Lorenzo M Donini

• MD
• Professor (Full) at Sapienza University of Rome

Background/Objectives: Low fasting blood lysosomal acid lipase (LAL) activity is associated with the pathogenesis of metabolic hepatic steatosis. We measured LAL activity in blood and plasma before and after an oral fat tolerance test (OFTT) in patients with metabolic-dysfunction-associated steatotic liver disease (MASLD). Methods: Twenty-six contr...

It is estimated that more than one-tenth of adults aged ≥60 years are now classified as having sarcopenic obesity (SO), a clinical condition characterized by the concurrent presence of sarcopenia (low muscle mass and weakness) and obesity (excessive fat mass). Independently, sarcopenia and obesity are associated with a high risk of numerous adverse...

We appreciate the interest of Schluessel S [...]

Sommario Il ciclo mestruale è un importante indicatore di salute femminile che riflette l’equilibrio ormonale e metabolico di una donna. L’amenorrea primaria, caratterizzata dall’assenza di menarca nelle ragazze con età superiore ai 15 anni e con segni di sviluppo puberale, o superiore ai 13 anni senza tali segni, può derivare da diverse cause. Tra...

Background/Objectives: Traditional weight-loss methods often result in the loss of both fat and muscle mass. For individuals with sarcopenic obesity (SO), additional muscle loss can exacerbate sarcopenia, leading to further declines in muscle strength and function, ultimately worsening quality of life. To mitigate this risk, weight-loss strategies...

Dysregulated eating behaviors, comprising subthreshold and clinical binge-eating disorder (BED) and bulimia nervosa (BN), are increasing among the general population, with a consequent negative impact on one’s health and well-being. Despite the severity of these outcomes, people with BED and BN often face a delay in receiving a diagnosis or treatme...

Purpose of review Sarcopenic obesity is a likely common, but certainly underestimated obesity phenotype, with an important negative clinical impact. Its definition and diagnosis have however remained elusive until recently. Recent findings Substantial progress has been recently made in sarcopenic obesity diagnostic tools, with the first internatio...

Background Eating disorders (EDs) pose a significant risk to health, especially when not diagnosed early. For several years EDs and oral health has been extensively studied, and now it is quite clear the existence of a correlation between specific oral manifestations and these disorders. While these oral signs could potentially aid early diagnosis...

Background: Sarcopenic obesity (SO) is a clinical condition characterized by coexistence of obesity and sarcopenia. The crosstalk that occurs between muscle tissue and adipose tissue is a complex and dynamic interaction with a crucial role in the development and progression of SO. Adipose tissue has been shown to release fatty acids affecting muscl...

Background Aging is associated with a progressive change of body composition characterized by muscle mass decline and accumulation of adipose tissue that can lead to sarcopenia and obesity, respectively. The prevalence of sarcopenia is poorly known given the different parameters and thresholds in proposed definitions. The combination of obesity (de...

Background: Sarcopenic obesity (SO) is the combination of excess fat, skeletal muscle and muscular strength/function deficit. The ESPEN/EASO have proposed new diagnostic criteria, but the SO prevalence in patients with severe obesity remains to be established. The aim of this study was to establish the SO prevalence in a large cohort of inpatients...

The 6th International Conference, "Controversies in Vitamin D," was convened to discuss controversial topics, such as vitamin D metabolism, assessment, actions, and supplementation. Novel insights into vitamin D mechanisms of action suggest links with conditions that do not depend only on reduced solar exposure or diet intake and that can be detect...

Purpose The aim of the present review is to analyze dynamic interactions between nutrigenomics, environmental cues, and parental influence, which can all lead to children’s neophobic reactions and its persistence in time. Methods We reviewed studies available on electronic databases, conducted on children aged from birth to 18 years. We also consi...

In order to tackle the global increase in overweight and obesity prevalence, several nutrient profiling systems have been developed; among others, Food Compass Score (FCS) has been designed to encompass multiple domains of food healthfulness. However, environmental sustainability of healthy diets is another crucial dimension which should not be ove...

Purpose of the review Sarcopenic obesity is a newly identified pathological entity defined by an increase in body fat mass with an associated sarcopenia, characterized by loss of muscle mass, strength, and function. Recently, the concomitant presence of skeletal alteration with sarcopenic obesity has been described leading to a new clinical entity...

Sarcopenic obesity is characterized by a concurrent decline in muscle mass and function, along with increased adipose tissue. Sarcopenic obesity is a growing concern in older adults owing to significant health consequences, including implications for mortality, comorbidities and risk of developing geriatric syndromes. A 2022 consensus statement est...

