Marialaura Bonaccio

IRCCS Istituto Neurologico Mediterraneo Neuromed | Neuromed · Epidemiology and Prevention

Introduction: Cardiovascular (CV) disease, the leading cause of death globally, is largely preventable through targeting modifiable risk factors. Scores of modifiable CV risk factors able to collect the combined effect of all the included components were mainly developed in US populations, or do not include nutritional aspects. Hypothesis: We asses...

Introduction: Vegetarian diets are characterized by the absence of some animal foods (e.g. red and processed meats), and a high consumption of plant-based foods. However, plant-based foods can include foods with varying nutritional value and divergent health effects. Hypothesis: We assessed the hypothesis that three different pro-vegetarian (PVG) f...

Introduction: Body mass index (BMI) has J-shaped associations with all-cause mortality, but it is unclear whether diet can modify the impact of BMI on mortality. Hypothesis: We tested the hypothesis that a large dietary share of ultra-processed food (UPF) can act as an effect modifier of this association. Methods: Longitudinal analysis on 22,836 wo...

Introduction: Epidemiologic studies suggest that heavy alcohol drinking is associated with unhealthy profile, whereas its light to moderate intake is associated with reduced hazard of total mortality as compared with lifetime abstention, a result largely driven by a reduction in cardiovascular mortality. Up to date, there is no agreement on a possi...

Excess consumption of ultra-processed foods (UPFs) is currently under investigation for its potentially detrimental impact on human health. Current evidence demonstrates a substantial association with an increased risk of metabolic disorders, but data on mental health outcomes are just emerging. The aim of this study was to investigate the relation...

Background: We aimed to assess the prevalence of depressive and anxiety symptoms, hopelessness and insomnia in the older adults before and during the COVID-19 pandemic identifying subgroups at higher risk of mental distress. Methods: Within the Lost in Lombardy project, a web-based cross-sectional study was conducted on a representative sample o...

Background High dietary glycaemic index (GI) and load (GL) have been associated with increased risk of various cardiometabolic conditions. Among the molecular potential mechanisms underlying this relationship, DNA methylation has been studied, but a direct link between high GI and/or GL of diet and global DNA methylation levels has not been proved...

Polyphenols are naturally occurring compounds endowed with antioxidant and anti-inflammatory properties. We sought to examine the association of dietary polyphenols with the risk of severe lumbar spinal stenosis (LSS), a condition possibly characterized by a high inflammatory component. A case-control study included 156 patients with LSS and indica...

Background The relationship between diet and central nervous system (CNS) tumours was almost exclusively focused on food composition. We evaluated the relationship of different degrees of food processing with risk of CNS tumours. Methods The study sample included 44 CNS tumours cases (20 non-malignant and 24 malignant) recruited from the Neurosurg...

Background A healthy diet plays a major role in supporting the immune system which is critical to protect the host from pathogenic organisms. To date, evidence on the relationship between dietary habits and the risk of SARS-CoV-2 infection is still scarce. Methods Analyses on 1,096 participants from the Moli-sani Study (2005-2010) who were re-exam...

Background Ultra-processed food (UPF) is a major public health concern being reportedly associated with increased risk of non-communicable diseases and lower survival. However, most of the epidemiological evidence has been almost exclusively provided by research conducted in populations of youths or middle-aged adults. We tested the hypothesis that...

There is convincing evidence that diet quality represents one of the most important public health targets to prevent non-communicable diseases. Dietary risks alone have been estimated to be responsible for about 10 million deaths due to cardiovascular diseases, metabolic disorders, and certain cancers worldwide, with trends not expected to decrease...

The COVID-19 pandemic and the adoption of restrictive measurements to control the SARS-CoV-2 spread disrupted general population lifestyles including dietary behaviours. However, there is poor knowledge on potential socioeconomic and gender disparities in dietary changes. We conducted a telephone-based survey during fall 2020 on a sample of 4,400 p...

