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| • RETE DI NUTRIZIONE - Articoli |
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| Articoli |
Overweight and obesity in Italian children aged 6-11 years
[Article in Italian]
Cairella G, Casagni L, Lamberti A, Censi L.
Area della Nutrizione, Dipartimento di Prevenzione, ASL RMB. giuliacairella@gmail.com
Ann Ig. 2008 Jul-Aug;20(4):315-27.
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ABSTRACT
The objective of this study is to obtain reliable data from recent surveys carried out in Italy on the prevalence of overweight (OW) and obesity (OB) in children. We searched in MEDLINE/PubMed, Google and Google Scholar and we included the surveys that fulfilled the following criteria: English or Italian language, time period January 2000-April 2008, target of 6-11 years; BMI evaluated according to IOFT cut-offpoints. Search terms included overweight, obesity, children, Italy, associated with AND/OR. 41 studies have been selected; the percentage of OW varied between 14.7% and 31.3% and OB between 4.3% and 27.3%. In girls, OW values ranged from 11.5% to 34.7% and in boys from 12.6% to 30.1%; in girls, the percentage of OB varied between 4.7% and 29.2%, in boys between 4.4% and 25.8%. There were some variations in the prevalence of OW and OB among diferent regions. The highest values were in Central and Southern Italy, except for Sardinia, where the values were similar to that of Northern Italy. Beyond BMI, the most frequently collected variables were dietary pattern, physical activity, and lifestyle. School is the main site of investigation; third grades (8-9 years) is the most studied age group. The urgency to develop actions to contrast obesity in childhood is confirmed by the prevalence values observed in the Italian regions.
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Obesity in children. Part 2: Prevention and management.
Kipping RR, Jago R, Lawlor DA.
BMJ. 2008 Oct 22;337:a1848. doi: 10.1136/bmj.a1848.
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Energy recommendations for normal weight, overweight and obese children and adolescents: are different equations necessary?
Woodruff SJ, Hanning RM, Barr SI.
Centre for Behavioural Research and Program Evaluation, University of Waterloo, Waterloo, ON, Canada.
Obes Rev. 2009 Jan;10(1):103-8. Epub 2008 Sep 5.
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ABSTRACT
In 2002/2005, separate energy requirement equations were generated by the Institute of Medicine's (IOM) Dietary Reference Intake process for normal weight and overweight/obese children and adolescents. The current paper questions the theoretical rationale of having two sets of equations (based solely on body-weight classification): when body weight is considered, overweight and obese children and adolescents do not seem to differ from their normal weight counterparts in energy expended for basal metabolism or physical activity tasks. However, energy needs for weight maintenance among overweight/obese girls were consistently higher when predicted using the equations for overweight/obese individuals compared with those developed for normal weight individuals. In contrast, among overweight/obese boys, they were consistently lower. Although the differences are within the variability of the estimates, even theoretical support for a higher energy intake (as occurs in girls) seems unwise because of the potential contribution to a higher body mass in children who are already at risk. It is the opinion of the authors that the IOM revisit the use of two separate equations and generate one set that is appropriate for all children and adolescents.
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Obesity in children. Part 1: Epidemiology, measurement, risk factors, and screening.
Kipping RR, Jago R, Lawlor DA.
Department of Family and Social Medicine, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Mazer, Bronx, NY 10461, USA. bonuck@montefiore.org
BMJ. 2008 Oct 15;337:a1824. doi: 10.1136/bmj.a1824.
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Growth and growth biomarker changes after adenotonsillectomy: systematic review and meta-analysis.
Bonuck KA, Freeman K, Henderson J.
Department of Family and Social Medicine, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Mazer, Bronx, NY 10461, USA. bonuck@montefiore.org
Arch Dis Child. 2009 Feb;94(2):83-91. Epub 2008 Aug 6.
