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Vitale M, Giosuè A, Sieri S, Krogh V, Massimino E, Rivellese AA, Riccardi G, Vaccaro O, Masulli M. Legume Consumption and Blood Pressure Control in Individuals with Type 2 Diabetes and Hypertension: Cross-Sectional Findings from the TOSCA.IT Study. Nutrients 2023; 15:2895. [PMID: 37447221 DOI: 10.3390/nu15132895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Our aims were to evaluate the relationship of habitual legume consumption with blood pressure (BP) control in a large cohort of people with T2D and hypertension, and to investigate whether specific nutritional components of legumes or other foods may contribute to regulate BP levels. METHODS We studied 1897 participants with T2D and hypertension. Dietary habits were assessed through a validated food frequency questionnaire. Sex-specific quartiles of legume consumption were created. RESULTS Higher legume consumption was associated with a lower intake of energy, carbohydrates, glycaemic load, alcohol, and sodium, and a significantly greater intake of proteins, fat, monounsaturated, polyunsaturated, fibre, potassium, and polyphenols. Significantly lower systolic and diastolic BP values were observed in the highest vs. lowest quartile of legume consumption (132.9 ± 6.7 vs. 137.3 ± 7.0 mmHg, p < 0.001; 78.9 ± 4.1 vs. 81.0 ± 4.2 mmHg, p = 0.002; respectively), as well as the proportion of people meeting the treatment targets (61.3% vs. 37.4% and 71.3% vs. 52.4%, respectively, p < 0.01). This association was independent from other foods whose consumption is associated with the high legume intake. CONCLUSIONS In people with T2D and hypertension, three servings of legumes per week are associated with significantly better BP control. This gives further support to current dietary guidelines in recommending the frequent consumption of legumes, as a "ready-to-use" dietary strategy to achieve optimal BP control.
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Affiliation(s)
- Marilena Vitale
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Annalisa Giosuè
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20121 Milan, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20121 Milan, Italy
| | - Elena Massimino
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | | | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Olga Vaccaro
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Maria Masulli
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
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Giosuè A, Riccardi G, Antonelli M. Maximizing cardiovascular benefits of fish consumption within the One Health approach: Should current recommendations be revised? Nutr Metab Cardiovasc Dis 2023; 33:1129-1133. [PMID: 37087360 DOI: 10.1016/j.numecd.2023.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 03/23/2023] [Indexed: 04/24/2023]
Abstract
AIMS Current dietary recommendations on fish consumption for cardiovascular disease (CVD) prevention put somewhat vague emphasis on fatty fish, mainly driven by evidence on the cardioprotective effects of n-3 PUFAs. Recent data on the consumption of different types of fish in relation to hard cardiovascular endpoints suggests that fatty but not lean fish can contribute to CVD prevention. This considered, we aimed at evaluating, by an environmental perspective, fish consumption limited to the fatty type - in appropriate amounts for optimizing CVD prevention - within the European context. DATA SYNTHESIS Starting from the current average intake of total fish by the European population (i.e., 2 servings/week of fatty plus lean fish), we show that the shift towards the consumption of 2 servings/week of solely fatty fish - appropriate for optimizing CVD prevention - would allow a 32% saving of greenhouse gas (GHG) emissions related to fish consumption. This is due to the lower environmental impact of fatty fish globally considered, compared to lean fish. However, since the carbon footprint of different fatty fish species can vary significantly - with small blue fish (e.g., anchovies, sardines, herrings) in the lowest range, we estimated that GHG emissions due to fish consumption in Europe could be reduced by 82% by focusing on small blue fish consumption. CONCLUSIONS Consumption of 2 servings/week of small blue fish could represent a feasible and effective choice among the functional dietary strategies available to achieve the maximal benefits for human and environmental health.
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Affiliation(s)
- Annalisa Giosuè
- Department of Clinical Medicine and Surgery, "Federico II" University, Naples, Italy.