Background Vegetarians diets are characterized by the absence of some animal foods (e.g. red and processed meats), and a high consumption of plant-based foods. However, plant-based foods can include foods with varying nutritional value and health effects. We examined the association of three different pro-vegetarian (PVG) food patterns defined as g...

Background Body mass index (BMI) is the most frequently used adiposity measure, yet it is unable to differentiate fat mass from lean mass. Relative fat mass (RFM) has been proposed as alternative. The aim of this paper is to study RFM and BMI association with mortality in a general Italian population and potential mediators. Methods 20,587 individ...

Ultra-processed food (UPF) consumption has been the focus of major attention due to their potential effects on human health. The aim of this study was to investigate the intake of UPFs in a sample of southern Italian individuals and assess its relationship with nutrient profile and dietary quality parameters. A cross-sectional study was conducted o...

Objective To jointly analyse two food dimensions, the Food Standards Agency Nutrient Profiling System (FSAm-NPS), used to derive the Nutri-Score front-of-pack label, and the NOVA classification in relation to mortality. Design Prospective cohort study. Setting Moli-sani Study, Italy 2005-10. Participants 22 895 participants (mean age 55 (SD 12)...

A cross-sectional study was conducted to assess the possible relationship between chronotype, sleeping, and eating patterns in 74 Italian adults (71.6% women). Based on Morningness-Eveningness Questionnare (MEQ) score, participants were classified as morning (n ¼ 24), intermediate (n ¼ 25), and evening (n ¼ 25) chronotypes. From analysis, no signif...

Healthcare delivery reorganization during the COVID-19 emergency may have had a significant impact on access to care for older adults with chronic conditions. We investigated such impact among all adults with chronic conditions aged ≥ 65 years, identified through the electronic health databases of two local health agencies—ATS Brianza and ATS Berga...

Background & Aims Food processing may adversely affect human health through a variety of mechanisms, including the development of a chronic pro-inflammatory state. In this study we aimed to test the hypothesis that an increasing degree of food processing is directly associated with low-grade inflammation, and evaluate to what extent this associatio...

Background/Objectives Unsaturated fats, fibre-rich foods and polyphenols are distinctive features of a traditional Mediterranean diet and have pleiotropic properties possibly contributing to reduce the long-term risk of non-communicable diseases and mortality associated with this diet. We aimed to evaluate whether changes over time in dietary fats,...

Aims Restrictions imposed to prevent SARS-CoV-2 transmission should be weighed against consequences on vulnerable groups’ health. Lifestyles and disease management of older people with diabetes might have been differentially impacted compared to non-chronic individuals. Methods A cross-sectional study (LOST in Lombardia) was conducted on a represe...

Background Evidence showed that mental health problems have risen markedly during COVID-19. It is unclear if part of the mental sufferings relates to the climate of uncertainty and confusion originated by rough communication by health officials and politicians. Here we test the impact of unanticipated policy announcements of lockdown policies on me...

PurposeNutrition is an important, modifiable, environmental factor affecting human health by modulating epigenetic processes, including DNA methylation (5mC). Numerous studies investigated the association of nutrition with global and gene-specific DNA methylation and evidences on animal models highlighted a role in DNA hydroxymethylation (5hmC) reg...

PurposeTo examine the relationship between psychological distress resulting from the COVID-19 lockdown and dietary changes.Methods Cross-sectional analysis from 2 retrospective Italian cohorts recruited from May to September 2020: (1) The Moli-LOCK cohort consists of 1401 participants from the Moli-sani Study (n = 24,325) who were administered a te...

Little is known on potential socioeconomic and gender disparities in dietary changes during the COVID-19 pandemic. We conducted a telephone-based survey during fall 2020 on 4400 participants representative of the population aged 65-99 years living in Lombardy, Italy. Changes in a Mediterranean lifestyle were assessed retrospectively by scoring modi...

Asbtract Background and aims Biological age (BA) is the hypothetical underlying age of an organism and has been proposed as a more powerful predictor of health than chronological age (CA). The difference between BA and CA (Δage) reflects the rate of biological aging, with lower values indicating slowed-down aging. We sought to compare the relation...

