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Marcella MALAVOLTI
Personale tecnico amministrativo
Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze Sede ex Sanità Pubblica
Ricercatore t.d. art. 24 c. 3 lett. B
Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze Sede ex Sanità Pubblica
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Pubblicazioni
2024
- Adherence to the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and exposure to selenium species: A cross-sectional study
[Articolo su rivista]
Urbano, Teresa; Filippini, Tommaso; Malavolti, Marcella; Fustinoni, Silvia; Michalke, Bernhard; Wise, Lauren A.; Vinceti, Marco
abstract
Selenium is a trace element found in many chemical forms. Selenium and its species have nutritional and toxicologic properties, some of which may play a role in the etiology of neurological disease. We hypothesized that adherence to the Mediterranean-Dietary Approach to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet could influence intake and endogenous concentrations of selenium and selenium species, thus contributing to the beneficial effects of this dietary pattern. We carried out a cross-sectional study of 137 non-smoking blood donors (75 females and 62 males) from the Reggio Emilia province, Northern Italy. We assessed MIND diet adherence using a semiquantitative food frequency questionnaire. We assessed selenium exposure through dietary intake and measurement of urinary and serum concentrations, including speciation of selenium compound in serum. We fitted non-linear spline-based regression models to investigate the association between MIND diet adherence and selenium exposure concentrations. Adherence to the MIND diet was positively associated with dietary selenium intake and urinary selenium excretion, whereas it was inversely associated with serum concentrations of overall selenium and organic selenium, including serum selenoprotein P-bound selenium, the most abundant circulating chemical form of the metalloid. MIND diet adherence also showed an inverted U-shaped relation with inorganic selenium and particularly with its hexavalent form, selenate. Our results suggest that greater adherence to the MIND diet is non-linearly associated with lower circulating concentrations of selenium and of 2 potentially neurotoxic species of this element, selenoprotein P and selenate. This may explain why adherence to the MIND dietary pattern may reduce cognitive decline.
2024
- Climate change-related factors and west nile virus spread in italy: a systematic review
[Abstract in Atti di Convegno]
Granata, M; Tommasi, L; Verzelloni, P; Lorenzon, A; Paduano, S; Malavolti, M; Bargellini, A; Filippini, T; Righi, E; Vinceti, M
abstract
West Nile Virus (WNV) is a vector-transmitted pathogen affecting both humans and animals, whose presence has recently risen in Europe and particularly in Italy, concurrently with climate changes that favoured the diffusion of mosquitoes. Our review aims to assess such relation with
environmental and meteorological factors focusing on the WNV spread in the Italian territory.
Following PRISMA guidelines, we performed a literature search in online databases up to May 31, 2023 on four different databases: PubMed, Web of Science, Embase, Scopus. We used keywords and MeSH terms related to WNV and its vectors (C. pipiens and modestus). Following the PECOS criteria, we included observational studies examining vector dynamics and the WNV infection epidemiology in the Italian population and the possible association with environmental factors. The protocol registration on PROSPERO is in process.
Out of the 341 articles retrieved, 222 remained after duplicates exclusion and 44 papers were selected after screening of title and abstract by two blinded reviewers. After full-text screening,
31 studies (published between 2011 and 2023) were included. Climatic factors such as temperature, daylight hours and humidity seem to be strongly associated with the spread of WNV and its vectors, while rainfall showed less influence. Among environmental factors, soil characteristics and population dynamics (of both vector and host) were found to be the most predictive. By contrast, distance from specific areas (e.g. urban or protected areas) seems to have no influence.
These findings suggest that some climatic and environmental factors linked with climate change strongly affect the presence of WNV and its vectors. This issue can be considered a warning bell about the potential future increase in cases related to climate change, but offers helpful resources for predicting its spread and implement tailored public health interventions.
2024
- Residential exposure to magnetic fields from transformer stations and risk of childhood leukemia
[Articolo su rivista]
Malavolti, M.; Malagoli, C.; Wise, L. A.; Poli, M.; Notari, B.; Taddei, I.; Fabbi, S.; Teggi, S.; Balboni, E.; Pancaldi, A.; Palazzi, G.; Vinceti, M.; Filippini, T.
abstract
Background: Several studies have documented an increased risk of leukemia among children exposed to magnetic fields from high-voltage power lines, with some evidence of dose-response relation. However, findings in some studies have been inconsistent, and data on the effects of different sources of exposure are lacking. In this study, we evaluated the relation of childhood leukemia risk to exposure to magnetic fields from transformer stations. Methods: We conducted a population-based case-control study in a pediatric population of two Northern Italian provinces of Modena and Reggio Emilia. We included 182 registry-identified childhood leukemia cases diagnosed during 1998-2019 and 726 population controls matched on sex, year of birth, and province of residence. We assessed exposure by calculating distance from childhood residence to the nearest transformer station within a geographical information system, computing disease odds ratios (ORs) and 95% confidence intervals (CIs) using conditional logistic regression, adjusting for potential confounders. We evaluated exposure using two buffers (15 m and 25 m radius) and assessed two case groups: leukemia (all subtypes) and acute lymphoblastic leukemia (ALL). Results: Residing within 15 m of a transformer station (vs. ≥15 m) was not appreciably associated with risk of leukemia (all subtypes) or ALL. We found similar results using a less stringent exposure buffer (25 m). Among children aged ≥5 years, the adjusted ORs were 1.3 (95% CI 0.1-12.8) for leukemia and 1.3 (95% CI 0.1-12.4) for ALL using the 15 m buffer, while they were 1.7 (95% CI 0.4-7.0) for leukemia and 0.6 (95% CI 0.1-4.8) for ALL using the 25 m buffer. Conclusions: While we found no overall association between residential proximity to transformer stations and childhood leukemia, there was some evidence for elevated risk of childhood leukemia among children aged ≥5 years. Precision was limited by the low numbers of exposed children.