Nutrition clinique et métabolisme 27 (2013) S57-S175 / Cahiers de nutrition et de diététique 48 (2013) S57-S175 S113 Il n'y avait pas de variations des phosphatases alcalines. La stéatose hépatique préopératoire des rats HF semblait s'amé-liorer mais des infiltrats inflammatoires lymphocytaires hépatiques étaient observés chez les opérés bariatriqu...

Despite being acknowledged as one of the healthiest diets in the world, there has been a shift away from the Mediterranean Diet (MD) pattern observed recently in the Mediterranean countries. This has undesirable consequences for health, but also for social, cultural, economic and environmental domains in the Mediterranean area. The Med Diet 4.0 fra...

Background: Orthorexia Nervosa (ON) is a condition characterized by an obsessive focus on healthy eating, inflexible dietary rules, and persistent preoccupations with food. Despite it has been recently the subject of increasingly relevant studies, little is known about the mechanisms that might foster ON symptoms. Objective: This study used a stru...

An emerging research niche has focused on the link between social determinants of health and diabetes mellitus, one of the most prevalent non-communicable diseases in modern society. The aim of the present mini-review is to explore and summarize current findings in this field targeting high-income countries. In the presence of disadvantaged neighbo...

The use of dietary supplements is widespread in developed countries, and in Italy we find the largest market, with a forecast of sales of 5 billion euros in 2025. The reasons for using dietary supplements are mainly the search for psycho-physical well-being or the answer to specific health needs. Dietary supplements are products intended to integra...

Purpose: The aim of the study was to examine the effects of meal supervision, provided by health professionals, volunteers or family members, on anthropometric, nutritional, psychological, and behavioural outcomes in patients with eating disorders (EDs). Methods: The present systematic review was performed according to the Preferred Reporting It...

Bariatric surgery is associated with a postoperative reduction of 25(OH) vitamin D levels (25(OH)D) and with skeletal complications. Currently, guidelines for 25(OH)D assessment and vitamin D supplementation in bariatric patients, pre- and post-surgery, are still lacking. The aim of this work is to analyse systematically the published experience on...

The extent to which inflammation impacts food intake remains unclear, serving as a key risk factor for malnutrition as defined by the Global Leadership Initiative on Malnutrition (GLIM). To address this, we analyzed a large, merged dataset of geriatric hospitalized patients across Europe. The study included 1650 consecutive patients aged ≥65 year f...

Background Dietary habits and Physical Activity (PA) are two pivotal features of healthy life in terms of the prevention and treatment of metabolic and chronic disease [1] . Few data are available concerning these issues in isolated Sjӧgren’s syndrome (SS) patients [2] . Objectives Aim of the study was to assess the level of PA, the adherence to M...

Aging and obesity are synergistic sarcopenia risk factors (RF). Their association in sarcopenic obesity (SO) enhances morbidity and mortality, but consensus on SO diagnostic criteria is limited. ESPEN and EASO issued a consensus algorithm for SO screening (obesity and clinical SO suspicion) and diagnosis [low muscle strength by hand-grip (HGS) and...

In a recent manuscript, our team published the results of an original pilot cross-sectional study assessing orthorexia nervosa (ON) tendencies among patients with rheumatoid arthritis (RA) [...]

Nutrient profiling and front-of-pack labeling (FOPL) have been developed to categorize food products as more or less healthy based on their nutrient content and to easily communicate this information to consumers. The goal is to change individual food choices toward a healthier diet. Since global climate change has recently become an urgent matter,...

Accumulating evidence supports a connection between sarcopenic obesity (SO) and NAFLD. The extent to which fatty liver contributes to impaired muscle contractility is not yet well established. The aim of our study was to investigate the effect of NAFLD on dynapenia in patients with SO. In this study, 71 non-diabetic subjects (age 55 (7.8) years, BM...

The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched the Sarcopenic Obesity Global Leadership Initiative (SOGLI) to reach expert consensus on a definition and diagnostic criteria for Sarcopenic Obesity (SO). The present paper describes the proceeding of the Sarcopen...

Medical nutrition therapy (MNT) is an indisputable component of the multidisciplinary therapeutic approach in rheumatoid arthritis (RA). Previous research has suggested that in chronic disease where nutrition is an important effector of prognosis, healthy dietary choices might take an unhealthy turn, with patients developing disordered eating in th...