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, "Federico II" University, Naples, Italy
| | - Marta Antonelli
- Division Impacts on Agriculture, Forests and Ecosystem Services (IAFES), Foundation Euro- Mediterranean Center on Climate Change (CMCC), Viterbo, Italy
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Dembska K, Antonelli M, Giosuè A, Calabrese I, Vaccaro O, Riccardi G. The Double Pyramid: bridging nutrition and sustainability recommendations with traditional ways of eating. Eur J Clin Nutr 2023:10.1038/s41430-023-01278-8. [PMID: 36801963 DOI: 10.1038/s41430-023-01278-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 02/19/2023]
Affiliation(s)
- Katarzyna Dembska
- Barilla Foundation, Via Madre Teresa di Calcutta, 3/a, Parma, Italy.
| | - Marta Antonelli
- Barilla Foundation, Via Madre Teresa di Calcutta, 3/a, Parma, Italy
| | - Annalisa Giosuè
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Via Sergio Pansini, 5, Naples, Italy
| | - Ilaria Calabrese
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Via Sergio Pansini, 5, Naples, Italy
| | - Olga Vaccaro
- Department of Pharmacy, "Federico II" University of Naples, Via Domenico Montesano, 49, Naples, Italy
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Via Sergio Pansini, 5, Naples, Italy
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Giosuè A, Recanati F, Calabrese I, Dembska K, Castaldi S, Gagliardi F, Vitale M, Vaccaro O, Antonelli M, Riccardi G. Good for the heart, good for the Earth: proposal of a dietary pattern able to optimize cardiovascular disease prevention and mitigate climate change. Nutr Metab Cardiovasc Dis 2022; 32:2772-2781. [PMID: 36323607 DOI: 10.1016/j.numecd.2022.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/26/2022] [Accepted: 08/01/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Human and planetary health are inextricably interconnected through food systems. Food choices account for 50% of all deaths for cardiovascular diseases (CVD) - the leading cause of death in Europe - and food systems generate up to 37% of total greenhouse gas (GHG) emissions. METHODS AND RESULTS Based on a systematic revision of meta-analyses of prospective studies exploring the association between individual foods/food groups and the incidence of CVD, we identified a dietary pattern able to optimize CVD prevention.. This dietary pattern was compared to the current diet of the European population. The nutritional adequacy of both diets was evaluated according to the European Food Safety Authority (EFSA) recommended nutrient intake for the adult population, and their environmental impact was evaluated in terms of carbon footprint (CF). As compared to the current diet, the desirable diet includes higher intakes of fruit, vegetables, wholegrains, low glycemic index (GI) cereals, nuts, legumes and fish, and lower amounts of beef, butter, high GI cereals or potatoes and sugar. The diet here identified provides appropriate intakes of all nutrients and matches better than the current Europeans' one the EFSA requirements. Furthermore, the CF of the proposed diet is 48.6% lower than that of the current Europeans' diet. CONCLUSION The transition toward a dietary pattern designed to optimize CVD prevention would improve the nutritional profile of the habitual diet in Europe and, at the same time, contribute to mitigate climate change by reducing the GHG emissions linked to food consumption almost by half.
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Affiliation(s)
- Annalisa Giosuè
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy
| | | | - Ilaria Calabrese
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy
| | | | - Simona Castaldi
- Dipartimento di Scienze e Tecnologie Ambientali Biologiche e Farmaceutiche, Università degli studi della Campania Luigi Vanvitelli, Caserta, Italy
| | - Francesca Gagliardi
- Dipartimento di Economia Politica e Statistica, Università degli Studi di Siena, Siena, Italy
| | - Marilena Vitale
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy
| | - Olga Vaccaro
- Department of Pharmacy, "Federico II" University of Naples, Naples, Italy
| | - Marta Antonelli
- Division Impacts on Agriculture, Forests and Ecosystem Services (IAFES), Foundation Euro-Mediterranean Center on Climate Change (CMCC), Viterbo, Italy.