2023
- Education and Disparities in Cardiac Rehabilitation Effectiveness
[Articolo su rivista]
Filippini, Tommaso; Malavolti, Marcella
abstract
2023
- Healthy dietary patterns and cognitive status in Mild Cognitive Impairment subjects
[Abstract in Rivista]
Urbano, T; Filippini, T; Carbone, C; Malavolti, M; Marti, A; Agnoli, C; Sieri, S; Chiari, A; Zamboni, G; Vinceti, M
abstract
2023
- Influence of dietary patterns on urinary excretion of cadmium in an Italian population: A cross-sectional study
[Articolo su rivista]
Urbano, Teresa; Verzelloni, Pietro; Malavolti, Marcella; Sucato, Sabrina; Polledri, Elisa; Agnoli, Claudia; Sieri, Sabina; Natalini, Nicoletta; Marchesi, Cristina; Fustinoni, Silvia; Vinceti, Marco; Filippini, Tommaso
abstract
Introduction: Cadmium is a toxic heavy metal with detrimental effects on human health. Apart from smoking and occupational factors, diet is the main source of cadmium. However, the relation between adherence to so-called "healthy" dietary patterns and cadmium exposure has not been investigated in detail. In this study, we aimed at assessing such association in a Northern Italian population. Methods: Using a cross-sectional study design, we investigated a population of non-smokers aged 30-60 years in the period 2017-2019. Each subject completed a validated food frequency questionnaire (FFQ) in order to estimate adherence to four dietary patterns, namely the Dietary Approach to Stopping Hypertension-DASH diet, Greek Mediterranean Index-GMI, the Italian Mediterranean Index-IMI, and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet. We collected a fasting morning urinary sample to measure urinary levels of cadmium and cotinine. The association between increasing adherence to dietary patterns and cadmium exposure was evaluated using a cubic spline regression non-linear model and adjusting for relevant confounders (age, sex, body mass index, urinary cotinine levels, intake of fiber, and alcohol). Results: We recruited 137 participants (males/females: 62/75) with median (interquartile range-IQR) age of 47 (IQR: 43-53) years. Median scores for the investigated dietary patterns were 24 (IQR: 21-28), 4 (IQR: 3-6), 4 (IQR: 3-5), and 7.5 (IQR: 6.5-8.5) for DASH, GMI, IMI and MIND diets, respectively. The median urinary cadmium level was 0.21 μg/L (IQR: 0.11-0.34 μg/L). Spline regression analysis showed an inverse linear association between increasing adherence to the DASH and MIND diets and urinary cadmium levels, reaching a plateau at high adherence scores, approximately > 25 and > 9 for DASH and MIND diets, respectively. An increase of cadmium exposure with increasing MIND score also emerged. Conversely, the association was almost null for IMI, and slightly positive for GMI. Conclusions: The present findings suggest that increasing adherence to the DASH and MIND diets are associated with decreased cadmium levels only at moderate level. Overall, these results indicate that public health strategies, including the decrease of cadmium contamination in healthy foods should be implemented.
2023
- Residential exposure to magnetic fields from high-voltage power lines and risk of childhood leukemia
[Articolo su rivista]
Malagoli, C.; Malavolti, M.; Wise, L. A.; Balboni, E.; Fabbi, S.; Teggi, S.; Palazzi, G.; Cellini, M.; Poli, M.; Zanichelli, P.; Notari, B.; Cherubini, A.; Vinceti, M.; Filippini, T.
abstract
Background: Several studies have suggested an excess risk of leukemia among children living close to high-voltage power lines and exposed to magnetic fields. However, not all studies have yielded consistent results, and many studies may have been susceptible to confounding and exposure misclassification. Methods: We conducted a case-control study to investigate the risk of leukemia associated with magnetic field exposure from high-voltage power lines. Eligible participants were children aged 0–15 years residing in the Northern Italian provinces of Modena and Reggio Emilia. We included all 182 registry-identified childhood leukemia cases diagnosed in 1998–2019, and 726 age-, sex- and province-matched population controls. We assessed exposure by calculating distance from house to nearest power line and magnetic field intensity modelling at the subjects’ residence. We used conditional logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs), with adjustment for potential confounders (distance from nearest petrol station and fuel supply within the 1000 m-buffer, traffic-related particulate and benzene concentrations, presence of indoor transformers, percentage of urban area and arable crops). Results: In multivariable analyses, the OR comparing children living <100 m from high-voltage power-lines with children living ≥400 m from power-lines was 2.0 (95% CI 0.8–5.0). Results did not differ substantially by age at disease diagnosis, disease subtype, or when exposure was based on modeled magnetic field intensity, though estimates were imprecise. Spline regression analysis showed an excess risk for both overall leukemia and acute lymphoblastic leukemia among children with residential distances <100 m from power lines, with a monotonic inverse association below this cutpoint. Conclusions: In this Italian population, close proximity to high-voltage power lines was associated with an excess risk of childhood leukemia.
