, D) and in its subscales. Secondary outcomes included changes in common anthropometric and biohumoral measurements. RESULTS Among 54 women randomly assigned to a study group, 40 (mean age 55.1±5.4 years) completed the study and complied with their assigned diet. Women randomized to the omega-3 group (n=18) showed significant improvements, compared to the EVO group (n=22), in Kupperman index (Δ=-11.4±9.8 vs. -5.9±8.2; p=0.045), hot flashes (Δ=-3.3±3.4 vs. -1.3±2.6; p=0.04), and a marginally significant improvement in nervousness (Δ=-1.7±1.7 vs. -0.8±1.5; p=0.07). No significant differences were observed for the secondary outcomes. No relevant side effects were reported. CONCLUSION After 16 weeks, a lacto-ovo-vegetarian diet rich in omega-3 reduced VMS frequency in postmenopausal women more than the lacto-ovo-vegetarian diet rich in EVO.
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Affiliation(s)
- Ornella Rotolo
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Iris Zinzi
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Nicola Veronese
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Anna M Cisternino
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Rosa Reddavide
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Rosa Inguaggiato
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Gioacchino Leandro
- Unit of Gastrenterology 1, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Maria Notarnicola
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Valeria Tutino
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Valentina De Nunzio
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Giampiero De Leonardis
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Vito Guerra
- Unit of Epidemiology and Biostatistics, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Rossella Donghia
- Unit of Gastrenterology 1, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Fabio Fucilli
- Unit of Radiology, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Raffaella Licinio
- Unit of Radiology, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Anna Mastrosimini
- Laboratory of Clinical Pathology, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Caterina C M Rinaldi
- Unit of Radiology, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Tiziana Daddabbo
- Unit of Radiology, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Nicola Giampaolo
- Unit of Radiology, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Palma A Iacovazzi
- Laboratory of Clinical Pathology, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Sara Giannico
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
| | - Maria G Caruso
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy.,Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology, Research Hospital, IRCCS "Saverio de Bellis" of Castellana Grotte (BA), Italy
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2
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Veronese N, Notarnicola M, Cisternino AM, Inguaggiato R, Guerra V, Reddavide R, Donghia R, Rotolo O, Zinzi I, Leandro G, Tutino V, Misciagna G, Caruso MG. Trends in adherence to the Mediterranean diet in South Italy: A cross sectional study. Nutr Metab Cardiovasc Dis 2020; 30:410-417. [PMID: 31822430 DOI: 10.1016/j.numecd.2019.11.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 11/02/2019] [Accepted: 11/04/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND AIMS Increasing literature data show that adherence to the Mediterranean diet is undergoing profound changes in recent years, albeit with marked differences across nations. In Italy, one of the cradles of the Mediterranean diet, the literature regarding the trend for Mediterranean diet adherence is conflicting. Thus, we aimed to explore the trends of adherence to the Mediterranean diet in a large cohort of participants living in South Italy, over 20 years from 1985-86 to 2005-06. METHODS AND RESULTS Cross-sectional study with two evaluations, one made in 1985-86 and another in 2005-06; all participants were adults aged 30-70 years of age. The adherence to the Mediterranean diet was evaluated using the score proposed by Panagiotakos et al. This score features values ranging from 0 to 55, higher scores reflecting a greater adherence. The data are reported by age (30-49 vs. 50-69 years). Overall, 2451 subjects were included in 1985-86 and 2375 in 2005-06. A significant reduction was observed in the adherence to the Mediterranean diet (age 30-49 years: 31.82 ± 4.18 in 1985-86 vs. 29.20 ± 4.48 in 2005-06, reduction by 8.2%, p < 0.0001; age 50-69: 32.20 ± 4.09 in 1985-86 vs.30.15 ± 4.27 in 2005-06, reduction by 6.3%, p < 0.0001). Among all these items, the most dramatic change was observed for olive oil consumption, that decreased by 2.35 points in younger and 0.89 in older people. CONCLUSION The adherence to the Mediterranean diet decreased from 1985-86 to 2005-06 in South Italy, particularly in younger people, above all due to a decreased olive oil consumption.
