Mediterranean Journal of Nutrition and Metabolism - Volume 2, issue 3

Authors: Sciacca, Salvatore | Conti, Gea Oliveri

Article Type: Editorial

Abstract: Water is the basic constituent of all living beings; it is, therefore, an essential dietary element and a primary resource. The D. Lgs. 31/2001 is the Italian standard reference concerning drinking-water issues. The purpose of this article is, firstly, to highlight that chlorination, as a water purifying treatment, does not guarantee an absolute absence of risk. On the contrary, it causes the formation of various by-products, many of which are known to be carcinogenic and mutagenic. Secondly, some drinking-water pollutants have mutagenic and carcinogenic properties, giving an appreciable risk for the user. As a result, water reserves, because of their …importance to public health, should be properly safeguarded and protected to prevent possible contamination. Although disinfection brings about mutagenic and carcinogenic molecules, we cannot do without it if we want to prevent the much more severe risks due to the presence of pathogens in water used for human consumption. Show more

Keywords: Water, Chlorination, Contamination, Mutagens, Carcinogens, Risk

DOI: 10.3233/s12349-009-0052-5

Citation: Mediterranean Journal of Nutrition and Metabolism, vol. 2, no. 3, pp. 157-162, 2009

Authors: Tubili, Claudio

Article Type: Review Article

Abstract: In patients who cannot, must not or do not want to drink, hydration is a real artificial nutrition intervention. Different clinical situations require a specific approach for fluid administration to reduce the risk of tissue hypoperfusion or oedema. The variations of plasma volume depend not only on the amount of the fluid infused, but also on its distribution, which is determined by the membranes' properties. Fluids for intravenous therapy are not vehicles but real drugs and the knowledge of their properties should guide the choice: the available data on mortality and major complications do not demonstrate the best efficacy between …crystalloids or colloids and between the different types of colloids: saline solution at 0.9% is commonly defined as “physiological”, but has significant differences with plasma; balanced electrolytic solutions seem to give better clinical outcomes compared to saline, which is ultimately overprescribed. 5% glucose solution is equivalent to water because glucose is rapidly metabolised, releasing it. It is necessary to strengthen educational interventions to improve the management of fluid therapy. Show more

Keywords: Parenteral nutrition, Fluids for intravenous administration, 0.9% saline solution, Colloids, Crystalloids

DOI: 10.3233/s12349-009-0066-z

Citation: Mediterranean Journal of Nutrition and Metabolism, vol. 2, no. 3, pp. 163-169, 2009

Authors: Lucchin, Lucio | D'Amicis, Amleto | Gentile, Maria Gabriella | Battistini, Nino Carlo | Fusco, Maria Antonia | Palmo, Augusta | Muscaritoli, Maurizio | Contaldo, Franco | Cereda, Emanuele | the PIMAI Group

Article Type: Research Article

Abstract: Hospital malnutrition is high in every country it was investigated, but no nationally representative prevalence study, considering potential geographical interfering factors, has yet been performed. We designed a multidisciplinary, cross-sectional, nation-wide survey: the PIMAI study (Project: Iatrogenic MAlnutrition in Italy). Adult (>18 years old) patient inclusion was managed on a four-strata randomisation model according to sex and age (<65 and ≥65 years). Malnutrition was defined by analytical criteria related to recent food intake and both physical (body mass index, weight loss, midupper arm anthropometry) and biochemical (albumin, prealbumin and lymphocyte count) malnutrition correlates. Thirteen hospitals (n = 1583) completed the …study. The survey is likely to represent the country of Italy. Overall prevalence of malnutrition was 30.7%, with higher rates in the northern macroarea (36.7%) than in central (28.0%), southern (26.9%) and island (16.7%) ones (p < 0.0001). This discrepancy appeared to be mainly related to the prevalence of overweight/obesity. By a multivariate model, malnutrition was significantly lower in males (p < 0.05) and surgical wards (p < 0.002), associated with geography (p < 0.05) and consistently higher in patients aged ≥65 years (p < 0.01), presenting with malignancies (p < 0.005) and having multidrug therapy (p < 0.05). The prevalence of hospital malnutrition is high also in Italy. It presents with different geographical distribution also according to overweight prevalence. This evidence should be considered when designing national nutritional policies. Show more