2023
- Residential proximity to petrol stations and risk of childhood leukemia
[Articolo su rivista]
Malavolti, Marcella; Malagoli, Carlotta; Filippini, Tommaso; Wise, Lauren A; Bellelli, Alessio; Palazzi, Giovanni; Cellini, Monica; Costanzini, Sofia; Teggi, Sergio; Vinceti, Marco
abstract
Petrol stations emit benzene and other contaminants that have been associated with an increased risk of childhood leukemia. We carried out a population-based case-control study in two provinces in Northern Italy. We enrolled 182 cases of childhood leukemia diagnosed during 1998-2019 and 726 age- and sex-matched population controls. We geocoded the addresses of child residences and 790 petrol stations located in the study area. We estimated leukemia risk according to distance from petrol stations within a 1000 m buffer and amount of supplied fuel within a buffer of 250 m from the child's residence. We used conditional logistic regression models to approximate risk ratios (RRs) and 95% confidence intervals (CIs) for associations of interest, adjusted for potential confounders. We also modeled non-linear associations using restricted cubic splines. In secondary analyses, we restricted to acute lymphoblastic leukemia (ALL) cases and stratifed by age (<5 and >= 5 years). Compared with children who lived >= 1000 m from a petrol station, the RR was 2.2 (95% CI 0.5-9.4) for children living<50 m from nearest petrol station. Associations were stronger for the ALL subtype (RR=2.9, 95% CI 0.6-13.4) and among older children (age >= 5 years: RR=4.4, 95% CI 0.6-34.1; age<5 years: RR=1.6, 95% CI 0.1-19.4). Risk of leukemia was also greater (RR=1.6, 95% CI 0.7-3.3) among the most exposed participants when assigning exposure categories based on petrol stations located within 250 m of the child's residence and total amount of gasoline delivered by the stations. Overall, residence within close proximity to a petrol station, especially one with more intense refueling activity, was associated with an increased risk of childhood leukemia, though associations were imprecise.
2023
- Selenium exposure and oxidative stress and genotoxicity risk in a healthy Italian population: a cross sectional study
[Abstract in Rivista]
Urbano, Teresa; Filippini, Tommaso; Malavolti, Marcella; Michalke, Bernhard; Fustinoni, Silvia; Vinceti, Marco
abstract
2023
- Selenium exposure and urinary 8-oxo-7,8-dihydro-2'-deoxyguanosine: Major effects of chemical species and sex
[Articolo su rivista]
Urbano, Teresa; Filippini, Tommaso; Wise, Lauren A; Sucato, Sabrina; Polledri, Elisa; Malavolti, Marcella; Fustinoni, Silvia; Michalke, Bernhard; Vinceti, Marco
abstract
: Selenium is an element present in trace amounts and different chemical forms. It may exert both beneficial and adverse effects on cellular redox status and on the generation of reactive oxygen species. 8-oxo-7,8-dihydro-2'deoxyguanosine (8-oxodG) is an oxidized derivative of deoxyguanosine, and a sensitive biomarker of oxidative stress and genotoxicity. The present study assessed the extent to which selenium status was associated with urinary 8-oxodG concentrations in a Northern Italian population. We recruited healthy, non-smoking blood donors living in the Reggio Emilia province during 2017-2019. We measured urinary 8-oxodG concentrations and used restricted cubic spline regression analyses to investigate the association between selenium status (estimated using food frequency questionnaires, urinary concentrations, and serum concentrations of selenium and selenium species) and 8-oxodG/g creatinine. Among 137 participants aged 30-60 years, median urinary selenium and 8-oxodG concentrations were 22.02 μg/L and 3.21 μg/g creatinine, respectively. Serum samples and selenium speciation analyses were available for 104 participants. Median total serum selenium levels and dietary intake were 116.5 μg/L and 78.7 μg/day, respectively. In spline regression analysis, there was little association between dietary, serum, or urinary selenium with 8-oxodG concentrations. In sex-specific analyses, urinary selenium showed a positive association with the endpoint among males. For single selenium species, we observed positive associations with urinary 8-oxodG for serum organic selenium species, and negative associations for inorganic selenium forms. In the most adjusted analysis, urinary 8-oxodG concentrations showed a strong positive association with selenomethione-bound selenium (Se-Met) and a negative association with inorganic tetravalent selenium, selenite. In sex-specific analyses, these associations were considerably stronger in males than in females. Overall, study findings indicate that selenium species exhibited very different patterns of associations with the biomarker of oxidative stress, and that these associations also depended on sex. Background exposure to Se-Met appears to be strongly and positively associated with oxidative stress.
