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Abstract Frailty is a common age-related clinical syndrome characterized by a decline in the function of multiple organ systems, increased vulnerability to stressors, and a huge socio-economic burden. Despite recent research efforts, the physiopathological mechanisms underlying frailty remain elusive and biomarkers able to predate its occurrence in the early stages are still lacking. Beyond its physical component, cognitive decline represents a critical domain of frailty associated with higher risk of adverse health outcomes. We measured by High-Performance Liquid Chromatography (HPLC) a pool of serum amino acids including L-glutamate, L-aspartate, glycine, and D-serine, as well as their precursors L-glutamine, L-asparagine, and L-serine in a cohort of elderly subjects encompassing the entire continuum from fitness to frailty. These amino acids are known to orchestrate excitatory and inhibitory neurotransmission, and in turn, to play a key role as intermediates of energy homeostasis and in liver, kidney, muscle, and immune system metabolism. To comprehensively assess frailty, we employed both the Edmonton Frail Scale (EFS), as a practical tool to capture the multidimensionality of frailty, and the frailty phenotype, as a measure of physical function. We found that D-serine and D-/Total serine ratio were independent predictors of EFS but not of physical frailty. Furthermore, higher levels of glycine, glycine/L-serine and D-/Total serine were associated with worse cognition and depressive symptoms in the frail group. These findings suggest that changes in peripheral glycine and serine enantiomers homeostasis may represent a novel biochemical correlate of frailty.

Nausea and vomiting during pregnancy (NVP) affect up to 85% of pregnant women and usually begin between the 4th and 7th weeks of gestation, and symptoms often peak around the 9th week and generally resolve by the 20th week in most cases, with severe cases termed hyperemesis gravidarum (HG) impacting physical and psychological health. This review aims to provide a structured dietary approach to managing NVP by developing a food pyramid specifically for this population, based on a systematic evaluation of dietary evidence. The findings highlight the beneficial effects of dietary patterns rich in fruits, vegetables, and protein sources in reducing NVP symptoms. Protein intake is shown to alleviate nausea and vomiting by stabilizing gastric motility and addressing nutritional deficiencies. The review also explores the potential benefits of herbal supplements, like ginger and vitamin B6. By integrating these dietary strategies with pharmacological treatments, a more holistic approach to managing NVP can be achieved, enhancing both maternal well-being and fetal health. The proposed food pyramid emphasizes glycemic stability, hydration, and gradual nutrient intake, offering a structured dietary guide for pregnant women experiencing NVP and HG.

This systematic review investigates the potential of bergamot, a polyphenol-rich citrus fruit, in improving osteosarcopenic obesity, a condition characterized by the simultaneous presence of osteoporosis, obesity, and sarcopenia. Bergamot extracts have been suggested to possess several pharmacological properties, including anti-inflammatory and antioxidant effects, which could be useful in the management of age-related diseases and neuromuscular health. The review highlights the promising effects of bergamot extracts on skeletal muscle mass and function, particularly in the context of obesity, metabolic syndrome, osteosarcopenic obesity, and osteoporosis. Furthermore, some studies have shown that bergamot extracts can improve the metabolic balance, endothelial function, and maximal oxygen uptake in athletes, highlighting their potential benefits for skeletal muscle health. Taken together, these results suggest that bergamot extracts, especially those rich in polyphenols, may be a valuable adjunct in the management of osteosarcopenic obesity and other associated clinical conditions involving pro-inflammatory effects on organs and tissues.

We recently described increased D- and L-serine concentrations in the striatum of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated monkeys, the post-mortem caudate-putamen of human Parkinson's disease (PD) brains and the cerebrospinal fluid (CSF) of de novo living PD patients. However, data regarding blood D- and L-serine levels in PD are scarce. Here, we investigated whether the serum profile of D- and L-serine, as well as the other glutamate N-methyl-D-aspartate ionotropic receptor (NMDAR)-related amino acids, (i) differs between PD patients and healthy controls (HC) and (ii) correlates with clinical-demographic features and levodopa equivalent daily dose (LEDD) in PD. Eighty-three consecutive PD patients and forty-one HC were enrolled. PD cohort underwent an extensive clinical characterization. Serum levels of D- and L-serine, L-glutamate, L-glutamine, L-aspartate, L-asparagine and glycine were determined using High Performance Liquid Chromatography.In age- and sex-adjusted analyses, no differences emerged in the serum levels of D-serine, L-serine and other NMDAR-related amino acids between PD and HC. However, we found that D-serine and D−/Total serine ratio positively correlated with age in PD but not in HC, and also with PD age at onset. Moreover, we found that higher LEDD correlated with lower levels of D-serine and the other excitatory amino acids. Following these results, the addition of LEDD as covariate in the analyses disclosed a selective significant increase of D-serine in PD compared to HC (Δ ≈ 38%). Overall, these findings suggest that serum D-serine and D−/Total serine may represent a valuable biochemical signature of PD.