Purpose Over the past two decades, orthorexia nervosa (ON) has been increasingly investigated. Recently, a new revision version of the ORTO-15, namely ORTO-R, was used. The main objective of the present study was to confirm the factor structure of Polish version of the ORTO-R for evaluating ON thoughts and behaviors. Method In three studies, a tot...

Digital anthropometry (DA) has been recently developed for body composition evaluation and for postural analysis. The aims of this review are to examine the current state of DA technology, as well as to verify the methods for identifying the best technology to be used in the field of DA by evaluating the reliability and accuracy of the available te...

The prevalence of obesity and of other non-communicable diseases related to overnutrition is significantly increasing in the past few years. Policy makers are called to counteract this pandemic, orienting consumers towards a healthier and more sustainable diet. Most of the proposed initiatives are dedicated to the content of nutrients with "unfavou...

Purpose Since the term orthorexia nervosa (ON) was coined from the Greek (ὀρθός, right and ὄρεξις, appetite) in 1997 to describe an obsession with “correct” eating, it has been used worldwide without a consistent definition. Although multiple authors have proposed diagnostic criteria, and many theoretical papers have been published, no consensus de...

Background Front-of-Pack Nutritional Labels are considered a useful tool to help consumers orient themselves in their food choices and direct their behavior toward a healthier diet. FOPNL development and use are part of a framework that includes cognitive, biological, hedonic and cultural aspects, able to affect consumers' eating and purchasing beh...

Sommario Descritte per la prima volta negli anni’20 del Novecento, le diete chetogeniche sono passate da dietoterapia “di nicchia” per epilessie farmaco-resistenti o secondarie a rare malattie metaboliche (es. deficit di GLUT-1), a trattamento diffuso di patologie associate a malnutrizione per eccesso (diabete mellito di tipo 2, obesità). Attualmen...

Obesity affects thyroid gland function. Hypothyroidism, thyroid nodules, goiter, and thyroid cancer are more frequent in patients with higher body mass index values. Although these data are supported by many clinical and epidemiological studies, very scarce is our knowledge at the molecular level. In this study, we present the first experimental ev...

Front-of-pack labels (FOPL) aim at communicating to consumers the health value of food items in support of public health policies. Two main types can be discerned: “directive and semi-directive” FOPL using colour schemes (e.g., Nutri-Score) and “informative” FOPL (e.g., Nutrinform Battery). “Directive” approaches tend to show a “wear out effect” an...

Exposure to artificial light at night (ALAN) has been associated with disruption of the circadian system, which has been pointed out to have detrimental effects on health. Exposure to outdoor ALAN is very frequent in industrialised countries due to nocturnal light pollution and the relevant involvement of the total workforce in shift work and night...

The adoption of supplementary nutrition information, i.e., front-of-pack labeling (FOPL), on pre-packed food products is advocated as a tool to improve the consumers' knowledge of the nutrient content or the nutritional quality of foods, but also to drive products reformulation by the food industry. Ultimately, FOPL should help people to select foo...

Background: Within the literature, there is a variety of different measurement methods for orthorexic behaviours. The ORTO-15 is the one that attracted most research attention. Many scholars criticized the ORTO-15 for its unstable factor structure and over-estimation of the prevalence of orthorexia nervosa. For this purpose, Rogoza and Donini (2020...

Nutrition labels advise consumers about the nutritional value of packaged foods and their contribution to the overall composition of the diet. They have been proposed as an instrument for the promotion of healthy diets and the primary prevention of obesity and diet-related non-communicable diseases (NCDs). In this opinion paper, we discuss the abil...

Objectives: Weight bias is defined as negative attitudes towards, and beliefs about, others because of their weight. Like other forms of stigma, weight stigma has a harmful impact on health, including depressive symptoms, disordered eating, body image disturbances and poor quality of life. Several instruments measuring weight-related attitudes have...

As a team of scientists who believe that exchanging views is one of the prerequisites of the scientific method, we welcome the comments from Aguenaou H et al. [...].

Purpose Orthorexia Nervosa (ON) is described as an extreme level of preoccupation around healthy eating, accompanied by restrictive eating behaviors. During the years, different assessment instruments have been developed. The aim of the study is to adapt into Italian the Düsseldorf Orthorexia Scale (I-DOS) and to test its psychometric properties....

Background: on the 9 March 2020, the Italian government declared a state of lockdown on the entire national territory aimed at reducing the spread of SARS-CoV-2, causing strong repercussions for people's lifestyles. The aim of the study was to analyze the impact of the lockdown on the nutritional status and lipid profile of employees of an Italian...

