-
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND: C-reactive protein (CRP) increases during an inflammatory response; its plasma levels are believed to be an independent predictor of future atherosclerotic disease. We report the distribution of plasma levels of CRP and its possible relationship with other cardiovascular risk factors in an Italian cohort. METHODS: CRP was assessed in frozen plasma samples of 1949 participants in the CHECK study (2001-2005), which collected clinical and biochemical data from randomly selected subjects (40-79years) in the setting of Italian general practice. RESULTS: Median CRP (interquartile range) was higher in women (1.42 [0.58-2.86] vs 1.28 [0.58-2.50]; p=.163), in people aged ≥65years (1.74 [0.89-3.34] vs 1.11 [0.52-2.45]; p<.001), in patients with obesity (2.37 [1.27-4.15] vs 1.16 [0.52-2.41]; p<.001), metabolic syndrome (2.12 [1.16-3.72] vs 1.10 [0.50-2.38]; p<.001), or higher cardiovascular risk (2.03 [1.01-3.42] vs 1.19 [0.53-2.50]; p<.001). Stepwise regression analysis showed significant associations (R(2)=.264) of circulating log(e)CRP with body mass index, fibrinogen, apoB, age, gender, smoking habits, physical inactivity, creatinine levels, and systolic blood pressure. CONCLUSION: This study provides epidemiological data of CRP in the Italian population and reinforces the existing evidences about the close correlation between CRP and markers of inflammation and adiposity.
European Journal of Internal Medicine 10/2012; · 2.00 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: In this article, we critically address the contribution of dietary advice to the overall strategy of prevention and treatment
of the metabolic syndrome. In particular, we underline how an appropriate choice of food items and nutrients should anticipate
or accompany pharmacological therapy (often greatly limiting the use of drugs).
KeywordsMetabolic syndrome-Inflammation-Nutrition-Omega 3 fatty acids-Micronutrients
Mediterranean Journal of Nutrition and Metabolism 04/2012; 3(3):203-207.
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of our study was to directly compare the metabolic effect of monounsaturated fatty acid rich oils and polyunsaturated
fatty acid rich oils on the plasma lipid pattern of moderately hypercholesterolaemic subjects under controlled isocaloric
condition. After a 30-day run-in diet, 44 healthy Caucasian subjects with moderate hypercholesterolaemia were randomly assigned
to one of four different isocaloric diets, differing only regarding the oil used (corn oil, corn oil supplemented with vitamin
E, extra-virgin olive oil or different self-selected oils), for 45 days. At the end of the study, when compared to the baseline
value, low-density lipoprotein (LDL)-cholesterolaemia was significantly lower only in patients taking corn oil (−13.9%; 95%CI
−5.9 to −20.1; p = 0.02) or corn oil with added vitamin E (−19.1%; 95%CI −6.9 to −24.1; p = 0.03). Differences in plasma high-density lipoprotein (HDL)-cholesterol and triglyceride levels from baseline levels and
between the four diets did not reach statistical significance.
Mediterranean Journal of Nutrition and Metabolism 04/2012; 1(3):187-192.
-
JAMA The Journal of the American Medical Association 02/2012; 307(7):666; author reply 666. · 30.03 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We estimated the need to use low-efficacy statins or high-efficacy statins or drug combinations to bring high- or very-high cardiovascular risk subjects to their LDL-c target, in a sample representative of the Italian adult population and according to the principles of reimbursement of hypercholesterolemic drugs currently used in Italy. The results allow us concluding that among high or very high cardiovascular risk patients about three patients out of five should be prescribed high-efficacy statins or drug combinations. The other two prescriptions might take into account lower-efficacy statins. If we also compute the values of HDL-c in these subjects--the large majority of which stands below the optimal values as suggested by International guidelines--we bring forward the need either to select specific statins able to increase the levels of these protective lipoproteins or to consider combination therapies of statins with fibrates or nicotinic acid. Our data might conceivably be applied to other low-cardiovascular risk countries and should be taken into account when defining the proportion of drugs with different efficacy and cost in the everyday clinical practice.
Pharmacological Research 06/2011; 64(4):393-6. · 4.44 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The intestinal microbiota is an ecosystem formed by a variety of ecological niches, made of several bacterial species and a very large amount of strains. The microbiota is in close contact with the intestinal mucosa or epithelial interface which is, after the respiratory area, the largest surface of the body, occupying approximately 250-400 m(2). The physiological activities of the microbiota are manifold and are just being unraveled. Based on the observations of the multiple roles played by the microbiota in health and disease, the notion of modifying it with appropriate formulations, i.e. probiotics, is being tested in several settings. This review summarizes the current knowledge on probiotics and discusses both limitations and acquired evidence to support their use in preventive and therapeutic medicine.
