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12. Manifesto delle criticità in Nutrizione clinica e preventiva: Le prime dieci sfide Italiane (2015-2018)

Author

Lucchin, L., Fusco, M. A., Caretto, A., Alessandrini, L., Facchin, N., Grossi, E., Dalle Grave, R., Banderali, G., Banderali, A., Rovera, G. M., Ballardini, D., Bertoni, G., Gramezi, A., Ronchi, B., Baldi, A., Carruba, M., Lacirignola, M., Capone, R., Agostoni, C., Fargion, S., Mosca, F., Roggero, P., Giannì, M. L., De Cosmi, V., Donegani, G., Leonardi, F., Mattivi, F., Viola, R., Ferreiro, M. S., Giannini, M., Poli, A., Marangoni, F., Fatati, G., Grandone, I., Di Lorenzo, N., Carbonelli, M. G., Foschi, D., Riccardi, G., Giacco, R., Trimarchi, F., Aroso, M., Corazza, G. R., Biolo, G., Brighenti, F., Casini, A., Giovannini, M., Riva, E., Verduci, E., Sirtori, C., Cicero, A., Racca, A., Sarpa, B., Nisoli, E., Sbraccia, P., Busetto, L., Muratori, F., Migliaccio, P., Piretta, L., Melchionda, N., Donini, L. M., Guberti, E., Alonzo, E., Giorgino, F., Laviola, L., Banni, S., Agodi, A., Frittitta, L., Rotella, C. M., Dicembrini, I., Barbaro, V., Morelli, L., Contaldo, F., Gnessi, L., Laviano, A., Muscaritoli, M., Pinto, A., Vania, A., De Lorenzo, A., Di Renzo, L., Vettor, R., D'Andrea, F., Battino, M., Melissano, M., Scaffidi, C., Archero, E., Vezzali, V., Buzzavo, G., Lucchin, L., Fusco, M. A., Caretto, A., Alessandrini, L., Facchin, N., Grossi, E., Dalle Grave, R., Banderali, G., Banderali, A., Rovera, G. M., Ballardini, D., Bertoni, G., Gramezi, A., Ronchi, B., Baldi, A., Carruba, M., Lacirignola, M., Capone, R., Agostoni, C., Fargion, S., Mosca, F., Roggero, P., Giannì, M. L., De Cosmi, V., Donegani, G., Leonardi, F., Mattivi, F., Viola, R., Ferreiro, M. S., Giannini, M., Poli, A., Marangoni, F., Fatati, G., Grandone, I., Di Lorenzo, N., Carbonelli, M. G., Foschi, D., Riccardi, G., Giacco, R., Trimarchi, F., Aroso, M., Corazza, G. R., Biolo, G., Brighenti, F., Casini, A., Giovannini, M., Riva, E., Verduci, E., Sirtori, C., Cicero, A., Racca, A., Sarpa, B., Nisoli, E., Sbraccia, P., Busetto, L., Muratori, F., Migliaccio, P., Piretta, L., Melchionda, N., Donini, L. M., Guberti, E., Alonzo, E., Giorgino, F., Laviola, L., Banni, S., Agodi, A., Frittitta, L., Rotella, C. M., Dicembrini, I., Barbaro, V., Morelli, L., Contaldo, F., Gnessi, L., Laviano, A., Muscaritoli, M., Pinto, A., Vania, A., De Lorenzo, A., Di Renzo, L., Vettor, R., D'Andrea, F., Battino, M., Melissano, M., Scaffidi, C., Archero, E., Vezzali, V., and Buzzavo, G.