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy
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5
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Giosuè A, Calabrese I, Riccardi G, Vaccaro O, Vitale M. Consumption of different animal-based foods and risk of type 2 diabetes: An umbrella review of meta-analyses of prospective studies. Diabetes Res Clin Pract 2022; 191:110071. [PMID: 36067917 DOI: 10.1016/j.diabres.2022.110071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/29/2022] [Accepted: 08/31/2022] [Indexed: 12/27/2022]
Abstract
We performed an umbrella review of dose-response meta-analyses of prospective studies reporting the incidence of type 2 diabetes associated with the consumption of animal-based foods. A systematic search was conducted in PubMed, Web of Science, Scopus, and Embase according to PRISMA. Thirteen meta-analyses are included in the study providing 175 summary risk ratio estimates. The consumption of 100 g/day of total or red meat, or 50 g/day of processed meat, were associated with an increased risk; RR and 95 % CI were respectively 1.20, 1.13-1.27; 1.22, 1.14-1.30 and 1.30, 1.22-1.39. White meat (50 g/day) was associated with an increased risk, but of lesser magnitude (RR 1.04, 95 % CI 1.00-1.08). A risk reduction was reported for 200 g/day of total dairy (RR 0.95, 95 % CI 0.92-0.98) or low-fat dairy (RR 0.96, 95 % CI 0.92-1.00) or milk (RR 0.90, 95 % CI 0.83-0.98), or 100 g/day of yogurt (RR 0.94, 95 % CI 0.90-0.98). No association with diabetes risk was reported for fish or eggs. In conclusions animal-based foods have a different association with diabetes risk. To reduce diabetes risk the consumption of red and processed meat should be restricted; a moderate consumption of dairy foods, milk and yogurt, can be encouraged; moderate amounts of fish and eggs are allowed.
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Affiliation(s)
- Annalisa Giosuè
- Dept. of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
| | - Ilaria Calabrese
- Dept. of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
| | - Gabriele Riccardi
- Dept. of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
| | - Olga Vaccaro
- Dept. of Pharmacy, Federico II University, Naples, Italy.
| | - Marilena Vitale
- Dept. of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
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Minotti B, Antonelli M, Dembska K, Marino D, Riccardi G, Vitale M, Calabrese I, Recanati F, Giosuè A. True Cost Accounting of a healthy and sustainable diet in Italy. Front Nutr 2022; 9:974768. [PMID: 35967799 PMCID: PMC9372443 DOI: 10.3389/fnut.2022.974768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
It is widely upheld that global food systems are unsustainable. Sustainable diets are gaining prominence as key components to entangle global food system challenges, as well as to transition towards the pathway of the 2030 Agenda and the Sustainable Development Goals (SDGs). Hence, sustainable and healthy diets are at the core of much research with the aim to bring together nutritional adequacy, cultural acceptability, environmental sustainability, economic affordability, and shape future consumption patterns. This article contributes to advancing knowledge on sustainable diets by proposing a True Cost Accounting method to assess the cost and impact of the adoption of a more sustainable and healthier diet, using Italy as an illustration. The research analyses the complexity of a diet from an environmental, health, and socioeconomic point of view and defines a new assessment framework that can be replicated and adapted to other contexts. Results show that in Italy, the adoption of a sustainable and healthy diet has a 47% lower carbon footprint and 25% lower water footprint than the current diet, while impacting 13% less on the average income and food monthly expenditure. Also, the desirable diet has a 21% lower impact on the sanitary costs related to cardiovascular disease. This study corroborates that the consumption of the desirable diet would provide a total cost saving of 741 EUR per year per capita, if we consider its impact on the environment, health, and socio-economic costs.
