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Background Timing of food intake impacts on metabolic diseases. Few data are available about post-meal changes in epinephrine (E), norepinephrine (NE), and acylated ghrelin (AG) at different times of the day. Subjects and methods This randomized cross-over trial investigated E/NE/AG concentrations after identical meals consumed at 0800 or 2000 hours in 20 healthy volunteers, by standardizing diet, exercise, duration of fast, and resting. Participants randomly received the test meal at 0800 or 2000 hours, and vice versa after 1 week. Blood samples were collected before and up to 180-min post-meal, every 30 min, with participants supine, motionless, but awake. Results Median E levels increased at 30–60 min, then declined and rose again at 150 min; values at 60 min (19.0 vs. 15.0 ng/l, p = 0.03) and 180 min (25.0 vs. 11.0 ng/l, p p = 0.02) and 120 min (208.8 vs. 142.0 ng/l, p = 0.04) increased more after morning meals. AG progressively declined to increase again at 90 min after meal; median AG area-under-the-curve (AUC) values were lower at morning (7206.8 vs. 8828.3 pg/mL×h). AG-AUC was inversely associated with diet-induced thermogenesis (β = −121.6; 95% CI −201.0 to 42.2; p = 0.009 for each unit increase), while log NE-AUC was inversely associated with log-triglyceride AUC (β = −0.57; 95% CI −0.98 to 0.16; p = 0.015) in a multiple regression model, after multiple adjustments. Conclusions In conclusion, E/NE concentrations were higher after the morning meal, while AG showed an opposite behavior. These data, although requiring confirmation in larger samples, suggest an adjunctive possible mechanism explaining the unfavorable effects of evening eating on metabolic risk

Background and aims NTproBNP and BNP levels are reduced in obese subjects, but population-based data comparing the pattern of this relationship in the full spectrum of insulin-resistance mediated conditions, overweight/obesity, metabolic syndrome and diabetes, are limited. Methods The study-base were 3244 individuals aged 45–74 years, none of whom had heart failure, 1880 without diabetes and 1364 with diabetes, identified as part of two surveys of the population-based Casale Monferrato Study. All measurements were centralized. We examined with multiple linear regression and cubic regression splines the relationship between NTproBNP and BMI, independently of known risk factors and confounders. A logistic regression analysis was also performed to assess the effect of overweight/obesity (BMI ≥ 25 kg/m2), diabetes and metabolic syndrome on NTproBNP values. Results Out of the overall cohort of 3244 people, overweight/obesity was observed in 1118 (59.4%) non-diabetic and 917 (67.2%) diabetic subjects, respectively. In logistic regression, compared to normal weight individuals, those with a BMI ≥ 25 kg/m2 had a OR of 0.70 (95% CI 0.56–0.87) of having high NTproBNP values, independently of diabetes. As interaction between diabetes and NTproBNP was evident (p 3 mg/dl conferred a fully adjusted OR of 0.65 (0.49–0.86). Conclusions NT-proBNP levels are lower in overweight/obesity, even in those with diabetes. Both insulin-resistance and chronic low-grade inflammation are involved in this relationship. Further intervention studies are required to clarify the potential role of drugs affecting the natriuretic peptides system on body weight and risk of diabetes.

The world is currently facing the coronavirus disease (COVID-19) pandemic which places great pressure on health care systems and workers, often presents with severe clinical features, and sometimes requires admission into intensive care units. Derangements in nutritional status, both for obesity and malnutrition, are relevant for the clinical outcome in acute illness. Systemic inflammation, immune system impairment, sarcopenia, and preexisting associated conditions, such as respiratory, cardiovascular, and metabolic diseases related to obesity, could act as crucial factors linking nutritional status and the course and outcome of COVID-19. Nevertheless, vitamins and trace elements play an essential role in modulating immune response and inflammatory status. Overall, evaluation of the patient's nutritional status is not negligible for its implications on susceptibility, course, severity, and responsiveness to therapies, in order to perform a tailored nutritional intervention as an integral part of the treatment of patients with COVID-19. The aim of this study was to review the current data on the relevance of nutritional status, including trace elements and vitamin status, in influencing the course and outcome of the disease 3 mo after the World Health Organization's declaration of COVID-19 as a pandemic., Highlights • Derangements in nutritional status can influence the course of coronavirus disease (COVID-19). • Obesity may worsen the outcome of COVID-19, requiring the most intensive care. • Vitamins and trace elements have a crucial role in immunomodulation.

Short-Bowel-Syndrome (SBS) is one of the most common causes of a rare disease: Intestinal-Failure (IF). Home-Parenteral-Nutrition (HPN) is a life-saving-therapy, the main and most effective medical-nutritional treatment to prevent malnutrition in SBS. A regular monitoring of the nutritional-status is essential to estimate the effectiveness of the treatment. We detected anthropometric measures, BIA-BIVA, parenteral-enteral nutrition-intakes and outputs (diuresis-feces-stoma) to describe the trends during 1year follow-up from the beginning of the HPN. We collected data on 39-SBS patients (M23+F16), age 63±13, residual-bowel-length cm103±54 (65% patients without ileocecal-valve, 64% with Ileostomy) in charge to our center during the last 2 year (T0 = early-assessment-treatment, T1 = after 2-months, T2 = after 6-months, T3 = after-1 year) to assess nutritional status using BIA-BIVA values, BMI, nutritional intakes and outputs. Body composition trend is described in tab.1. We found a significant reduction in TBW% both for males and females from T0vsT3 (p BIVA may represent a simple and affordable non-invasive way to monitor SBS patients, helping nutritional follow-up during HPD. Our results suggest an adaptation of residual-bowel-function after 1-year confirmed by a reduction of fecal-output. An increase in oral-intake was observed which allowed a reduction of parenteral-nutrition burden. Strict and adequate nutritional monitoring is a key-point to obtain improvements in body-composition and nutritional-status in these patients.