Subjects
Medicine (all)
Abstract

Razionale EXPO 2015 affronta un bisogno primario per l’essere umano: “nutrire il pianeta; energia per la vita”. Per le ripercussioni globali a breve-medio termine è una importante occasione di confronto nazionale e internazionale. La problematica dovrebbe essere affrontata in modo razionale, chiaro e, soprattutto, ampiamente compartecipato dall’opinione pubblica. Dato per scontato che il primo nutrimento è l’ossigeno, l’assunto è che la composizione e non solo la qualità del cibo ingerito siano indispensabili per stabilire la porzione e la frequenza di consumo. Il primo aspetto da fare emergere dovrebbe pertanto riguardare le caratteristiche della corretta nutrizione e le modalità per ottenerla, considerando che il comportamento alimentare è la risultante di una complessa interazione tra fattori biologici, psicologici e l’ambiente in cui si vive. Cibo in quantità suf#ciente, sicuro e in grado di fornire il giusto apporto nutrizionale sono le condizioni per mantenere la salute e avere una vita attiva (World Food Summit del 1996). Mentre la Commissione Europea propone un aggiornamento dei Regolamenti a garanzia della sicurezza alimentare con una rinnovata attenzione alla prevenzione e alle ricadute ecologiche dell’alimentazione, le Agenzie Internazionali (OMS, FAO, UE) sottolineano la necessità di porre la giusta attenzione agli aspetti nutrizionali dell’alimentazione e alle sue conseguenze in termini di salute. Sulla scelta al consumo le tre priorità emergenti sono: 1. ricerca del benessere e salute. L’equazione “mangiare bene-stare bene”, sempre più percepita dalla popolazione, necessita di chiarimenti sui rapporti tra sano e naturale, sano e industriale, sano e biologico (più di 700 milioni di euro in Italia nel 2014 per prodotti bio), sano ed eco-friendly; 2. attenzione all’ambiente e alla sostenibilità; 3. criteri etici nella scelta dei prodotti. La visione globale della problematica risulta estremamente complessa, richiedendo una pianificazione a 360° che va oltre il mero ambito sanitario. Imprescindibile alla sua realizzazione, specie a livello nazionale, l’esistenza di un “Sistema Paese” di fatto coeso. Se nutrire l’individuo è lo scopo principale del cibo, dovrebbero risultare de#nite le priorità/emergenze nutrizionali da affrontare su scala nazionale e internazionale per poter rendere efficaci i modelli d’intervento sia di tipo preventivo sia terapeutico e di piani#cazione agro-alimentare per le popolazioni. Purtroppo, le politiche d’intervento attivate nei vari Paesi dimostrano ancora impostazioni fortemente settoriali e in parte condizionate da interessi economico-finanziari. Una constatazione risulta evidente: l’incomprensibile inadeguato investimento strategico in nutrizione clinica e preventiva nell’ambito della politica sanitaria nazionale. E a maggior ragione, alla luce dei grandi cambiamenti demografici avvenuti in tutti i Paesi del mondo: invecchiamento della popolazione, aumento degli adolescenti, specie nei Paesi in via di sviluppo, migrazioni. Ciò ha modificato prevalenza e incidenza delle patologie cronico degenerative, che richiedono un numero crescente d’interventi riabilitativi, specie in relazione alla malnutrizione per eccesso e difetto (calorico-proteica e/o in micronutrienti). Una evidenziazione delle criticità condivisa dai tecnici del settore, nel rispetto della necessaria multidisciplinarietà, risulta pertanto quanto mai necessaria per un serio raffronto, anche a livello internazionale, su problematiche comuni. La “pesatura” delle stesse, sulla base di criteri quantitativi assoluti, rende oggettiva e trasparente all’opinione pubblica e ai policy maker la possibile e ottimale allocazione delle risorse necessarie per contrastarle. Il manifesto delle criticità in nutrizione clinica e preventiva: • faciliterà la riflessione dei cittadini italiani, sottoposti a una eccessiva e costante pressione mediatica – prevalentemente a fini commerciali – su tali argomenti, fonte di crescente confusione e insicurezza circa i comportamenti da seguire. Non bisognerebbe lasciarsi sfuggire l’opportunità di un’ampia ri*essione di carattere scientifico, che possa portare all’attenzione di un pubblico globale temi che sono centrali per l’intera Comunità Internazionale non solo per la durata di Expo 2015; • potrà fungere da strumento operativo d’indirizzo istituzionale per un intervallo temporale di almeno quattro anni, necessario per una ef#cace pianificazione degli interventi. Il documento non è una linea-guida o un decalogo di nobili propositi, ma una analisi oggettiva corredata di azioni strategiche fattibili e auspichiamo vincolanti. Deve aumentare il convincimento che le problematiche nutrizionali (per lo più connesse alla patologia cronica), non sono risolvibili con soli interventi sanitari, ma richiede un cambio di orientamento culturale a livello produttivo, distributivo e di consumo. In questa operazione risulta evidente la centralità del Ministero della Salute e in particolare della Direzione Generale della Igiene e Sicurezza degli Alimenti e della Nutrizione, per un’eventuale revisione delle politiche in materia (tramite strumenti quali linee-guida, LEA, PSN, ecc.) e ricadute in ambito nazionale (politiche regionali in materia sanitaria dedicate alla nutrizione) e internazionale.

