francesco cipriani, m.d. - ars.toscana.it · francesco cipriani, m.d. tuscan regional health...
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Life expectancy at birth (years) – WHO, 2008
COUNTRY MALE FEMALE COUNTRY MALE FEMALEJapan 79 86 Canada 78 83Tuscany* 79 84 Norway 78 83Switzerland 79 84 Netherlands 78 82Iceland 79 83 New Zealand 78 82Sweden 79 83 France 77 84Cyprus 79 82 Austria 77 83Israel 79 82 Luxembourg 77 83Monaco 78 85 Belgium 77 82Italy 78 84 Germany 77 82Andorra 78 84 Greece 77 82S. Marino 78 84 Ireland 77 82Spain 78 84 Ireland 77 82Australia 78 83 Malta 77 81
* From: Regional Agency for Health, Tuscany Region 2006
750
850
950
1.050
1.150
1.250
1.350
1.450
1.550
1.650
1.750
Mortality rates– Tuscany and Italy
Italy
Tuscany
Death causes in Tuscany
Tumori28,9%
Respiratorio7,3%
Altre11,8%
Traumi3,9%
Cardiocircolatorio39,9%
Neurologico4,1%
Digerente4,1%
Caridovascular diseases 40%
Cancer 29%
Respiratory 7%
Neurologic 4%
Gastrointesti 4%
Injuries 4%
Others 12%
Causes of cancerTobacco 30Diet and nutrition 30Infection (H. pylori, EBV,HPV,HCV.HBV,HIV, Schystosoma, …)
18Occupation 4-5Alcohol 3-6Genetic factors 4Environment 1-4Contaminated foods ?Drugs ?Radiation (Rx, UV, EMF) ?Hormonal and reproductive factors ?
Diet and diseases
Cardiovascular diseases (CVD)Coronary hearth disease (CHD)Cerebrovascular diseases (CVD)Peripheral artery disease (PAD)
CancerGastrointestinal, Prostate, Breast, Others
Overweight, Obesity, Eating disordersDiabetes
HypertensionOsteoporosis
Gastrointestinal diseases (cirrhosis, gallstones)Dental disease
Seven different countries• The Seven Countries Study effectively documented the variations in CHD risk related to diet and
culture and demonstrated that the major risk factors are universal.
From: The seven countries study [http://sevencountriesstudy.com/]
Mediterranean Diet
A diet typical of the Mediterranean region, characterized by a pattern: high in fruits and vegetables, cereals and bread, potatoes, poultry, beans, nuts, olive oil and fish, low in red meat and dairymoderate in alcohol consumption.
- General mortality - 9 %
- CVD mortality - 9 %
- Cancer mortality - 6 %
- Parkinson and Alzheimer - 13 %
Source: (Sofi et al., 2008)
After 40 years of epidemiological studies on Mediterranean diet and health ……….
Blood lipids and CVD
CHOLESTEROL– LDL = “bad”
CHOLESTEROL – HDL = “good”
TRIGLYCERIDS
POSTPRANDIAL LIPIDS
DIETARY FATS and LDL/HDL RATIO effectsFATTY ACID C = NAME FOODS Blood lipids
C TOT
C LDL
CHDL
TRG
SATURURED 6 0 - CAPROIC BUTTER
8 0 - CAPRYLIC BUTTER
10 0 - CAPRIC BUTTER, COCONUT, PALM
12 0 - LAURIC BUTTER, COCONUT, PALM
14 0 - MYRISTIC BUTTER, COCONUT, PALM
16 0 - PALMITIC BUTTER, MEAT
18 0 - STEARIC BUTTER, MEAT, LARD
16 1 7 PALMITOLEICO FISH OIL
MONOUNSATURED 18 1 9 OLEIC OLIVE OIL, Avocado, Other seeds
POLYUNSATURED (PUFAs)
OMEGA-6 18 2 6 LINOLEIC (LA) SEED OILS
18 3 6
–LINOLEIC SEED OILS
20 3 6 DIOMO - -LINOLEIC SEED OILS
20 4 6 ARACHIDONIC SEED OILS, LARD
OMEGA-3 18 3 3 Alfa- LINOLENIC (ALA) FISH, VEG, WALNUT OIL
20 5 3 EICOSAPENTAENOIC (EPA) FISH OILS
22 5 3 DOCOSAPENTAENOIC (DPA) FISH OILS
22 6 3 DOCOSAESAENOIC (DHA) FISH OILS
http://www.conipiediperterra.com/il-salento-eletto-territorio-dellanno-2013-0213.html/olivi-puglia-10
2014: Clouds on olive oil production in Italy…..
