le universita del lazio verso expo2015 · abstract. – background: normal weight obese (nwo)...

LE UNIVERSITA’ DEL LAZIO VERSO EXPO2015

La qualità degli alimenti e della vita

Diete a confronto: questione di moda o di stile?

Prof. Antonino De Lorenzo Prof.ssa Laura Di Renzo

Dott. Alberto Carraro Sezione di Nutrizione Clinica e Nutrigenomica

Università di Roma Tor Vergata

Scelte alimentari

!  Informazioni!!  Tempo!

!  Abitudini!!  Mode!

A RIDOTTO CONTENUTO DI ZUCCHERI >DIETA ATKINS >DIETA PUNTI o dell’Astronauta DIETE IPERPROTEICHE >DIETA A ZONA >DIETA SCARSDALE > DIETA DUKAN DIETE VEGETARIANE >DIETA PRITIKIN >ZEN DIETE SENZA VARIETA’ >DIETA DISSOCIATA CLASSICA (di Antoine) >DIETA DISSOCIATA (di Shelton) > dei 4 giorni > pompelmo e uova > Mayo > minestrone >monocibo > Beverly Hills >Hollywood DIETE NON EDUCATIVE >DIETA “Starch Blocker” >Dieta Cambridge >PASTI SOSTITUTIVI (liquidi,barrette)

E tante altre ancora…………

Guardiani del cibo

“Fetal Programming” l’uomo si adatta all’ambiente: in risposta a un fenomeno transitorio (malnutrizione fetale) mette in atto modifiche della fisiologia e del metabolismo che divengono permanenti o “programmate” poiché si verificano in un periodo critico dello sviluppo e della differenziazione cellulare

  Eccesso di calorie in rapporto all’attività fisica   Eccessivo consumo di proteine   Eccessivo consumo di grassi saturi e idrogenati   Eccessivo consumo di alcool   Eccessivo consumo di zuccheri raffinati e ad alto

carico glicemico   Errata distribuzione dei pasti   Scarso consumo di fibre

LA CONTRADDIZIONE ALIMENTARE MODERNA…

CI ALIMENTIAMO, MA NON CI NUTRIAMO

….1900… si moriva per mancanza di alimenti

2000…ci ammaliamo per eccesso di alimenti

Importanza degli alimenti e della risposta a questi dell’organismo

Tuttoscienze-La Stampa 18/12/2013

…una dieta “che si rispetti”… …come quella mediterranea…. …deve avere queste proprietà:

EQUILIBRATA BILANCIATA

ADEGUATA OTTIMALE Il fabbisogno energetico giornaliero deve corrispondere a:

LA DIETA MEDITERRANEA

De Lorenzo et al. Ann. New York Academy Sci, 1999

ACIDI GRASSI POLI-INSATURI

(Foto Bonavia)

Watzl et al. Am J Clin Nutr. 2005;82:1052-8

*

ANTOCIANI

hHypertension  2008,  British  Journal  of  Nutrition  (2010)  

Mac Donald MEAL MEDITERRANEAN MEAL

Nut Val Valorizzazione della qualità Salutare e Nutraceutica della nocciola: la corilicoltura tra prassi produttivo territoriali, usi gastronomico-alimentari e patrimonializzazione della memoria locale DM n° 17188 del 04/11/2010, pubblicato sulla GU n.300 del 24/12/2010 approvato con DM 06/12/2011 n° prot. 32064

Abstract. – BACKGROUND: Normal weightobese (NWO) syndrome is defined as an exces-sive body fat associated with a normal body massindex and characterized by a higher risk for car-diovascular morbidity and mortality. Recent stud-ies have demonstrated that dark chocolate (DC)has beneficial effects in the prevention of cardio-vascular diseases (CVD) due to its anti-inflamma-tory and antioxidant properties.

AIM: The aim of the present study was to in-vestigate the effects of DC consumption on lipidprofile, inflammatory markers, biochemical para-meters, and blood pressure, in NWO women.