Published
2015

13. Effect of Sibutramine on Cardiovascular Outcomes in Overweight and Obese Subjects

Author

James, Wp, Caterson, Id, Coutinho, W, Finer, N, VAN GAAL LF, Maggioni, Ap, TORP-PEDERSEN, C, Sharma, Am, Shepherd, Gm, Rode, Ra, Renz, Cl, Van Gaal LF, Torp-Pedersen, C, Pepine, C, Pocock, S, Drexler, H, Swedberg, K, Sleight, P, Armstrong, P, Kerr, D, Dagenais, G, Brophy, J, Avezum, A, Bogaty, P, Fabbri, G, Galli, M, Hildebrandt, P, Mann, J, Ostergren, J, Sherman, D, Zannad, F, Colquhoun, D, Hollanders, G, e Forti A, Costa, Cifkova, R, Toubro, S, Ziegler, O, Scherbaum, Wa, Jordan, J, Halmy, L, Ferrannini, E, Santini, F, Gonzalez, C, Narkiewicz, K, Hancu, N, Payer, J, Pascual, J, Wilding, J, Campbell, L, Carey, D, Gerstman, M, Karrasch, J, Lefkovits, J, Marks, J, Marks, S, Moses, R, Phillips, P, Proietto, J, Roberts, D, Roberts-Thomson, P, Shaw, J, Simpson, R, Singh, B, Singleton Jeffries, W, Stuckey, B, Boland, J, Brohet, C, Coucke, F, Dendale, P, Jouret, G, Kolanowski, J, Kutnowski, M, Martens, F, Muls, E, Peiffer, F, Penninckx, H, Scheen, A, Schoors, D, Vaerenberg, M, Van Cleemput, J, Van Crombrugge, P, Van Kuyk, M, Verhaegen, A, Wollaert, B, de Albuquerque DC, Appolinario, J, de Godoy Matos AF, Gross, Jl, Halpern, A, Kerr Saraiva JF, Milagres, R, Repetto, G, Suplicy, Hl, Zanella, Mt, Bednarova, J, Cepelak, V, Cerny, P, Hainer, V, Havranek, P, Homza, M, Jansa, P, Karlicek, M, Kolesar, J, Kotik, I, Kucera, D, Kuchar, J, Kunc, M, Kvapil, M, Linhart, A, Machova, V, Matuska, J, Oral, I, Pavlas, J, Pesatova, S, Povolny, J, Semrad, B, Smetana, K, Soucek, M, Svacina, S, Tesinsky, P, Urbanek, R, Wasserburger, B, Zachoval, R, Zahumensky, E, Zidkova, E, Astrup, A, Dominguez, H, Faber, J, Hilderbrant, P, Kober, L, Perrild, H, Richelsen, B, Sogaard, P, Svendsen, Ol, Urhammer, S, Archambeaud, F, Basdevant, A, Borys, Jm, Bringer, J, Brunetiere, C, Charpentier, G, Cocaul-André, M, Dabadie, H, Dubreuil, A, Estour, B, Gautier, Jf, Gibault, T, Halimi, S, Hespel, Jp, Issa Sayegh, M, Krempf, M, Laville, M, Lecerf, Jm, Louvet, Jp, Penfornis, A, Ritz, P, Schlienger, Jl, Schmitt, B, Valensi, P, Baar, M, Beermann, J, Bock, M, Boenner, G, Dammann, Hg, Diehm, C, Ditschuneit, H, Gadow, J, Gehlhar, S, Gessner, S, Guthersohn, A, Hamann, A, Hanefeld, M, Hasenfuss, G, Herzner, A, Heun, Kc, Heufelder, Ae, Hohensee, H, Jacob, S, Krings, P, Krätzig, B, Krosse, B, Lehmann, Rt, Mindt-Prüfert, S, Maisch, B, Pfeiffer, Af, Richard, F, Rose, B, Schmidt, E, Scholze, J, Schreckenberg, A, Stuebler, P, Walter, J, Wirth, A, Wunderlich, J, Abraham, G, Altorjay, A, Augusztin, G, Csaszar, A, Czuriga, I, Dinnyes, J, Gero, L, Gyimesi, A, Janosi, A, Kovacs, I, Liziczai, I, Majtenyi, A, Medvegy, M, Nadhazi, Z, Pados, G, Polak, G, Ronaszeki, A, Sido, Z, Simon, K, Anzà, C, Bevilacqua, M, Bosello, O, Chiariello, M, Cordera, R, Ferrari, E, Frittitta, L, Giorgino, R, Liuzzi, A, Malinverni, C, Di Mario, U, Melchionda, N, Occhi, G, Perticone, F, Pinchera, A, Pinelli, G, Rovera, G, Santeusanio, F, Urbinati, S, Alpizar-Salazar, M, Carrillo-Ortega, E, Fanghanel Salmon, G, Laviada-Molina, Ha, Madero, Ma, Rodriguez, G, Saldate, C, Sanchez-Castillo, Cp, Violante, Rm, Wacher, N, Zayas-Jaime, Fj, Zuniga-Guajardo, S, Adamiec, R, Banasiak, W, Chrusciel, P, Derlaga, B, Gebala, A, Gessek, J, Janik, K, Janion, M, Kalina, Z, Kozlowski, A, Kusnierz, B, Majcher, Z, Miekus, P, Niegowska, J, Okopien, B, Ostrowska, L, Pasowicz, M, Piepiorka, M, Pluta, W, Polaszewska-Muszynska, M, Ponikowski, P, Pupek-Musialik, D, Sawicki, A, Sobocik, H, Stankiewicz, A, Szpajer, M, Trojnar, R, Tykarski, A, Wrabec, K, Wyrzkowski, B, Zahorska-Markiewicz, B, Zalewski, M, Carrageta, M, Mendes Pedro MM, Parente Martins LM, dos Santos, L, Babes, A, Creteanu, G, Dan, Ga, Dragulescu, Si, Graur, M, Tirgoviste, Ci, Morosanu, M, Mota, M, Paveliu, Fs, Radoi, M, Ranetti, A, Totoian, I, Andre, I, Bugan, V, Cencarik, J, Csala, L, Farsky, S, Gonsorcik, J, Kamensky, G, Kmec, J, Krahulec, B, Kurian, R, Macek, V, Majercak, I, Micko, K, Mokan, M, Riecansky, I, Sojka, G, Uhliar, R, Urgeova, L, Vancik, J, Baro, Fm, Barrios Merino, A, Borras, Jl, Caixas, A, Cuatrecasas Cambra, G, Dominguez Escribano JR, Duran Garcia, S, Escobar-Jimenez, L, Esteva de Antonio, I, Formiguera Sala, X, Garcia-Luna, Pp, Garcia Robles, R, Gonzalez Albarran, O, Hernandez-Mijares, A, Martin Hidalgo, A, Masmiquel Comas, L, Morales Perez, F, Moreno Esteban, B, Pascual Izuel JM, Redon Mas, J, Ricart, W, Rubio, Ma, Ruilope, Lm, Salas-Salvado, J, Terroba Larumbe, M, Tinahones, F, de la Torre Casares ML, Vidal Cortada, J, Zuniga-Perez Lemaur, M, Abdulhakim, Ee, Adler, A, Barnett, Ah, Bodmer, C, Campbell, Iw, Chowdhury, T, Cleland, J, Cook, Rc, Dinneen, S, Donnachie, H, Haslam, Dw, Hillis, Gs, Horne, M, Howarth, Dj, Hughes, E, Jackson, S, Jones, Sc, Jones, Th, Kumar, S, Lean, M, Maroni, J, Mcinnes, G, Middleton, A, Morris, A, Newcombe, G, O'Kane, Kp, Pavel, Ic, Pawa, R, Perry, C, Pitts, C, Raja, A, Reckless, J, Robinson, J, Sarmiento, R, Soo, Sc, Taylor, S, Thomas, Ho, Thomson, Ma, and Wilkins, M.

