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Poli A.,Nutrition Foundation of Italy
Giornale Italiano di Diabetologia e Metabolismo | Year: 2015

Type 2 diabetic patients, with their high cardio-metabolic risk, need to pay close attention to the quality of dietary macronutrients. Among dietary fats, they should prefer extra-virgin olive oil (with its high content of antioxidant polyphenols), and food rich in polyunsaturated fats, both omega-3 and omega-6. Dietary cholesterol (and egg yolk) needs to be restricted, even though it has only weak effects on plasma cholesterol (especially in diabetics). Carbohydrates should be selected among low glycemic index products, possibly whole-grain cereals, rich in fiber. Alcohol intake, if moderate, needs not be discouraged. These general concepts suggest that the Mediterranean diet, with some selected adaptation, may continue to serve as the reference dietary model for diabetic patients. © 2015, UTET Periodici Scientifici srl. All rights reserved. Source

Poli A.,Nutrition Foundation of Italy | Visioli F.,University of Padua
European Journal of Lipid Science and Technology | Year: 2015

As evidence accumulates, our knowledge of the role of individual fatty acids in cardiovascular disease improves. This re-evaluation is being applied to poly- (PUFAs) and mono- (MUFAs) unsaturated fatty acids. Among the former, omega 6 (or n-6) fatty acids from vegetables and seed oils have always been labeled as cardioprotective. However, this notion was challenged in the 80s, when in vitro data on the high oxidizability of omega 6 fatty acids, their potential pro-inflammatory effects purportedly due to the formation of prostaglandins, and their hypothesized competition for the same enzymes that elongate and desaturate omega 3 fatty acids cast doubts on their healthful roles and even led to the suggestion to limit their dietary intake. As outlined in this review and based on the most recent studies, this is most probably not the case: indeed, adequate intakes of omega 6 fatty acids appear to be extremely helpful in CHD risk reduction and a hypothetical reduction of omega 6 intake by the population at large would actually increase CHD risk. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim. Source

Filippi A.,Italian Society of General Medicine SIMG | Casula M.,University of Milan | Tragni E.,University of Milan | Brignoli O.,Italian Society of General Medicine SIMG | And 3 more authors.
European Journal of Cardiovascular Prevention and Rehabilitation | Year: 2010

Background: Elevated blood pressure (BP) is one of the most important modifiable risk factors for cardiovascular diseases. In this study we assessed the excess of cardiovascular risk attributable to high BP and antihypertensive treatment in a sample of Italian patients enrolled by the 'Cholesterol and Health: Education, Control and Knowledge' (CHECK) study. Methods: CHECK is a large, cross-sectional epidemiological study, which randomly enrolled patients aged 40-79 years from 425 Italian General Practices from March 2002 to April 2004. Among 5731 patients enrolled in the study [49.6% men, mean age (standard deviation) 57.7 (10.3) years], 723 (12.6%) had 'optimal' BP, 1496 (26.1%) had 'high normal' BP, and 1942 (33.9%) were hypertensive. Results: According to the European Guidelines stratification of the cardiovascular risk-excess attributable to high BP, 34.7% of the sample had a low added risk and 53.2% had a moderate-to-very high added risk. The pharmacological therapy was prescribed in 22.3, 43.9, 61.4, and 76.9% of the patients with low, moderate, high, and very high added risk, respectively. Conclusion: Overall dietary and drug therapies are under prescribed, as most of the treated patients would require two additional antihypertensive drugs to meet the recommended BP target. This effort could provide significant individual benefit to moderate/high-risk patients. © 2010 The European Society of Cardiology. Source

Caroli A.,University of Brescia | Poli A.,Nutrition Foundation of Italy | Ricotta D.,University of Brescia | Banfi G.,Istituto Ortopedico Galeazzi | Cocchi D.,University of Brescia
Journal of Dairy Science | Year: 2011

The aim of this review was to focus on the complex relationships between milk and dairy products intake and bone health, with particular emphasis on osteoporosis. The literature was extensively examined to provide an objective overview of the most significant achievements on the subject. Osteoporosis can be defined as a disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk. Although the major determinants of peak bone mass and strength are genetic, major factors during childhood and adolescence may affect the ability to achieve peak bone mass. These include nutrition, particularly calcium and protein intake, physical activity, endocrine status, as well as exposure to a wide variety of risk factors. The role of calcium intake in determining bone mineral mass is well recognized to be the most critical nutritional factor to achieve optimal peak bone mass. The greatest amount of dietary calcium is obtained from milk and dairy foods, which also provide the human diet with vitamin D (particularly for products fortified with vitamin D), potassium, and other macro- and micronutrients. Although studies supporting the beneficial effects of milk or calcium on bone health are predominant in the literature, perplexity or discordance on this subject was expressed by some authors. Discordant data, mainly on the risk of fractures, provided limited proof of the unfavorable effect of dairy intake. More often, discordant works indicate no effect of dairy consumption on bone safety. Some considerations can be drawn from this viewpoint. Milk and dairy products are an optimal source of calcium as well as of other limiting nutrients (e.g., potassium and magnesium), with important effects on bone health. Bioactive components occurring in milk and dairy products may play an essential role on bone metabolism, as shown by in vivo and in vitro studies on colostrum acidic proteins and milk basic proteins. Calcium intake positively affects bone mass and is crucial in childhood and youth for correct bone development. In elderly people, calcium intake as well as vitamin D availability should be carefully checked. As a general conclusion, calcium is essential for bone health, although it will not prevent bone loss due to other factors; in this context, milk and dairy foods are bioavailable, relatively inexpensive sources of calcium for the human diet. © 2011 American Dairy Science Association. Source

Augustin L.S.A.,Clinical Nutrition and Risk Factor Modification Center | Kendall C.W.C.,Clinical Nutrition and Risk Factor Modification Center | Kendall C.W.C.,University of Toronto | Kendall C.W.C.,University of Saskatchewan | And 21 more authors.
Nutrition, Metabolism and Cardiovascular Diseases | Year: 2015

Background and aims: The positive and negative health effects of dietary carbohydrates are of interest to both researchers and consumers. Methods: International experts on carbohydrate research held a scientific summit in Stresa, Italy, in June 2013 to discuss controversies surrounding the utility of the glycemic index (GI), glycemic load (GL) and glycemic response (GR). Results: The outcome was a scientific consensus statement which recognized the importance of postprandial glycemia in overall health, and the GI as a valid and reproducible method of classifying carbohydrate foods for this purpose. There was consensus that diets low in GI and GL were relevant to the prevention and management of diabetes and coronary heart disease, and probably obesity. Moderate to weak associations were observed for selected cancers. The group affirmed that diets low in GI and GL should always be considered in the context of diets otherwise understood as healthy, complementing additional ways of characterizing carbohydrate foods, such as fiber and whole grain content. Diets of low GI and GL were considered particularly important in individuals with insulin resistance. Conclusions: Given the high prevalence of diabetes and pre-diabetes worldwide and the consistency of the scientific evidence reviewed, the expert panel confirmed an urgent need to communicate information on GI and GL to the general public and health professionals, through channels such as national dietary guidelines, food composition tables and food labels. © 2015 Elsevier B.V. Source

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