OLIVE OIL and CVD
1- OLIVE OIL = OLEIC ACID
2- OLEIC ACID = < LDL / HDL
3- OLIVE OIL = GOOD DIETARY LIPID
OIL SATURED UNSATURED
OLEIC LINOLEIC LINOLENIC
Peanut 19,5 52,5 26,3 0,1Coconut 91,2 7,5 0,8 0,0Rape 11,0 15,0 14,0 8,0Sunflower 7,5 34,0 57,5 0,5Corn 17,2 30,0 50,0 1,0
Olive 17,2 72,9 9,3 0,5Palma 80,8 18,5 0,7 0,0Sesame 14,2 43,4 40,4 0,4Soyy
15,8 23,5 51,2 8,5Canola 7,0 61,0 21,0 11,0
FATTY ACID CONTENT OF OILS
OLIVE OIL IS MUCH MORE THAN JUST OLEIC ACID
RELEVANCE OF “MINOR” COMPONENTS OF THE
UNSAPONIFIABLE AND SOLUBLE FRACTION OF EXTRA VIRGIN OLIVE
OIL (EVOO)
Selected components of EVOO, unsaponifiable fraction (1-2%)
Hydrocarbons
(squalene, …)Sterols
Terpene alcoholsPigments
TocopherolsCarotenoids
POLIPHENOLsTyrosol
HydroxytyrosolOleuropeinLigstrosideCaffeic
acid
………….
Better control of blood pressure and insulin-sensitivity (glycemic control)
Lower lipid oxidation (Eurolive study) thanks to phenolic compounds
Lower inflammatory markers, endothelial activation and thrombogenic state
Antiarrhytmic and vasodilator effect
OLIVE OIL AND CVD Other protective mechanism of Olive Oil
Dietary factors and Cancer risk
Level of strenghtLowered
riskNo risk
IncreasedRisk
ConvincingPhysical activity Overweight
AlcoholAflatoxinsSalted fish
ProbableFruit / Vegetables Cold cuts, Cured
meat, Salted foodsHot foods
PossibleFiber, Soy, Fish, Omega-3,Vit B, C, Carotenoids, Ca, Zn, Se,
Lauric acidBetacarotene Suppl
Insufficiente Ca, Mg, Vit. C
Animal fatsHAA Nitrosamine
Dietary fats are relevant for cancer of :- breast- colon- uterus- prostate
FAT AND CANCER epidemiologic studies
EVOO components with anticancer activity
SqualeneBetasitosterolTocopherolCarotenoids
POLIPHNOLS Tyrosol, Hydroxytyrosol
OleuropeinLingstrosideSecoiridoids
Lignans………….
OLIVE OIL IS PROTECTIVE FORHypertension
(< incidence)
Diabetes
(< incidence, > control)
Obesity
Metabolic
syndrome
Cognitive impairment
(in DietMed)
gastroduodenal
ulcer
Gallstones
Rheumatoid
arthritis
Dermatopathies
……………………..
1- OLIVE OIL is certainly useful for CVD prevention (if the total caloric intake is within the limits)
2- OLIVE OIL is probably more useful to avoid tumors than other fats
3- The research on the biological effects of different substances by the acid oleic contained in olive oil, not only with respect to the atherogenic processes and cancer, is rapidly developing and is very promising
4- In any case, the OLIVE OIL has never been reported as a risk for some disease
OLIVE OIL AND HEALTH - CONCLUSIONS
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