Subjects
Male, medicine.medical_specialty, Myocardial Infarction, Blood Pressure, Kaplan-Meier Estimate, Type 2 diabetes, Klinikai orvostudományok, Placebo, law.invention, Double-Blind Method, Randomized controlled trial, Weight loss, law, Internal medicine, Appetite Depressants, medicine, Humans, Obesity, Myocardial infarction, Stroke, Aged, business.industry, Hazard ratio, Orvostudományok, General Medicine, Middle Aged, Overweight, medicine.disease, Surgery, Diabetes Mellitus, Type 2, Cardiovascular Diseases, Cardiology, Female, Human medicine, medicine.symptom, business, Cyclobutanes, Sibutramine, medicine.drug
Abstract

Background The long-term effects of sibutramine treatment on the rates of cardiovascular events and cardiovascular death among subjects at high cardiovascular risk have not been established. Methods We enrolled in our study 10,744 overweight or obese subjects, 55 years of age or older, with preexisting cardiovascular disease, type 2 diabetes mellitus, or both to assess the cardiovascular consequences of weight management with and without sibutramine in subjects at high risk for cardiovascular events. All the subjects received sibutramine in addition to participating in a weight-management program during a 6-week, single-blind, lead-in period, after which 9804 subjects underwent random assignment in a double-blind fashion to sibutramine (4906 subjects) or placebo (4898 subjects). The primary end point was the time from randomization to the first occurrence of a primary outcome event (nonfatal myocardial infarction, nonfatal stroke, resuscitation after cardiac arrest, or cardiovascular death). Results The mean duration of treatment was 3.4 years. The mean weight loss during the lead-in period was 2.6 kg; after randomization, the subjects in the sibutramine group achieved and maintained further weight reduction (mean, 1.7 kg). The mean blood pressure decreased in both groups, with greater reductions in the placebo group than in the sibutramine group (mean difference, 1.2/1.4 mm Hg). The risk of a primary outcome event was 11.4% in the sibutramine group as compared with 10.0% in the placebo group (hazard ratio, 1.16; 95% confidence interval [CI], 1.03 to 1.31; P=0.02). The rates of nonfatal myocardial infarction and nonfatal stroke were 4.1% and 2.6% in the sibutramine group and 3.2% and 1.9% in the placebo group, respectively (hazard ratio for nonfatal myocardial infarction, 1.28; 95% CI, 1.04 to 1.57; P=0.02; hazard ratio for nonfatal stroke, 1.36; 95% CI, 1.04 to 1.77; P=0.03). The rates of cardiovascular death and death from any cause were not increased. Conclusions Subjects with preexisting cardiovascular conditions who were receiving long-term sibutramine treatment had an increased risk of nonfatal myocardial infarction and nonfatal stroke but not of cardiovascular death or death from any cause. (Funded by Abbott; ClinicalTrials.gov number, NCT00234832.)

