Marialaura Bonaccio

IRCCS Istituto Neurologico Mediterraneo Neuromed | Neuromed · Epidemiology and Prevention

Background/Objectives: The study aim was to evaluate the association between UPF consumption and semen quality in a sample of healthy young men in Italy. Methods: A cross-sectional analysis was carried out using data from 126 participants (mean age ± SD 20.0 ± 1.2 years) enrolled in the FASt randomized controlled trial. Food intake was assessed thr...

Current evidence suggests that several aspects of diet quality is globally suboptimal. While increasing animal-based products could exert certain benefits against undernutrition in developing countries, the preference of mass-produced low-quality meat-products over other animal-based ones (i.e., milk, dairy, and eggs) and their overall excessive co...

Background Artificial sweeteners (AS) are chemical substances developed by the food industry to reduce sugar and calories while maintaining sweetness. Cohort studies suggested an increased risk of certain cancers, including breast cancer (BC), associated with AS intake, however evidence exclusively relied on self-reported dietary data rather than o...

Background Diet quality can have beneficial effects on male reproductive health, although studies are still limited, and little is known on the potential impact of ultra-processed foods (UPFs) on semen quality parameters. Methods A cross-sectional analysis was run on 126 participants (mean age 20.0 ± 1.2 y) from the FAST randomized controlled tria...

Background/Objectives: Studies investigating the associations between life-course socioeconomic status (SES) and biological aging (the difference between biological and chronological age, Δage) have mostly been focused on epigenetic clocks and on a limited number of mediators. The aim of this study was to investigate this relationship using a blood...

Background Olive oil consumption has been reportedly associated with lower mortality rates, mostly from cardiovascular diseases, but its potential impact on cancer death remains controversial. Moreover, biological mechanisms possibly linking olive oil consumption to mortality outcomes remain unexplored. Methods We longitudinally analysed data on 2...

Background Serum albumin is inversely associated with overall mortality, but its association with specific causes of death remains uncertain. This study aims to investigate whether hypoalbuminemia, defined as serum albumin levels ≤35 g/L, is associated with mortality specifically attributed to cancer and/or vascular diseases. Methods Serum albumin...

Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides critical evidence that guides local, regional, and global public health decisions. A key feature of the GBD is the collection and calculation of risk-outcome data for modifiable lifestyle exposures (e.g. dietary intake) and physical health outcomes (e.g. cance...

Background Breakfast quality, together with regularity of breakfast, has been suggested to be associated with cardiometabolic health advantages. We aimed to evaluate the quality of breakfast and its socioeconomic and psychosocial correlates in a large sample of the Italian population. Methods Cross-sectional analyses on 7,673 adult and 505 childre...

Introduction Central nervous system (CNS) tumors are severe health conditions with increasing incidence in the last years. Different biological, environmental and clinical factors are thought to have an important role in their epidemiology, which however remains unclear. Objective The aim of this pilot study was to identify CNS tumor patients’ sub...

Background The COVID-19 disease pandemic highlighted the importance of healthy diets in the management of SARS-CoV-2 infection and COVID-19 disease. Evidence suggests the influence of the diet and dietary patterns during post-COVID-19 disease, and the impact of the COVID-19 disease pandemic on dietary habits and quality. However, limited evidence e...

Background Trade-offs between health and sustainability dimensions should be addressed since environmentally sustainable diets can require a substantial dietary shift and result in nutrient deficiencies. The study aimed at modelling the current dietary consumption of the adult population in Italy to reduce diet-related greenhouse gas emission (GHGe...

A global shift from traditional to “Westernized” dietary patterns is being considered responsible for the substantial worsening of global diets and the consequent impact on human health. The need for easily accessible, palatable, and affordable food has driven an industry-led globalization of the markets with products easily available worldwide oft...

Besides the Mediterranean diet, there is a paucity of studies examining plant-based diets in relation to cancer outcomes in Mediterranean populations. We analyzed 22,081 apparently cancer-free participants (mean age 55 ± 12 year) from the Moli-sani study (enrollment period 2005–2010; Italy). A general pro-vegetarian food pattern was computed by ass...

The COVID-19 pandemic highlighted the importance of healthy diets in the management of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and COVID-19. Evidence suggests the influence of diet and dietary patterns during post–COVID-19, and the impact of the COVID-19 pandemic on dietary habits and quality. However, limited evidenc...

Background The COVID-19 pandemic and associated lockdown measures posed an unprecedented challenge to the crucial role of grandparenting in family-oriented cultures, such as Italy. Reduced contact with grandchildren during this period potentially threatened grandparents’ mental health and well-being. Methods We analysed data from the LOckdown and...

Background: Nutritional strategies for prevention and management of type 2 diabetes traditionally emphasize dietary patterns reflecting nutrient goals, but the health implications of ultra-processed food (UPF) for patients with type 2 diabetes remain unknown. Objective: To evaluate the association of UPF intake with all-cause and cardiovascular...

Background: Cardiovascular (CV) disease is preventable through interventions targeting modifiable factors. Most algorithms based on modifiable CV risk factors (CV-rf) have been developed in US populations and do not account for the role of diet. We aimed to assess an algorithm based on modifiable CV-rf including diet, using data from an Italian po...

The association between socioeconomic status (SES) and alcohol-related diseases has been widely explored. Less is known, however, on whether the association of moderate drinking with all-cause mortality is modified by educational level (EL). Using harmonized data from 16 cohorts in the MORGAM Project (N = 142,066) the association of pattern of alco...

The assignment of foods to one of four categories proposed by the Nova framework may be challenging in the absence of information on how these foods were prepared and their specific composition. A three-step iterative approach can make the categorization process more efficient and transparent, thereby increasing the accuracy of Nova estimates.

Evidence on habitual Mediterranean diet (MD) and risk of SARS-CoV-2 infection, and COVID-19 is limited. 1,520 participants from the Moli-sani Study (2017-2020) were tested during January-September 2021 and adherence to MD was ascertained through the Mediterranean Diet Score (MDS). SARS-CoV-2 infection cases were determined through serology, and pre...

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 an alternative. This paper aims to study RFM and BMI association with mortality in a general Italian population and potential mediators of such association. Method...

Background: Olive oil is a key component of a traditional Mediterranean Diet and its with cancer mortality is less robust, and it remains unclear whether the health advantages of olive oil may be accounted for by specific biological mechanisms. We therefore sought to investigate the relationship between olive oil consumption with cancer mortality i...

Chronological age (CA) may not accurately reflect the health status of an individual. Rather, biological age (BA) or hypothetical underlying “functional” age has been proposed as a relevant indicator of healthy aging. Observational studies have found that decelerated biological aging or Δage (BA-CA) is associated with a lower risk of disease and mo...

Late eating is reportedly associated with adverse metabolic health, possibly through poor diet quality. We tested the hypothesis that meal timing could also be linked to food processing, an independent predictor of health outcomes. We analysed data on 8688 Italians (aged > 19years) from the Italian Nutrition & HEalth Survey (INHES) established in 2...

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: There is little knowledge on the association of changes over time in adherence to a Mediterranean diet (MD) with changes in modifiable cardiovascular disease (CVD) risk factors and of markers of low-grade inflammation. Objective: To evaluate the association between long-term changes in MD adherence and concurrent changes in establish...

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...