2023
- Serum selenium concentrations and adherence to the MIND diet in a Northern Italian population: a cross sectional study
[Abstract in Rivista]
Filippini, Tommaso; Urbano, Teresa; Malavolti, Marcella; Grioni, Sara; Agnoli, Claudia; Sieri, Sabina; Michalke, Bernhard; Vinceti, Marco
abstract
2023
- Sulfur content in foods consumed in an Italian population and impact of diet quality on sulfur intake
[Articolo su rivista]
Passafiume, A.; Rossetti, A.; Vescovi, L.; Malavolti, M.; Baraldi, C.; Rovesti, S.; Vinceti, M.; Filippini, T.
abstract
Sulfur is an essential nutrient but data about its intake are scarce. We aimed to measure sulfur content in food samples and assess its habitual intake in relation to adherence to healthy dietary patterns in 719 Italian adults. Using a food frequency questionnaire, we estimated overall sulfur intake, and its relation with adherence to healthy dietary patterns. The highest sulfur content was found in preserved/canned fish (3.0 g/kg), seafood (2.8 g/kg), white meat (2.8 g/kg) and dairy products, particularly aged cheeses (2.1 g/kg) and lowest in fresh fruit (87 mg/kg), oils and fats (157 mg/kg), and beverages (141 mg/kg), with the exception of onion and garlic (1.3 g/kg). The mean sulfur intake in the study population was 1.1 g/day, slightly higher in men than women. The foods contributing most to sulfur intake were meat (29%) and cereals (19%), with also substantial contribution (>10%) from beverages and dairy products. Adherence to dietary patterns had little influence on sulfur intake, except for adherence to MIND diet positively and linearly associated with sulfur intake. Our study provides an updated overview of sulfur content in foods composing the Italian diet, as well as of sulfur intake in an Italian community of Northern Italy.
2022
- Association between dietary patterns and urinary cadmium levels in an Italian population
[Abstract in Atti di Convegno]
Filippini, T.; Urbano, T.; Malavolti, M.; Fustinoni, S.; Vinceti, M.
abstract
2022
- Associations of urinary and dietary cadmium with urinary 8-oxo-7,8-dihydro-2′-deoxyguanosine and blood biochemical parameters
[Articolo su rivista]
Urbano, Teresa; Filippini, Tommaso; Wise, Lauren A.; Lasagni, Daniela; De Luca, Tiziana; Sucato, Sabrina; Polledri, Elisa; Malavolti, Marcella; Rigon, Chiara; Santachiara, Annalisa; Pertinhez, Thelma A.; Baricchi, Roberto; Fustinoni, Silvia; Vinceti, Marco
abstract
Cadmium is a heavy metal with established adverse effects on human health, namely on bone, liver and kidney function and the cardiovascular system. We assessed cadmium exposure and its correlation with biomarkers of toxicity. We recruited 137 non-smoking blood donors without a history of chronic disease or cancer who resided in the Northern Italy province of Reggio Emilia (mean age 47 years, range 30–60 years) in the 2017–2019 period. We used a semi-quantitative food frequency questionnaire to estimate dietary cadmium intake and urine samples to assess concentrations of urinary cadmium and 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG). Median urinary cadmium and 8-oxodG concentrations were 0.21 μg/L (interquartile range (IQR): 0.11–0.34 μg/L) and 3.21 μg/g creatinine (IQR: 2.21–4.80 μg/g creatinine), respectively, while median dietary cadmium intake was 6.16 μg/day (IQR: 5.22–7.93 μg/day). We used multivariable linear and spline regression models to estimate mean differences exposure concentrations. Dietary and urinary cadmium were positively correlated, and both were positively and linearly correlated with 8-oxodG. We found a positive association of urinary cadmium with blood alanine aminotransferase (ALT), total cholesterol, low-density lipoprotein (LDL)-cholesterol and thyroid-stimulating hormone (TSH) concentrations. We also observed a positive association with triglycerides, in both linear (beta regression coefficient = 77.03, 95% confidence interval 32.27–121.78) and non-linear spline regression analyses. Despite the positive correlation between dietary and urinary cadmium estimates, dietary cadmium intake showed inconsistent results with the study endpoints and generally weaker associations, suggesting a decreased capacity to reflect actual cadmium exposure. Overall, these findings suggest that even low levels of cadmium exposure may adversely alter hematological and biochemical variables and induce oxidative stress.