Published
2010

14. Manifesto delle criticità in nutrizione clinica e preventiva (2015-2018)

Author

Fusco, Ma, Lucchin, L, Dalle Grave, R, Banderali, G, Rovera, Gm, Ballardini, D, Bertoni, G, Gramezi, A, Ronchi, B, Baldi, A, Carruba, M, Lacirignola, M, Agostoni, C, Fargion, S, Donegani, G, Leonardi, F, Mattivi, F, Viola, R, Ferreiro, Ms, Giannini, M, Fatati, G, Grandone, I, Di Lorenzo, N, Carbonelli, Mg, Riccardi, G, Giacco, R, Trimarchi, F, Aroso, M, Corazza, G, Brighenti, F, Casini, A, Giovannini, M, Riva, E, Sirtori, C, Cicero, A, Nisoli, E, Sbraccia, P, Migliaccio, P, Piretta, L, Melchionda, N, Donini, Lorenzo Maria, Guberti, E, Alonzo, E, Giorgino, F, Laviola, L, Agodi, A, Frittitta, L, Rotella, Cm, Dicembrini, I, Morelli, L, Contaldo, F, Gnessi, Lucio, Laviano, Alessandro, Muscaritoli, Maurizio, Pinto, Alessandro, Vania, Andrea, De Lorenzo, A, Di Renzo, L, Vettor, R, D’Andrea, F, Battino, M, and Biolo, G.

Subjects
nutrizione clinica
Published
2015

15. Obesity and eating disorders. Indications for the different levels of care. An Italian Expert Consensus Document

Author

Lm, Donini, Cuzzolaro M, Spera G, Badiali M, Basso N, Bollea MR, Bosello O, Brunani A, Busetto L, Cairella G, Cannella C, Capodaglio P, Mg, Carbonelli, Castellaneta E, Castra R, Clini E, Contaldo F, Dalla Ragione L, Dalle Grave R, D'Andrea F, Del Balzo V, De Cristofaro P, Di Flaviano E, Fassino S, Am, Ferro, Forestieri P, Franzoni E, Mg, Gentile, Giustini A, Jacoangeli F, Lubrano C, Lucchin L, Manara F, Marangi G, Marcelli M, Marchesini G, Marri G, Marrocco W, Melchionda N, Mezzani B, Migliaccio P, Muratori F, Nizzoli U, Ostuzzi R, Panzolato G, Pasanisi F, Persichetti P, Ml, Petroni, Pontieri V, Prosperi E, Renna C, Rovera G, Ferruccio Santini, Saraceni V, Savina C, Scuderi N, Silecchia G, Strollo F, Todisco P, Tubili C, Ugolini G, Zamboni M, Donini, Lm, Cuzzolaro, M, Spera, G, Badiali, M, Basso, N, Bollea, Mr, Bosello, O, Brunani, A, Busetto, L, Cairella, G, Cannella, C, Capodaglio, P, Carbonelli, Mg, Castellaneta, E, Castra, R, Clini, E, Contaldo, Franco, Dalla Ragione, L, Dalle Grave, R, D'Andrea, Francesco, Del Balzo, V, De Cristofaro, P, Di Flaviano, E, Fassino, S, Ferro, Am, Forestieri, Pietro, Franzoni, E, Gentile, Mg, Giustini, A, Jacoangeli, F, Lubrano, C, Lucchin, L, Manara, F, Marangi, G, Marcelli, M, Marchesini, G, Marri, G, Marrocco, W, Melchionda, N, Mezzani, B, Migliaccio, P, Muratori, F, Nizzoli, U, Ostuzzi, R, Panzolato, G, Pasanisi, Fabrizio, Persichetti, P, Petroni, Ml, Pontieri, V, Prosperi, E, Renna, C, Rovera, G, Santini, F, Saraceni, V, Savina, C, Scuderi, N, Silecchia, G, Strollo, F, Todisco, P, Tubili, C, Ugolini, G, Zamboni, M., D'Andrea, F, Contaldo, F, Forestieri, P, and Pasanisi, F

Subjects
obesity, Anorexia Nervosa, Consensus, National Health Programs, Day Care, Nutritional Status, Walking, Comorbidity, eating disorders, therapy, rehabilitation, Motor Activity, Social Environment, Feeding and Eating Disorders, Disability Evaluation, Risk Factors, Ambulatory Care, Humans, Settore MED/49 - Scienze Tecniche Dietetiche Applicate, Bulimia Nervosa, Expert Testimony, Residential Treatment, Patient Care Team, consensus document, Hospitalization, Italy, Practice Guidelines as Topic, Guideline Adherence, Day Care, Medical, Binge-Eating Disorder, Obesity, Eating Disorders, Algorithms
Abstract

This paper is an Italian Expert Consensus Document on multidimensional treatment of obesity and eating disorders. The Document is based on a wide survey of expert opinion. It presents, in particular, considerations regarding how clinicians go about choosing the most appropriate site of treatment for a given patient suffering from obesity and/or eating disorders: outpatient, partial hospitalization, residential rehabilitation centre, inpatient hospitalization. In a majority of instances obesity and eating disorders are long-term diseases and require a multiprofessional team-approach. In determining an initial level of care or a change to a different level of care, it is essential to consider together the overall physical condition, medical complications, disabilities, psychiatric comorbidity, psychology, behaviour, family, social resources, environment, and available services. We first created a review manuscript, a skeleton algorithm and two rating scales, based on the published guidelines and the existing research literature. As the second point we highlighted a number of clinical questions that had to be addressed in the specific context of our National Health Service and available specialized care units. Then we submitted eleven progressive revisions of the Document to the experts up to the final synthesis that was approved by the group. Of course, from point to point, some of the individual experts would differ with the consensus view. The document can be viewed as an expert consultation and the clinical judgement must always be tailored to the particular needs of each clinical situation. We will continue to revise the Document periodically based on new research information and on reassessment of expert opinion to keep it up-to-date. The Document was not financially sponsored.