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ABSTRACT
OBJECTIVE: To determine the effect of adenoidectomy and/or tonsillectomy ("adenotonsillectomy") upon growth and growth biomarkers, in the context of sleep disordered breathing (SDB). SDB in children, primarily due to adenotonsillar hypertrophy, increases the risk of growth failure. DESIGN: Systematic review and meta-analysis. PubMed, ERIC and Cochrane Reviews databases from January 1980 to November 2007 were searched for studies reporting: pre/post-adenotonsillectomy height and weight changes as percentage increased or decreased, raw data, z scores or centiles, or: IGF-1 and/or IGFBP-3 serum-level changes as z scores or raw data. For anthropometrics, the meta-analysis included studies presenting z scores or centiles. SETTING: Observational studies. PATIENTS: Otherwise healthy children, not selected for obesity. MAIN OUTCOME MEASURES: Pre/post-surgery changes in standardised height and weight, and IGF-1 and IGFBP-3. RESULTS: Of 211 citations identified, 20 met systematic review criteria. SDB was an enrolment criterion in 13 of the studies, and one of several enrolment criteria in three. Meta-analysis findings for pre/post-surgery changes were: standardised height: 10 studies, 363 total children, pooled standardised mean differences (SMD) = 0.34 (95% CI 0.20 to 0.47); standardised weight: 11 studies, 390 total children, pooled SMD = 0.57 (95% CI 0.44 to 0.70); IGF-1: 7 studies, 177 total children, pooled SMD = 0.53 (95% CI 0.33 to 0.73); IGFBP-3: 7 studies, 177 total children, pooled SMD = 0.59 (95% CI 0.34 to 0.83). CONCLUSIONS: Standardised height and weight, and IGF-1 and IGFBP-3 increased significantly after adenotonsillectomy. Findings suggest that primary care providers and specialists consider SDB secondary to adenotonsillar hypertrophy when screening, treating and referring children with growth failure.
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WHO growth standards for infants and young children
[Article in French]
de Onis M, Garza C, Onyango AW, Rolland-Cachera MF; le Comité de nutrition de la Société française de pédiatrie.
Collaborators (14)
Briend A, Bocquet A, Bresson JL, Chouraqui JP, Darmaun D, Dupont C, Frelut ML, Ghisolfi J, Girardet JP, Goulet O, Rieu D, Rigo J, Turck D, Vidailhet M.
Département de nutrition, Organisation mondiale de la santé, Genève, Suisse. deonism@who.int
Arch Pediatr. 2009 Jan;16(1):47-53. Epub 2008 Nov 25.
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ABSTRACT
The growth pattern of healthy breastfed infants deviates to a significant extent from the NCHS/WHO international reference. In particular, this reference is inadequate because it is based on predominantly formula-fed infants, as are most national growth charts in use today. The WHO multicentre growth reference study (MGRS), aimed at describing the growth of healthy breastfed infants living in good hygiene conditions, was conducted between 1997 and 2003 in 6 countries from diverse geographical regions: Brazil, Ghana, India, Norway, Oman and the United States. The study combined a longitudinal follow-up of 882 infants from birth to 24 months with a cross-sectional component of 6669 children aged 18-71 months. In the longitudinal follow-up study, mothers and newborns were enrolled at birth and visited at home a total of 21 times at weeks 1, 2, 4 and 6; monthly from 2-12 months; and bimonthly in the 2nd year. The study populations lived in socioeconomic conditions favorable to growth. The individual inclusion criteria for the longitudinal component were: no known health or environmental constraints to growth, mothers willing to follow MGRS feeding recommendations (i.e., exclusive or predominant breastfeeding for at least 4 months, introduction of complementary foods by 6 months of age and continued breastfeeding to at least 12 months of age), no maternal smoking before and after delivery, single-term birth and absence of significant morbidity. Term low-birth-weight infants were not excluded. The eligibility criteria for the cross-sectional component were the same as those for the longitudinal component with the exception of infant feeding practices. A minimum of 3 months of any breastfeeding was required for participants in the study's cross-sectional component. Weight-for-age, length/height-for-age, weight-for-length/height and body mass index-for-age percentile and Z-score values were generated for boys and girls aged 0-60 months. The full set of tables and charts is presented on the WHO website (www.who.int/childgrowth/en), together with tools such as software and training materials that facilitate their application. The WHO child growth standards were derived from children who were raised in environments that minimized constraints to growth, such as poor diets and infection. In addition, their mothers followed healthy practices such as breastfeeding their children and not smoking during and after pregnancy. The standards depict normal human growth under optimal environmental conditions and can be used to assess children everywhere, regardless of ethnicity, socioeconomic status and type of feeding. The standards explicitly identify breastfeeding as the biological norm and establish the breastfed child as the normative model for growth and development. They have the potential to significantly strengthen health policies and public support for breastfeeding. The pooled sample from the 6 participating countries allowed the development of a truly international reference that underscores the fact that child populations grow similarly across the world's major regions when their health and care needs are met. It also provides a tool that is timely and appropriate for the ethnic diversity seen within countries and the evolution toward increasingly multiracial societies in the Americas and Europe as elsewhere in the world. The WHO standards provide a better tool to monitor the rapid and changing rate of growth in early infancy. They also demonstrate that healthy children from around the world who are raised in healthy environments and follow recommended feeding practices have strikingly similar patterns of growth.