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Affiliation(s)
- Nicola Veronese
- Laboratory of Nutritional Biochemistry, Castellana Grotte, Bari, Italy; Ambulatory of Clinical Nutrition, Castellana Grotte, Bari, Italy.
| | - Maria Notarnicola
- Laboratory of Nutritional Biochemistry, Castellana Grotte, Bari, Italy
| | | | - Rosa Inguaggiato
- Ambulatory of Clinical Nutrition, Castellana Grotte, Bari, Italy
| | - Vito Guerra
- Clinical Trial Unit, Castellana Grotte, Bari, Italy
| | - Rosa Reddavide
- Ambulatory of Clinical Nutrition, Castellana Grotte, Bari, Italy
| | | | - Ornella Rotolo
- Ambulatory of Clinical Nutrition, Castellana Grotte, Bari, Italy
| | - Iris Zinzi
- Ambulatory of Clinical Nutrition, Castellana Grotte, Bari, Italy
| | - Gioacchino Leandro
- Ambulatory of Clinical Nutrition, Castellana Grotte, Bari, Italy; Unit of Gastroenterology, Castellana Grotte, Bari, Italy
| | - Valeria Tutino
- Laboratory of Nutritional Biochemistry, Castellana Grotte, Bari, Italy
| | - Giovanni Misciagna
- Scientific and Ethical Committee-National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Maria G Caruso
- Laboratory of Nutritional Biochemistry, Castellana Grotte, Bari, Italy; Ambulatory of Clinical Nutrition, Castellana Grotte, Bari, Italy
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3
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Veronese N, Cisternino AM, Shivappa N, Hebert JR, Notarnicola M, Reddavide R, Inguaggiato R, Guerra V, Logroscino A, Rotolo O, Chiloiro M, Leandro G, De Leonardis G, Tutino V, Misciagna G, Fontana L, Caruso MG. Dietary inflammatory index and mortality: a cohort longitudinal study in a Mediterranean area. J Hum Nutr Diet 2019; 33:138-146. [PMID: 31829488 DOI: 10.1111/jhn.12701] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Higher Dietary Inflammatory Index (DII®) scores are associated with increased morbidity and mortality. However, little is known about the effects of DII on mortality in Mediterranean countries. Therefore, in the present study, we aimed to investigate the potential association between DII scores and overall, cancer and cardiovascular disease (CVD) mortality in people living in a Mediterranean area. METHODS DII scores were calculated using a validated food-frequency questionnaire. DII scores were then categorised into tertiles. Mortality was ascertained via death certificates. The association between DII scores with overall and cause-specific mortality was assessed via a multivariable Cox's regression analysis and reported as hazard ratios (HRs) with their 95% confidence intervals (CIs). RESULTS The study included 1565 participants (mean age 65.5 years; females 44.7%). After a median follow-up of 12 years (2005-2017), 366 (23.4%) participants died. After adjusting for 17 potential confounders, people with higher DII scores had an increased risk of death compared to those in the lowest (most anti-inflammatory) tertile (HR = 1.38; 95% CI = 1.04-1.82 for the second tertile; HR = 1.38; 95% CI = 1.03-1.86 for the third tertile). Each 1 SD increase in DII score increased the risk of death by 13%. No association was found between DII scores and cancer or CVD death when considered separately. CONCLUSIONS Higher DII scores were associated with a significantly higher mortality risk, whereas the association with cause-specific mortality was less clear. These findings highlight the potential importance of diet in modulating inflammation and preventing death.
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Affiliation(s)
- N Veronese
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy.,Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - A M Cisternino
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - N Shivappa
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Connecting Health Innovations LLC, Columbia, SC, USA
| | - J R Hebert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Connecting Health Innovations LLC, Columbia, SC, USA
| | - M Notarnicola
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - R Reddavide
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - R Inguaggiato
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - V Guerra
- Clinical Trial Unit, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - A Logroscino
- Thoracic Medical Oncology, I.R.C.C.S. 'Giovanni Paolo II', Bari, Italy
| | - O Rotolo
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - M Chiloiro
- Radiology Unit, Hospital San Giacomo, Bari, Italy
| | - G Leandro
- Unit of Gastroenterology, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - G De Leonardis
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy.,Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - V Tutino
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
| | - G Misciagna
- Scientific and Ethical Committee, University Hospital Policlinico, Bari, Italy
| | - L Fontana
- Central Clinical School and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.,Department of Clinical and Experimental Sciences, Brescia University Medical School, Brescia, Italy
| | - M G Caruso
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy.,Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology 'S. De Bellis' Research Hospital, Bari, Italy
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4
