Mediterranean Journal of Nutrition and Metabolism - Volume 4, issue 2
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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: A condition of insulin resistance (IR) frequently occurs in the elderly. This is because of some age-related hormonal and metabolic changes, which are responsible for increased serum levels of fasting blood glucose. IR also induces an increased and prolonged serum value of post-prandial hyperglycaemia, favouring the atherosclerotic process and frequent acute cardiovascular events. This review examines how the post-prandial hyperglycaemic “spikes” play a major role in vascular damage in aged individuals with or without diabetes mellitus. This occurs through oxidative stress, endothelial dysfunction and subclinical inflammation induced by IR, as illustrated by numerous experiments and clinical reports. The evidence opposing…all this is from two major trials, the STOP-NIDDM study and the recent HEART2D study. Finally, it is hypothesised that a daily dose of acarbose may prevent or mitigate this damage in aged people without overt diabetes mellitus.
Abstract: Lipids are indispensable in artificial nutrition, not only because of their high energy density that allows a volume reduction as well as a limitation of carbohydrate provision, but also because they reduce osmolarity of the formulas, provide essential fatty acids, enhance the bio-availability of fat-soluble vitamins and because of their pharmacological properties, including effects on inflammation and the immune response. First generation formulas in parenteral nutrition are based on soybean/safflower oils. New generations include olive oil, medium-chain/structured triglycerides and fish oil. Their respective indications are not clearly defined, but are a basis for individualized nutritional support. Recent ESPEN guidelines in…enteral and parenteral nutrition provide useful information on their use in specific situations.
Abstract: Body composition and anthropometric assessment provide the sports physician with useful information on the health state of the athlete and with some necessary elements to plan specific training loads in the most appropriate way. In practice, the chemical composition of an athlete's body (especially those who carry out 1–2 daily workouts) is always in a physiologic condition that we can define as “dynamic” (concentration of electrolytes, hydration state and relationship between intra-and extracellular water, stages of growth of muscle mass and/or reduction of fat mass, etc.), with the exception of few times of year, such as the short resting break…before resuming training. As a consequence, a real “baseline” (or “stationary”) physiological state, allowing to detect the parameters of body composition under the same conditions several times during the year, is only rarely achieved. In this paper, we wanted to review the most interesting parameters and methods for the evaluation of athletes' body composition, and underline their potential applications, possible advantages, theoretical and practical limitations.
Keywords: Body composition, Anthropometry, Bioelectrical impedance analysis, Body compartments, Athletes
Abstract: New roles have been discovered for the adipose mass/tissue of obese subjects linked to the production of different cytokines, leptin and oxidative stress, all together playing a crucial role in developing obesity, insulin resistance, metabolic syndrome, and the pathogenesis of various diseases. Inflammatory status and plasma oxidative stress have been reported as also characterizing a new metabolic condition known as normal-weight obese (NWO) syndrome observed in women with normal index but fat mass (FM) >30%. The aim of the present study was to investigate in NWO women, compared with preobese-obese (OB) and control normal weight (NW) subjects, the occurrence of…DNA damage, particularly oxidative DNA damage, by using different Comet assay versions. Our goal was to find out some possible new early hallmarks of obesity. We observed above all increase in DNA damage both in OB and NWO women, compared with NW subjects, underlining DNA to be involved in oxidative stress related to metabolic abnormalities occurring in obesity. In addition, the use of either pH >13 versus pH 12.1 alkaline Comet assay versions or pH 12.1 in presence of Fpg enzyme versus pH 12.1 alone, allow us to draw attention to two possible new early differentiated hallmarks: first, alkali labile sites higher in OB compared to NWO; second, 8-oxo-dG level slightly higher in NWO than in OB women. These preliminary results encourage planning broad cohort studies in order to verify and validate these hypothesized predictive/prognostic new hallmarks.
Keywords: DNA damage, Oxidative stress, Normal weight obese syndrome, Comet assay, 8-OhdG
Abstract: The aim of this study was to assess Ca digestibility using in vitro and in vivo methodology (rats). The tested foods were: cheese (Grana Padano; Emmentaler), soybean-based products (tofu; burger; milk; yogurt), and legumes (peas; beans). Ca digestibility was found to be high in Emmentaler (84.3%), Grana Padano (83.6%) and tofu (80.3%), with significantly lower values for soya burgers (64.1%) and soya milk (60.6%). The lowest values were detected in peas (49.6%) and beans (31.4%). Poor correlation was found between in vivo and in vitro data. The current RDAs have been established on the basis of 30% Ca digestibility, a…value which reduces the risk of calcium deficiency but underestimates the contribution of dairy products. The adoption of specific, instead of general, digestibility values for each food might improve the accuracy of dietary formulations. This will require considerable efforts to develop simple and reliable in vitro methods to assess foods.
