Mediterranean Journal of Nutrition and Metabolism - Volume 5, issue 3
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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: This review summarizes the main toxic effect of ochratoxin A (OTA) on liver metabolism. This contaminant is a mycotoxin that can be found in raw materials (cereals, coffee, cocoa, spices or grapewine), in processed foods (bread and other bakery products) and, if animals are fed with contaminated feedstuffs, in pork meat. Kidney is a well-known target of OTA, although several findings suggest that liver metabolism can be affected too. OTA intake reduces, in a dose-dependent manner, the synthesis of albumin, while the concomitant increase in transaminases (ALT, ASP) and alkaline phosphatase is in agreement with the hypothesis of liver damage…induced by OTA. Feeding animals with OTA-contaminated feeds has significant prooxidative effects that cause a reduction in anti-oxidative defences and an increase in malondialdehyde formation. Experiments on human liver cells support the hypothesis of an inflammatory effect of OTA mediated by TNF-α. An upregulation of apoptosis has also been detected in hepatic cells after OTA treatment, which leads to a higher rate of cell death and to a reduction of liver activity. All these findings suggest that OTA can have a toxic effect on the liver too and for this reason we should pay attention to liver toxicity of OTA in the risk assessment for this mycotoxin.
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Keywords: Ochratoxin A, Liver, Toxicity, Transaminases
Abstract: Primary prevention of cardiovascular disease should begin with a detailed metabolic study of our patients who must follow a nutritional therapy. Recently, new guidelines ESC/EAS 2011 on the treatment of dyslipidemia have been drawn up, according to which it is possible to arrive at desirable values of cholesterol and triglycerides with a synergy between drug treatment and adequate diet therapy. At this time, Mediterranean diet has been undergoing a radical transformation: there is hyperalimentation of the Mediterranean diet in all its components. The effectiveness of the Mediterranean diet on the reduction of lipids has been demonstrated, and the problem is…how to implement this diet in the general population and dyslipidemic patients. Certainly, awareness, education of their nutritional status, suitable food and portions can increase adherence to diet.
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Abstract: Thyroid has a key role in energetic metabolism and its activity is influenced by caloric intake: reducing in prolonged fasting and malnutrition. Iodine deficiency may induce severe thyroid diseases; if it occurs during growth, it results in permanent disabling systemic damage. For this reason, local governments and WHO promote programs of iodine supplementation. Goitrogenic foods induce clinical damage only if ingested in great amounts and in case of iodine deficiency. The relationship among diet, foods and thyroid function is complex whether it regards iodine intake or its absorption and utilization favoring inhibiting nutrients. People with thyroid dysfunction should change some…dietetic habits, choosing synergic nutrient-rich foods and reducing the antagonist ones; they should reduce fats for slowing their cellular oxidation rate and introduce proteins and carbohydrates at 20 and 55% of total energy intake, respectively.
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Abstract: The aim of the present study was to evaluate the antioxidant properties of oleuropein on ethanol-induced oxidative stress in the rat testis. 32 adult male Sprague–Dawley rats were divided into four equal groups: the first group as a control, the second group of rats were given ethanol (4 g/kg), the third group received oleuropein (15 mg/kg), and the fourth group of rats were supplemented of oleuropein (15 mg/kg) and after 120 min were ingested via ethanol (4 g/kg) orally. Oleuropein could prevent the reduction of motility and plasma membrane integrity of the spermatozoa against ethanol-induced oxidative stress in treated rats…(P < 0.05). While, thiobarbituric acid reactive substances (as a lipid peroxidation marker) concentration was decreased significantly in the oleuropein plus ethanol group compared to the ethanol group (P < 0.05). Notably, glutathione peroxidase and superoxide dismutase activity increased significantly in the ethanol-treated animals compared to controls and total glutathione (GSH-content) increased significantly in ethanol-treated rats compared to the oleuropein group. Our findings suggest that oleuropein possesses beneficial antioxidant effects on ethanol-induced sperm toxicity, subsequently enhancing sperm motility and plasma membrane integrity.