2022
- Associazione tra livelli di cadmio e 8‑oxo‑7,8‑diidro‑2’‑deossiguanosina in una popolazione italiana
[Articolo su rivista]
Urbano, Teresa; Filippini, Tommaso; Malavolti, Marcella; Fustinoni, Silvia; Vinceti, Marco
abstract
2022
- Associazione tra livelli di cadmio e parametri ematologici e biochimici in una popolazione del Nord Italia
[Abstract in Atti di Convegno]
Urbano, Teresa; Filippini, Tommaso; Lasagni, Daniela; De Luca, Tiziana; Sucato, Sabrina; Polledri, Elisa; Malavolti, Marcella; Santachiara, Annalisa; Pertinhez Thelma, A.; Baricchi, Roberto; Fustinoni, Silvia; Vinceti, Marco
abstract
2022
- Dietary Patterns and Blood Biochemical and Metabolic Parameters in an Italian Population: A Cross-Sectional Study
[Articolo su rivista]
Cecchini, Marta; Urbano, Teresa; Lasagni, Daniela; De Luca, Tiziana; Malavolti, Marcella; Baraldi, Claudia; Grioni, Sara; Agnoli, Claudia; Sieri, Sabina; Santachiara, Annalisa; Pertinhez, Thelma A.; Fustinoni, Silvia; Baricchi, Roberto; Vinceti, Marco; Filippini, Tommaso
abstract
Diet has long been identified as a major determinant of cardiovascular and other chronic diseases. In this study, we assess the relation between adherence to different dietary patterns and biochemical and metabolic parameters as well as the 10-year risk of major cardiovascular diseases (CVDs) in a community of blood donors in Northern Italy. We assess their adherence to four dietary patterns, namely, the Dietary Approach to Stop Hypertension (DASH) diet, the Mediterranean diet through the Greek and Italian Mediterranean Indices (GMI and IMI) and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, using a validated semi-quantitative food frequency questionnaire (FFQ). We then assess their association with blood parameters and the 10-year risk of major CVD using a spline regression model. We found an inverse association between the DASH and MIND diets and total and LDL cholesterol, and triglyceride and HDL cholesterol values for the Mediterranean diets (IMI and GMI). Additionally, according to our sex-stratified analyses, men who have greater adherence to dietary patterns have a decreased risk of major CVD for all patterns. The results suggest that greater adherence to dietary patterns positively influences blood biochemical and metabolic parameters, thus reducing the risk of developing cardiovascular disease and delaying the use of drug treatments
2022
- Dietary intake of potentially toxic elements and children's chemical exposure
[Articolo su rivista]
Urbano, T.; Zagnoli, F.; Malavolti, M.; Halldorsson, T. I.; Vinceti, M.; Filippini, T.
abstract
Environmental pollution is a major global public health problem, which has been extensively associated with several adverse health outcomes in both developed and undeveloped countries. In this review, we aimed at summarizing the most recent epidemiological evidence on the association between environmental pollutants intake and possible adverse health effects in children. What emerged is that several contaminants negatively affect children's health. In particular, exposure to heavy metals, plastic-derived chemicals, pesticides, and per- and polyfluoroalkyl substances have been associated with developmental disorders, cancers, allergies, and obesity in children.
2022
- Environmental and lifestyle risk factors for early-onset dementia: a systematic review
[Articolo su rivista]
Bosi, Matteo; Malavolti, Marcella; Garuti, Caterina; Tondelli, Manuela; Marchesi, Cristina; Vinceti, Marco; Filippini, Tommaso
abstract
The term early-onset dementia (EOD) encompasses several forms of neurodegenerative diseases characterized by symptom onset before 65 years and leading to severe impact on subjects already in working activities, as well as on their family and caregivers. Despite the increasing incidence, the etiology is still unknown, with possible association of environmental factors, although the evidence is still scarce. In this review, we aimed to assess how several environmental and lifestyle factors may be associated with the onset of this disease.
2022
- Exposure to overhead high-voltage power lines and childhood leukemia risk: an Italian population-based case-control study
[Abstract in Atti di Convegno]
Malagoli, Carlotta; Malavolti, Marcella; Fabbi, Sara; Zanichelli, Paolo; Notari, Barbara; Poli, Maurizio; Palazzi, Giovanni; Cellini, Monica; Filippini, Tommaso; Teggi, Sergio; Vinceti, Marco
abstract
Background
Previous epidemiologic findings suggest a positive association between magnetic field exposure induced by high voltage power lines and childhood leukemia (CL). Contrasting results are still reported, possibly biased by exposure misclassification, relying on different assessment methods across studies, and by unmeasured confounders.
Methods/Approach
We further studied this relation in the Modena and Reggio Emilia provinces (Northern Italy), and through a modelling exposure assessment we identified the corridors along high voltage power lines with magnetic field intensity in the 0.1-0.4 µT ranges. Then we identified 182 cases of newly-diagnosed CL within these provinces from 1998 to 2019. We sampled four age-, sex-, province of residence- and calendar year- matched controls for each case. We computed the odds ratio (OR) and its 95% confidence interval (CI) of CL in a conditional logistic regression analysis according to distance between home address at the time of diagnosis of the case and the nearest high voltage power line and also to residential magnetic field modeled intensity.
Results
OR of CL was 0.9 (95% CI 0.5-1.6), 0.9 (95% CI 0.4-2.0), 1.5 (95% CI 0.5-4.7) and 4.0 (95% CI 1.0-16.0) for children living respectively 200-400 m, 100-200 m, 50-100 m, and less than 50 m from the nearest high voltage power line compared to those residing further than 400 m. OR of CL associated with residence in the area with exposure >0.1 µT was 8.0 (95% CI 0.7-88.2).