Keywords: Hospital malnutrition, Prevalence, Nutritional assessment, Nutritional status, Nationwide survey, Multidisciplinary

DOI: 10.3233/s12349-009-0054-3

Citation: Mediterranean Journal of Nutrition and Metabolism, vol. 2, no. 3, pp. 171-179, 2009

Authors: Magno, Mauro | Di Gregorio, Clara | Becci, Maria Venneri | Miale, Ada | Galli, Maria | Mastronuzzi, Vitalba | Albano, Stefano

Article Type: Research Article

Abstract: To properly evaluate the incidence of protein-calorie malnutrition (PCM) in hospitalised patients, we have compared a log sheet used routinely for all patients admitted to our Hospital Department with the score from Nutritional Risk Screening (NRS) 2002, considered by the European Society of Parenteral and Enteral Nutrition (ESPEN) to be the benchmark screening method for malnutrition in hospitalised patients. The log sheet used in our Hospital Department provides for the evaluation of 4 factors: body mass index (BMI), weight loss in recent months, the presence of hypercatabolism and an estimate of daily calorie intake with respect to requirements. These 4 …factors, ranked at three levels of severity, are recorded on a “dual grid” chart that allows for three possible final diagnoses of nutritional risk: low, medium and high. In contrast, NRS 2002 evaluates the sum of 3 factors: impairment of nutritional status, severity of the pathology and possible age over 70, with a total score that can be diagnosed as PCM only if equal to or greater than 3. Of 220 patients admitted to the Endocrinology Department of the SS. Annunziata Hospital (Taranto), all submitted to dual evaluation; equivalence was seen in the PCM diagnoses in 98.2% of the cases (216 out of 220). Specifically, in 90.4% of the cases the rating on our log sheet was medium or low and coincided with a score of 0, 1 or 2, while in 7.8% of the cases the rating on our log sheet was medium or high and coincided with an NRS score of 3 or higher. Only in 1.8% of the cases (4 in 220) was there a lack of agreement between a low risk on our log sheet and an NRS score of 3. In conclusion, the PCM evaluation carried out with the log sheet used in our Hospital Department is comparable to the assessment using NRS 2002, which is considered the benchmark screening method for hospitalised patients. Show more

Keywords: Protein-calorie malnutrition, NRS 2002, Hospitalised patients, Endocrinology

DOI: 10.3233/s12349-009-0060-5

Citation: Mediterranean Journal of Nutrition and Metabolism, vol. 2, no. 3, pp. 181-185, 2009

Authors: Donini, Lorenzo M. | Scavone, Luciano | Savina, Claudia | Coletti, Cecilia | Paolini, Maddalena | Tempera, Settimio | Neri, Barbara | De Felice, Maria Rosaria | Pinto, Alessandro | Cannella, Carlo

Article Type: Research Article

Abstract: Background: For an “in the field” estimate of visceral adiposity, simple, inexpensive, non-invasive and highly repetitive methods are needed. The anthropometric measurement most commonly used as an indicator for visceral fat deposits is waist circumference (W). Nevertheless, there are some doubts with regard to the anatomic landmark points where the evaluation needs to be carried out. Sagittal abdominal diameter (SAD) is another anthropometric measurement that has been proposed for the estimation of visceral fat. Objective: The aims of the study are to evaluate intra- and inter-operator variability of the estimation of the SAD compared to W; correlate SAD to other …anthropometric parameters and to factors involved in the metabolic syndrome (MS); and identify the values for the estimation of the SAD able to classify different risk levels with respect to the MS. Methods: Ninety-five subjects at the Metabolic and Nutritional Rehabilitation Unit “Villa delle Querce” in Nemi were selected. Anthropometric and biochemical parameters were collected. The presence of a MS was detected. Intra- and inter-operator variability in the measurement of W and SAD and the predictive capacity of SAD in the estimation of the risk for MS were calculated. Results: The main results achieved were reduced intra- and inter-operator variability in the measurement of SAD compared to W; confirmation of the correlations between SAD and the anthropometric parameters as indicators of a higher fat mass; and good predictive capacity of SAD towards MS (cut-off points: 22.2 cm for men and 19.5 cm for women). Show more