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Keywords: Oleuropein, Antioxidant enzymes, Ethanol, Rat, Testis
Abstract: Morocco like several developing countries is undergoing a nutritional transition characterized by the coexistence of nutritional deficiencies and diseases of overweight within the same household. The aim of this work was to determine the prevalence of anemia and overweight (overweight and obesity) among women of reproductive age in two sentinel centers, one rural and one urban area Kenitra. A sample of 128 women was recruited during their visit to the immunization of their preschool children at the health centers. Anthropometric measures and evaluation of hemoglobin were done under the supervision of the medical team of the health center. Women responded…to a questionnaire on their demographic and socioeconomic characteristics. The mean age and standard deviation was 28.37 ± 6.91 with a minimum of 15 and a maximum of 50 years. Body mass index average was 25.83 ± 6.15 kg/m2 and the average hemoglobin was 11.43 ± 1.5 g/dl. According to standard threshold of more than 30 kg/m2 and less than 12 mg/dl, respectively, for BMI and hemoglobin, the results show rates of overweight or obesity in 56 % of subjects with a strict obesity prevalence of 15.6 %. Anemia reached a high rate of 60 %. The prevalence of anemia is very high compared with the values of national surveys. Obesity is strongly associated with age. Indeed, older women are at increased risk especially if they have a high number of siblings. The nutrition transition looks serious in the study area. Nutrition education and awareness for physical activity are needed. On the other hand, the strategies against iron deficiency and anemia should identify at-risk populations and advocate a more aggressive nutrition communication.
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Abstract: The purpose of the study was to assess the vitamin D status of obese patients with severe mental illness (SMI) treated with olanzapine. Fifteen obese SMI patients treated with olanzapine were pair-matched with healthy obese subjects. Another 52 overweight and obese SMI patients volunteered to participate in the study (total n = 67) and were divided into three subgroups (group A = overweight, group B = obese, group C = severely obese). Anthropometric, body composition, blood glucose, lipids, 25(OH)D, intact parathyroid hormone, and calcium measurements were performed. No differences were found between healthy and SMI subjects in any of the…dependent variables (p > 0.05). The obese and severely obese patients demonstrated significantly lower levels of serum 25(OH)D concentration (p < 0.01) compared with overweight. A significant inverse correlation was found between serum 25(OH)D concentration and all anthropometric parameters (p < 0.05). The results indicate that obese SMI patients appear to be vitamin D deficient, similar to healthy obese subjects. The level of obesity seems to play a significant role in their vitamin D status: the greater the body fat of the patients the lower the serum 25(OH)D concentration. Thus, as in healthy individuals, an inverse association exists between the degree of adiposity and the serum 25(OH)D concentration in SMI patients.
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Keywords: Vitamin D, Severe mental illness, Antipsychotic medications, Obesity
Abstract: In the last few years, increasing evidence about the role played by obesity as cardiovascular risk factor has been shown. However, not all the obese patients are at the same high cardiovascular risk and it is important to have simple and reliable diagnostic tools to detect those patients worthy of a stricter cardiovascular prevention. The purpose of the present pilot study was to test the capability of biomarker dosage in detecting early cardiac dysfunction. Twenty-eight consecutive obese patients, visited at the obese clinic of the San Maurizio Regional Hospital of Bolzano were included in the study. The patients with known…cardiovascular disease were excluded. All the patients underwent the dosage of copeptin, mid regional proANP (Mr-proANP), BNP, the standard haematological testing and a complete echocardiography. All the patients had a normal ejection fraction of the left ventricle (61 ± 5.2 %), normal copeptin (median 8.2 pmol/L with and interquartile range of 6.05–12.6) and BNP levels (37.0 ± 27.5 pg/mL). Mr-proANP was 67.5 ± 45.5 pmol/L, resulting above the upper level of normality in 5/28 patients (17.8 %). No significant relation was found between copeptin levels and left ventricular volumes, mass, ejection fraction, atrial dimensions and diastolic function. Mr-proANP showed a significant reverse non-linear relationship with diastolic dysfunction of the left ventricle, measured by E/E′ ratio. BPN, on the contrary, showed a significant non-linear relation with diastolic dysfunction. BNP dosage has been shown to have efficacy in early identification of heart dysfunction, even in the presence of preserved systolic function.