MATERIALS AND METHODS: 15 women af-fected by NWO syndrome, aged 20-40 years,were included in the study. After a DC-freewashout period, subjects received DC (100g/die) containing 70% cocoa for 7-days. Bodycomposition by Dual energy-X-ray absorptiom-etry (DXA) was performed at baseline. Bloodpressure, anthropometric measurements, bio-chemical parameters and plasma levels ofsome cytokines were measured before and af-ter DC consumption.

RESULTS:: After DC consumption, we observeda significant increase in the HDL cholesterol lev-el (Delta% = +10.41±13,53; p !! 0.05), a significantdecrease of total cholesterol/HDL cholesterol ra-tio (Delta %= –11.45±7.03; p !! 0.05), LDL/HDLcholesterol ratio (Delta % = –11.70±8.91; p !!0.05), and interleukin-1 receptor antagonist (IL-1Ra) (Delta % = –32.99±3.84; p !! 0.05). In addi-tion, a reduction in abdomen circumference wasobserved. We also found a positive correlationbetween changes in atherogenic indices, and IL-1Ra, abdomen reduction.

CONCLUSIONS: Our findings suggest thatregular consumption of DC could be useful inmaintaining a good atherogenic profile, due tothe favourable effects on HDL cholesterol,lipoprotein ratios and inflammation markers.

Key Words:Dark chocolate, Normal weight obese syndrome,

Atherogenic profile, HDL cholesterol, Interleukin-1Ra.

European Review for Medical and Pharmacological Sciences

Effects of dark chocolate in a population ofNormal Weight Obese women: a pilot study

L. DI RENZO1,2, M. RIZZO1, F. SARLO1, C. COLICA3, L. IACOPINO1, E. DOMINO1, D. SERGI1, A. DE LORENZO1,2

1Department of Neuroscience, Division of Human Nutrition, University of Tor Vergata, Rome, Italy2I.N.Di.M, National Institute for Mediterranean Diet and Nutrigenomic, Amantea, Cosenza, Italy3CNR, ISN UOS of Pharmacology, Department of Pharmacology, University Magna Graecia, Roccelletta di Borgia, Catanzaro, Italy

Corresponding Author: Antonino De Lorenzo, MD, Ph.D.; e-mail: delorenzo@uniroma2.it 2257

Introduction

For a long time believed to be simply an inertenergy storage tissue with irrelevant metabolicactivity, in the last years the adipose tissue, prop-erly defined as the adipose organ, has assumed aconstantly growing metabolic relevance due to itspleiotropic functions1. Indeed, besides its wellknown fundamental function in regulating energyhomeostasis, adipocytes also mediate many phys-iologic and pathologic processes by means of nu-merous secretory products. In this regard,adipocytokines, such as leptin and adiponectin,and proinflammatory factors, such as TNF-!, IL-6 and 1, have been demonstrated to play an im-portant role in the onset of the major obesity-re-lated comorbidities. Actually, these cytokines arespeculated to have a local and systemic action,e.g. by modulating insulin sensitivity and athero-genesis. Many reports have highlighted that plas-ma pro-inflammatory cytokine concentrations areelevated in obese subjects2.

In our previous studies we identified the Nor-mal Weight Obese (NWO) syndrome3 present inthe general population. The NWO syndrome, thedistinctive characteristic of 10% of healthy fe-males subjects studied, was characterized by anormal BMI (< 25 kg/m2), but high total body fatmass (FM) percentage (FM% > 30%) and signifi-cantly higher values of proinflammatory cy-tokines, such as IL-1, IL-6, IL-8 and TNF-!11-13.NWO were similar to preobese-obese women in-sofar as their increased cardiovascular disease(CVD) risk indexes values. They also do notmanifest the metabolic syndrome, despite a clus-ter of metabolic and genetic features associatedwith increased CV mortality9.