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Affiliation(s)
- Bianca Minotti
- Department of Bioscience and Territory, University of Molise, Campobasso, Italy.,Department of Humanities, Faculty of Economics and Management, Czech University of Life Science, Prague, Czechia
| | - Marta Antonelli
- Barilla Center for Food & Nutrition Foundation, Parma, Italy.,Division on Climate Change, Impacts on Agriculture, Forests and Ecosystem Services (IAFES), Fondazione Centro Euro-Mediterraneo sui Cambiamenti Climatici, Viterbo, Italy
| | | | - Davide Marino
- Department of Bioscience and Territory, University of Molise, Campobasso, Italy
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Marilena Vitale
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Ilaria Calabrese
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | | | - Annalisa Giosuè
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
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7
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Giosuè A, Calabrese I, Riccardi G, Lupoli R, Vaccaro O, Vitale M. Fatty fish but not lean fish consumption is associated with reduced risk of coronary heart disease: A meta-analysis of prospective cohort studies. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Lupoli R, Lembo E, Giosuè A, Schiavo L, Capaldo B. Clinical insights into management options for recurrent type 2 diabetes and cardiovascular risk after metabolic-bariatric surgery. Nutr Metab Cardiovasc Dis 2022; 32:1335-1342. [PMID: 35365370 DOI: 10.1016/j.numecd.2022.02.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/21/2022] [Accepted: 02/27/2022] [Indexed: 10/18/2022]
Abstract
AIMS Long-term clinical trials evaluating the effects of metabolic-bariatric surgery (MBS) on type 2 diabetes (T2D) demonstrate that a significant proportion of patients either fail to achieve remission or experience T2D recurrence over time. Furthermore, patients with recurrent T2D might require reinstitution of pharmacotherapy to control comorbidities (hypertension, dyslipidemia). This paper reviews therapeutic options in patients with T2D relapse. DATA SYNTHESIS Although presently there is no recommended pharmacological strategy, the available data support GLP-1 analogues (GLP-1a) as the most suitable option to control hyperglycemia post-MBS. Beside their efficacy in lowering glycemia and body weight while preserving lean mass, GLP-1a exert cardiovascular/renal-protection and are also safe and well tolerated in surgical patients. In addition, the s.c. route of administration of these medications circumvents the problem of changes in oral drugs bioavailability following MBS. Of note, the available data refers to liraglutide and needs to be confirmed with weekly GLP-1a agents. Information regarding the impact of MBS on the pharmacokinetics of lipid lowering and anti-hypertensive drugs is scarce and inconclusive. The findings indicate that timing from intervention is particularly important because of adaptive intestinal mechanisms. CONCLUSIONS The recurrence of T2D following MBS is a clinically relevant issue. GLP-1a therapy represents the best option to improve glycemic and weight control with good tolerability. Long-term clinical trials will clarify the impact of these drugs on cardiovascular outcomes. A close monitoring of MBS patients is advised to guide drug dosage adjustments and ensure the control of cardiovascular risk factors.
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Affiliation(s)
- Roberta Lupoli
- Department of Molecular Medicine and Medical Biotechnology, Federico II University, Naples, Italy
| | - Erminia Lembo
- Department of Clinical Medicine and Surgery University Federico II Naples, Italy
| | - Annalisa Giosuè
- Department of Clinical Medicine and Surgery University Federico II Naples, Italy
| | - Luigi Schiavo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Italy
| | - Brunella Capaldo
- Department of Clinical Medicine and Surgery University Federico II Naples, Italy.
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Giosuè A, Calabrese I, Vitale M, Riccardi G, Vaccaro O. Consumption of Dairy Foods and Cardiovascular Disease: A Systematic Review. Nutrients 2022; 14:831. [PMID: 35215479 PMCID: PMC8875110 DOI: 10.3390/nu14040831] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/22/2022] [Accepted: 02/10/2022] [Indexed: 11/16/2022] Open
Abstract
Limited consumption of dairy foods and use of low-fat products is recommended for cardiovascular (CV) prevention; however, other features besides fat content modulate their metabolic effects. We analyze updated evidence on the relationship of different dairy products (low/full-fat dairy, milk, cheese, yogurt) with CVD by reviewing meta-analyses of cohort studies and individual prospective cohort studies with CV hard endpoints (CVD/CHD incidence/mortality), together with meta-analyses of randomized controlled trials exploring the effect of dairy on major CV risk factors. The analyses provide evidence that moderate dairy consumption (up to 200 g/day, globally) has no detrimental effects on CV health and that their effect depends more on the food type (cheese, yogurt, milk) than on the fat content. These data expand current knowledge and may inform revision of current guidelines for CVD prevention.
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Affiliation(s)
- Annalisa Giosuè
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, 80131 Naples, Italy; (A.G.); (I.C.); (M.V.); (G.R.)
| | - Ilaria Calabrese
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, 80131 Naples, Italy; (A.G.); (I.C.); (M.V.); (G.R.)
| | - Marilena Vitale
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, 80131 Naples, Italy; (A.G.); (I.C.); (M.V.); (G.R.)