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Childhood obesity.
Han JC, Lawlor DA, Kimm SY.
Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, MD, USA.
Lancet. 2010 May 15;375(9727):1737-48. Epub 2010 May 5.
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ABSTRACT
Worldwide prevalence of childhood obesity has increased greatly during the past three decades. The increasing occurrence in children of disorders such as type 2 diabetes is believed to be a consequence of this obesity epidemic. Much progress has been made in understanding of the genetics and physiology of appetite control and from these advances, elucidation of the causes of some rare obesity syndromes. However, these rare disorders have so far taught us few lessons about prevention or reversal of obesity in most children. Calorie intake and activity recommendations need reassessment and improved quantification at a population level because of sedentary lifestyles of children nowadays. For individual treatment, currently recommended calorie prescriptions might be too conservative in view of evolving insight into the so-called energy gap. Although quality of research into both prevention and treatment has improved, high-quality multicentre trials with long-term follow-up are needed. Meanwhile, prevention and treatment approaches to increase energy expenditure and decrease intake should continue. Recent data suggest that the spiralling increase in childhood obesity prevalence might be abating; increased efforts should be made on all fronts to continue this potentially exciting trend. Copyright 2010 Elsevier Ltd. All rights reserved.
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Trends in food availability, 1909-2007.
Barnard ND.
Washington Center for Clinical Research, Washington, DC 20016, USA. nbarnard@pcrm.org
Am J Clin Nutr. 2010 May;91(5):1530S-1536S. Epub 2010 Mar 24.
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ABSTRACT
The increase in childhood obesity mainly reflects increased energy intake. However, it is not clear which food categories are responsible for this increase. Food availability data, which are calculated from annual food production, imports, beginning stocks, subtracting exports, ending stocks, and nonfood uses, provide clues about which categories are the primary contributors. Data from 1909 to 2007 show increases in per capita availability of several product classes: added oils increased from 16.1 to 39.4 kg/y, meat increased from 56.3 to 91.2 kg/y, cheese increased from 1.7 to 14.9 kg/y, and frozen dairy products increased from 0.7 to 11.5 kg/y. From 1970 to 2007, per capita availability of sweeteners increased from 54.1 to 62.0 kg/y. Carbonated beverage availability has increased, partly at the expense of fluid milk. Flour and cereal availability decreased from 1909 until the late 1960s but rebounded thereafter. Availability of fruit, fruit juices, and vegetables has increased. We conclude that the major contributors to increased energy intake over the last century are oils, shortening, meat, cheese, and frozen desserts, with more recent increases in added sweeteners, fruit, fruit juices, and vegetables. These changes may have influenced the prevalence of childhood obesity.
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Childhood diet and cardiovascular risk factors.
[Article in French]
Girardet JP, Rieu D, Bocquet A, Bresson JL, Chouraqui JP, Darmaun D, Dupont C, Frelut ML, Ghisolfi J, Goulet O, Rigo J, Turck D, Vidailhet M; Comité de nutrition de la société française de pédiatrie
Gastro-entérologie et nutrition pédiatriques, hôpital Armand-Trousseau, 26, avenue Arnold-Netter, 75012 Paris, France. jean-philippe.girardet@trs.aphp.fr
Arch Pediatr. 2010 Jan;17(1):51-9. Epub 2009 Nov 26
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ABSTRACT
Atherosclerosis begins during childhood. From childhood, a strong relation has been shown between the prevalence and extent of the asymptomatic atherosclerosis lesions and cardiovascular risk factors such as elevation in body mass index, blood pressure and plasma lipid concentrations. These risk factors depend not only on the subjects' genetic predisposition, but also on environmental parameters, particularly diet. The Committee on Nutrition reviewed the scientific basis of dietary recommendations for children that could reduce the risk factors and thereby, reduce the risk of coronary heart disease in later life: the effects of prenatal nutrition; the beneficial consequences of breast-feeding on later levels of cholesterolemia, blood pressure and corpulence; the role of dietary lipids on plasma lipid concentration, of salt and potassium on blood pressure, and of lifestyle on corpulence. Copyright 2009 Elsevier Masson SAS. All rights reserved.
