Mediterranean Journal of Nutrition and Metabolism - Volume 2, issue 1
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Mediterranean Journal of Nutrition and Metabolism publishes original scientific papers on metabolism, including diabesity and eating disorders; nutrition (epidemiological, basic, clinical and artificial); dietary and nutritional practices and management and their impact on health from prevention to treatment.
The journal hosts the proceedings of relevant congresses and presents shorter notices focused on the original character of the Mediterranean nutritional civilisation. In addition, this journal is intended as a platform for scientific debate and knowledge-sharing among students and clinical practitioners, and between them and the broader scientific community, and finally as a tool for promoting and enhancing scientific cooperation.
Abstract: Evaluation of human body composition in vivo remains a critical component in the assessment of nutritional status of an individual. Whereas traditional measurements of standing height and body weight provide information on body mass index and, hence, the risk of some chronic diseases, advanced technologies, such as dual X-ray absorptiometry, air displacement plethysmography and various forms of bioelectrical impedance analysis enable the determination of soft tissue composition (fat and lean) as well as bone. This review summarises the physical bases of these methods and critically evaluates their accuracy in observational and interventional studies. It also discusses a new approach, bioelectrical…impedance vector analysis, which assesses the hydration status of an individual, and includes pertinent examples of its novel applications in clinical nutrition.
Keywords: Dual X-ray absorptiometry, Body volume, Bioelectrical impedance, Bioelectrical impedance vector analysis, Hydration status
Abstract: The metabolic syndrome consists of a group of metabolic abnormalities that at least in the early phases are easily treated with a nutritional intervention. Although there has been considerable debate in the past is now evident that the quality and the quantity of the dietary carbohydrate (CHO) content has a central role in the control of the hyperglycemia and the coexistent hyperlipidemia. Also the favorable role of the Monounsaturated Fatty Acids (MUFA) has emerged. Although the effect of some micronutrients is still to be defined and any dietary advice should be tested at the individual level, clear guidelines for the…treatment of these subjects have now been defined.
Abstract: Clinical data suggest that people who use green tea have a lower cardiovascular risk. However, the exact mechanisms of these cardioprotective effects are unknown. We know that STAT1 plays a critical role in promoting apoptotic cell death and STAT3 may antagonise STAT1 and protect cardiac myocytes from ischaemia/reperfusion (I/R) injury. More recently it has been shown that specific molecules such as epigallocatechin-3-gallate (EGCG), which is present in green tea extract (GTE), have antioxidant properties. Considering that: (i) oxygen free radicals (OFR) are produced during myocardial I/R insult and (ii) OFR are responsible for reperfusion cardiac damage, we therefore investigated whether…chronic administration per os of GTE reduced I/R damage in the Langendorff perfused isolated rat heart. In addition we evaluated myocardial content of STAT1 and STAT3 and degree of apoptosis. In Sprague–Dawley isolated hearts, GTE reduced the ischaemic mechanical insult, prolonged STAT3 activation/phosphorylation and reduced STAT1 activation with consequent less cell apoptosis. These results show that chronic treatment with GTE protects the heart from I/R injury. Activation of prosurvival STAT3 over the pro-apoptotic STAT1 could be one of the molecular mechanisms involved in green tea-mediated cardiopretection.
Keywords: Green tea, Heart, Ischaemia, Reperfusion, Apoptosis
Abstract: Introduction: Today breast cancer (BC) patients can expect more prolonged survival than in the past, but obesity at diagnosis and/or weight gain during adjuvant therapies increase the risk of recurrences as well as of weight-related disorders (diabetes, cardiovascular disease … ). Therefore lifestyle intervention might offer a valuable approach to positively influence the prognosis of survivors. Design and objectives: The charts of 189 overweight/obese outpatients with “early-stage BC” were reviewed to evaluate the effects of nutritional intervention on weight, body mass index (BMI), waist circumference and metabolic parameters. After the first clinical evaluation, in 97 subjects (education group), dieting therapy and periodical…medical examinations were connected with brief individual sessions of nutritional education. Instead, 92 patients (no-education group) were treated only with diet and routine visits. At baseline and after nearly 1 year of treatment, data (weight, waist circumference, BMI, systolic and diastolic pressure, metabolic parameters and results of a battery of self-administered questionnaires to assess Nutritional Knowledge (NK), Physical Functioning (PF) and Quality Of Life (QOL) of patients) were collected and compared. Results: Ninety-two (48.7%) patients completed a one-year follow-up. The dropout rate was higher (73.2%) in traditionally treated women (no-education group) than in education group patients (22.8%); these data highlight that more educated patients completed the programme than non-educated patients (ODs 9.2, p < 0.000). The low follow-up rate makes any comparison between the 2 types of treatment impossible since the weight and metabolic changes of the vast majority of the non-educated subjects remain unknown. Anyway, the education group patients, in active follow-up at 1 year, showed significant weight loss (−6.6 kg, SD 3.7) and improvements of metabolic parameters and questionnaire scores. Conclusions: Data from the study show the usefulness of this simple nutritional education intervention, which appears to increase the adherence to a weight loss programme. In educated patients who completed a 1-year follow-up, the weight reduction and metabolic changes were significant, but the analysis was carried out on less than half of the subjects and this very high global dropout rate (51.3%) makes it impossible to draw generalised conclusions.