Introduction: The Nutri-Score front-of-pack label rates foods according to their nutritional quality while the NOVA classification is focused on degree of food processing; both systems are reported to separately predict mortality in population-based studies. Hypothesis: We tested the following hypotheses: a) both the Nutri-Score and ultra-processed...

Introduction: Psychological resilience (PR) is understood as the capacity to adapt positively in face of adverse events. Its role as an independent protective factor for health has been increasingly acknowledged in recent years. Hypothesis: We tested the hypothesis that psychological resilience could act as a protective factor towards disease, in p...

Introduction: Excessive consumption of ultra-processed food (UPF) is associated with increased risk of mortality and disease in general populations but its health impact for individuals with type 2 diabetes is poorly defined. Hypothesis: We assessed the hypothesis of an association between elevated UPF intake and all-cause and cause-specific mortal...

Background Positive psychosocial factors can play an important role in the development of cardiovascular disease (CVD). Among them, psychological resilience (PR) is defined as the capacity of responding positively to stressful events. Our aim was to assess whether PR is associated with CVD or metabolic disturbances through a systematic review. Met...

Objectives: To estimate psychological distress experienced during the Italian lockdown (March-May 2020) by assessing, in the transition period of the pandemic (June-September 2020), participants’ recalling of their psychological state. Methods: Cross-sectional analysis on 1,880 adults (mean age 48.9 ± 14.5 years) from the web-based ALT RISCOVID-19...

Deep Neural Networks (DNN) have been recently developed for the estimation of Biological Age (BA), the hypothetical underlying age of an organism, which can differ from its chronological age (CA). Although promising, these population-specific algorithms warrant further characterization and validation, since their biological, clinical and environmen...

The lockdowns resulting from the first wave of the COVID-19 pandemic impacted deeply on all life activities, including diet. We performed a systematic review to investigate changes in food intake, eating behaviours and diet quality during lockdown as compared to before. A literature search was performed using three electronic databases from incepti...

Psychological resilience (PR) is the capacity to adapt positively in face of adversity. Its role as an independent protective factor has been acknowledged in recent years. We aimed to test the association of PR with all-cause and cardiovascular disease (CVD) mortality in a general adult population. We performed longitudinal analyses on 10,406 CVD-f...

Aims To evaluate the association of ultra-processed food (UPF) intake and mortality among individuals with history of cardiovascular disease (CVD) and analyse some biological pathways possibly relating UPF intake to death. Methods and results Longitudinal analysis on 1171 men and women (mean age: 67 ± 10 years) with history of CVD, recruited in...

Background The Mediterranean Diet (MD) is one of the healthy eating plans recommended to promote health and prevent chronic diseases. During the COVID-19 pandemic, many countries adopted restrictive measures to mitigate infection spread, which might have influenced people's lifestyle and dietary habits. We conducted a systematic review to evaluate...

Background Economic downturns may have detrimental effects on mental health. We investigated whether economic hardship resulting from the late 2000s great recession is associated with long-term changes in mental health over 12.8 years of follow up. Methods We analysed data on 2,001 participants from the CASSIOPEA Study, a sub-cohort of the larger...

Background The confinement due to COVID-19 pandemic had adverse effects on mental health, but the relation between psychological distress resulting from lockdown measures and dietary habits needs to be elucidated. Methods We analysed 2,741 subjects (mean age 58.1±15.3 y) pooled from 2 retrospective Italian cohorts recruited from May to September 2...

Background The Nutri-Score front-of-pack label rates foods according to their nutritional quality while the NOVA classification is focused on degree of processing; both systems separately predicted mortality in epidemiological contexts. We evaluated whether ultra-processed food (UPF) modifies the association of the Nutri-Score with mortality. Meth...

Background Data on milk and other dairy products intake with health outcomes are inconsistent. We investigated the association of milk and total dairy consumption with the risk of all-cause and cause-specific mortality in a Mediterranean population. Methods We performed a longitudinal analysis on 22,889 men and women (mean age 55.4±11.7 y; 52.3% w...