Keywords: Ca digestibility, Legumes, Cheese, Anti-nutritional factors
Abstract: The aim of this study is to examine the associated risk factors of hypertension and the relationship between blood pressure and obesity determined by different anthropometric measurements in a population of urban adult women of Morocco. The study was conducted in an agricultural community, El Jadida province of Morocco. Body weight, height, waist (WC) and hip circumferences, blood pressure, fasting capillary blood glucose, triglycerides and cholesterol were measured in a sample of 213 women volunteers (18–55 years old). Body mass index (BMI), and waist/hip ratio (WHR) were determined. High blood pressure was detected in 35.8% of women. All hypertensive women…were at high risk of hyperglycemia (22.4% were hyperglycemic, among which 17.6% were diabetic), hypertriglyceridemia (10.7%), hypercholesterolemia (14.5%) and metabolic syndrome (18.4%). Only 6.6% of the women practice physical activity and 23.6% had no education level. Bivariate correlation showed a positive association between age and obesity. In the same way blood pressure was also positively associated with obesity, age, WC, WHR, fasting plasma glucose and triacylglycerols. The results show a high prevalence of obesity associated with increased prevalence of hypertension (HT). The study data reinforce the need to increase detection and treatment of hypertension and to approach patients' global risk profiles. It is also suggested that the simultaneous interpretation of anthropometric measurements could be used as screening tool for the identification of HT.
Keywords: High blood pressure, Metabolic disorder, Obesity, Moroccan women
Abstract: In patients with obesity, it is important to know the exact metabolic function in order to assess balanced nutritional support, reducing the risks of the initial situation. For an adequate detection of the resting metabolic rate (RMR), commonly indirect calorimeters are used. In the present study, two different indirect calorimeters [an expiratory collection open-circuit system (Fitmate) and a ventilated open-circuit system (Quark RMR)], were correlated and analysed for better adequacy. The predictive equation of Harris–Benedict (HBE) was confronted with the measured RMR of the better evaluated indirect calorimeter. 42 obese women (age 55 ± 12 years and BMI 42.9 ±…6.8 kg/m2 ) were included in the study after selecting patients according to the predefined inclusion and exclusion criteria. Measurement durations of each 15 min were performed after an overnight fast with both calorimeters. Received values of Fitmate and Quark were compared while the calorimeter with the more reliable values was compared with the HBE. Significant correlations (P < 0.001) between the devices were achieved, although a significant difference of 1,051 kJ/day (14.9%) between Fitmate (7,542 ± 1,230 kJ/day) and Quark RMR (6,491 ± 806 kJ/day) was detected. The mean calculated RMR of the HBE (7,181 ± 716 kJ/day), in comparison with Quark RMR was significantly different (P < 0.001). The correlation of the two indirect calorimeters, their different functioning, led to significant differences between devices and RMR measurements. The HBE was found to overestimate the measured RMR of Quark RMR. Though the HBE was developed on lean subject, it cannot be considered as a reliable equation for obese subjects.
Abstract: The relation between oxidative stress and tamoxifen is not completely clear, since some studies attribute a possible antioxidant action, while others describe several pro-oxidative effects. The aim of this study was to evaluate oxidative stress in patients treated with tamoxifen and the effect of administration of green tea catechins on this parameter. Tests aimed at evaluating the derivatives of reactive oxygen metabolites (d-Roms test) and the antioxidant reserve (BAP test) were adopted to estimate oxidative stress. Subjects treated with tamoxifen received Categ [Sofar] (green tea extract with 200 mg of catechins, 2 tablets twice a day for 3 weeks), according…to a crossover design. High or very high antioxidant stress levels were found in all the 46 patients treated with tamoxifen, while in a control group of 18 patients treated with aromatase inhibitors or who had no longer been treated with tamoxifen for 1 year or more, high or very high oxidative stress levels were found in 66.7% of cases (p < 0.0001). The antioxidant reserve was low in 52% of patients treated with tamoxifen versus 40% of the patients in the control group, but the difference was not statistically significant (p = n.s.). The levels of oxidative stress and antioxidant reserve did not change significantly in a subgroup where the patients took Categ for 3 weeks followed by 3 weeks washout (group A), while there was a statistical significant reduction in the levels of oxidative stress (p < 0.05) and an increase in the antioxidant reserve (p < 0.01) in the subgroup where 3 weeks of no treatment were followed by 3 weeks of treatment with Categ (group B). In conclusion, our study confirms a pro-oxidant effect of tamoxifen. The supplementation with green tea catechins gave discordant results. A high number of variables might intervene in the delicate oxidative–reductive equilibrium of human beings and, despite progress achieved in the last few years, there are several aspects concerning the oxidative–reductive equilibrium that still have to be explained.