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Abstract: Aim of the investigation was to get epidemiological informations regarding the home enteral nutrition (HEN) as well as to check the point of view of caregivers regarding organisation, technical aspects and their quality of life. The observational study was conducted on the caregivers of all HEN patients of the health-district of Bolzano. The first survey was conducted in February 2008 (n = 028) and the second one in September 2009 (n = 40), with a questionnaire composed of 16 items related to general/emotional/technical/social/economic and ethical aspects. The participants of the study could validate the questions on a scale from 1…(none) to 7 (very much). Prevalent disease of HEN patients was in 55.8% neurological, in 19.1% neoplastic, in 17.5% vascular and in 7.6% from other causes. The main reported difficulties in the management of HEN patients were related to constipation (30.8%), adjustment of the drip (22.1%), vomiting (14.7%), diarrhoea (10.3%), peristomitis from PEG (8.8%), ulcers and regurgitation (7.7%). Emotional involvement of the caregivers was very high (6.14–7 in 2008 and 5.13–7 in 2009), but the social life and relationships of caregivers did not seem impaired (3.82–7 in 2008 and 3.29–7 in 2009). 83.8% of the caregivers were first degree relatives, in which emotional involvement was very high. The most frequent suggestions to improvements were more home visits and more support on weekends and holidays. Management of HEN does not raise particular concerns in caregivers, but the presence of a specifically dedicated structure and its support were perceived very useful.
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Keywords: Caregiver, Enteral nutrition, Home nutrition support, Long-term care, Epidemiology
Abstract: In recent years, the role of Vitamin D in extra-skeletal tissue has been strongly emphasized. The importance of optimizing Vitamin D levels in patients with chronic diseases and for risk reduction of many of those diseases including certain types of cancer is being increasingly recognized. Knowledge of the rapidly emerging, therapeutic and preventive utilities of Vitamin D is suboptimal among the health care providers (HPs). HPs do not regularly evaluate or optimize Vitamin D levels in patients. This study was conducted to explore the awareness, knowledge and attitude of HPs towards the current therapeutic and preventive roles of Vitamin D.…A survey of HPs was conducted during the preregistration for a Vitamin D Symposium conducted at King Khalid University Hospital, Riyadh. The participants were asked to answer a questionnaire pertaining to the significance of Vitamin D in chronic diseases, diagnosis and prevalence of Vitamin D inadequacy, optimal levels of Vitamin D for health and disease prevention, laboratory estimates and treatment regimens. A total of 150 participants completed the survey. Out of these, 118 (78.7%) HPs were aware of extra-skeletal Vitamin D receptors and 125 (83.3%) knew about its role in extra-skeletal health. While 25 (16.7%) of the HPs were not sure about the role of Vitamin D in chronic diseases, 108 (74.4%) HPs knew about the role of Vitamin D in reducing cancer risk and 96 (64%) HPs were aware that the Vitamin D reduces overall mortality. The HPs largely underestimated the correct global prevalence of Vitamin D deficiency. A majority of the HPs were not clear about the normal levels, cut off levels for diagnosis of deficiency, frequency of measurement and the form of Vitamin D that needs to be assayed. 102 (68%) HPs were of the opinion that up to 400 IU/day of Vitamin D3 was the maintenance dose to prevent Vitamin D deficiency in adults who had been treated for Vitamin D deficiency. A large number of HPs were unaware of the adequate sources of Vitamin D for the healthy adults. All HPs supported the need for guidelines pertaining to Vitamin D deficiency. This is one of the first studies from this region providing objective evidence that HPs' knowledge of Vitamin D is suboptimal. This highlights the need to rectify the existing Vitamin D care gap. This could be achieved by intensifying Vitamin D-related education, establishing guidelines and ensuring the diffusion of these guidelines to the HPs.
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Keywords: Awareness, Vitamin D, Health workers, Care gap, Therapy, Prevention