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, 80131 Naples, Italy; (A.G.); (I.C.); (M.V.); (G.R.)
| | - Olga Vaccaro
- Department of Pharmacy, “Federico II” University of Naples, 80131 Naples, Italy
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10
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Giosuè A, Calabrese I, Lupoli R, Riccardi G, Vaccaro O, Vitale M. Relations between the Consumption of Fatty or Lean Fish and Risk of Cardiovascular Disease and All-Cause Mortality: A Systematic Review and Meta-Analysis. Adv Nutr 2022; 13:1554-1565. [PMID: 35108375 PMCID: PMC9526843 DOI: 10.1093/advances/nmac006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/07/2021] [Accepted: 01/19/2022] [Indexed: 02/04/2023] Open
Abstract
Fish consumption is associated with a reduced risk of cardiovascular diseases (CVDs) partly ascribed to the high content of long-chain (LC) n-3 PUFAs; however, not all fish types are equally rich in these components. To date, it is not clear whether the beneficial effects of fish consumption are shared by fatty and lean fish. Therefore, the aim of this meta-analysis was to synthesize knowledge regarding the relation between the intake of fatty fish or lean fish and the risk of cardiovascular events and all-cause mortality. We conducted a systematic search in PubMed, Web of Science, and Embase until May 2021 for full text with a prospective design involving humans providing data for the highest compared with the lowest fish consumption categories. Summary risk ratios (RRs) and 95% CIs were estimated using a random-effects model. Out of 1902 articles retrieved from the literature search, 19 reports met the criteria for inclusion in the meta-analysis. Altogether, studies on fatty fish comprised 1,320,596 person-years of follow-up, 20,531 incident coronary heart disease (CHD) cases, 9256 incident CVD cases, and 104,763 total deaths. Studies on lean fish comprised 937,362 person-years of follow-up, 21,636 incident CHD cases, 7315 incident CVD cases, and 16,831 total deaths. An inverse association was present for fatty fish with CHD incidence (RR: 0.92; 95% CI: 0.86, 0.97), CHD mortality (RR: 0.83; 95% CI: 0.70, 0.98), and total mortality (RR: 0.97; 95% CI: 0.94, 0.99). This was not the case for lean fish. The summary estimates for CVD incidence and mortality did not show significant association with both fatty fish and lean fish consumption. The study findings are innovative in highlighting that the health benefits so far linked to fish consumption are, in fact, driven by fatty fish.
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Affiliation(s)
- Annalisa Giosuè
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Ilaria Calabrese
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Roberta Lupoli
- Department of Molecular Medicine and Medical Biotechnology, Federico II University of Naples, Naples, Italy
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | | | - Marilena Vitale
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
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Riccardi G, Giosuè A, Calabrese I, Vaccar O. Authors Reply to: Limitations of the Glycemic Index and the Need for Nuance When Determining Carbohydrate Quality, by Mitch Kanter, Siddhartha Angadi, Julie Miller Jones, Katherine A. Beals. Cardiovasc Res 2021; 118:e40-e41. [PMID: 34613364 DOI: 10.1093/cvr/cvab313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Gabriele Riccardi
- University of Naples Federico II, Universita degli Studi di Napoli Federico II, Napoli, Italy
| | - Annalisa Giosuè
- University of Naples Federico II, Universita degli Studi di Napoli Federico II, Napoli, Italy
| | - Ilaria Calabrese
- University of Naples Federico II, Universita degli Studi di Napoli Federico II, Napoli, Italy
| | - Olga Vaccar
- University of Naples Federico II, Universita degli Studi di Napoli Federico II, Napoli, Italy
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12
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Riccardi G, Giosuè A, Calabrese I, Vaccaro O. Dietary recommendations for prevention of atherosclerosis. Cardiovasc Res 2021; 118:1188-1204. [PMID: 34229346 DOI: 10.1093/cvr/cvab173] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/07/2021] [Accepted: 05/18/2021] [Indexed: 12/17/2022] Open
Abstract