Keywords: Oxidative stress, D-Roms test, BAP test, Green tea catechins, Tamoxifen, Breast cancer
Abstract: Efficacy of a new patented proprietary combination of natural nutraceuticals (PN) containing natural hypolipidemic as red yeast, policosanol and berberine was tested in a large study on dyslipidemic patients in clinical practice. A parallel, controlled, randomized, multicenter study was designed. After 2 weeks on a stable dietary regimen, the patients were randomized to PN 1 tablet/day associated with diet (PN + D) or diet alone (D) for 16 weeks. Entry criteria were: Tot-Chol >200 mg/dL or LDL-Chol >150 mg/dL without a clear indication for statins, or plasma triglycerides >150 mg/dL. Lipid pattern and CV parameters were evaluated at baseline and…monthly. 1,751 patients were enrolled in 248 Italian units, 933 patients on PN + D and 818 on D. The baseline lipid values were: Tot-Chol 255.4 versus 243.1 mg/dL, LDL-Chol 170.1 versus 162.2 mg/dL, HDL-Chol 50.0 versus 48.8 mg/dL, and TG 190.5 versus 184.4 mg/dL. PN constantly and significantly improved lipid parameters versus D group: at 16 weeks −19.1 versus −9.4% for Tot-Chol (p < 0.001), −23.5 versus −10.8% for LDL-Chol (p < 0.001), +11.6 versus +4.0% for HDL-Chol (p < 0.001), −17.9 versus −11.3% for TG (p < 0.001). In conclusions, PN plus diet allows an effective improvement of blood lipids with a significant reduction of global CV risk, suggesting a role for PN in CHD prevention.
Keywords: Metabolic syndrome, Nutraceuticals, Berberine, Red yeast, Dyslipidemia
Abstract: Hypoglycemia is a frequent and often dramatic event in subjects with type 1 diabetes. It is also probable that an unrecognized nocturnal hypoglycemia may cause a marked variability of the fasting blood glucose. We used a nutritional formula with slow release carbohydrates represented by modified maltodextrins to reduce the risk of these events in 14 type 1 diabetic subjects. The continuous subcutaneous monitoring of interstitial glucose demonstrated a marked reduction in the number and depth of the hypoglycemic episodes throughout the 48 h when the formula was used versus the preceding 48 h.
Abstract: Nutrition is an environmental factor of major importance in human health. Barley is a cereal, rich in dietary fibres (DF) such as β-glucan, arabinoxylans and cellulose. DF is rapidly fermented by the intestinal microflora, with the formation of short-chain fatty acids (SCFA). High levels of SCFA, particularly of butyrate, are important for a healthy large intestine mucosa. SCFA are rapidly absorbed by the colonic mucosa. Butyrate is the preferred energy source of the colonic epithelial cells and acts specifically as a signal metabolite, stimulating cell migration and proliferation. Both the significantly higher formation and the increased absorption of SCFA are…important in the protection of the colon mucosa. Olive oil is an integral ingredient of the Mediterranean diet. It is known for its high levels of monounsaturated fatty acids and is also a good source of phytochemicals. Accumulated evidence suggests that it may have health benefits that include the reduction of several varieties of cancers affecting the mucosa in the colon. It might influence the polyamine metabolism in colonic enterocytes in ways that reduce the progression from normal mucosa to adenoma and carcinoma. Therefore, it is important to study the effects of olive oil and the barley on the colonic mucosa, because they are commonly combined in the diet of North African population. The aim of our study is to determine the effects of consumed olive oil and the barley on some histological colonic mucosa parameters as the proliferation, crypt depth and width in rats consuming these types of diets experimentally, the coecum was taken as an example of colonic portion for this study. Seventy-two female Wistar rats were considered to assess the effects of consumption of the olive oil and barley diet on colonic morphology. These diets (olive oil and barley) and a control diet were compared. The experimental period was 40 days. Eight rats from each group were killed at the, 20th and 40th day after consuming experimental diets, caecums were than extracted. Crypt depth and width, the average of mitoses per crypt in the caecal mucosa were determined, using a morphometric system (SAMBA, Grenoble, France). Our results showed that length of the crypts was very similar; this did not achieve statistical significance for olive oil or barley diet supplementation. However, the barley diet was associated with a statistically significant increase in the width of the crypt compared to the control diet (p < 0.05). Statistical differences were not observed for the number of mitoses per crypt, compared to the experimental diets. We concluded that Barley diet can have influence on the colonic crypt width. This might be explained by the high levels of SCFA. Olive oil and the barley diet do not influence on the number of mitoses per crypt and the crypt length in ceacal mucosa.
Abstract: Gestational diabetes mellitus (GDM) is a common pregnancy disorder. It is the result of inadequate insulin resistance regulation, a biological phenomenon usually accepted as a fact of unknown purpose. The regulation of insulin resistance, changes in the dynamics of quantitative and qualitative parameters of fetal growth, the onset of active fetal insulin secretion and clinical manifestation of GDM are too harmonized throughout pregnancy to be accidental. It is hypothesized that the origin of GDM, at least partially, might be explained by dissonance between the rapid lifestyle changes in the last decades/centuries and the Mother Nature inability to reprogram the physiologic…processes, acquired long ago within such a ‘short time’.
Keywords: Gestational diabetes mellitus, Insulin resistance, Human placental lactogen