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Caruso MG, Veronese N, Notarnicola M, Cisternino AM, Reddavide R, Inguaggiato R, Guerra V, Donghia R, Logroscino A, Rotolo O, Chiloiro M, Leandro G, De Leonardis G, Tutino V, Misciagna G, Bonfiglio C, Guerra R, Osella A. Fatty liver and mortality: a cohort population study in South Italy. BMJ Open 2019; 9:e027379. [PMID: 31227533 PMCID: PMC6596964 DOI: 10.1136/bmjopen-2018-027379] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE Alcoholic fatty liver (AFLD) and non-alcoholic fatty liver (NAFLD) are two common conditions. However, if they can increase the risk of death is poorly explored. We therefore aimed to investigate the potential association between the presence and severity of liver steatosis and mortality in a large sample of older people. DESIGN Prospective. SETTING Community. PARTICIPANTS Women and men randomly sampled from the electoral rolls of the population of Castellana Grotte, a town in Southern Italy (Apulia region) between 2005 and 2006. Among 1942 initially contacted, 1708 (=87.9%) participated to the baseline survey (Multicentrica Colelitiasi III (MICOL III)). This specific study included 1445 older participants (mean age=65.2 years, females=44.2%). EXPOSURE NAFLD or AFLD. PRIMARY AND SECONDARY OUTCOMES Mortality (all-cause and specific-cause). RESULTS After a median of 12 years, 312 participants (=21.6%) died. After adjusting for nine potential confounders, the presence of steatosis was not associated with any increased risk of death in both NAFLD and AFLD. The severity of liver steatosis was not associated with any increased risk of mortality in NAFLD, while in AFLD, the presence of moderate steatosis significantly increased the risk of overall (HR=2.16; 95% CI 1.19 to 3.91) and cancer-specific (HR=3.54; 95% CI 1.16 to 10.87) death. CONCLUSIONS Liver steatosis is not associated with any increased risk of death in NAFLD, while moderate steatosis could be a risk factor for mortality (particularly due to cancer) in people affected by AFLD.
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Affiliation(s)
- Maria Gabriella Caruso
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Nicola Veronese
- Istituto di Neuroscienze Consiglio Nazionale delle Ricerche, Padova, Italy
| | - Maria Notarnicola
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Anna Maria Cisternino
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Rosa Reddavide
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Rosa Inguaggiato
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Vito Guerra
- Clinical Trial Unit, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Rossella Donghia
- Clinical Trial Unit, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Antonio Logroscino
- I.R.C.C.S. "Giovanni Paolo II", Thoracic Medical Oncology, Castellana Grotte, Italy
| | - Ornella Rotolo
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Marisa Chiloiro
- Radiology Unit, National Institute for Digestive Disease, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Gioacchino Leandro
- Gastroenterological Hospital, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Giampiero De Leonardis
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Valeria Tutino
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - G Misciagna
- Epidemiology, National Institute of Gastroenterology-Research Hospital, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Caterina Bonfiglio
- Laboratory of Biostatistics and Epidemiology, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Rocco Guerra
- Laboratory of Biostatistics and Epidemiology, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Alberto Osella
- Laboratory of Biostatistics and Epidemiology, IRCCS "Saverio de Bellis", Castellana Grotte, Italy
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5
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Veronese N, Notarnicola M, Osella AR, Cisternino AM, Reddavide R, Inguaggiato R, Guerra V, Rotolo O, Zinzi I, Chiloiro M, Leandro G, Correale M, Tutino V, Misciagna G, Bonfiglio C, Caruso MG. Menopause Does Not Affect Fatty Liver Severity In Women: A Population Study in a Mediterranean Area. Endocr Metab Immune Disord Drug Targets 2019; 18:513-521. [PMID: 29692271 DOI: 10.2174/1871530318666180423101755] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 02/23/2018] [Accepted: 03/29/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Estrogens could protect the liver from fatty degeneration, but there is little information about whether menopause is associated with the severity of alcoholic (AFL) and non-alcoholic fatty liver (NAFL). Our aim was to evaluate the distribution of fatty liver detected by ultrasound in pre- and post-menopausal women and the factors associated with these conditions. METHODS In this cross-sectional study, the years from menopause were investigated through selfreported information. The degree of fatty liver was assessed through a standardized ultrasound examination (scores 0 to 6, higher values reflecting a greater severity). Liver steatosis was classified as NAFL or AFL based on a daily alcohol intake > 20g/d. RESULTS The study included 752 women in menopause and 535 in pre-menopause. The years from menopause were not associated with the severity of liver steatosis in NAFL (p for trend=0.74; Spearman correlation=0.04; 95%CI: -0.09 to 0.17), whereas all the indexes of adiposity and the number of metabolic syndrome factors were associated with a higher liver steatosis score. Taking AFL liver steatosis as the outcome, the years since menopause were not significantly associated with liver steatosis in AFL (p for trend=0.50; Spearman correlation=0.09; 95%CI: -0.17 to 0.34), whilst the association between anthropometric parameters and liver steatosis severity resulted stronger in postmenopausal compared to pre- menopausal women. CONCLUSION the higher prevalence of fatty liver observed in post-menopausal women is probably not due to menopause per se, but to the adiposity (particularly abdominal) typical of this age and its consequences (such as metabolic syndrome).