This review aims at summarizing updated evidence on cardiovascular disease (CVD) risk associated with consumption of specific food items to substantiate dietary strategies for atherosclerosis prevention. A systematic search on PubMed was performed to identify meta-analyses of cohort studies and RCTs with CVD outcomes. The evidence is highly concordant in showing that, for the healthy adult population, low consumption of salt and foods of animal origin, and increased intake of plant-based foods-whole grains, fruits, vegetables, legumes, and nuts-are linked with reduced atherosclerosis risk. The same applies for the replacement of butter and other animal/tropical fats with olive oil and other unsaturated-fat-rich oil. Although the literature reviewed overall endorses scientific society dietary recommendations, some relevant novelties emerge. With regard to meat, new evidence differentiates processed and red meat-both associated with increased CVD risk-from poultry, showing a neutral relationship with CVD for moderate intakes. Moreover, the preferential use of low-fat dairies in the healthy population is not supported by recent data, since both full-fat and low-fat dairies, in moderate amounts and in the context of a balanced diet, are not associated with increased CVD risk; furthermore, small quantities of cheese and regular yogurt consumption are even linked with a protective effect. Among other animal protein sources, moderate fish consumption is also supported by the latest evidence, although there might be sustainability concerns. New data endorse the replacement of most high glycemic index (GI) foods with both whole grain and low GI cereal foods. As for beverages, low consumption not only of alcohol, but also of coffee and tea is associated with a reduced atherosclerosis risk while soft drinks show a direct relationship with CVD risk. This review provides evidence-based support for promoting appropriate food choices for atherosclerosis prevention in the general population.
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Affiliation(s)
- Gabriele Riccardi
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Via Sergio Pansini, 5 - 80131, Naples, Italy
| | - Annalisa Giosuè
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Via Sergio Pansini, 5 - 80131, Naples, Italy
| | - Ilaria Calabrese
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Via Sergio Pansini, 5 - 80131, Naples, Italy
| | - Olga Vaccaro
- Department of Pharmacy, "Federico II" University of Naples, Via Domenico Montesano, 49 - 80131, Naples, Italy
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13
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Schiavo L, Giosuè A, Izzo V, Piaz FD, Filippelli A, Pilone V. Liquid levothyroxine sodium therapy improves pharmacologic thyroid-stimulating hormone homeostasis in patients with reduced efficacy for tablet levothyroxine sodium after sleeve gastrectomy. A case report. Obes Surg 2021; 31:4649-4652. [PMID: 34142312 DOI: 10.1007/s11695-021-05518-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 05/27/2021] [Accepted: 06/08/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Luigi Schiavo
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, SA, Italy. .,Center of Excellence of Bariatric Surgery of the Italian Society of Obesity Surgery and Metabolic Disease (SICOB), Unit of General and Emergency Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Mercato San Severino, Salerno, Italy. .,Unit of Clinical Pharmacology, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy.
| | - Annalisa Giosuè
- Center of Excellence of Bariatric Surgery of the Italian Society of Obesity Surgery and Metabolic Disease (SICOB), Unit of General and Emergency Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Mercato San Severino, Salerno, Italy.,Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Viviana Izzo
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, SA, Italy.,Unit of Clinical Pharmacology, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Fabrizio Dal Piaz
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, SA, Italy.,Unit of Clinical Pharmacology, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, SA, Italy.,Unit of Clinical Pharmacology, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Vincenzo Pilone
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, SA, Italy.,Center of Excellence of Bariatric Surgery of the Italian Society of Obesity Surgery and Metabolic Disease (SICOB), Unit of General and Emergency Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Mercato San Severino, Salerno, Italy
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14
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Lupoli R, Vitale M, Calabrese I, Giosuè A, Riccardi G, Vaccaro O. White Meat Consumption, All-Cause Mortality, and Cardiovascular Events: A Meta-Analysis of Prospective Cohort Studies. Nutrients 2021; 13:nu13020676. [PMID: 33672599 PMCID: PMC7924043 DOI: 10.3390/nu13020676] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/05/2021] [Accepted: 02/15/2021] [Indexed: 01/22/2023] Open
Abstract
