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Mattiello A.,University of Naples Federico II | Chiodini P.,The Second University of Naples | De Magistris M.S.,University of Naples Federico II | Krogh V.,Unita di Epidemiologia E Prevenzione | And 9 more authors.
Epidemiologia e Prevenzione | Year: 2015

OBJECTIVES: To report and evaluate the evidence produced by the EPIC Italian collaboration (EPICOR Project) on the dietary determinants of cardiovascular diseases in Italy. DESIGN: prospective study carried out in a large Italian population, composed by cohorts recruited in Northern, Central and Southern Italy. SETTING AND PARTICIPANTS: data on dietary habits collected at the baseline observation through standardised questionnaires on 47,749 free-living adults at the time of the recruitment of the study (1993-1998). MAIN OUTCOME MEASURES: major coronary and cerebrovascular events (acute coronary syndrome, PTCA, CABG, ischemic and haemor- rhagic stroke, TEA of supraortic vessels) identified at follow-up. The longitudinal analyses here reported have measured risks through the use of multivariate Cox regression models, adjusted for potential confounders. RESULTS: The longitudinal analyses of EPICOR indicate that Mediter- ranean-oriented dietary habits, measured through specific indicators and the consumption of various typical food, are able to reduce coronary and cerebrovascular risks, and that this protection is possible even nowadays, although many changes in diet have occurred in the last decades in Italy. Habitual consumption of plant origin products, including all foods with low glycemic index, is an advantage for cardiovascular risk. CONCLUSIONS: The EPICOR Project is the largest, long-lasting Italian study on the relationship between diet and cardiovascular diseases. It is also the study with the greater number of observed variables. Its results point out the importance to support preventive programmes and industrial policies able to favour a dietary style inspired to the Italian Mediterranean tradition. Source

Vitale M.,University of Naples Federico II | Masulli M.,University of Naples Federico II | Cocozza S.,University of Naples Federico II | Anichini R.,UO di Diabetologia | And 39 more authors.
Nutrition, Metabolism and Cardiovascular Diseases | Year: 2016

Background and aims: Diabetic women have a more adverse plasma lipid profile than men. Sex differences in dietary habits may play a role, but are little investigated. The study evaluates the quality of diet, adherence to the nutritional recommendations of the Diabetes and Nutrition Study Group and their relation with plasma lipid in men and women with diabetes. Methods and results: We studied 2573 people, aged 50-75, enrolled in the TOSCA.IT study (clinicaltrials.gov; NCT00700856). Plasma lipids were measured centrally. Diet was assessed with a semi-quantitative food frequency questionnaire. Women had a more adverse plasma lipid profile than men. Women consumed significantly more legumes, vegetables, fruits, eggs, milk, vegetable oils, and added sugar, whereas men consumed more starchy foods, soft drinks and alcoholic beverages. This stands for a higher proportion (%) of energy intake from saturated fat and added sugar (12.0 ± 2.4 vs 11.5 ± 2.5 and 3.4 ± 3.2 vs 2.3 ± 3.2, P < 0.04), and a higher intake of fiber (11.2 ± 2.8 vs 10.4 ± 2.6 g/1000 Kcal/day) in women. Adherence to the recommendations for saturated fat and fiber consumption was associated with significantly lower LDL-cholesterol regardless of sex. Adherence to the recommendations for added sugars was associated with significantly lower triglycerides and higher HDL-cholesterol in men and women. Conclusions: Men and women with diabetes show significant differences in adherence to nutritional recommendations, but sex differences in plasma lipid profile are unlikely to be explained by nutritional factors. Adherence to the nutritional recommendations is associated with a better plasma lipid profile regardless of sex, thus reinforcing the importance of substituting saturated for unsaturated fat sources, increasing fiber and reducing added sugar intake. © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Source

Sieri S.,Unita di Epidemiologia E Prevenzione | Agnoli C.,Unita di Epidemiologia E Prevenzione | Pala V.,Unita di Epidemiologia E Prevenzione | Mattiello A.,University of Naples Federico II | And 9 more authors.
Epidemiologia e Prevenzione | Year: 2015

OBJECTIVES: To investigate hypothesised relationships between diet and cancer by assessing diet as a whole, in the Italian cohort EPIC DESIGN: multicentric prospective study. SETTING AND PARTICIPANTS: 47,749 volunteers were recruited between 1993 and 1998 in the centres of Varese and Turin (Northern Italy), Florence (Central Italy), Naples and Ragusa (Southern Italy). Information on diet and lifestyle were collected through validated questionnaires. An thropometric measurements were taken and biological samples collected using standardised protocols. MAIN OUTCOME MEASURES: follow-up was carried out by accessing regional cancer and mortality registries, hospital discharge records, and by telephone inquiries (only for Naples). After a median follow-up of 11 years, 879 incident cases of breast cancer, 421 cases of colorectal cancer, and 152 deaths were identified. Multivariate Cox regression models were used to estimate risks in relation to dietary characteristics. RESULTS: The "Olive oil & Salad" dietary pattern, characterised by high consumption of raw vegetables and olive oil, was associated with a lower risk of overall mortality in the elderly. Adherence to a Mediterranean diet rich in vegetables and fruit was associated with reduced risk of colon cancer. Consumption of high-glycemic carbohydrates was associated with higher incidence of breast cancer and colorectal cancer. Reduced risk of colon cancer was also found in regular consumers of yoghurt. CONCLUSIONS: The accuracy and comprehensiveness of EPIC-Italy data made it possible to investigate both individual dietary components and dietary habits as a whole, to thereby provide Italians with dietary and lifestyle advice that will help them to remain healthy. Source

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