Pharmacological Research 02/2011; 63(5):366-76. · 4.44 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Phytosterols are typical constituents of plants' cell walls. When ingested with plant foods, they reduce cholesterol absorption from the gut, due to their structural similarity with cholesterol. In the last decades, purified plant sterols or stanols have been added to various foods items to obtain functional foods with remarkable hypocholesterolemic activity. A daily intake of plant sterols or stanols of 1.6-2g/day, incorporated in these foods, is able to reduce cholesterol absorption from the gut by about 30%, and plasma LDL cholesterol levels by 8-10%. Since the action of plant sterols or stanols on plasma LDL cholesterol is additive to that of statins, the former can be used to increase the latter's hypocholesterolemic action in patients needing a marked reduction in plasma LDL cholesterol levels. Phytosterols, up to 3g/day, are safe and effective cholesterol-lowering agents.
Pharmacological Research 03/2010; 61(3):193-9. · 4.44 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Elevated blood pressure (BP) is one of the most important modifiable risk factors for cardiovascular diseases. In this study we assessed the excess of cardiovascular risk attributable to high BP and antihypertensive treatment in a sample of Italian patients enrolled by the 'Cholesterol and Health: Education, Control and Knowledge' (CHECK) study.
CHECK is a large, cross-sectional epidemiological study, which randomly enrolled patients aged 40-79 years from 425 Italian General Practices from March 2002 to April 2004. Among 5731 patients enrolled in the study [49.6% men, mean age (standard deviation) 57.7 (10.3) years], 723 (12.6%) had 'optimal' BP, 1496 (26.1%) had 'high normal' BP, and 1942 (33.9%) were hypertensive.
According to the European Guidelines stratification of the cardiovascular risk-excess attributable to high BP, 34.7% of the sample had a low added risk and 53.2% had a moderate-to-very high added risk. The pharmacological therapy was prescribed in 22.3, 43.9, 61.4, and 76.9% of the patients with low, moderate, high, and very high added risk, respectively.
Overall dietary and drug therapies are under prescribed, as most of the treated patients would require two additional antihypertensive drugs to meet the recommended BP target. This effort could provide significant individual benefit to moderate/high-risk patients.
European journal of cardiovascular prevention and rehabilitation: official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology 03/2010; 17(5):562-8. · 2.51 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The importance of non-pharmacological control of plasma cholesterol concentrations in the population is increasing, along with the number of subjects whose plasma lipid levels are non-optimal (or frankly elevated) according to international guidelines. In this context, a panel of experts, organized and coordinated by the Nutrition Foundation of Italy, has recently evaluated the nutritional and lifestyle interventions to be adopted in the control of plasma cholesterol concentrations (and specifically of low-density lipoprotein cholesterol levels). Attention was also paid to interventions able to increase plasma high-density lipoprotein levels and to decrease plasma triacylglycerol concentrations. This article summarizes and updates the Consensus Document, with the aim of providing clinicians, and other health professionals involved in cardiovascular prevention, a useful reference tool.
Cardiology and Clinical Practice. 12/2009; 2(1):41-52.
-
Franca Marangoni, Andrea Poli,
Carlo Agostoni,
Pasquale Di Pietro,
Claudio Cricelli,
Ovidio Brignoli,
Giuseppe Fatati,
Marcello Giovannini,
Enrica Riva,
Giuseppe Marelli,
Marisa Porrini,
Carlo Maria Rotella,
Giuseppe Mele,
Lorenzo Iughetti,
Rodolfo Paoletti
Acta bio-medica: Atenei Parmensis 08/2009; 80(2):166-71.
-
[show abstract]
[hide abstract]
ABSTRACT: We investigated whether regular decaffeinated green tea intake could modulate body weight in an experimental model of obesity. Male leptin-deficient (ob/ob) mice and their C57BL/6J lean littermates (4 weeks of age; n 20/genotype) were assigned randomly to receive either decaffeinated green tea or vehicle, for 6 weeks. Body weights were recorded weekly and fluid intake was measured at each replacement. Blood was collected from the heart into collection tubes, with Li(+)-heparin as the anticoagulant. Administration of decaffeinated green tea to ob/ob mice significantly slowed their rate of weight gain, as compared with animals that were fed buffer alone. This effect is apparent after only 1 week of supplementation. No significant difference was recorded between C57BL/6J lean mice administrated decaffeinated green tea and those given buffer alone. Decaffeinated green tea consumption by ob/ob mice was also associated with significantly lower cholesterolemia, triglyceridemia, and adiponectin concentration. Fecal lipids did not change significantly throughout the experiment. In conclusion, administration of decaffeinated green tea might contribute to weight control and provides an opportunity for through-the-day consumption, without the excitatory effects of caffeine.