Published
2010

21. In memory of Roberto Ostuzzi

Author

Balestrieri, M, Bosello, O, Caputo, G, Cecchetto, G, Cetty, L, Cuzzolaro, M, Gagliardini, C, Gravina, G, Jacoangeli, F, Luxardi, G, Manara, F, Melchionda, N, Minniti, A, Nizzoli, U, Pennacchi, L, Perrone, S, RIPA DI MEANA, G, Schumann, R, Spera, Giovanni, Tarrini, G, Turrini, G, and Uber, E.

Published
2010

23. Snoring, hypertension and Type 2 diabetes in obesity. Protection by physical activity

Author

Marchesini, G., Pontiroli, A., Salvioli, G., Novi, R. F., Vitacolonna, E., Taboga, C., Ciccarone, A. M., Grossi, E., Melchionda, N., and Giovanni Apolone

Subjects
Adult, Male, medicine.medical_specialty, Waist, Databases, Factual, Endocrinology, Diabetes and Metabolism, Type 2 diabetes, Weight Gain, Body Mass Index, Snoring, Diabetes, Non-insulin Dependent, Obesity, Exercise, Weight Gain, Diabetes Complications, Endocrinology, Surveys and Questionnaires, Diabetes mellitus, Internal medicine, Diabetes Mellitus, Prevalence, medicine, Humans, Non-insulin Dependent, Obesity, Exercise, Aged, Univariate analysis, business.industry, Snoring, Diabetes, Odds ratio, Middle Aged, medicine.disease, Diabetes Mellitus, Type 2, Italy, Hypertension, Physical therapy, Female, medicine.symptom, business, Body mass index, Weight gain
Abstract

Sleep-related breathing disorders are recognized as major health problems in obesity. They are involved in both hypertension and Type 2 diabetes, through mechanisms possibly related to increased sympathetic tone. We studied the association of habitual snoring with diabetes, hypertension, weight cycling and physical activity in a large Italian database of treatment-seeking obese subjects. Clinical and behavioral data were assessed by standardized questionnaires. Consecutive data of 1890 obese patients were analyzed [average body mass index (BMI), 38.2 kg/m2, median age: 46 yr, 78% females], from 25 obesity Italian centers, with low prevalence of clinical manifestations of cardiovascular disease. Habitual snoring was reported in 56% of the cases, and was associated with day-time sleepiness. The prevalence increased with obesity class and waist circumference, and was positively associated with weight cycling and weight gain since the age of 20, and smoking. Regular physical activity had a protective effect. Snoring was associated with diabetes and hypertension at univariate analysis, but in multivariate analysis an independent effect was only observed for hypertension. After adjustment for age, gender and BMI, physical activity maintained an independent, protective effect on both snoring (odds ratio 0.65, 95% confidence interval 0.49-0.84; p=0.001), diabetes (0.50, 0.30-0.86; p=0.011) and hypertension (0.71, 0.53-0.95; p=0.023). We conclude that in treatment-seeking, obese subjects with low prevalence of cardiovascular disease, snoring independently increases the risk of hypertension, whereas physical activity exerts a protection on both snoring and complications. These data underline the importance of lifestyle interventions to limit the burden of obesity and associated diseases.

Published
2004

25. The QUOVADIS Study: features of obese Italian patients seeking treatment at specialist centers

Author

Melchionda, N, Marchesini, G, Apolone, G, Cuzzolaro, M, Mannucci, E, Grossi, E, Avagninas, and Corica, Francesco

Subjects
Adult, Male, Obesity, anthropometry, quality of life, behavior, therapy, therapy, anthropometry, Adolescent, behavior, Health Status, Middle Aged, Aged, Body Image, Female, Health Surveys, Humans, Italy, Obesity, Quality of Life, Sex Factors, Mental Health, quality of life
Abstract