Keywords: Nutritional status, Metabolic syndrome, Sagittal abdominal caliper, Waist circumference

DOI: 10.3233/s12349-009-0067-y

Citation: Mediterranean Journal of Nutrition and Metabolism, vol. 2, no. 3, pp. 187-195, 2009

Authors: Yousfi, Mohamed | Bombarda, Isabelle | Hamia, Chahrazed | Djeridane, Amar | Stocker, Pierre | Gaydou, Emile

Article Type: Research Article

Abstract: The main focus of the present work is the analytical study of the fatty acid, triglyceride (TAG) and tocopherol composition of oil extract from the fruit of Algerian tree Argania spinosa. The four dominant fatty acids (FA) found in the oil are: oleic C18:1 (52.86%), linoleic C18:2 (25.0%), palmitic C16:0 (14.65%) and stearic C18:0 (7.06%). The distribution of FA between the sn-2 and sn-1,3 positions of TAG from the oil was also determined. Unsaturated FA showed a preference for the internal position, as generally found in vegetable oils. The TAG composition was calculated using the lipase hydrolysis. The oil was …found to contain trisaturated (0.47%), disaturated (9.3%), monosaturated (43.95%) and triunsaturated (45.20%) FA. Flash chromatography with solvent of increasing polarity yielded 83.42% neutral lipids, 1.56% glycolipids and 2.09% phospholipids. The oil was characterised by a relatively high amount of tocopherols (1027.8 mg/kg). The (γ+β)-tocopherols were the major isomers, with the rest being α- and δ-tocopherols. Show more

Keywords: Argania spinosa oil, Fatty acids, Triglycerides, Tocopherols, Polar lipids

DOI: 10.3233/s12349-009-0058-z

Citation: Mediterranean Journal of Nutrition and Metabolism, vol. 2, no. 3, pp. 197-203, 2009

Authors: Dekanski, D. | Ristić, S. | Mitrović, D.M.

Article Type: Research Article

Abstract: Previous studies demonstrated that the damaging action of absolute ethanol could be attributed to the enhancement in the reactive oxygen species, increase in lipid peroxidation and inhibition of antioxidative enzyme activity. In this study we investigated the mechanism of protective effect of olive leaf extract (OLE), a natural antioxidant, on gastric mucosal damage induced by absolute ethanol in rats. OLE (80 mg/kg daily) was applied intragastrically (i.g.) two weeks prior to absolute ethanol administration. Areas of gastric lesions were measured and ulcer index (UI) was calculated. The effects of applied OLE on gastric mucosal lesions, malondialdehyde level and antioxidative enzyme …(catalase and superoxide dismutase) activity were compared with effects of i.g. pretreatment of reference drug, ranitidine (50 mg/kg). Absolute ethanol administration caused severe gastric mucosal haemorrhage. Pretreatment with OLE, as well as with ranitidine, significantly (p < 0.001) attenuated the gastric lesions induced. Furthermore, OLE was effective in the prevention of an increase in gastric lipid peroxidation and in the prevention of a decrease in antioxidative enzyme activity. The results obtained indicate that OLE has gastroprotective activity against ethanol-induced gastric lesions in rats, possibly related to its antioxidative properties. Show more

Keywords: Olive leaf, Antioxidants, Gastroprotection, Rats

DOI: 10.3233/s12349-009-0068-x

Citation: Mediterranean Journal of Nutrition and Metabolism, vol. 2, no. 3, pp. 205-211, 2009

Authors: Sahin, Kazim | Juturu, Vijaya | Tuzcu, Mehmet | Sahin, Nurhan | Cikim, Gurkan | Komorowski, James R.