Conclusions
Though the number of exposed children in this study was too low to allow firm conclusions, yielding in such cases high but very imprecise estimates, our results seem more suggestive of an excess risk of leukemia among children living close to electric power lines or exposed to higher magnetic fields intensity.
2022
- Mercuric chloride (HgCl2)
[Capitolo/Saggio]
Urbano, Teresa; Malavolti, Marcella; Vinceti, Marco; Filippini, Tommaso
abstract
Mercuric chloride (CAS# 7487-94-7) is used in photographical processes, wood preservatives, disinfectants, fungicides, and some pharmaceutical products. Mercury chloride is one of the most toxic salts of mercury, and it is poisonous if absorbed by inhalation, ingestion, and skin contact. In humans, the gastrointestinal absorption of metallic mercury is generally low. However, ingested metallic mercury is oxidized in the gastrointestinal tract to mercury salts such as mercury chloride, thus increasing the uptake in the central circulation. Central nervous system, gastrointestinal tract, and especially the kidneys are most vulnerable to its toxic effects. Mercuric chloride is primarily a skin and mucous membrane irritant. Acute poisoning by ingestion or inhalation may cause respiratory insufficiency, gastrointestinal disturbances (nausea, vomiting), and renal damage. As little as 0.1 g is enough to cause damage to body tissues, and 1–4 g ingestion may be fatal. As regards chronic exposure, the main target of toxicity is the kidney, but other symptoms may include increased salivation, inflammation of the gums and black lines on the teeth. Although mercuric chloride showed carcinogenic effects in some animal models, evidence in humans are scarce, and therefore it is considered a Group 3 carcinogen.
2022
- Relation between adherence to dietary patterns and serum selenium species levels in a healthy Italian cohort
[Abstract in Atti di Convegno]
Urbano, T.; Filippini, T.; Malavolti, M.; Michalke, B.; Vinceti, M.
abstract
2022
- Relation between adherence to dietary patterns and urinary selenium levels in an Italian cohort
[Abstract in Atti di Convegno]
Malavolti, M.; Urbano, T.; Filippini, T.; Fustinoni, S.; Vinceti, M.
abstract
2022
- Residence in proximity of petrol stations and childhood leukemia risk
[Abstract in Atti di Convegno]
Malavolti, Marcella; Malagoli, Carlotta; Costanzini, Sofia; Palazzi, Giovanni; Cellini, Monica; Filippini, Tommaso; Teggi, Sergio; Vinceti, Marco
abstract
Background
Air pollutant concentrations close to petrol stations tend to increase, especially for benzene and other carcinogenic contaminants, depending on meteorological factors, features of nearby buildings and station activity. For this reason, it is suggested that petrol stations increase the risk of cancer, in particular, childhood leukemia.
Methods/Approach
We carried-out a population-based case-control study in two Northern Italy provinces, Modena and Reggio Emilia. We included 182 cases of childhood leukemia diagnosed in the period 1998-2019, and 726 age and sex-matched controls. We geocoded child residence and the 790 petrol stations located in the study area, of which we retrieved the annual refueling activity. Exposure was assessed based on both residential distance from the nearest petrol station and on the activity of all plants located up to 1000 m from the home. Risk ratio of leukemia was estimated by computing disease odds ratio (OR) through conditional logistic regression models adjusted for potential confounders.
Results
We found an increased risk for childhood leukemia associated to residence in close proximity to petrol stations. Compared to those who live ≥ 1000m, OR was 2.30 (95% CI 0.53-9.97) for children living <50 m from nearest petrol station in bivariate analysis and 2.16 (95% CI 0.49-9.42) in multivariable analysis. The excess risk was higher when considering acute lymphoblastic leukemia (ALL) subtype (OR=2.83, 95% CI 0.61-13.21), and in children diagnosed after 5 years of age (OR=4.68, 95% CI 0.61-35.95) compared with < 5 years (OR=1.63, 95% CI 0.14-18.84).
Conclusions
Our study found an increased childhood leukemia risk for residence in close proximity (<50 meters) to a petrol station. Such excess risk was higher for the ALL subtype and for children diagnosed after 5 years.
2022
- Selenium and its association with oxidative stress and genotoxicity risk in a healthy Italian population: a cross sectional study
[Abstract in Atti di Convegno]
Urbano, Teresa; Filippini, Tommaso; Malavolti, Marcella; Fustinoni, Silvia; Michalke, Bernhard; Vinceti, Marco
abstract
Background
Selenium is present in trace amounts and different chemical forms in living organisms, which may beneficially and adversely affect cellular redox status. 8-oxo-7,8-dihydro-2’deoxyguanosine (8-oxodG) is an oxidized derivative of deoxyguanosine and a sensitive biomarker of oxidative stress and genotoxicity in biological systems. In this study, we aimed to determine if selenium exposure in a population in Northern Italy may be associated with 8-oxodG levels in urine and if sex and other factors may influence such association.
