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Spagnolo A.,ISFOL | Giussani M.,Pediatra di Famiglia | Ambruzzi A.M.,Pediatra nutrizionista | Bianchetti M.,Bellinzona Hospitals | And 9 more authors.
Italian Journal of Pediatrics | Year: 2013

Abstract. The European Society of Hypertension has recently published its recommendations on prevention, diagnosis and treatment of high blood pressure in children and adolescents. Taking this contribution as a starting point the Study Group of Hypertension of the Italian Society of Pediatrics together with the Italian Society of Hypertension has conducted a reappraisal of the most recent literature on this subject. The present review does not claim to be an exhaustive description of hypertension in the pediatric population but intends to provide Pediatricians with practical and updated indications in order to guide them in this often unappreciated problem. This document pays particular attention to the primary hypertension which represents a growing problem in children and adolescents. Subjects at elevated risk of hypertension are those overweight, with low birth weight and presenting a family history of hypertension. However, also children who do not present these risk factors may have elevated blood pressure levels. In pediatric age diagnosis of hypertension or high normal blood pressure is made with repeated office blood pressure measurements that show values exceeding the reference values. Blood pressure should be monitored at least once a year with adequate methods and instrumentation and the observed values have to be interpreted according to the most updated nomograms that are adjusted for children's gender, age and height. Currently other available methods such as ambulatory blood pressure monitoring and home blood pressure measurement are not yet adequately validated for use as diagnostic instruments. To diagnose primary hypertension it is necessary to exclude secondary forms. The probability of facing a secondary form of hypertension is inversely proportional to the child's age and directly proportional to blood pressure levels. Medical history, clinical data and blood tests may guide the differential diagnosis of primary versus secondary forms. The prevention of high blood pressure is based on correct lifestyle and nutrition, starting from childhood age. The treatment of primary hypertension in children is almost exclusively dietary/behavioral and includes: a) reduction of overweight whenever present b) reduction of dietary sodium intake c) increase in physical activity. Pharmacological therapy will be needed rarely and only in specific cases. © 2013 Spagnolo et al.; licensee BioMed Central Ltd.

De Luca G.,ISFOL | Peracchi F.,University of Rome Tor Vergata | Peracchi F.,Economics and Finance Institute
Journal of Applied Econometrics | Year: 2012

This paper estimates food Engel curves using data from the first wave of the Survey on Health, Aging and Retirement in Europe (SHARE). Our statistical model simultaneously takes into account selectivity due to unit and item nonresponse, endogeneity problems, and issues related to flexible specification of the relationship of interest. We estimate both parametric and semiparametric specifications of the model. The parametric specification assumes that the unobservables in the model follow a multivariate Gaussian distribution, while the semiparametric specification avoids distributional assumptions about the unobservables. © 2011 John Wiley & Sons, Ltd.

Menghetti E.,University of Rome La Sapienza | Musacchio P.,ASL RMD | Tawill L.,IDI Inc | Vicini S.,ASL RMD | And 2 more authors.
Minerva Pediatrica | Year: 2014

Aim. A study was conducted on children from a junior high school in Rome, Monteverde district, to observe data on hypertension and obesity. Data were compared with results from the study carried on two years ago in the same school by the same working group.Methods.The study enrolled 336 students, 52% males and 48% females. Blood pressure was measured with Omron 2 automatic monitor, with child cuffs, weight and height were measured with Seca scale with stadiometer. We assessed hypertension by means of recent Task Force Tables, overweight and obesity with the tables by Cole et al.Results. A proportion of 5% of screened children presented hypertension, 13.9% overweight, 2.3% obesity.Conclusion. Prevalence of hypertension, overweight and obesity was lower than prevalence observed two years ago in the same school, thanks to a change in eating habits which included breakfast promotion, adoption of correct food choices for lunch and dinner, and most of all an increase in extracurricular sports activity, currently performed by 92% of students.