Increasing evidence suggest that cocoa, theseed of the cocoa tree, Theobroma cacao L.(Sterculiaceae) either in the form of cocoa bean

2013; 17: 2257-2266shown in Table III. A significant increase ofHDL cholesterol concentration (!% = +10.41 ±13.53 [CI: +1.59 ÷ +17.07]; p " 0.05) was ob-served after the intervention period. Total cho-lesterol and LDL cholesterol did not change sig-nificantly, despite showing a trend towards a re-duction. No significant changes were observedin BUN, creatinine, AST, ALT and HOMA-IRvalues after DC consumption. No significantchanges were observed in serum inflammationmarkers, i.e. fibrinogen, hs-CRP and ESR, be-tween T0 and T1. Plasma concentrations of IL-

1#, IL-1$, IL-6 and TNF-# did not change sig-nificantly after the intervention period. Instead, asignificant decrease in IL-1Ra plasma concentra-tion (!% = –32.99 ± 3.84 [CI: –37.75 ÷ –28.22];p " 0.05) was highlighted in the study popula-tion. A significant positive correlation betweenLM (kg) at baseline and IL-1Ra variation washighlighted (R = 0.865, p " 0.05; data notshown). No significant correlations betweenBMI, FM (kg and %) and IL-1Ra variationswere otherwise observed.

Atherogenic indices changes after DC con-

2261

Effects of dark chocolate in a population of Normal Weight Obese women: a pilot study

Parameters Minimum Maximum Mean ± SD

Weight (kg) 56.90 65.80 61.98 ± 4.01BMI (kg/m2) 20.90 24.89 22.92 ± 1.89Waist (cm) 70.00 81.00 74.17 ± 4.08Hip (cm) 96.50 107.00 102.50 ± 3.82Waist/Hip 0.69 0.86 0.75 ± 0.06Abdomen (cm) 86.00 98.00 92.36 ± 5.18FM (kg) 16.53 35.09 26.13 ± 6.59LM (kg) 33.05 42.45 36.95 ± 3.78FM (%) 31.90 45.00 39.43 ± 4.48FM L2-L5 (kg) 1.22 3.53 2.41 ± 0.79LM L2-L5 (kg) 3.24 4.12 3.72 ± 0.34FM L2-L5 (%) 24.60 47.40 38.48 ± 7.59

Table II. Anthropometric and body composition of the study population at baseline§.

§All values are arithmetic ± SD. FM, Fat Mass; FM L2-L5, Fat Mass from L2 to L5 vertebral disc space; LM, Lean Mass; LML2-L5, Lean Mass from L2 to L5 vertebral disc space by DXA.

Parameters T0 mean ± SD T1 mean ± SD

Total Cholesterol (mmol/L) 5.02 ± 0.98 4.87 ± 0.97HDL Cholesterol (mmol/L) 1.44 ± 0.28 1.57 ± 0.27*LDL Cholesterol (mmol/L) 3.01 ± 0.94 2.89 ± 0.86Fibrinogen (µmol/L) 7.16 ± 0.74 7.86 ± 1.03hs-CRP (mg/L) 0.97 ± 0.66 1.51 ± 1.63ESR (mm/h) 11.28 ± 6.21 10.43 ± 8.08AST (U/L) 30.86 ± 32.87 17.71 ± 3.54ALT (U/L) 18.71 ± 15.70 16.14 ± 7.82BUN (mmol/L) 12.7 ± 3.60 11.7 ± 2.30Creatinine (µmol/L) 64 ± 3.60 65 ± 7,00Fasting glucose (mg/dL) 85.28 ± 21.18 84.28 ± 22.62Fasting insulin (mg/dL) 6.25 ± 2.21 8.33 ± 2.77HOMA-IR 1.38 ± 0.66 1.72 ± 0.77IL-1# (pg/mL) 2.74 ± 0.68 2.70 ± 0.83IL-1$ (pg/mL) 1.17 ± 0.55 0.83 ± 0.35IL-6 (pg/mL) 1.81 ± 2.35 1.22 ± 1.75TNF-# (pg/mL) 0.16 ± 0.10 0.13 ± 0.13IL-1Ra (pg/mL) 80.94 ± 19.79 54.14 ±13.12**

Table III. Biochemical parameters before (T0) and after (T1) DC consumption§.