Pharmacological Research 06/2009; 59(5):351-4. · 4.44 Impact Factor
-
Francesco Visioli,
Herwig Bernaert,
Roberto Corti,
Claudio Ferri,
Stan Heptinstall,
Enrico Molinari, Andrea Poli,
Mauro Serafini,
Henk J Smit,
Joe A Vinson,
Francesco Violi,
Rodolfo Paoletti
[show abstract]
[hide abstract]
ABSTRACT: Interest in the biological activities of cocoa polyphenols is increasing steadily. In fact, the high polyphenol content of cocoa, coupled with its widespread presence in many food items, render this food of particular interest from the nutritional and "pharmacological" viewpoints. This paper summarizes the new findings and developments regarding the effects of cocoa and chocolate consumption on human health as presented at the International Conference "Chocolate, Lifestyle, and Health" (Milan, Italy, March 2, 2007) regarding the effects of cocoa and chocolate consumption on human health.
Critical reviews in food science and nutrition 05/2009; 49(4):299-312. · 3.73 Impact Factor
-
Current Atherosclerosis Reports 01/2009; 10(6):451-3. · 2.66 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The assessment of cardiovascular risk represents the essential prerequisite to any health policy aimed to the reduction of modifiable risk factors.The CHECK (Cholesterol and Health: Education, Control and Knowledge) Study originated from this context: CHECK is the first randomized Italian epidemiological study conducted in primary care, composed of a cross-sectional and a longitudinal phase. The main objective is to evaluate the distribution of cardiovascular risk factors and the prevalence of clinically evident cardiovascular disease in a representative sample of the Italian adult population aged 40-79 years. After the final database clean-up, 5,846 subjects were included in the analysis.Data presented refer to socio-demographic and lifestyle characteristics, educational level, occupational status, anthropometric and vital parameters and biochemical levels, prevalence of cardiovascular diseases, hypertension, hypercholesterolemia, diabetes and metabolic syndrome and family history for cardiovascular disease and other conditions, cardiovascular risk status. The epidemiological data resulting from the CHECK sample have been compared to other population data available in Italy, such as epidemiological studies (Seven Countries, MONICA, Atlante), and statistical data (ISTAT).The CHECK study provides a detailed, in depth description of a significant sample of the Italian population, contributing to evaluate the prevalence of cardiovascular risk factors and the main cardiovascular pathologies.
HEN: Cardiology (Sub-Topic). 11/2008;
-
[show abstract]
[hide abstract]
ABSTRACT: Low glycemic index (GI) foods are associated with improved prevention and control of metabolic and cardiovascular diseases (e.g. diabetes and myocardial infarction), even if the impact of their consumption within mixed meals is difficult to predict. Since the availability of wheat based products maintaining taste and texture of traditional ones, but with a low GI, is of relevant nutritional interest, the aim of this study was to assess the effects of a specific proprietary fiber mix, added to the wheat flour used for biscuits and bread preparation, on their GI.
Fifteen healthy non-diabetic volunteers ate on different days a portion equivalent to 75 g of available carbohydrates, of fiber enriched bread, traditional bread, fiber enriched biscuits and traditional biscuits, or a solution of 75 g of glucose in water. The glycemic index of each product was calculated by relating the area under their glycemic curve to that of glucose. The areas under the glycemic curves of fiber enriched bread and biscuits were lower than those obtained with the equivalent control food. Consequently, a marked reduction of their GI of 21% and 41% for bread and biscuits, respectively, was observed.
The fiber mix added to the flour used in the preparation of biscuits and bread markedly reduces their GI. A similar effect could be expected in other oven-baked foods produced using the same fiber supplementation.
Nutrition, metabolism, and cardiovascular diseases: NMCD 05/2008; 18(9):602-5. · 3.52 Impact Factor
-
Andrea Poli,
Franca Marangoni,
Rodolfo Paoletti,
Elmo Mannarino,
Graziana Lupattelli,
Alberto Notarbartolo,
Paolo Aureli,
Franco Bernini,
Arrigo Cicero,
Antonio Gaddi, [......],
Roberto Volpe,
Carlo Cannella,
Alessandro Pinto,
Eugenio Del Toma,
Carlo La Vecchia,
Alessandra Tavani,
Enzo Manzato,
Gabriele Riccardi,
Cesare Sirtori,
Alberto Zambon
[show abstract]
[hide abstract]
ABSTRACT: The importance of non-pharmacological control of plasma cholesterol levels in the population is increasing, along with the number of subjects whose plasma lipid levels are non-optimal, or frankly elevated, according to international guidelines. In this context, a panel of experts, organized and coordinated by the Nutrition Foundation of Italy, has evaluated the nutritional and lifestyle interventions to be adopted in the control of plasma cholesterol levels (and specifically of LDL cholesterol levels). This Consensus document summarizes the view of the panel on this topic, with the aim to provide an updated support to clinicians and other health professionals involved in cardiovascular prevention.