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Childhood obesity and adult morbidities.
Biro FM, Wien M.
University of Cincinnati College of Medicine, Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA. frank.biro@cchmc.org
Am J Clin Nutr. 2010 May;91(5):1499S-1505S. Epub 2010 Mar 24.
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ABSTRACT
The prevalence and severity of obesity have increased in recent years, likely the result of complex interactions between genes, dietary intake, physical activity, and the environment. The expression of genes favoring the storage of excess calories as fat, which have been selected for over many millennia and are relatively static, has become maladaptive in a rapidly changing environment that minimizes opportunities for energy expenditure and maximizes opportunities for energy intake. The consequences of childhood and adolescent obesity include earlier puberty and menarche in girls, type 2 diabetes and increased incidence of the metabolic syndrome in youth and adults, and obesity in adulthood. These changes are associated with cardiovascular disease as well as with several cancers in adults, likely through insulin resistance and production of inflammatory cytokines. Although concerns have arisen regarding environmental exposures, there have been no formal expert recommendations. Currently, the most important factors underlying the obesity epidemic are the current opportunities for energy intake coupled with limited energy expenditure.
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Effectiveness of Weight Management Interventions in Children: A Targeted Systematic Review for the USPSTF
Evelyn P. Whitlock, Elizabeth A. O'Connor, Selvi B. Williams, Tracy L. Beil and Kevin W. Lutz
Pediatrics 2010;125;e396-e418; originally published online Jan 18, 2010;DOI: 10.1542/peds.2009-1955
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Diagnosis and management of vitamin D deficiency
Published 11 January 2010, doi:10.1136/bmj.b5664
Cite this as: BMJ 2010;340:b5664
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Simon HS Pearce, professor of endocrinology, honorary consultant physician1,2 ,Tim D Cheetham, senior lecturer in paediatric endocrinology, honorary consultant paediatrician 1,31,3
1 Institute of Human Genetics, Newcastle University, International Centre for Life, Newcastle upon Tyne NE1 3BZ, 2 Endocrine Unit, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, 3 Paediatric Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP
Correspondence to: SHS Pearce s.h.s.pearce@ncl.ac.uk
Lo stile di vita dei bambini, che ormai passano più tempo in casa davanti al PC piuttosto che all'aria aperta, ha causato un inquietante ritorno del rachitismo in Gran Bretagna: malattia molto diffusa nell'età Vittoriana, ma che grazie allo sviluppo economico del Paese, si era quasi del tutto estinta. Cinquant'anni fa il rachitismo era ancora molto diffuso nelle fasce più povere della popolazione, poiché la malattia e'spesso causata dalla malnutrizione e da troppo tempo passato in luoghi chiusi. L'esposizione al sole, infatti, e' cruciale per stimolare il corpo umano a produrre la vitamina D, essenziale per la crescita sana e regolare dei bambini. Secondo un recente studio pubblicato da due ricercatori della Newcastle University, sul ''British Medical Journal'', le ore che i bambini passano davanti allo schermo del computer o qualche videogioco non sono solo dannose per il cervello, ma sono nocive per la loro crescita, e in alcuni casi possono portare ad una dolorosa deformazione delle gambe. I due studiosi, Simon Pearce e Tim Cheetham, hanno annunciato che i casi di rachitismo si stanno ''incrementando in maniera estremamente preoccupante''. ''I ragazzini preferiscono giocare al computer piuttosto che divertirsi all'aria aperta, e la cosa è molto dannosa per la loro salute'', scrive Pearce sul giornale medico. ''Gambe arcuate e una crescita anormale sono problemi diffusi nei Paesi poveri e sottosviluppati, o anche nell'età Vittoriana, ma è inammissibile che si verifichino nella Gran Bretagna moderna del 21esimo secolo''.
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Prevalence of Fatty Liver in Children and Adolescents
PEDIATRICS Vol. 118 No. 4 October 2006, pp. 1388-1393
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Jeffrey B. Schwimmer, MDa, Reena Deutsch,
PhDb, Tanaz Kahen, MDa,
Joel E. Lavine, MD, PhDa, Christina Stanley,
MDac and Cynthia Behling, MD, PhDd
a Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics
b Department of Family and Preventive Medicine
c Department of Pathology, University of California, San Diego School of Medicine, San Diego, California
d Office of the Medical Examiner, County of San Diego, San Diego, California
OBJECTIVE. Fatty liver disease is diagnosed increasingly in children,
but the prevalence remains unknown. We sought to determine the prevalence of pediatric fatty
liver as diagnosed by histology in a population-based sample.