Keywords: Nutritional education, Breast cancer, Body mass index, Obesity
Abstract: Cancer-related anorexia/cachexia syndrome (CACS) is a multifactorial syndrome characterised by tissue wasting, particularly lean body mass (LBM), metabolic alterations, fatigue, anorexia and reduced food intake. In April 2005 we started a phase III randomised study to establish the most effective and safest treatment for CACS addressing as primary endpoints: LBM, resting energy expenditure (REE), total daily physical activity, interleukin (IL)-6 and tumour necrosis factor (TNF)-α levels, and fatigue. According to the statistical design the sample size was 475 patients (95 per arm). Eligibility criteria: histologically confirmed tumours of any site; weight loss ≥5% in the last 3 months and/or abnormal…laboratory values; life expectancy >4 months. Patients were treated with either antineoplastic therapy or supportive care. All patients received as basic oral treatment polyphenols plus alpha lipoic acid plus carbocysteine plus vitamins A, C and E. Patients were then randomised to one of the following 5 arms: (1) medroxyprogesterone acetate (MPA)/megestrol acetate (MA); (2) pharmaconutritional support containing eicosapentaenoic acid (EPA); (3) L-carnitine; (4) thalidomide; and (5) a combination of all the above agents. Treatment duration was 4 months. Interim analyses were planned after every 100 randomised patients. In September 2008, 280 patients were randomised and 240 were evaluable: M/F 167/113, mean age 62 years (range 30–84), 96% stage IV. A first interim analysis on 125 patients showed a worsening of LBM, REE and fatigue in arm 2 in comparison to the others and therefore it was withdrawn from the study. A second interim analysis after the enrolment of 204 patients showed that arm 1 was clearly significantly less effective than the others for primary efficacy endpoints, therefore it was withdrawn from the study. Statistical analysis in September 2008 showed a significant improvement of LBM (by dual X-ray energy absorptiometry), REE and fatigue in arm 5, a decrease of IL-6 in arms 3 and 5, and a decrease of TNF-α in arms 3 and 4. As for toxicity, 1 patient discontinued MPA because of deep vein thrombosis and 1 patient discontinued L-carnitine because of severe diarrhoea. In conclusion, the interim results seem to suggest that the most effective treatment for cancer patients with CACS/oxidative stress (OS) should be the combination regimen. The study is in progress.
Keywords: Cancer-related anorexia/cachexia syndrome, Oxidative stress, Lean body mass, Quality of life, Combined treatment approach
Abstract: Objective: This research was performed in order to define the prevalence of the introduction of infant fortified cereals (IFC) in the first year of life and the practical aspects of IFC preparation and practices. Materials and methods: A prospective study was conducted in Damascus Hospital in the emergency room. A sample of 100 children was studied over a period of five months from February 2008 to June 2008. The information was gathered using a questionnaire. Results: It was observed that IFC had been introduced in 50% of the sample; 94% of mothers had introduced IFC before the 6th month of…age. The role of doctors in the prescription was limited to only 18%. Mothers' estimation in preparing the IFC meals was incorrect in 96% of the sample and 76% of the errors were intentional; 54% added other ingredients and 7.4% prepared the meal with tea. Conclusions: IFC were consumed by 50% of the sample. Many errors were made in the preparation of IFC. Much effort is required in the future to improve children's nutrition.
Abstract: Background and aim: Studies to measure motivation for behavioural change were developed in Italy 15 years ago, following the validation of MAC and MAC2, Italian self-administered questionnaires created for heroin users, tobacco smokers and those with alcohol problems. This article presents the validation study of two sets of instruments created to assess motivation for change toward healthy nutrition and regular physical activity in Italian adult subjects who require or are referred for assessment or treatment to nutrition services. Methods and results: The two sets of questionnaires (created within the Nutrition Counselling Project connected to the Piano Triennale Sicurezza Alimentare 2005–2007…(Food and Nutrition Security Plan 2005–2007) of the Region of Veneto) were administered to 431 patients to assess motivation for change toward healthy nutrition and 450 patients to assess motivation for change toward regular physical activity. The instruments showed good internal consistency. Exploratory and Confirmatory Factor Analysis confirms the consistency with the theoretical assumptions. Reliability and concurrent validity yielded strong correlations with the corresponding variables. Conclusions: The study confirms the validity of the sets of instruments and their consistency with the model. These sets of instruments are the first psychometric tools integrating three factors (Discrepancy, Self-Efficacy, Readiness to Change) into a three-dimensional model of motivation for change.