Sommario La prima osservazione che la malnutrizione e la perdita di peso contribuiscano alla morte dei malati di cancro in maniera significativa e indipendentemente dagli effetti del tumore stesso risale a più di 70 anni fa. Da allora l’intervento nutrizionale, inteso sia come screening sia come trattamento medico orientato alla ricerca e alla cura...

Purpose Anorexia nervosa (AN) is a serious and complex mental disorder affecting mainly young adult women. AN patients are characterized by low body weight in combination with self-induced starvation, intense fear of gaining weight, and distortion of body image. AN is a multifactorial disease, linked by recent evidence to a dysregulation of the imm...

Introduction: Loss of skeletal muscle mass and function (sarcopenia) is common in individuals with obesity due to metabolic changes associated with a sedentary lifestyle, adipose tissue derangements, comorbidities (acute and chronic diseases) and during the ageing process. Co-existence of excess adiposity and low muscle mass/function is referred t...

Introduction Loss of skeletal muscle mass and function (sarcopenia) is common in individuals with obesity due to metabolic changes associated with a sedentary lifestyle, adipose tissue derangements, comorbidities (acute and chronic diseases), and during the ageing process. Co-existence of excess adiposity and low muscle mass/function is referred to...

To stem the increasing incidence of non-communicable diseases (NCDs) and obesity, front-of-pack labels (FOPLs) have been developed since 1989. Whereas several countries have already adopted one voluntarily, the European Community wants to harmonize an FOPL system that will be mandatory for all member states. The purpose of this narrative review is...

Sommario Negli ultimi anni il digiuno intermittente è emerso quale approccio innovativo per promuovere il calo ponderale e migliorare lo stato di salute metabolica in contrapposizione agli interventi più convenzionali incentrati sulla restrizione calorica. Il digiuno intermittente ( Intermittent Fasting ) e il Time-Restricted Feeding (TRF) negli an...

Purpose: The present study aimed to validate the ORTO-15 questionnaire for orthorexia nervosa (ON), translated by our group into the Greek language, and replicate the findings of the recently proposed 6-item ORTO-R. Methods: The tool was translated into the Greek language (ORTO-15-GR) using the forward-backward-forward method. A total of 848 adu...

Orthorexia nervosa (ON) is an emerging eating disorder characterized by an obsession with healthy food that may lead to malnourishment, medical complications, loss of social and personal relationships and poor quality of life.

Objectives Eating disorders (EDs) are severe psychiatric conditions characterized by malnutrition, dysfunctional behaviors, and hypovitaminosis D. In various psychiatric conditions, including EDs, preliminary evidence has correlated impulsivity to a low level of 25-hydroxyvitamin D [25(OH)D]. This study aims to reinforce this evidence by examining...

Orthorexia nervosa (ON) is an unspecified feeding or eating disorder (USFED) characterized by an exaggerated, unhealthy obsession with healthy eating. Τypical eating disorders (EDs) and USFEDs are common among patients with diabetes mellitus (DM), which complicates metabolic control and disease outcomes. The present systematic review summarizes the...

Purpose: Malnutrition, whether characterized by not enough or too much nutrient intake, is detrimental to the liver. We herein provide a narrative literature revision relative to hepatic disease occurrence in over or undernourished subjects, to shed light on the paradox where both sides of malnutrition lead to similar liver dysfunction and fat accu...

Purpose Quality of life is a fundamental aspect of both clinical practice and research on eating disorders (ED) due to the significant impacts these disorders have on everyday life. Disorder-specific scales can improve the quality of research and findings and offer greater sensitivity and responsiveness. However, no specific instrument is available...

The use of the direct oral anticoagulants dabigatran, rivaroxaban, apixaban and edoxaban (DOACs) offers some major advantages over warfarin and other vitamin K antagonists (VKAs). One advantage is the possibility to use a fixed dose in normal-weight patients, overweight patients and patients with obesity. However, the “one size fits all” strategy r...

The hospital catering service plays a decisive role in responding to the clinical and nutritional needs and in providing food acceptable to patients. Unfortunately, at the moment, most hospital catering services provide a service deemed insufficient by users and are burdened by a high proportion of food waste that may negatively affect the nutritio...

The role of diet in the prevention of chronic non-communicable diseases has been demonstrated in numerous studies and attributed to various nutrients and bioactive compounds, naturally present in foods. It is therefore important to preserve the nutritional quality of the dishes served in hospital settings where the prevalence of malnutrition is par...