§All values are arithmetic ± SD. *p " 0.05; **p " 0.01 (paired t-test). T0, baseline; T1, after 7-d DC consumption; ALT, Ala-nine Aminotransferase; AST, Aspartate Aminotransferase; BUN, Blood Urea Nitrogen; ESR, Erythrocyte Sedimentation Rate;hs-CRP, high sensitivity C-Reactive Protein; HOMA-IR Homeostasis Model Assessment of Insulin Resistance.

(Foto Bonavia)

Programma di Azione Nazionale per l’Agricoltura Biologica e i Prodotti Biologici

per gli anni 2008 e 2009

Decreto Ministeriale del 23/12/2009 n.0020099

“ Mensa Sana, e corpore sano ”

Responsabile Prof. Antonino De Lorenzo Coordinatore: Prof.ssa Laura Di Renzo

I.N.Di.M.I.N.Di.M.

A CMIA CMI

LE UNIVERSITA’ DEL LAZIO VERSO EXPO2015

La qualità degli alimenti e della vita

Dalla Sicurezza alimentare alla qualità nutrizionale

Prof. Antonino De Lorenzo Prof.ssa Laura Di Renzo

Dott. Alberto Carraro Sezione di Nutrizione Clinica e Nutrigenomica

Università di Roma Tor Vergata

SICUREZZA ALIMENTARE

FOOD SAFETY: La sicurezza alimentare contempla innanzitutto la buona qualità di un

alimento sotto il profilo igienico e sanitario.

FOOD SECURITY: tutte le persone, in ogni momento, hanno accesso fisico, sociale ed economico ad alimenti sufficienti, sicuri e

nutrienti che garantiscano le loro necessità e preferenze alimentari per condurre una vita

attiva e sana”

FOOD SECURITY+ FOOD SAFETY

LA STRATEGIA DELL'UE IN MATERIA DI SICUREZZA ALIMENTARE

Rispetto della diversità

alimenti tradizionali DOP –IGP

Tipicità territoriali

La sicurezza degli animali

Benessere e controllo veterinario

La salute delle piante

Allarme rapido

Tracciabilità e gestione del rischio

Decisioni fondate su una base scientifica valida

Sistema RASFF

Pesticidi e Fitofarmaci

EFSA Europea Food Safety

Agency

HACCP

ANALISI DEI PERICOLI

Individuazione, IN TUTTE LE FASI DEL PROCESSO PRODUTTIVO, tutti i pericoli

(chimici, fisici, biologici) che possono verificarsi e manifestarsi.

Fare una buona analisi dei pericoli è fondamentale per costruire il piano di autocontrollo.

Dare una garanzia certa al consumatore di SICUREZZA NUTRIZIONALE

Tracciabilità del Nutriente

Essere perso o ridotto a livelli insufficienti per esplicare una funzione salutistica al consumatore

GNP Good Nutritional Pratics

GAP Good

Agricolture Pratics

GEP Good

Environmentale Pratics GMP

Good Manufacting

Pratics

GHP Good Hygiene

Pratics

GLP Good

Laboratory Pratics

GKP Good

Housekeeping pratics

Verifica delle proprietà salutari

IDENTIFICAZIONE DEL MARCATORE NUTRIZIONALE

Verifica qualità Nutrizionale

Verifica del processo

TRACCIABILITA’ DEL NUTRIENTE

Verifica dell’effetto

TRIAL CLINICI

FORMAZIONE

NORMATIVA

GNP Good Nutritional Pratics

NORMATIVA

CONSUMATORE