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Biolo G.,University of Trieste | Di Girolamo F.G.,University of Trieste | Breglia A.,University of Trieste | Chiuc M.,University of Trieste | And 9 more authors.
Clinical Nutrition | Year: 2015

Background & aims: Sarcopenic obesity may be defined by a high fat to fat-free mass (FM/FFM) ratio. Skeletal muscle may be negatively influenced by the pro-inflammatory milieu associated with visceral fat, while the loading effect induced by a heavier body mass index (BMI) may enhance muscle anabolism. Recently, a new anthropometric measure based on waist circumference (A Body Shape Index, ABSI) was developed. In this study we have assessed the predictive power of ABSI on the FFM index (FFMI), a surrogate marker of lean mass. Methods: Standard anthropometric parameters and ABSI as well as body composition data (fat and fat-free mass determined by bioelectrical impedance analysis) were assessed in 111 female and 89 male overweight/obese subjects, with no clinically significant co-morbidities. Groups with higher- or lower-ABSI were identified according to median values of this index. Results: In women and men, ABSI did not correlate with BMI, while multiple linear regression indicated that BMI (β-coefficients: 0.62 and 0.77, respectively) and ABSI (β-coefficients:-0.26 and-0.22, respectively) independently predicted FFMI (multiple R: 0.72 and 0.83, respectively, P<0.001). Men and women with lower-ABSI exhibited significantly greater FFMI than the higher-ABSI groups for comparable values of BMI. In men, ABSI was correlated positively with C-reactive protein (CRP) (R=0.30; P<0.05) and negatively with the reciprocal of insulin (R=0.28; P<0.05), an index of insulin sensitivity. FM/FFM ratio significantly (P<0.01) correlated with CRP (R=0.31) in women only. Conclusions: ABSI, a recently introduced marker of abdominal adiposity, may contribute to define the risk of sarcopenia in overweight/obese individuals. © 2014. Source

Cena H.,University of Pavia | Roggi C.,University of Pavia | Lucchin L.,Dietetic and Clinical Nutrition Unit | Turconi G.,University of Pavia
Nutrition Reviews | Year: 2010

The increasing need for nutrition professionals is driven by growing public interest in nutrition and the potential of nutrition to prevent and treat a variety of diet-related conditions. Health promotion units and health services face great challenges in trying to address current and future population health issues. This review describes the present state of health nutrition practice in Italy, exploring the nature, role, and utility of training for nutrition professionals to meet the increasing burden of nutrition-related diseases. Evidence suggests that the public health nutrition workforce and infrastructures lack the necessary capacity to respond to national population needs regarding food and nutrition at many levels. This situation is aggravated by the growing prevalence of nutrition-related diseases as well as by the lack of adequate academic nutrition training. The public health nutrition infrastructures need to be enhanced, as do the education and training systems. Roles and functions in health nutrition practice need to be defined and discipline-specific competencies should be integrated. © 2010 International Life Sciences Institute. Source

Cereda E.,Nutrition and Dietetics Service | Cereda E.,Parkinson Institute Istituti Clinici Of Perfezionamento | Barichella M.,Parkinson Institute Istituti Clinici Of Perfezionamento | Pedrolli C.,Dietetic and Clinical Nutrition Unit | And 4 more authors.
Diabetes Care | Year: 2011

OBJECTIVE - Diabetes has been associated with chronic neurodegeneration.We performed a systematic review and meta-analysis to assess the relationship between pre-existing diabetes and Parkinson's disease (PD). RESEARCH DESIGNANDMETHODS - Original articles in English published up to 10 May 2011 were searched for in electronic databases (PubMed, Embase, and Scopus) and by reviewing references of eligible articles. Prospective cohort and case-control studies providing risk and precision estimates relating to pre-existing diabetes and PD were considered eligible. RESULTS - Nine studies/1,947 citations (cohort, N = 4; case-control, N = 5) fulfilled inclusion criteria for meta-analysis. In prospective studies, the onset of diabetes before onset of PD was found to be a risk factor for future PD (relative risk [RR] = 1.37 [95%CI 1.21-1.55]; P<0.0001). This association was confirmed by secondary analyses based on estimates derived after the exclusion of participants who had vascular disease at baseline and/or who developed vascular disease during follow-up (RR = 1.34 [1.14-1.58]; P<0.001) and by sensitivity analyses addressing the association with diabetes at baseline or during follow-up. However, the association found for case-control studies was not significant (odds ratio [OR] 0.75 [95%CI 0.50-1.11]; P = 0.835). Sensitivity analysis based on estimates adjusted for BMI confirmed the lack of a relationship between PD and diabetes (OR 0.56 [0.28-1.15]; P = 0.089). CONCLUSIONS - Although data from cohort studies suggest that diabetes is a risk factor for PD, there is no conclusive evidence on this association. Further prospective studies focused on putative pathogenic pathways and taking a broad range of confounders into account is required to clarify this relationship. © 2011 by the American Diabetes Association. Source