Methods/Approach
We recruited 137 substantially healthy and non-smoking blood donors from the Reggio Emilia province at the Transfusion Medicine Unit of the Reggio Emilia Hospital. Their median age was 48.2 years, and the recruitment occurred 2017-19. We assessed selenium in urine and serum, and urinary 8-oxodG levels. We also speciated selenium in serum. We used cubic spline regression analyses to investigate the association between selenium matrices and urinary content of 8-oxodG/g creatinine.
Results
Median urinary selenium and 8-oxodG levels were 22.02 µg/L and 3.21 µg/g creatinine, respectively. Median total serum concentrations were 116.50 µg/L in the 104 individuals for which a serum sample was available. We found that urinary selenium positively correlated with 8-oxodG levels in men, while in women an inverted U-shaped association emerged. Total organic selenium and selenoprotein P levels were positively associated with 8-oxodG until 100 µg/L and then the association became slightly inverse in both sexes. In males, glutathione peroxidase-bound selenium, selenomethionine and human serum albumin-bound selenium were positively correlated with 8-oxodG, while negative associations emerged for inorganic selenium species. In females, positive associations, though slightly positive, emerged for organic species.
Conclusions
Our study highlights the different role played by selenium compounds, suggesting that organic selenium - but not its inorganic species - may exert genotoxic effects, and that sex considerably influences the risk of oxidative stress and genotoxicity associated with selenium exposure.
2022
- Seroprevalence Survey of Anti-SARS-CoV-2 Antibodies in a Population of Emilia-Romagna Region, Northern Italy
[Articolo su rivista]
Paduano, Stefania; Galante, Pasquale; Berselli, Nausicaa; Ugolotti, Luca; Modenese, Alberto; Poggi, Alessandro; Malavolti, Marcella; Turchi, Sara; Marchesi, Isabella; Vivoli, Roberto; Perlini, Paola; Bellucci, Rossana; Gobba, Fabriziomaria; Vinceti, Marco; Filippini, Tommaso; Bargellini, Annalisa
abstract
taly was the first Western European country to be severely hit by the COVID-19 pandemic. Variations in seroprevalence rates were reported according to geographical and temporal differences of previous surveys, as well as depending on demographic and occupational factors. In this cross-sectional study, we evaluated the prevalence of anti-SARS-CoV-2 antibodies in a population of the Emilia-Romagna region in Northern Italy after the first wave in the period from 26 September 2020–26 March 2021. We included 5128 subjects who voluntarily underwent serological tests to determine anti-SARS-CoV-2 antibody positivity, including both self-referred individuals (24.2%) and workers adhering to company screening programs (76.8%). Overall, seroprevalence was 11.3%, higher in self-referred (13.8%) than employed-referred (10.5%) individuals. A slightly higher seroprevalence emerged in women compared to men (12.3% and 10.7%), as well as in the extreme age categories (18.6% for 60–69 years, 18.0% for ≥70 years, and 17.1% for <20 years compared to 7.6% for 20–39 years). Healthcare professionals showed the highest prevalence of seropositivity (22.9%), followed by workers in direct contact with customers, such as the communication, finance, and tourism sectors (15.7%). Overall subgroups seroprevalence increased compared to the first wave data but the trends agreed between the first and subsequent waves, except for an increase in the younger age group and in the sector in direct contact with customers. Among the occupational categories, our study confirms that healthcare workers and workers in the sports sector were at high risk of exposure to SARS-CoV-2.
2022
- Sodium Intake and Risk of Hypertension: A Systematic Review and Dose-Response Meta-analysis of Observational Cohort Studies
[Articolo su rivista]
Filippini, Tommaso; Malavolti, Marcella; Whelton, Paul K; Vinceti, Marco
abstract
Purpose of the review: To assess the relationship between sodium intake and hypertension risk in cohort studies, based on a systematic review up to January 21, 2022, that also employed a dose-response meta-analysis. Recent findings: Dose-response analysis of available cohort studies (n = 11), using a dietary intake or urinary sodium excretion of 2 g/day as the reference category, showed an excess risk starting at 3 g/day. However, we found a linear relationship across the entire range of sodium exposure in an analysis restricted to studies that used 24 h urinary sodium excretion information and had a low risk of bias. This review confirms prior findings based on experimental studies and identified an almost linear relationship between sodium intake/excretion and hypertension risk in cohort studies, reinforcing the validity of recommendations to prevent cardiovascular disease through the reduction of sodium intake in both normotensive and hypertensive adults.