Nutrition, metabolism, and cardiovascular diseases: NMCD 03/2008; 18(2):S1-16. · 3.52 Impact Factor
-
Journal of the American Dietetic Association 02/2008; 108(1):34-5; author reply 35. · 3.59 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The prevalence of non-communicable diseases (for example, cardiovascular disorders, type 2 diabetes and cancer) is rampant in Western societies, accounting for approximately 60 % of all causes of death. A large proportion of non-communicable diseases can be prevented through appropriate diets and lifestyles. Accordingly, several health authorities and regulatory bodies are assessing the nutritional profiles of food items and whole diets, to implement guidelines aimed at improving the diet of the general population. While a global approach is desirable, the need of individuals to maintain their distinct dietary habits must also be taken into account. The portion sizes of food as well as pattern of food consumption, for example during or between the main meals, are very important in determining the nutritional profile of a diet. A novel method to assess the nutritional profile of foods is being proposed and made available on-line. Its main innovative aspects are (1) the comprehensive manner with which the system analyses and computes a great range of features of individual food items and (2) the distinction among eating occasions, namely during or in-between the main meals. Moreover, this approach allows for rapid modification and great flexibility to suit individual needs and gastronomic habits.
British Journal Of Nutrition 01/2008; 98(6):1101-7. · 3.01 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Ingestion of alpha linolenic acid (ALA), with the richest source among dry fruits such as walnuts, is associated with cardiovascular prevention. The aim of this study was to selectively evaluate the effects of moderate walnut consumption on the levels of ALA and its metabolic derivatives in human blood.
After a 2-week run-in period, 10 volunteers consumed 4 walnuts per day (in addition to their habitual diet) for 3 weeks. Fatty acid profiles, with special attention to levels of ALA and long chain polyunsaturated fatty acids (LC-PUFA), were assessed in blood drops collected from fingertips. The data indicate that the administration of a few walnuts a day for 3 weeks significantly increases blood levels, not only of ALA (from 0.23+/-0.07 SD to 0.47+/-0.13 SD), but also of its longer chain derivative eicosapentaenoic acids (EPA) (from 0.23+/-0.37 to 0.82+/-0.41) with levels remaining elevated over basal values after washout.
The findings of this pilot study indicate that plant ALA in appropriate food items favourably affects the n-3 LC-PUFA status.
Nutrition, metabolism, and cardiovascular diseases: NMCD 08/2007; 17(6):457-61. · 3.52 Impact Factor
-
Andrea Poli
[show abstract]
[hide abstract]
ABSTRACT: By inhibiting 3-hydroxy-3-methylglutaryl coenzyme-A (HMG-CoA) reductase, the statins reduce hepatocyte cholesterol levels, which results in up-regulation of low-density lipoprotein (LDL) receptors and, consequently, increased clearance of LDL-cholesterol (LDL-C) from the plasma. Structural differences among the available statins partially account for differences in their capacity to inhibit HMG-CoA reductase and their lipid-lowering efficacy, and for variability in other biological properties, such as their pharmacokinetic characteristics and their tolerability and propensity to interact with other drugs. In terms of pharmacokinetic properties, the synthetic (type II) HMG-CoA analogue atorvastatin exhibits a number of characteristics that are different to those of other members of the class, including a longer plasma half-life and metabolites that have an ability to inhibit HMG-CoA reductase equivalent to that of the parent drug. These characteristics are postulated to be responsible for a more prolonged inhibition of HMG-CoA reductase, and, hence, for the greater efficacy of atorvastatin in decreasing total and LDL-C levels relative to other statins (with the exception of rosuvastatin) noted in clinical trials in patients with dyslipidaemias. From the available clinical trial data, atorvastatin can be considered one of the most effective statins, not only by taking into account its effects on LDL-C and ability to meet recommended treatment guidelines for this parameter, but also its effect on triglyceride levels and capacity to modify lipoprotein composition in a non-atherogenic manner. Clinical studies with atorvastatin have also shed some light on the question as to whether it is better to focus on obtaining maximal reduction of LDL-C in at-risk patients or on cardiovascular outcomes. Cardiovascular event rates have been shown to be substantially lower in patients attaining LDL-C levels between 1.0 and 1.6 mmol/L (40-60 mg/dL) or < or =1.0 mmol/L (< or =40 mg/dL) compared with higher levels (>2.1-2.6 mmol/L [>80-100 mg/dL]). This finding reinforces the update of the National Cholesterol Education Programme's clinical practice guidelines, which recommend LDL-C levels <2.6 mmol/L (100 mg/dL) to be the goal of antihyperlipidaemic drug therapy in high-risk patients with CHD, with an optional therapeutic target of <1.8 mmol/L (70 mg/dL) in patients at very high risk.
Drugs 01/2007; 67 Suppl 1:3-15. · 4.23 Impact Factor