Pedrolli C.,Dietetic and Clinical Nutrition Unit | Sacchi M.C.,Azienda Ospedaliera di Lecco | Togni M.,Gastroenterology and Digestive Endoscopy Unit | Cereda E.,Nutrition and Dietetics Service
International Journal of Eating Disorders | Year: 2015

Bulimia nervosa is an eating disorder defined by recurrent episodes of binge eating followed by compensatory behaviors, primarily self-induced vomiting. Most common complications are due to purge behaviors and are frequently responsible for hospitalization. These include electrolyte disturbances, dehydration, hypovolemia, stomatitis, esophageal diseases, and functional impairment of the colon. However, an obstruction-like syndrome has never been reported. We report the case of a middle-age woman suffering from bulimia nervosa and referring at the emergency department with a 7-day story of hyperemesis responsible for an acute renal failure. During hospitalization, after the most important and common medical causes of hyperemesis were excluded, an upper gastrointestinal endoscopy was performed. The endoscopist reported the presence of an impressive bezoar, which underwent to mechanical fragmentation and biopsy sampling, revealing it was made up exclusively of liquorice wheels. An endoscopy performed few days after showed the complete dissolution of the bezoar, and the patient was discharged without any further gastrointestinal complaint. © 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:446-448) © 2014 Wiley Periodicals, Inc. Source

Cereda E.,Nutrition and Dietetics Service | Pedrolli C.,Dietetic and Clinical Nutrition Unit | Klersy C.,Biometry and Clinical Epidemiology Service | Bonardi C.,Nutrition and Dietetics Service | And 5 more authors.
Clinical Nutrition | Year: 2016

Background & aims: Old persons are more likely to suffer from malnutrition, which may result in higher dependency in activities of daily living. We aimed to provide a quantitative synthesis of prevalence data on malnutrition and its risk as assessed by the Mini Nutritional Assessment across different healthcare settings. The association between nutritional status and setting-related level of dependence was also investigated. Methods: Non-interventional studies published as full-text articles in English up to 31th December 2014 were searched for in PubMed and by reviewing references of eligible articles. Meta-analysis and meta-regression of potential sources of heterogeneity were conducted. Results: A total of 240 studies/795 citations - providing 258 setting-specific prevalence estimates (113,967 subjects) - fulfilled inclusion criteria for meta-analysis. Prevalence of malnutrition differed significantly across the healthcare settings considered: community, 4.0% (95%CI, 2.7-5.4); outpatients, 4.9% (95%CI, 3.4-6.5); home-care services, 9.9% (95%CI, 5.7-14.0); hospital, 22.3% (95%CI, 18.2-26.5); nursing homes, 15.2% (95%CI, 10.9-19.4); long-term care, 30.0% (95%CI, 20.9-39.0); rehabilitation/sub-acute care, 32.5% (95%CI, 22.5-42.5).For every setting significant heterogeneity in individual study results was observed (I 2 ≥80%, P < 0.001) and meta-regression showed that study quality was the most important determinant. Finally, meta-regression of all the studies included showed that both malnutrition and its risk were directly associated with the setting-related level of dependence (P < 0.001). However, despite multiple adjustments, residual heterogeneity remained high. Conclusion: We provided updated estimates of malnutrition and its risk in different healthcare settings. Although the level of dependence appears to be an important determinant, heterogeneity in individual study results remained substantially unexplained. The cause-effect relationship between nutritional status and level of dependence deserves further investigation. © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. Source

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