Lorenzo M Donini

Sapienza University of Rome | la sapienza · Department of Experimental Medicine

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...

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...

It's a frightening time due to COVID-19, but the great elderly/centenarians, apparently with more frailty, seem to have a better response to the pandemic. "The South Italy" lifestyle seems an "effective strategy" promoting the well-being embedded in a holistic solution: healthy diet, less exposure to PM10 pollution, protected environment, and moder...

Malnutrition is common in older adults and is associated with functional impairment, reduced quality of life, and increased morbidity and mortality. The aim of this study was to explore the association between health (including depression), physical functioning, disability and cognitive decline, and risk of malnutrition. Participants were recruited...

Aging is a risk factor for the development of multiple chronic diseases, including cardiovascular disease, cancer and dementia. Life expectancy has increased in certain countries but this phenomenon is associated with a reduction of years of healthy life. Aging is associated with a number of physical and functional changes, especially sarcopenia. S...

riAssUnTO. l’emergenza sanitaria della epidemia da Covid-19 ha sollecitato lacondivisione di dati scientifici dapprima dai focolai maggiormentecolpiti fino a coinvolgere le comunità scientifiche di diversi continenti a causa della diffusio- ne pandemica della infezione. numerosi articoli apparsi nella Medline sono basati su informazioni provenienti...

L’emergenza sanitaria della epidemia da Covid-19 ha sollecitato la condivisione di dati scientifici dapprima dai focolai maggiormente colpiti fino a coinvolgere le comunità scientifiche di diversi continenti a causa della diffusione pandemica della infezione. numerosi articoli apparsi nella Medline sono basati su informazioni provenienti dalle sche...

Background The association between folate insufficiency and congenital neural tube defects has been extensively investigated since 1990s. To reach an adequate intake of folic acid (FA), it is suggested to improve folate status through periconceptional supplementation with FA, promotion of the consumption of foods rich in natural folates, and the ap...

Short and long sleep duration have been associated with risk of obesity in children and adolescents. Evidence in adults is more mixed, with biological and psychosocial factors underlying these relationships mostly unknown. This review aimed at qualitatively and quantitatively summarizing previous studies on sleep duration as a predictor of obesity...

Sommario Alla base dell’attuale epidemia di obesità (globesity) la sedentarietà occupa un posto di primo ordine: non solo perché mantiene l’eccesso di tessuto adiposo, ma perché predispone il soggetto obeso all’erosione della massa muscolare scheletrica (sarcopenia) e del patrimonio minerale osseo (osteopenia/osteoporosi). In questo scenario si ins...

The obesity paradox refers to extant evidence showing that obesity in older subjects or in patients with several chronic diseases may be protective and associated with decreased mortality. A number of mechanisms have been postulated to support the existence of obesity paradox; however, marked heterogeneity was found across studies and this has cast...