The association of meat consumption with mortality and morbidity for non-communicable diseases has been extensively studied. However, the relation of white meat consumption with health outcomes remains controversial. The present meta-analysis was conducted to comprehensively analyze the available evidence on the consistency and strength of the association between the consumption of white meat, death from any cause and incidence of fatal and non-fatal cardiovascular (CV) events. PubMed, Web of Science, Scopus and Embase databases were searched for articles published up to April 30, 2020. We included prospective cohort studies reporting relative risks and pertinent 95% confidence intervals (CI) for all-cause mortality and/or CV events (fatal or non-fatal). A total of 22 studies were included in the meta-analysis. Eleven studies (14 data sets) reported data on all-cause mortality, 10 studies (15 datasets) on cardiovascular disease (CVD) mortality and 10 studies (11 datasets) on non-fatal CV events. When comparing the highest versus the lowest consumption of white meat, the pooled OR and pertinent 95% CI were 0.94 (0.90, 0.97, p < 0.001) for all-cause mortality, 0.95 (0.89, 1.01, p = 0.13) for CV mortality, and 0.99 (0.95, 1.02, p = 0.48) for non-fatal CV events. In conclusion, the study shows for the first time a robust and inverse association between white meat consumption and all-cause mortality and a neutral association with CV mortality and morbidity. This highlights the importance of differentiating the meat types for what concerns their health effects and suggests that white meat might be a healthier alternative to read and processed meat consumption.
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Affiliation(s)
- Roberta Lupoli
- Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy; (R.L.); (M.V.); (I.C.); (A.G.)
| | - Marilena Vitale
- Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy; (R.L.); (M.V.); (I.C.); (A.G.)
| | - Ilaria Calabrese
- Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy; (R.L.); (M.V.); (I.C.); (A.G.)
| | - Annalisa Giosuè
- Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy; (R.L.); (M.V.); (I.C.); (A.G.)
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy; (R.L.); (M.V.); (I.C.); (A.G.)
- Correspondence: ; Tel.: +390817462117; Fax: +390817464736
| | - Olga Vaccaro
- Department of Pharmacy, “Federico II” University, 80131 Naples, Italy;
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15
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Vitale M, Giosuè A, Vaccaro O, Riccardi G. Recent Trends in Dietary Habits of the Italian Population: Potential Impact on Health and the Environment. Nutrients 2021; 13:476. [PMID: 33572514 PMCID: PMC7911362 DOI: 10.3390/nu13020476] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/25/2021] [Accepted: 01/28/2021] [Indexed: 12/25/2022] Open
Abstract
Population growth, globalization, urbanization, and economic pressures are causing changes in food consumption all over the world. The study's aims are (1) to evaluate trends in food habits in Italy to highlight deviations from the traditional Mediterranean diet, (2) to analyze the features of the present Italian diet that should be modified to meet evidence-based global scientific targets for a healthy and sustainable diet proposed by the EAT-Lancet Commission. Trends in food availability for human consumption during the period 2000-2017 were assessed using the food balance sheets (FBSs). Greenhouse gas (GHG) emission was estimated according to life cycle assessment (LCA) analyses. During the study period, the availability of animal fat and beef meat greatly declined (-58% and -32%, respectively), followed by fruit, potatoes, vegetables, milk, and non-tropical oils (-20%, -15%, -13%, -14%, and -11%, respectively). A substantial increase has occurred for tropical oils, fish, and nuts (+156, +26%, and +21%, respectively). In order to meet the targets of consumption proposed by the EAT-Lancet Commission, the consumption of legumes and nuts should be almost doubled, whereas the consumption of meat, eggs, dairy products, animal fat, tropical oils, and sugars should be reduced by proportions ranging from 60% to 90%. If implemented, these changes would reduce the diet-related greenhouse gas emission by nearly 50%. In conclusion, these data call for nutritional education programs and interventions on the food system aimed at promoting a healthier and more environmentally sustainable diet. To this end, the availability and affordability of products with a better impact on human health and the environment should be promoted.
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Affiliation(s)
- Marilena Vitale
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (M.V.); (A.G.); (G.R.)
| | - Annalisa Giosuè
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (M.V.); (A.G.); (G.R.)
| | - Olga Vaccaro
- Department of Pharmacy, Federico II University, 80131 Naples, Italy
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (M.V.); (A.G.); (G.R.)
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