IntroductionGiven that rice serves as a crucial staple food for a significant portion of the global population and with the increasing number of individuals being diagnosed with diabetes, a primary objective in genetic improvement is to identify and cultivate low Glycemic Index (GI) varieties. This must be done while ensuring the preservation of grain quality.Methods25 Italian rice genotypes were characterized calculating their GI “in vivo” and, together with other 29 Italian and non-Italian genotypes they were studied to evaluate the grain inner structure through Field Emission Scanning Electron Microscopy (FESEM) technique. Using an ad-hoc developed algorithm, morphological features were extracted from the FESEM images, to be then inspected by means of multivariate data analysis methods.Results and DiscussionLarge variability was observed in GI values (49 to 92 with respect to glucose), as well as in endosperm morphological features. According to the percentage of porosity is possible to distinguish approximately among rice varieties having a crystalline grain (< 1.7%), those intended for the preparation of risotto (> 5%), and a third group having intermediate characteristics. Waxy rice varieties were not united by a certain porosity level, but they shared a low starch granules eccentricity. With reference to morphological features, rice varieties with low GI (

Nuts are dry, single-seeded fruits with a combination of beneficial compounds that aid in disease prevention and treatment. The aims of this research are to evaluate the total antioxidant activity (AI) by ferric reducing antioxidant power (FRAP) assay, fatty acids by acid-catalyzed esterification method, and minerals by inductively coupled plasma optical emission (ICP-OE) spectrometer in hazelnuts, pistachios, and almond seeds and skins. Considering total AI, the results demonstrated that the highest activity was found in hazelnut and pistachio skin. The results considering minerals demonstrated that manganese, zinc, and iron levels are high in almond and hazelnut skins, copper is dominant in pistachio skin and hazelnut seed, and selenium is high in pistachio and almond skins and seed. Finally, the results showed palmitic acid is present in almond skin and pistachio seed, palmitoleic acid is high in almond and pistachio skins, and stearic acid is present in almond and hazelnut skins. Oleic acid was found in hazelnut seeds and their skin, linoleic acid in almond skin and pistachio seeds, and α-linolenic acid in almond and pistachio skins. In conclusion, hazelnut, pistachio, and almond skins are a great source of antioxidants, minerals, and healthy fatty acids, making them useful for nutraceutical development.

Nuts are dry, single-seeded fruits, with a combination of beneficial compounds that aid in disease prevention and treatment. This review aims to summarize the antioxidant components and the nutraceutical properties and applications of hazelnut, almond, and pistachio skins, as well as discuss their ability to prevent and treat specific diseases based on in vitro and in vivo studies. The search strategy included searching PubMed database and Google Scholar for relevant articles published in English. Research articles focusing on hazelnut, pistachio, and almond were included. The nut skin extracts were considered and other by-products were excluded from this search. Pistachio and almond skin hydroalcoholic extracts have antibacterial effects and decrease the risk of liver cancer by eliminating reactive oxygen species. Moreover, hazelnut skin can lower plasma against low-density lipoprotein-cholesterol, thus reducing the risk of colon cancer, and its polyphenolic extract can also decrease the formation of advanced glycation end products in vitro with multidimensional effects. Overall, hazelnut, pistachio, and almond skins are a great source of antioxidants, making them suitable for nutraceuticals’ development.