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Affiliation(s)
- Nicola Veronese
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy.,Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Maria Notarnicola
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Alberto Ruben Osella
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Anna Maria Cisternino
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Rosa Reddavide
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Rosa Inguaggiato
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Vito Guerra
- Clinical Trial Unit, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Ornella Rotolo
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Iris Zinzi
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Marisa Chiloiro
- Unit of Radiology, Hospital San Giacomo, Monopoli, Bari, Italy
| | - Gioacchino Leandro
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy.,Unit of Gastroenterology, National Institute of Gastroenterology- Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Mario Correale
- Laboratory of Clinical Pathology, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Valeria Tutino
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Giovanni Misciagna
- Scientific and Ethical Committee, University Hospital Policlinico, Bari, Italy
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Biostatistics, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
| | - Maria Gabriella Caruso
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy.,Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy
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6
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Veronese N, Notarnicola M, Cisternino AM, Reddavide R, Inguaggiato R, Guerra V, Rotolo O, Zinzi I, Leandro G, Correale M, Tutino V, Misciagna G, Osella AR, Bonfiglio C, Giannelli G, Caruso MG. Coffee Intake and Liver Steatosis: A Population Study in a Mediterranean Area. Nutrients 2018; 10:nu10010089. [PMID: 29342916 PMCID: PMC5793317 DOI: 10.3390/nu10010089] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 01/10/2018] [Accepted: 01/11/2018] [Indexed: 12/21/2022] Open
Abstract
Coffee drinking seems to have several beneficial effects on health outcomes. However, the effect on hepatic steatosis, depending on a high alcohol consumption (AFLD, alcoholic fatty liver disease) or on metabolic factors (non-alcoholic fatty liver disease, NAFLD), is still equivocal. Thus, we aimed to explore the potential association between coffee consumption and the presence and severity of hepatic steatosis in people with NAFLD or AFLD. In this cross-sectional study, coffee drinking was recorded using a semi-quantitative food frequency questionnaire, and categorized as yes vs. no and as 0, 1, 2, ≥3. The degree of fatty liver was assessed through a standardized ultrasound examination (score 0 to 6, with higher values reflecting higher severity). Liver steatosis was classified as NAFLD or AFLD on daily alcohol intake >30 g/day for men and >20 g/day for women. This study included 2819 middle-aged participants; the great majority were coffee drinkers (86.1%). After adjusting for 12 potential confounders, drinking coffee was not associated with decreased odds for NAFLD (n = 916) (odds ratio, OR = 0.93; 95% confidence intervals, CI: 0.72-1.20) or AFLD (n = 276) (OR = 1.20; 95% CI: 0.66-2.0). The consumption of coffee (categorized as yes vs. no), or an increased consumption of coffee were not associated with the presence of mild, moderate or severe liver steatosis in either NAFLD or AFLD. In conclusion, coffee intake was not associated with any lower odds of hepatic steatosis in either non-alcoholic or alcoholic forms in this large cohort of South Italian individuals.
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Affiliation(s)
- Nicola Veronese
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
- National Research Council, Neuroscience Institute, Aging Branch, 35128 Padova, Italy.
| | - Maria Notarnicola
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Anna Maria Cisternino
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Rosa Reddavide
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Rosa Inguaggiato
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Vito Guerra
- Clinical Trial Unit, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Ornella Rotolo
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Iris Zinzi
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Gioacchino Leandro
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
- Unit of Gastroenterology, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Mario Correale
- Laboratory of Clinical Pathology, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Valeria Tutino
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Giovanni Misciagna
- Scientific and Ethical Committee, University Hospital Policlinico, 70124 Bari, Italy.