METHODS. We conducted a retrospective review of 742 children between the ages
of 2 and 19 years who had an autopsy performed by a county medical examiner from 1993 to 2003.
Fatty liver was defined as >=5% of hepatocytes containing macrovesicular fat.
RESULTS. Fatty liver was present in 13% of subjects. For children and
adolescents age 2 to 19 years, the prevalence of fatty liver adjusted for age, gender, race,
and ethnicity is estimated to be 9.6%. Fatty liver prevalence increases with age, ranging from
0.7% for ages 2 to 4 up to 17.3% for ages 15 to 19 years. Fatty liver prevalence differs significantly by race and
ethnicity (Asian: 10.2%; black: 1.5%; Hispanic: 11.8%; white: 8.6%). The highest rate of fatty liver was seen
in obese children (38%).
CONCLUSIONS. Fatty liver is the most common liver abnormality in children age
2 to 19 years. The presence of macrovesicular hepatic steatosis in
˜1 of every 10 children has important ramifications for the long-term health of children and young adults.
The influence of the risk factors identified should be taken into consideration in the development of protocols
designed to screen at-risk children and adolescents.
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La dieta mediterranea: il valore aggiunto degli antiossidanti
Giorgio Pitzalis
Responsabile Fimp Rete Eccellenza Nutrizione Regione Lazio
Responsabile scientifico di www.giustopeso.it
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Le abitudini alimentari tipiche della dieta mediterranea sono tra le più adatte a mantenere uno
stato di salute ottimale ed a prevenire le malattie cosiddette del “benessere”. Il problema è
che attualmente sempre più persone si lasciano attrarre da modelli d’oltreoceano, da tutti
ritenuti poco salutari. Ma allora, perché la gente sceglie di accorciarsi la vita? Chi abusa
consapevolmente della propria salute, sembra che ragioni così: “il piacere che mi dà mangiare o
bere in maniera eccessiva e/o errata è più importante della sofferenza di una malattia futura o della morte prematura “.
Alternativa sono gli Health foods, quali verdure, ortaggi, cereali, legumi, frutta fresca, olio extravergine di oliva,
pesce, carni, formaggi magri e il vino in quantità moderata. Una alimentazione disordinata e carente comporta altri
problemi. Tutte le cellule viventi hanno bisogno di ossigeno per produrre energia necessaria al loro funzionamento.
L’ossigeno può, d’altra parte, essere fonte di danni, dovuti ai radicali liberi dell’ossigeno. Questi possono procurare
un danno a livello della membrana cellulare, delle proteine e degli acidi nucleici (insorgenza del cancro,
invecchiamento cellulare). Le principali fonti di queste “mine vaganti” sono rappresentate da radiazioni solari,
radiazioni ionizzanti, fumo di sigaretta, smog, radiazioni ultraviolette, gas di scarico dei veicoli, impianti di
riscaldamento e industrie, pesticidi, antiparassitari, inquinanti chimici, farmaci, carni cotte alla brace.
Le cellule sono in grado di difendersi dall’attacco dei radicali liberi con l’aiuto di sostanze antiossidanti.
Ma talvolta il difetto dei fattori antiossidanti sposta la “bilancia” in senso negativo, e si verifica lo stress
ossidativo, evento che può essere definito come una situazione nella quale l’esposizione ai radicali liberi o ad
altri agenti ossidanti crea un elemento di disturbo per la normale funzione della cellula o addirittura per la
sua stessa sopravvivenza. Le sostanze vegetali (frutta e verdura) rappresentano la principale fonte di antiossidanti,
grazie al loro elevato contenuto in vitamine A, E e C. Accanto agli antiossidanti vitaminici grande interesse viene
rivolto ai carotenoidi ed ai composti fenolici. In particolare è stata dimostrata una spiccata attività antitumorale
(specie per la prostata) per il licopene presente nei pomodori maturi. Comunque l’assorbimento di questo carotenoide è
condizionato dalla contemporanea presenza di lipidi e quindi, poiché si tratta di una sostanza stabile, resistente ai
processi tecnologici ed alla cottura, indicatissima appare la salsa di pomodori condita con olio di oliva. Licopene in
quantità minore si trova nelle albicocche, nei cocomeri e negli agrumi rossi. Per quanto riguarda i composti fenolici
(flavonoidi e non flavonoidi), li troviamo diffusi in tutti i vegetali, particolarmente a foglie verdi e nei frutti
colorati, oltre che nei loro derivati, come il vino rosso, l’olio di oliva extravergine, il tè, il caffè e la birra.