Minicocci I.,University of Rome La Sapienza | Tikka A.,Finnish National Institute for Health and Welfare | Poggiogalle E.,University of Rome La Sapienza | Metso J.,Finnish National Institute for Health and Welfare | And 11 more authors.
Journal of Lipid Research | Year: 2016

The consequences of angiopoietin-like protein 3 (ANGPTL3) deficiency on postprandial lipid and lipoprotein metabolism has not been investigated in humans. We studied 7 homozygous (undetectable circulating ANGPTL3 levels) and 31 heterozygous (50% of circulating ANGPTL3 levels) subjects with familial combined hypolipidemia (FHBL2) due to inactivating ANGPTL3 mutations in comparison with 35 controls. All subjects were evaluated at fasting and during 6 h after a high fat meal. Postprandial lipid and lipoprotein changes were quantified by calculating the areas under the curve (AUCs) using the 6 h concentration data. Plasma changes of ô-hydroxybutyric acid (ô-HBA) were measured as marker of hepatic oxidation of fatty acids. Compared with controls, homozygotes showed lower incremental AUCs (iAUCs) of total TG (ô69%, P < 0.001), TG-rich lipoproteins (ô90%, P < 0.001), apoB-48 (ô78%, P = 0.032), and larger absolute increase of FFA (128%, P < 00.1). Also, heterozygotes displayed attenuated postprandial lipemia, but the difference was significant only for the iAUC of apoB-48 (ô28%; P < 0.05). During the postprandial period, homozygotes, but not heterozygotes, showed a lower increase of ô-HBA. Our findings demonstrate that complete ANGPTL3 deficiency associates with highly reduced postprandial lipemia probably due to faster catabolism of intestinally derived lipoproteins, larger expansion of the postprandial FFA pool, and decreased influx of dietaryderived fatty acids into the liver. These results add information on mechanisms underlying hypolipidemia in FHBL2.-Minicocci, I., A. Tikka, E. Poggiogalle, J. Metso, A. Montali, F. Ceci, G. Labbadia, M. Fontana, A. Di Costanzo, M. Maranghi, A. Rosano, C. Ehnholm, L. M. Donini, M.Jauhiainen, and M. Arca. Effects of angiopoietin-like protein 3 deficiency on postprandial lipid and lipoprotein metabolism. J. Lipid Res. 2016. 57: 1097-1107. © 2016 by the American Society for Biochemistry and Molecular Biology, Inc.

Menghetti E.,University of Rome La Sapienza | Strisciuglio P.,University of Naples Federico II | Spagnolo A.,ISFOL | Carletti M.,University of Insubria | And 5 more authors.
Nutrition, Metabolism and Cardiovascular Diseases | Year: 2015

Background and aims: In Italy, the prevalence of hypertension, obesity and overweight in paediatric patients has increased in the past years. The purpose of this study was to analyse the relationship between obesity and hypertension and related factors in Italian students. Methods and results: We studied 2007 healthy individuals between the ages of 6 and 17 years of age (998 males and 1009 females) attending schools in the cities of Varese (northern Italy), Rome (central Italy) and Catanzaro (southern Italy). The blood pressure, weight and height of the students were measured. We also assessed their daily intake of foods and the amount of physical activity they performed. A questionnaire was administered to the parents of the subjects to obtain information on the child's medical history and family lifestyle. Of the students, 27.2% were overweight, and 6.6% were obese, with the highest percentages in southern Italy. A total of 6.2% of students had hypertension, and the region with the highest percentage was found to be northern Italy. Obese students had a risk of developing hypertension that was four times greater than those subjects who were of normal weight. Conclusion: Overweight and obese children/adolescents were more frequently found in southern Italy as opposed to northern and central Italy, and hypertensive children were more prevalent in the north. An unhealthy diet might explain the more widely spread obesity among children living in the south; an excess use of salt could explain the greater rate of hypertension found among children/adolescents living in the north. •The purpose was to analyze the relationship between obesity and hypertension and related factors in young Italian students.•We studied healthy individuals between 6 and 17 years of age in three cities of different Italian regions.•We assessed blood pressure, weight, height, daily intake of foods and amount of physical activity.•We found highest percentage of overweight and obesity in southern Italy.•We found highest percentage of hypertension in northern Italy. © 2015 Elsevier B.V.

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