Many eye diseases, such as diabetic retinopathy (DR), age-related macular degeneration (AMD), and cataracts are preventable and treatable with lifestyle. The objective of this review is to assess the most recent research on the ideal dietary approach to prevent or support the treatment of DR, AMD, and cataracts, as well as to construct a food pyramid that makes it simple for people who are at risk of developing these pathologies to decide what to eat. The food pyramid presented here proposes what should be consumed every day: 3 portions of low glycemic index (GI) grains (for fiber and zinc content), 5 portions (each portion: ≥200 g/day) of fruits and vegetables (spinach, broccoli, zucchini cooked, green leafy vegetables, orange, kiwi, grapefruit for folic acid, vitamin C, and lutein/zeaxanthin content, at least ≥42 μg/day, are to be preferred), extra virgin olive (EVO) oil (almost 20 mg/day for vitamin E and polyphenols content), nuts or oil seeds (20–30 g/day, for zinc content, at least ≥15.8 mg/day); weekly: fish (4 portions, for omega-3 content and eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA) 0.35–1.4 g/day), white meat (3 portions for vitamin B12 content), legumes (2 portions for vegetal proteins), eggs (2 portions for lutein/zeaxanthin content), light cheeses (2 portions for vitamin B6 content), and almost 3–4 times/week microgreen and spices (saffron and curcumin). At the top of the pyramid, there are two pennants: one green, which indicates the need for personalized supplementation (if daily requirements cannot be met through diet, omega-3, and L-methylfolate supplementation), and one red, which indicates that certain foods are prohibited (salt and sugar). Finally, 3–4 times per week, 30–40 min of aerobic and resistance exercises are required.

The aim of this study is to assess the bone mineral density (BMD) and T -score reference values in a population from 18 to 95 years old in Lombardy region, Italy. This study also investigates the association between BMD values and body mass index (BMI) divided by gender and age. The evaluation of BMD was analyzed by T -score and BMD in each site, femur, and column. A total of 10,503 patients (9,627 females and 876 males, 65.04±12.18 years) have been enrolled in this study. The women hip femur reference values associated with a situation of osteopenia highlighted in-line with the class of age of 45 to 55 years were: mean values: −1.3132 T -score; 95% confidence interval (CI): −1.3600 to −1.2664 and of osteoporosis from the class of age 85 to 95 years, mean values: −2.6591 T -score, 95% CI: −2.7703 to −2.5479. The men hip femur reference values associated with a situation of osteopenia highlighted in-line with the class of age of 45 to 55 years were: mean values: 1.2986 T -score; 95% CI: −1.5454 to −1.0518. A positive association between BMI and the two sites of BMD was recorded ( p > .05). This study provides an Italian overview of national and regional reference values about the BMD and T -score values divided by age and gender as reference values for clinicians for a correct assessment and monitoring.

IntroductionThe aim of the present study was to assess the dropout rate at 2, 6, and 12 months after an inpatient multidisciplinary residential program (MRP) for the treatment of obesity. Furthermore, this study assessed anthropometric and biochemical predictors associated with the dropout.MethodsAdult and elderly patients (age 59 ± 14 years) with obesity had undergone an MRP, were followed up from 2 to 12 months. Biochemical and anthropometric markers have been assessed at the beginning of the follow-up period after the MRP.ResultsThe study enrolled 178 subjects, 117 women and 61 men. The overall dropout rate at 2 months was 21.3%, after 6 months was 44.4%, and after 1 year was 68.5%. There was no difference by gender recorded. Furthermore, patients under medical treatment with psychiatric disorders did not show an association with the dropout rate. Patients with a higher level of body mass index (BMI) at the discharge of MRP showed +48% of dropout at 6 months. After the MRP, the baseline values of uricemia and white blood cells (WBCs) resulted as predictors of dropout at 2 months (p > 0.05). Furthermore, the excess percentage of fat mass lost during the MRP was associated with the risk of dropout at 2, 6, and 12 months (p > 0.05).ConclusionThe MRP for obesity is an opportunity for losing weight for patients with established criteria. The future challenge will be addressing the best strategic plans in order to reduce the dropout rate after this intervention. Investigating deeply the main predictors could be an opportunity to improve the long-term efficacy of MRP.