Epidemiological evidence has confirmed the potential causal relationship between specific dietary factors and non-communicable diseases. However, currently nutrition was shown to be insufficiently integrated into medical education, regardless of the country. Without an adequate nutrition education, it is reasonable to assume that future physicians,...

Purpose: Orthorexia Nervosa (ON) is described as an extreme level of preoccupation around healthy eating, accompanied by restrictive eating behaviors. During the years different assessment instruments have been developed. The aim of the study is to adapt into Italian the Düsseldorf Orthorexia Scale (I-DOS) and to test its psychometric properties. M...

Background The Mediterranean Diet (MD) has anti-inflammatory and immunomodulatory effects 1,2 suggesting a protective role in rheumatic diseases. There is limited knowledge about the eating habits and the nutritional state in patients with isolated Sjögren Syndrome (SS) living within the Mediterranean area. Objectives assessment of adherence to th...

Sarcopenic obesity (SO) is characterised by a concomitant high fat mass (FM) and low fat free mass (FFM) leading to an increased cardio‐metabolic risk. This analysis aims to estimate the SO prevalence in Iranian adults and evaluate the association of SO with metabolic syndrome (MetS) risk. This cross‐sectional analysis included 4296 subjects (age 3...

Background Orthorexia nervosa has attracted significant attention in the field, however, alongside increasing knowledge, more and more gaps are being identified. One of the fundamental problems concerns measurement of orthorexia nervosa. The most commonly used self-report measure, the ORTO-15, demonstrated an unstable factorial structure across dif...

Objective : Primary objective is to explore the effect of eucaloric ketogenic diet (EKD) on mortality, admission to intensive care unit (ICU) and the need for non-invasive ventilation (NIV) in hospitalized patients affected by COVID-19 in comparison to eucaloric standard diet (ESD). Secondary objectives are: the verification of safety and feasibili...

Purpose of review: Tough plenty of literature investigated therapeutic options for body composition changes targeting elderly people, evidence concerning potential treatments of sarcopenic obesity as a unique condition is scarce. The aim of the present review was to summarize recent evidence regarding treatment of sarcopenic obesity in adult and o...

Purpose: To the best of our knowledge, no scientific publications on orthorexia nervosa have been based on a French population. The goal of our study was to confirm the factor structure of the French version of the ORTO-15 questionnaire. Methods: An online survey (N = 768) was conducted asking participants (84.77% were women) to answer several q...

Background: Nowadays the food production, supply and consumption chain represent a major cause of ecological pressure on the natural environment, and diet links worldwide human health with environmental sustainability. Food policy, dietary guidelines and food security strategies need to evolve from the limited historical approach, mainly focused o...

The knowledge of factors determining dietary intake is important to develop targeted strategies to prevent malnutrition and age-related diseases. Objective : The aim of the present systematic review was to analyze the state of the art regarding the role of social status, cultural aspects and psychological distress on dietary intake in community-dw...

Background: Obesity is a clinical condition that contributes to the development of related disability in different areas (physical, psychological and social). Multidisciplinary treatment calls for specific instruments able to evaluate all related functional problems. We have developed a tool (an ICF-based assessment instrument, the ICF-OB schedule...

Background: Some patients affected by Covid 19 present a life threatening hyperinflammatory state known as a cytokine storm syndrome (CSS) associated with a high mortality rate. Our hypothesis is that eucaloric ketogenic diet (EKD) may be a safe and efficacious treatment option to reduce CSS and consequently to reduce need of CPAP, ICU admission an...

Background: Some patients affected by COVID-19 present a life-threatening hyperinflammatory state known as cytokine storm syndrome (CSS) associated with a high mortality rate. Our hypothesis is that a eucaloric ketogenic diet (EKD) may be a safe and efficacious treatment option to reduce CSS and consequently to reduce the need for CPAP, ICU admissi...

The purpose of this article is to review the historical development of the healthy food model of the Mediterranean Diet and related scientific knowledge from the early 1960s to the present time. The review presents the origins of the first pyramid of the traditional Mediterranean Diet in 1993 and how it has been revised to produce, in 2010, a new u...

Sommario L’obesità sarcopenica è una sindrome più frequentemente presente nella popolazione anziana, associata ad aumentato rischio di disabilità, morbilità e mortalità. Questo articolo discute l’evoluzione e le controversie legate alla definizione di tale patologia, i fattori di rischio, i meccanismi fisiopatologici, le conseguenze clinico-funzion...