| | - Alberto Ruben Osella
- National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Caterina Bonfiglio
- National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Gianluigi Giannelli
- National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Maria Gabriella Caruso
- Ambulatory of Clinical Nutrition, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
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Misciagna G, Del Pilar Díaz M, Caramia DV, Bonfiglio C, Franco I, Noviello MR, Chiloiro M, Abbrescia DI, Mirizzi A, Tanzi M, Caruso MG, Correale M, Reddavide R, Inguaggiato R, Cisternino AM, Osella AR. Effect of a Low Glycemic Index Mediterranean Diet on Non-Alcoholic Fatty Liver Disease. A Randomized Controlled Clinici Trial. J Nutr Health Aging 2017; 21:404-412. [PMID: 28346567 DOI: 10.1007/s12603-016-0809-8] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Non-Alcoholic Fatty Liver Disease (NAFLD) is currently the most common form of liver disease worldwide affecting all ages and ethnic groups and it has become a consistent threat even in young people. Our aim was to estimate the effect of a Low Glycemic Index Mediterranean Diet (LGIMD) on the NAFLD score as measured by a Liver Ultrasonography (LUS). DESIGN NUTRIzione in EPAtologia (NUTRIEPA) is a population-based Double-Blind RCT. Data were collected in 2011 and analyzed in 2013-14. SETTING/PARTICIPANTS 98 men and women coming from Putignano (Puglia, Southern Italy) were drawn from a previous randomly sampled population-based study and identified as having moderate or severe NAFLD. INTERVENTION The intervention strategy was the assignment of a LGIMD or a control diet. OUTCOME MEASURES The main outcome measure was NAFLD score, defined by LUS. RESULTS After randomization, 50 subjects were assigned to a LGIMD and 48 to a control diet. The study lasted six months and all participants were subject to monthly controls/checks. Adherence to the LGIMD as measured by Mediterranean Adequacy Index (MAI) showed a median of 10.1. A negative interaction between time and LGIMD on the NAFLD score (-4.14, 95% CI -6.78,-1.49) was observed, and became more evident at the sixth month (-4.43, 95%CI -7.15, -1.71). A positive effect of the interaction among LGIMD, time and age (Third month: 0.07, 95% CI 0.02, 0.12; Sixth month: 0.08, 95% CI 0.03,0.13) was also observed. CONCLUSIONS LGIMD was found to decrease the NAFLD score in a relatively short time. Encouraging those subjects who do not seek medical attention but still have NAFLD to follow a LGIMD and other life-style interventions, may reduce the degree of severity of the disease. Dietary intervention of this kind, could also form the cornerstone of primary prevention of Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease.
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Affiliation(s)
- G Misciagna
- Alberto Rubén Osella, PhD, Laboratory of Epidemiology and Biostatistics, IRCCS Saverio de Bellis, Via Turi 27, 70013 Castellana Grotte (BA), Italy, Tel: +39 0804994655, Fax: +39 0804994650, e-mail:
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Rizzi M, Mazzuoli S, Regano N, Inguaggiato R, Bianco M, Leandro G, Bugianesi E, Noè D, Orzes N, Pallini P, Petroni ML, Testino G, Guglielmi FW. Undernutrition, risk of malnutrition and obesity in gastroenterological patients: A multicenter study. World J Gastrointest Oncol 2016; 8:563-572. [PMID: 27559436 PMCID: PMC4942745 DOI: 10.4251/wjgo.v8.i7.563] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 03/23/2016] [Accepted: 04/22/2016] [Indexed: 02/05/2023] Open
Abstract
AIM: To investigate the prevalence of undernutrition, risk of malnutrition and obesity in the Italian gastroenterological population.
METHODS: The Italian Hospital Gastroenterology Association conducted an observational, cross-sectional multicenter study. Weight, weight loss, and body mass index were evaluated. Undernutrition was defined as unintentional weight loss > 10% in the last three-six months. Values of Malnutrition Universal Screening Tool (MUST) > 2, NRS-2002 > 3, and Mini Nutritional Assessment (MNA) from 17 to 25 identified risk of malnutrition in outpatients, inpatients and elderly patients, respectively. A body mass index ≥ 30 indicated obesity. Gastrointestinal pathologies were categorized into acute, chronic and neoplastic diseases.
RESULTS: A total of 513 patients participated in the study. The prevalence of undernutrition was 4.6% in outpatients and 19.6% in inpatients. Moreover, undernutrition was present in 4.3% of the gastrointestinal patients with chronic disease, 11.0% of those with acute disease, and 17.6% of those with cancer. The risk of malnutrition increased progressively and significantly in chronic, acute and neoplastic gastrointestinal diseases in inpatients and the elderly population. Logistical regression analysis confirmed that cancer was a risk factor for undernutrition (OR = 2.7; 95%CI: 1.2-6.44, P = 0.02). Obesity and overweight were more frequent in outpatients.