Obesity is a major risk factor for several chronic diseases, but the burden associated with it also extends to psychosocial areas and to perceived health status. In 1999 an observational study on health-related quality of life in obesity was planned. The study was entirely web-based. Case Report Forms and the individual items of 7 self-administered questionnaires were directly implemented on a general database via an extranet system from 25 Italian centers. By December 2001, after enrolment had stopped, the database included anthropometric, socioeconomic and clinical data of 1944 patients (78% females). Weight-cycling was reported in over 80% of cases, overeating in 60-65%, structured physical activity in only 13-15%. Several chronic illnesses were associated. Whereas the prevalence of diabetes and hypertension was related to the degree of obesity, hyperlipidemia and coronary heart disease did not increase further with increasing obesity. A disturbed psychological mood was twice more common in females. Concern for present health was the main reason for seeking treatment in both genders; concern for body appearance was more common in females. Male subjects were more frequently assigned to dietary counseling and physical exercise, whereas in females psychotherapy was more frequently considered. Various forms of behavioral approach were planned in approximately 50% of patients. Finally, very few patients were initially considered for pharmacological intervention or bariatric surgery. The study provides a comprehensive picture of Italian patients seeking treatment for obesity. Data on perceived health status, psychological well being, body image awareness, eating behavior disorders and psychopathological distress will provide clues to a comprehensive assessment of obesity, the effects of treatments and reasons for failure.

Published
2003

30. Ghrelin in non-alcoholic fatty liver disease

Author

Bugianesi, E., primary, Marchesini, G., additional, Pagotto, U., additional, Manini, R., additional, Vanni, E., additional, De Iasio, R., additional, Pasquali, R., additional, Melchionda, N., additional, and Rizzetto, M., additional

Published
2003
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39. Citations and Clinicians' Notes: Liver.

Author

Marchesini, G., Bugianesi, E., Forlani, G., Cerrelli, F., Lenzi, M., Manini, R., Natale, S., Vanni, E., Villanova, N., Melchionda, N., Neuschwander-Tetri, B. A., Caldwell, S. H., Mofrad, P., Contos, M. J., Haque, M., Sargeant, C., Fisher, R. A., Luketic, V. A., Sterling, R. K., and Shiffman, M. L.

Subjects
LIVER, FATTY liver, AMINOTRANSFERASES, PATIENTS, HIGH density lipoproteins
Abstract

The article discusses several notes by clinicians related to liver. Non-alcoholic fatty liver diseases (NAFLD) are a new growth area in hepatology research, and are being increasingly diagnosed. In the USA, a survey has shown that 80 percent of patients with abnormal transaminase values have NAFLD. It has been associated with the insulin resistance syndrome, obesity; diabetes and hyperdyslipidaemia. This syndrome has recently been defined as metabolic syndrome, using five variable factors, central obesity, hypertension, hypertriglyceridaernia low high density lipoprotein cholesterol and hyperglycaemia. The authors of the first paper evaluated the presence of metabolic syndrome using the above criteria in a cohort of 304 consecutive NAFLD Italian patients.

Published
2003

43. Urinary excretion rate of C-peptide in fed and fasted obese humans

Author

Pasquali, R., Buratti, P., Casimirri, F., Patrono, D., Capelli, M., Melchionda, N., and Barbara, L.

Abstract

Abstract. The aim of the study was to evaluate the reliability of urinary excretion rate of C-peptide as a marker of B-cell function during fasting. Ten obese subjects of both sexes fasted for 5 days. Diurnal serum C-peptide was collected before and on the 5th day; morning serum samples (for glucose, insulin and C-peptide) and 12-h urine samples (7.00 to 19.00 h) were collected daily. Body weight decreased from 138.7 ± 15.9 to 132.9 ± 15.6 kg. Morning glucose, insulin (–40%) and C-peptide (–50%) fell significantly throughout the study. Mean diurnal C-peptide values were 2.19 ±0.69 nmol/l before and 0.60 ±0.19 nmol/l after fasting (P< 0.0001) and its secretion rate was 909.4 ± 297.9 and 244.4 ± 83.9 nmol/12 h (P< 0.005), respectively. Excretion rate of C-peptide fell progressively from basal (11.2 ± 4.2 nmol/12 h) to a nadir value of 1.3 ± 0.8 nmol/12 h (P< 0.0005); similarly, the C-peptide to creatinine clearance ratio fell from 0.062 ± 0.035 to 0.028 ± 0.015 (P< 0.05). These results indicate that fasting modifies renal metabolism of C-peptide thus creating several complications in the quantitative interpretation of urinary levels as an index of its secretion rate from the B-cell.

Published
1988
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47. The QUOVADIS study: Features of obese Italian patients seeking treatment at specialist centers