I bioflavonoidi sono i componenti di molti frutti e diverse verdure. Sono costituenti chimici dagli splendidi colori,
contenuti nella polpa e nella scorza degli agrumi, nel pepe verde, nelle albicocche, in ciliegie, uva, papaia,
pomodori e broccoli. Questi prodotti aumentano l’azione della Vit. C. E’ perciò importante che ognuno di noi abbia
l’abitudine di consumare alimenti ricchi di antiossidanti. E’ possibile suddividere gli alimenti in 3 grandi gruppi.
Il primo ha un modesto contenuto di antiossidanti (albicocche, cavolfiore, pera, pesca, banana, mela, melanzana,
cetrioli, pomodori, spinaci, fagiolini). Al gruppo 2 appartengono il pompelmo, avocado, kiwi, uva nera e bianca,
cipolla, patata, peperone, susina, succo di arancia. Il gruppo 3 comprende alimenti ricchi di antiossidanti
(succo di uva nera, fragole, prugne nere, ciliegie, arancia, mirtilli, spinaci cotti, succo di pompelmo, more, cavolo
verde, cavoli di Bruxelles). In conclusione mangiare una giusta quantità di alimenti della tradizione mediterranea,
variando quanto più possibile e tenendo conto degli alimenti antiossidanti (e quindi protettivi per il nostro organismo)
è la maniera migliore per assicurarci un futuro forse sgombro dalle malattie cibo-correlate (ipertensione arteriosa,
diabete, malattie cardio-vascolari, ecc.).
To be continued….
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| Systematic Review Finds Higher Protein Intake May Benefit Bone Density |
Background: Increasing lifespans are accompanied by increases in chronic diseases,
such as osteoporosis, which some experts consider to be at epidemic proportions: 1 in 4 women will experience a bone
fracture in her lifetime. Consequently, measures to enhance bone health are of great importance, and diet tends to take
center stage. Although it is tempting to think of bone as being an inert structure made up of minerals, it is living
tissue that changes as we age. Protein makes up about half its volume, and adequate dietary protein across the lifespan
is critical in the development and maintenance of healthy bones. Considerable research has been done to look at the
relation between dietary protein and bone health, but the results from these studies have not been systematically reviewed.
A recently conducted research project at the University of Surrey and the University of York, however, did just this.
The results, as well as a complementary editorial by Kerstetter, are published in the December 2009 issue of The American
Journal of Clinical Nutrition.
Study Design: To conduct this investigation, the researchers searched several scientific
databases to identify all human studies published since 1966 on protein intake and bone. To be included, studies had
to have collected relatively rigorous data concerning indexes of bone health, such as bone mineral density,
bone mineral content, bone turnover, or fracture risk. Both epidemiologic (observational) and intervention
(experimental) studies were considered. Of the 2180 studies initially identified, 61 met the criteria for
inclusion in this systematic review.
Results: When all studies were considered together, the data
suggested a very small, positive relation between protein intake and bone mineral density.
Variation in protein intake accounted for 1–2% of variation in bone strength. Similarly,
the researchers found that increased protein intake was related to greater bone mineral
density at the lumbar spine region. They found no association between protein consumption and
risk of bone fracture.
Conclusions: The authors concluded that there may be a small benefit
of higher protein consumption on bone health, but this does not necessarily translate into
reduced fracture risk in the long term. In her accompanying opinion piece, Kerstetter reminds
us that these data can be looked at another way as well. That is, they support the contention
that, contrary to what we often hear, higher dietary protein consumption (including animal
protein) is not detrimental to bone health. In fact, the opposite may be true. The highest risk
group may be the frail elderly because their protein and calcium intakes may be low and their
risk of osteoporosis is high. For those individuals, Kerstetter recommends “let us make it a
goal to add a small protein source to their tea and toast meals.” This certainly seems to be
safe and prudent advice.
Reference:
- Darling AL, Millward DJ, Torgerson DJ, Hewitt CE,
Lanham-New SA. Dietary protein and bone health: a systematic review and meta-analysis.
American Journal of Clinical Nutrition 2009;90:1674–92.
- Kerstetter JE. Dietary protein and bone: a new approach to an old question.
American Journal of Clinical Nutrition 2009;90:1451–2.
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