Article Type: Research Article

Abstract: The objective of this study was to evaluate the effects of whey protein (WP) and chromium picolinate (CrPic) on body composition and metabolic status in rats fed a high-fat diet (HFD). Male Wistar rats (n = 10/group, 8 weeks old) were divided into three groups. The control group was fed a HFD (300 g fat/kg diet). The other two groups were fed the HFD plus 320 g whey protein isolate/kg diet (HFD + WP) with or without 80 mcg CrPic/kg body wt/day (HFD + WP + CrPic). After six weeks, rats were fasted, blood samples were drawn, and visceral and …subcutaneous fat pads were removed and weighed. Daily food intake was not affected by treatment. Rats fed HFD exhibited significant increases in body weight, body fat and metabolic risk factors (p ≤ 0.05). Rats fed the HFD + WP showed a significant decrease in body weight, serum glucose and blood lipids, and a significant increase in insulin levels (p ≤ 0.05). Rats fed the HFD + WP + CrPic had the lowest levels in total visceral fat, triglycerides, total cholesterol and free fatty acids, and the highest insulin levels (p ≤ 0.05). Tissue concentrations of chromium (Cr) increased with CrPic supplementation (p < 0.001). The results of this study support the use of WP and CrPic supplementation to improve body composition and metabolic syndrome risk factors. Show more

Keywords: Chromium, Whey protein, Insulin resistance, Metabolic syndrome

DOI: 10.3233/s12349-009-0065-0

Citation: Mediterranean Journal of Nutrition and Metabolism, vol. 2, no. 3, pp. 213-219, 2009

Authors: Cano, Sandra Sumalla | Azpíroz, Irma Domínguez | Motte, Sandra Jarrín | Bachs, Anna Marín | Battino, Maurizio | Villar, Santos Gracia

Article Type: Short Communication

Abstract: Miracle diets are characterised by promises of fast weight loss without any effort. However as these types of diet lack many essential nutrients and are unbalanced, they may cause negative long-term health problems. The Mayo Clinic Diet, analysed in our study, was found to be unbalanced in the amount of macronutrients (47.65% fat, 32.06% proteins and 20.37% carbohydrates) and all minerals (the amount of minerals are under 50% of the RDA) and deficient in vitamins B1 , B2 , B3 , B6 , D and E. As multiple studies show that weight loss is similar, independent of the macronutrient composition …of the diet, and data from recent studies indicate that following these types of diets in the long term can be associated with an increase in mortality, recommended diets should have a wide variety of foods and be balanced in the amount of macro- and micronutrients, like the Mediterranean diet. Show more

Keywords: Slimming diets, Weight-loss diets, High-protein diets, Low-carb diets, Mediterranean diet

DOI: 10.3233/s12349-009-0061-4

Citation: Mediterranean Journal of Nutrition and Metabolism, vol. 2, no. 3, pp. 221-224, 2009

Authors: Cuttica, Carla Micaela | Del Monte, Patrizia | Cardillo, Teresa | Robotti, Paola Carla | Foppiani, Luca | Marugo, Alessandro | Oppezzi, Massimo | Quilici, Paolo | Arlandini, Anselmo

Article Type: Research Article

Abstract: We describe the case of a woman affected by morbid obesity associated to type 2 diabetes mellitus (T2DM), hyperlipidaemia and hypertension, configuring a picture of metabolic syndrome (MS). Hormonal investigations revealed that her MS was secondary to the presence of a cortisol-producing left adrenal adenoma. After monolateral adrenalectomy, the MS subsided. Excessive and sustained hypercortisolism gives rise to the entire spectrum of MS. As some clinical manifestations of MS and Cushing's syndrome (CS) overlap, it is important to consider CS as a possible cause of secondary MS, in order to avoid a delay in diagnosis and proper treatment, which exposes …the patient to an increased risk of morbidity and mortality. Show more

Keywords: Metabolic syndrome, Obesity, Cushing's syndrome, Intragastric balloon

DOI: 10.3233/s12349-009-0053-4

Citation: Mediterranean Journal of Nutrition and Metabolism, vol. 2, no. 3, pp. 225-228, 2009