Background and aim of the work: During the COVID-19 pandemic, many countries adopted restrictive measures to mitigate infection spread, which might have influenced people's lifestyle and dietary habits. We conducted a systematic review to evaluate the impact of national lockdowns on adherence to the Mediterranean Diet (MD). Methods: Studies were...

Purpose Dietary guidelines recommend to limit egg consumption to 4 servings per week but the relation between egg intake and health outcomes is still controversial. To evaluate the association of egg consumption and mortality risk in Italian adults and to investigate nutritional factors and serum lipids as potentially explaining such associations....

Excessive consumption of ultra-processed foods (UPFs), as described by the NOVA classification system, represents a potential threat to human health. The nutritional composition of UPFs may explain their observed adverse effects. The present study aimed to provide a quantitative meta-analysis of nationally representative surveys on the consumption...

Background and Aims There is a lack of knowledge on the association of dietary factors and Lumbar Spinal Stenosis (LSS). We evaluated the association of a Mediterranean diet (MD), its major food components and ultra-processed food (UPF) with the risk of LSS. Methods and Results Participants were recruited from the Neurosurgery Department of the IR...

Background: Depression is a mood disorder characterized by a high rate of resistance to pharmacological treatments, which has often been linked to chronic inflammation. This can be influenced by different environmental factors, in particular pro-inflammatory diets. However, a mediating role of circulating inflammation has never been observed. Aim...

The efficacy of hydroxychloroquine (HCQ) in treating SARS-CoV-2 infection is harshly debated, with observational and experimental studies reporting contrasting results. To clarify the role of HCQ in Covid-19 patients, we carried out a retrospective observational study of 4,396 unselected patients hospitalized for Covid-19 in Italy (February–May 202...

Objective To assess ultra-processed food (UPF) consumption and its sociodemographic, psychosocial and behavioural correlates in a general population of Italian children, adolescents and adults. Design Cross-sectional telephone-based survey Setting Italy, 2010-2013 Participants 9,078 participants (5-97 y), from the Italian Nutrition & HEalth Surv...

The beneficial effects of coffee on human diseases are well documented, but the molecular mechanisms of its bioactive compounds on cancer are not completely elucidated. This is likely due to the large heterogeneity of coffee preparations and different coffee-based beverages, but also to the choice of experimental models where proliferation, differe...

Aim To test the association of alcohol consumption with total and cause-specific mortality risk Design Prospective observational multicentre population-based study Setting Sixteen cohorts (15 from Europe) in the MOnica Risk, Genetics, Archiving and Monograph (MORGAM) Project Participants A total of 142,960 individuals (mean age 50±13 y, 53.9% me...

The efficacy of hydroxychloroquine (HCQ) in treating SARS-CoV-2 infection is harshly debated, withobservational and experimental studies reporting contrasting results. To clarify the role of HCQ in Covid-19patients, we carried out a retrospective observational study of 4,396 unselected patients hospitalized for Covid-19 in Italy (February–May 2020)...

Introduction: Trends in diet quality worldwide indicate a progressive decline in adherence to Mediterranean diet (MD), but data on longitudinal individual-level changes are still limited, especially in Mediterranean countries. Hypothesis: We assessed the hypothesis of an association, in a Mediterranean population, between life course trajectories i...

Biological aging, or the discrepancy between biological and chronological age of a subject (Δage), has been associated with a polyphenol-rich Mediterranean diet and represents a new, robust indicator of cardiovascular disease risk. We aimed to disentangle the relationship of dietary polyphenols and total antioxidant capacity with Δage in a cohort o...

Aim to investigate the relation of pulmonary function impairment with mortality and the possible mediation by low-grade inflammation in a general adult population. Methods A prospective investigation was conducted on 14,503 individuals from the Moli-sani study (apparently free from lung disease and acute inflammatory status at baseline; 2005-2010)...