Epidemiological and public health resonance of sarcopenia in late life requires further research to identify better clinical markers useful for seeking proper care strategies in preventive medicine settings. Using a machine-learning approach, a search for clinical and fluid markers most associated with sarcopenia was carried out across older populations from northern and southern Italy. A dataset of adults >65 years of age (n = 1971) made up of clinical records and fluid markers from either a clinical-based subset from northern Italy (Pavia) and a population-based subset from southern Italy (Apulia) was employed (n = 1312 and n = 659, respectively). Body composition data obtained by dual-energy X-ray absorptiometry (DXA) were used for the diagnosis of sarcopenia, given by the presence of either low muscle mass (i.e., an SMI < 7.0 kg/m2 for males or 2 for females) and of low muscle strength (i.e., an HGS < 27 kg for males or

Recent literature has shown that vitamin D, in addition to its well-known activity on the skeleton, has many positive effects on health. Unfortunately, it is not easy to meet intake needs solely with food. Mushrooms could provide a valid way to achieve this goal, because they are one of the few sources of vitamin D. The aim of this systematic review was to summarize what has been reported in the literature on the treatment of animal and human models with irradiated commercial mushrooms, with particular attention paid to the effects on clinical outcomes associated with the classical and nonclassical vitamin D functions. A total of 18 articles were selected. Six studies were conducted on human samples, while twelve were focused on animal models. The six studies conducted in humans involved a large number of subjects (663), but the treatment period was relatively short (1–6 months). Furthermore, the treatment dosage was different in the various groups (600–3800 IU/day). Probably for this reason, the studies did not demonstrate clinical efficacy on the parameters evaluated (cognitive functions, muscle system/function, metabolic syndrome). Indeed, those studies demonstrated an efficacy in increasing the blood levels of 25(OH)D2, but not in increasing the levels of 25(OH)D total. In 9 of 12 studies conducted on the animal model, however, a clinical efficacy on bone metabolism, inflammation, and cognitive performance was demonstrated. The results of this systematic review indicate that the intake of vitamin D from irradiated mushrooms could possibly help to meet vitamin D needs, but the dosage and the time of treatment tested need to be evaluated. Therefore, studies conducted in humans for longer periods than the studies carried out up to now are necessary, with defined dosages, in order to also evaluate the clinical efficacy demonstrated in animal models both for the classical (bone metabolism) and nonclassical (muscle function, cognitive performance, anti-inflammatory, and antioxidant activities) effects of vitamin D.

Background: Chronic kidney disease (CKD) is a global health issue. Evidence of the effectiveness of nutritional intervention on slowing time to dialysis is limited in Arab countries. Therefore, this study aims to contribute to current research by providing new insights on the efficacy of personalized nutritional intervention in pre-dialysis patients in the Kingdom of Bahrain. Methods: This retrospective cohort study included 265 CKD patients (163 males and 108 females) who were admitted to the nephrology outpatient clinic at Salmaniya Medical Complex in Bahrain. The nutritional intervention group (NIG) receiving dietary advice by an expert renal dietitian consisted of 121 patients, while the non-nutritional intervention control group (non-NIG) that did not receive any nutritional support consisted of 150 patients. Patients were evaluated at baseline and follow-up. Results: The NIG had a significant increase in the estimated glomerular filtration rate (eGFR) compared to the non-NIG that had a significant decrease (5.16 vs. −2.85 mL/min/1.73 m2 (p = 0.000), respectively). When adjusted for age and gender, the mean difference was greater (8.0 mL/min/1.73 m2, p = 0.000). Additionally, there was a significant reduction in blood urea nitrogen and serum creatinine (−2.19 mmol/L and −25.31 µmol/L; p = 0.000, respectively). Moreover, the intervention had a positive impact on weight loss and body mass index (−1.84 kg and−0.69 kg/m2, respectively; p = 0.000) and lipid profile, with a significant reduction in total cholesterol and triglyceride levels (−0.17 mmol/L, p = 0.006 and −0.15 mmol/L, p = 0.026, respectively). Additional significant results from the NIG included reduced uric acid (−28.35 µmol/L, p = 0.006), serum phosphorus (−0.05 mol/L, p = 0.025), fasting blood glucose (−0.70 mmol/L, p = 0.016) and glycated hemoglobin (1.10 mmol/mol, p = 0.419). Conclusions: This study suggests that, in patients of CKD, nutritional intervention counselling plays a significant role in reducing the time needed for dialysis and improves nutritional-related biomarkers compared to patients not receiving this intervention.