CONCLUSION: More than 63% of outpatients and 80% of inpatients in gastroenterological centers suffered from significant changes in body composition and required specific nutritional competence and treatment.
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Chiloiro M, Caruso MG, Cisternino AM, Inguaggiato R, Reddavide R, Bonfiglio C, Guerra V, Notarnicola M, De Michele G, Correale M, Noviello MR, Misciagna G. Ultrasound evaluation and correlates of fatty liver disease: a population study in a Mediterranean area. Metab Syndr Relat Disord 2013; 11:349-58. [PMID: 23758075 DOI: 10.1089/met.2012.0169] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the distribution of fatty liver-nonalcoholic (NAFL) and alcoholic (AFL)-and its association with metabolic syndrome and its components in a population sample from a Mediterranean area. METHODS A sample of 2974 subjects (1679 males, 1295 females, age range 30-89 years) was randomly drawn from the population of a town in southern Italy. The survey visit included a validated semiquantitative food frequency questionnaire, anthropometric measurements, a blood sample taken in the morning after overnight fasting, as well as abdominal ultrasound examination to evaluate liver fat with a standardized scoring system. The 2001 National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) definition of the metabolic syndrome was adopted. RESULTS In this Mediterranean population, where alcohol intake is mostly as wine with meals, NAFL is present in 36.8% of men and 25.7% of women and AFL in 13.8% of men and 5.5% of women. NAFL and AFL are associated with metabolic syndrome and its characteristics, body mass index (BMI), and visceral and subcutaneous fat (in AFL subjects, only in women) measured by ultrasound. Stratifying by BMI and controlling for confounders (age, height, smoking habit, and alcohol consumption), in overweight and obese subjects, liver and visceral fat are associated with the metabolic syndrome both in men and women and subcutaneous fat only in women. In normal weight subjects, only liver fat in men is associated with the metabolic syndrome. CONCLUSIONS Fatty liver is highly prevalent in this Mediterranean population and is associated with metabolic syndrome in overweight and obese men and women as well as in men with normal BMI.
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Affiliation(s)
- Marisa Chiloiro
- 1 Radiology Unit, National Institute for Digestive Disease , IRCCS "S. de Bellis," Castellana, Bari, Italy
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Pierucci P, Misciagna G, Ventura MT, Inguaggiato R, Cisternino AM, Guerra VMB, Suppressa P, Resta F, Sabbà C. Diet and myocardial infarction: a nested case-control study in a cohort of elderly subjects in a Mediterranean area of southern Italy. Nutr Metab Cardiovasc Dis 2012; 22:727-733. [PMID: 21482083 DOI: 10.1016/j.numecd.2010.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Revised: 12/07/2010] [Accepted: 12/09/2010] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIM We evaluated the incidence of myocardial infarction (MI) in a population of Southern Italy and the relationship of dietary macronutrients with incident MI. METHODS AND RESULTS The ONCONUT cohort included 5632 subjects followed-up, over 50 years, recruited in 1992. At baseline, they completed a validated semi-quantitative food frequency questionnaire and gave details of their medical history. After 5years they were traced by their family physician, who found 108 incident MI. Ninety-seven of them and 194 controls, sampled from the noncases at baseline and paired for diabetes to the cases, entered this nested case-control study. MI rate per 1000 person-years was 9.6 in males and 3.7 in females. In non-diabetics, saturated fat were associated with MI directly (odds ratio (OR): tertile 2 vs. 1 = 2.32, tertile 3 vs. 1 = 2.82; chi-square for trend, p = 0.03) and polyunsaturated fats inversely (OR: tertile 2 vs. 1 = 0.80, tertile 3 vs. 1 = 0.37; chi-square for trend, p = 0.05), while in diabetics, starchy carbohydrates (OR: tertile 2 vs. 1 = 1.51, tertile 3 vs. 1 = 6.73; chi-square for trend, p = 0.01) and glycaemic index (OR: tertile 2 vs. 1 = 2.74, tertile 3 vs. 1 = 5.34; chi-square for trend, p = 0.01) were associated directly with MI. CONCLUSIONS MI incidence in this population was lower than that found in northern countries. In non-diabetics, saturated fats were associated directly and polyunsaturated fat inversely with MI; in diabetics, starchy carbohydrates and high-glycaemic-index foods were associated directly with MI.
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Affiliation(s)
- P Pierucci
- Department of Geriatrics and Rare Diseases, University of Bari, Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
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