In 2010, the Mediterranean diet was awarded the recognition of UNESCO as an Intangible Heritage of Humanity because of its complex interplay between several factors, including skills, knowledge, processing, cooking, and particularly the sharing and consumption of food. Also, the Mediterranean way of eating emphasizes local food, seasonality and bio...

We investigated the effect of confinement during the COVID-19 pandemic on the consumption of foods characterising the Mediterranean dietary pattern (MDP) and its major correlates in two Italian population-based cohorts comprising 3161 subjects (mean age 57.7 ± 15.4 y). At population level, 38.8% of participants reported an improvement of diet quali...

Objective To evaluate changes in ultra-processed food (UPF) intake and its major correlates during the first Italian lockdown (March 9 -May 3 2020). Design Retrospective observational study. Setting Italy. Participants We analysed 2,992 subjects (mean age 57.9±15.3 y, 40.4% men). Individual participant data were pooled from 2 retrospective cohor...

PurposeTo evaluate in an Italian general population, the association with mortality of a traditional Mediterranean diet (MD) and non-Mediterranean dietary (non-MD) patterns, and their combined effect, and to test some biomarkers of cardiovascular (CVD) risk as potential mediators of such associations.Methods Longitudinal analysis on 22,849 men and...

We investigated the association of cumulative socioeconomic disadvantage (CSD) and socioeconomic (SES) trajectories across life course with the risk of first hospitalization for heart failure (HF) or atrial fibrillation (AF) and tested some biological mechanisms in explaining such associations. Longitudinal analysis on 21,756 HF- and AF-free subjec...

NOVA is a classification that divides foods into four groups according to processing. Since no questionnaires have been validated to assess the consumption of foods with different levels of processing in the general adult population, we tested the reliability and validity of a 94-item Food Frequency Questionnaire (NFFQ) designed to estimate the int...

Background and Aims Experimental and non-experimental human studies have consistently shown a positive association between exposure to the trace element selenium, which occurs primarily through diet, and risk of type 2 diabetes mellitus. Plausible biological mechanisms include adverse effects of selenium and selenium-containing proteins on glucose...

Deep Neural Networks (DNN) have been recently developed for the estimation of Biological Age (BA), the hypothetical underlying age of an organism, which can differ from its chronological age (CA). Although promising, these population-specific algorithms warrant further characterization and validation, since their biological, clinical and environmen...

Objective: The hypothesis that been set forward that use of Renin Angiotensin Aldosterone System (RAAS) inhibitors is associated with COVID-19 severity. We set-up a multicenter Italian collaboration (CORIST Project, ClinicalTrials.gov ID: NCT04318418) to retrospectively investigate the relationship between RAAS inhibitors and COVID-19 in-hospital m...

Background An inverse relationship between coffee intake and mortality has been observed in several population cohorts, but rarely within Mediterranean countries. Moreover, the biological pathways mediating such an association remain unclear. Objectives We assessed the associations between coffee consumption and total and cause-specific mortality...

Background Consumption of ultra-processed food (UPF) is gaining growing attention in relation to disease/mortality risk, but less is known on the main nutritional factors or biological mechanisms potentially underlying such associations. Objectives We aimed to assess the association between UPF and mortality risk in a large sample of the Italian a...

Background and aims The CASSIOPEA Study was designed to evaluate whether the economic downturn during the late 2000s was a contributing factor to the observed decrease in adherence to Mediterranean diet (MD). Methods and results The study protocol consists of two steps: A) recall of 7,406 men and women who, between 2005 and 2006, had been randomly...

Background Psychosocial resilience is the capacity of responding positively to stressful events in life. We performed a systematic review of the literature to find whether resilience has any protective effect on cardiovascular disease (CVD) or mortality. Methods We searched Pubmed and Prospero systematic Review Registry using terms resilience, psy...

Description of the problem The increasing globalization of diet and dietary habits resulting from the large availability and diversity of food poses new questions for the actual health benefits of different dietary patterns in populations not traditionally exposed to a certain dietary model. Consuming a traditional Mediterranean diet (MD) has been...