In this retrospective-observational study we investigated on the role of p-citrulline as a possible marker of dependence on PN with a cut-off of 20 µmol/l. Fasting p-citrulline was analyzed with Ion-Exchange HPLC in IICB patients enrolled in SC Dietetics and Clinical Nutrition. Inclusion criteria: small bowel length Data reported were expressed as median (range) or mean (± ds) as appropriate. Correlations and a multivariate analysis were performed between p-cit and age, intestinal features, eGFR and PN nutrition. Twenty-seven 21- 82 years old (14M/13F) patients participated in this study; small bowel length was 60 cm (2-200); percent of colon: 50% (0-100); ileo-cecal valve 1 yes/26 no; diagnosis: 11 pts mesenteric vasculopathy, 6 pts surgical outcome, 7 pts IBD, 3 pts other diseases. HPN duration 712 days (167-7239); PN energy: 69,6 %BEE (5-120); PN volume 1900 ml (1000-3600); BMI 21,8 kg/m2 (16-32,1); eGFR 78 ml/min/1,73m2 (43-141); p-cit (reference range 29.1-42.8 µmol/l): 24,5 µmol/l (5-49,6); 9 pts 29,1 µmol/l: 33,3 % of pts was below literature cut-off. Significant correlations were found for: age, r=0,418 (p ≤ 0,05); small bowel length, r = 0,48 (p ≤ 0,01); eGFR, r= −0,4 (p ≤ 0,05); PN-energy, r = −0,49 (p ≤ 0,01); PN volume, r= −0,48 (p≤0,01). The multivariate analysis confirms the correlation with the same variables (F = 4,26; P = 0,0079). The significant correlation between p-cit and small bowel length confirmed p-cit as a possible indicator of spontaneous bowel adaptation but different cut-off for PN dependence could be assessed beacause the 66,6% of pts in HPN had values > 20 µmol/l.

Food-induced thermogenesis is generally reported to be higher in the morning, although contrasting results exist because of differences in experimental settings related to the preceding fasting, exercise, sleeping and dieting. To definitively answer to this issue, we compared the calorimetric and metabolic responses to identical meals consumed at 0800 hours and at 2000 hours by healthy volunteers, after standardized diet, physical activity, duration of fast and resting.Twenty subjects (age range 20-35 years, body mass index=19-26 kg m(-)(2)) were enrolled to a randomized cross-over trial. They randomly received the same standard meal in the morning and, 7 days after, in the evening, or vice versa. A 30-min basal calorimetry was performed; a further 60-min calorimetry was done 120-min after the beginning of the meal. Blood samples were drawn every 30-min for 180-min. General linear models, adjusted for period and carry-over, were used to evaluate the 'morning effect', that is, the difference of morning delta (after-meal minus fasting values) minus evening delta (after-meal minus fasting values) of the variables.Fasting resting metabolic rate (RMR) did not change from morning to evening; after-meal RMR values were significantly higher after the morning meal (1916; 95% confidence interval (CI)=1792, 2041 vs 1756; 1648, 1863 kcal; P0.001). RMR was significantly increased after the morning meal (90.5; 95% CI=40.4, 140.6 kcal; P0.001), whereas differences in areas-under-the-curve for glucose (-1800; -2564,-1036 mg dl(-1) × h, P0.001), log-insulin (-0.19; -0.30,-0.07 μU ml(-1) × h; P=0.001) and fatty free acid concentrations (-16.1;-30.0,-2.09 mmol l(-1) × h; P=0.024) were significantly lower. Delayed and larger increases in glucose and insulin concentrations were found after the evening meals.The same meal consumed in the evening determined a lower RMR, and increased glycemic/insulinemic responses, suggesting circadian variations in the energy expenditure and metabolic pattern of healthy individuals. The timing of meals should probably be considered when nutritional recommendations are given.

Background/objectivesIt has been hypothesized that assuming most of the caloric intake later in the day leads to metabolic disadvantages, but few studies are available on this topic. Aim of our study was to prospectively examine whether eating more of the daily caloric intake at dinner leads to an increased risk of obesity, hyperglycemia, metabolic syndrome, and non-alcoholic fatty liver disease (NAFLD).Subjects/methods1245 non-obese, non-diabetic middle-aged adults from a population-based cohort underwent a 3-day food record questionnaire at enrollment. Anthropometric values, blood pressure, blood metabolic variables, and estimated liver fat were measured at baseline and at 6-year follow-up.DesignProspective cohort study.ResultsSubjects were divided according to tertiles of percent daily caloric intake at dinner. A significant increase in the incidence rate of obesity (from 4.7 to 11.4%), metabolic syndrome (from 11.1 to 16.1%), and estimated NAFLD (from 16.5 to 23.8%) was observed from the lower to higher tertile. In a multiple logistic regression model adjusted for multiple covariates, subjects in the highest tertile showed an increased risk of developing obesity (OR = 2.33; 95% CI 1.17-4.65; p = 0.02), metabolic syndrome (OR = 1.52; 95% CI 1.01-2.30; p = 0.04), and NAFLD (OR = 1.56; 95% CI 1.10-2.22; p = 0.01).ConclusionsConsuming more of the daily energy intake at dinner is associated with an increased risk of obesity, metabolic syndrome, and NAFLD.