Author

Melchionda, N., Marchesini, G., Apolone, G., Cuzzolaro, M., Mannucci, E., Grossi, E., Avagnina, S., Ferrero, L., Barantani, E. G., Molinari, E., Petroni, M. L., Marsala, R. M., Prof. Angelo Compare, Hacker, S., Belfiore, F., Caviezel, F., Ambrosi, B., Tufano, A., Corica, F., Corsonello, A., Domenico, D., Giancotti, V., Valentini, M., Antonini, S., Dall Aglio, E., Adami, A., Dalle Grave, R., Scutari, C., Del Rio, G., Bondi, M., Menozzi, R., Fatati, G., Palazzi, M., Fusco, M. A., Carbonelli, M. G., Gennaro, M., Scaglione, L., Rossin, K., Lucchin, L., Trovato, R., Natale, S., Baraldi, L., Forlani, G., Villanova, N., Ciccarone, A. M., Chatzianagnostou, K., Novi, R. F., Trombetta, A., Seardo, M. A., Alberto, G. F., Pontiroli, E. A., Saibene, A., Vedani, P., Rotella, C., Ciani, S., Zucchi, T., Salvioli, G., Ventura, P., Morselli, L., Tomasi, F., Barbieri, S., Scalambra, E., Capani, F., Vitacolonna, E., Taraborrelli, M., Noacco, C., Taboga, C., Mreule, S., Ferrari, E., Magri, F., Beck Peccoz, P., Morpurgo, P. S., Rosa, M., Covezzoli, A., Campana, F., Rivolta, G., and Cerutti, D.

48. Aminotransferase and gamma-glutamyltranspeptidase levels in obesity are associated with insulin resistance and the metabolic syndrome

Author

Marchesini, G., Avagnina, S., Barantani, E. G., Ciccarone, A. M., Corica, F., Dall Aglio, E., Riccardo Dalle Grave, Morpurgo, P. S., Tomasi, F., Vitacolonna, E., Baraldi, L., Forlani, G., Villanova, N., Melchionda, N., Belfiore, F., Capani, F., Taraborrelli, M., Barbieri, S., Scalambra, E., Scutari, C., Corsonello, A., Mirone, S., Beck-Peccoz, P., Adami, A., Ferrari, E., Magri, F., Hacker, S., Chatzianagnostou, K., and Ferrero, L.

49. [Obesity and Eating Disorders. Indications for the different levels of care. An Italian Expert Consensus Document]. | Documento di Consensus. Obesità e Disturbi dell'Alimentazione Indicazioni per i diversi livelli di trattamento

Author

Donini, L. M., Cuzzolaro, M., Spera, G., Badiali, M., Basso, N., Bollea, M. R., Bosello, O., Brunani, A., Busetto, L., Cairella, G., Cannella, C., Capodaglio, P., Carbonelli, M. G., Castellaneta, E., Castra, R., Clini, E., Contaldo, F., Dalla Ragione, L., Dalle Grave, R., D Andrea, F., Del Balzo, V., Cristofaro, P., Di Flaviano, E., Fassino, S., Ferro, A. M., Forestieri, P., Franzoni, E., Gentile, M. G., Giustini, A., Jacoangeli, F., Lubrano, C., Lucchin, L., Manara, F., Marangi, G., Marcelli, M., Marchesini, G., Marri, G., Marrocco, W., Melchionda, N., Mezzani, B., Migliaccio, P., Muratori, F., Nizzoli, U., Ostuzzi, R., Panzolato, G., Pasanisi, F., Persichetti, P., Petroni, M. L., Pontieri, V., Prosperi, E., Renna, C., Rovera, G., Santini, F., Saraceni, V., Savina, C., Scuderi, N., Silecchia, G., Strollo, F., Todisco, P., Tubili, C., Ugolini, G., and Mauro ZAMBONI

50. Manifesto of the critical issues in preventive and clinical nutrition: The first ten Italian challenges (2015-2018),Manifesto delle criticità in Nutrizione clinica e preventiva: Le prime dieci sfide Italiane (2015-2018)

Author

Lucchin, L., Fusco, M. A., Caretto, A., Alessandrini, L., Facchin, N., Grossi, E., Dalle Grave, R., Banderali, G., Banderali, A., Rovera, G. M., Ballardini, D., Bertoni, G., Gramezi, A., Ronchi, B., Baldi, A., Carruba, M., Lacirignola, M., Capone, R., Agostoni, C., Fargion, S., Mosca, F., Roggero, P., Giannì, M. L., Cosmi, V., Donegani, G., Leonardi, F., Mattivi, F., Viola, R., Ferreiro, M. S., Giannini, M., Poli, A., Marangoni, F., Fatati, G., Grandone, I., Di Lorenzo, N., Carbonelli, M. G., Foschi, D., Riccardi, G., Giacco, R., Trimarchi, F., Aroso, M., Corazza, G. R., Biolo, G., Brighenti, F., Casini, A., Giovannini, M., Riva, E., Elvira Verduci, Sirtori, C., Cicero, A., Racca, A., Sarpa, B., Nisoli, E., Sbraccia, P., Busetto, L., Muratori, F., Migliaccio, P., Piretta, L., Melchionda, N., Donini, L. M., Guberti, E., Alonzo, E., Giorgino, F., Laviola, L., Banni, S., Agodi, A., Frittitta, L., Rotella, C. M., Dicembrini, I., Barbaro, V., Morelli, L., Contaldo, F., Gnessi, L., Laviano, A., Muscaritoli, M., Pinto, A., Vania, A., Lorenzo, A., Di Renzo, L., Vettor, R., D Andrea, F., Battino, M., Melissano, M., Scaffidi, C., Archero, E., Vezzali, V., and Buzzavo, G.

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