2022
- Sodium intake and cardiovascular diseases: a systematic review and dose–response meta‑analysis
[Abstract in Atti di Convegno]
Malavolti, M; Filippini, T; Urbano, T; Vinceti, M.
abstract
2021
- Association between cadmium and genotoxicity and oxidative stress risk biomarkers in a population of Northern Italy
[Abstract in Rivista]
Urbano, Teresa; Filippini, Tommaso; Lasagni, Daniela; De Luca, Tiziana; Sucato, Sabrina; Polledri, Elisa; Malavolti, Marcella; Baraldi, Claudia; Santachiara, Annalisa; Pertinhez, Thelma A.; Baricchi, Roberto; Fustinoni, Silvia; Vinceti, Marco
abstract
Cadmium is a toxic heavy metal exerting several adverse effects in humans, especially for kidney, bone, liver, and cardiovascular system. In particular, genotoxic effects may occur through several epigenetic mechanisms, but a direct genotoxicity has been suggested. 8-oxo-7,8-dihydro-2’deoxyguanosine (8-oxodG) is an oxidized derivative of deoxyguanosine, largely used as biomarker of oxidative stress in urine. In this study, we aimed to assess cadmium levels in a population in Northern Italy, in order to evaluate the correlation between cadmium exposure with different haematological and biochemical parameters, as well as the relationship with 8-oxodG levels. METHODS: We recruited healthy and non-smoking subjects living in the Reggio Emilia province in the period 2017-2019 at the Transfusion Medicine Unit of Santa Maria Nuova Hospital, AUSL-IRCCS of Reggio Emilia, Northern Italy. Urinary cadmium and 8-oxodG, and fasting blood haematological and biochemical parameters were assessed. RESULTS:We eventually recruited 140 participants (mean age 47.4 years). Mean urinary cadmium and 8-oxodG levels were 0.25 µg/L (range: 0.01–1.33 µg/L) and 3.68 µg/g creatinine respectively. All haematological and biochemical parameters were in the normal range. We found a positive association of cadmium concentrations with alanine aminotransferase, total cholesterol, triglyceride, and TSH levels, while a negative one was observed with glycaemia, HDL levels. In addition, we found a strong positive correlation between urinary cadmium and 8-oxodG. CONCLUSIONS:Our study suggests that cadmium exposure is associated with detrimental effects on some haematological and biochemical parameters even at very low levels, generally considered safe for the general population. The positive association between urinary cadmium levels and oxidative stress, as assessed through 8-oxodG levels, highlights the potential role of this heavy metal in causing direct genotoxic effects. We acknowledge the collaboration of Transfusion Medicine Unit-Reggio Emilia Hospital personnel, AVIS-Section of Reggio Emilia staff and volunteers, and all blood donors who participated to this study
2021
- Association of urinary and dietary selenium and of serum selenium species with serum alanine aminotransferase in a healthy italian population
[Articolo su rivista]
Urbano, T.; Filippini, T.; Lasagni, D.; De Luca, T.; Grill, P.; Sucato, S.; Polledri, E.; Noumbi, G. D.; Malavolti, M.; Santachiara, A.; Pertinhez, T. A.; Baricchi, R.; Fustinoni, S.; Michalke, B.; Vinceti, M.
abstract
The trace element selenium is of considerable interest due to its toxic and nutritional properties, which markedly differ according to the dose and the chemical form. It has been shown that excess selenium intake increases the risk of type 2 diabetes and, possibly, other metabolic diseases like hyperlipidemia and non-alcoholic fatty liver disease (NAFLD). For the latter, however, epidemiologic evidence is still limited. We carried out a cross-sectional study recruiting 137 healthy blood donors living in Northern Italy and assessed their exposure to selenium through different methods and measuring serum selenium species. We performed linear and spline regression analyses to assess the relation of selenium and its forms with serum alanine aminotransferase (ALT) levels, a marker of NAFLD. Urinary selenium levels were positively and somewhat linearly correlated with ALT (beta regression coefficient (β) 0.11). Conversely, the association of dietary selenium intake with ALT was positive up to 100 µg/day and null above that amount (β 0.03). Total serum selenium was inversely associated with ALT up to 120 µg/L, and slightly positive above that amount. Concerning the different serum selenium species, ALT positively correlated with two organic forms, selenocysteine (β 0.27) and glutathione peroxidase-bound selenium (β 0.09), showed a U-shaped relation with the inorganic tetravalent form, selenite, and an inverse association with human serum albumin-bound selenium (β −0.56). Our results suggest that overall exposure to selenium, and more specifically to some of its chemical forms, is positively associated with ALT, even at levels so far generally considered to be safe. Our findings add to the evidence suggesting that low-dose selenium overexposure is associated with NAFLD.
2021
- Associations between urinary and dietary selenium and blood metabolic parameters in a healthy northern italy population
[Articolo su rivista]
Urbano, T.; Filippini, T.; Lasagni, D.; De Luca, T.; Sucato, S.; Polledri, E.; Bruzziches, F.; Malavolti, M.; Baraldi, C.; Santachiara, A.; Pertinhez, T. A.; Baricchi, R.; Fustinoni, S.; Vinceti, M.
abstract
Selenium is both an essential nutrient and a highly toxic element, depending on its dose and chemical forms. We aimed to quantify urinary selenium excretion and dietary selenium intake in 137 healthy non-smoking blood donors living in the northern Italian province of Reggio Emilia. We assessed selenium status by determining urinary selenium levels (mean 26.77 µg/L), and by estimating dietary selenium intake (mean 84.09 µg/day) using a validated semi-quantitative food frequency questionnaire. Fasting blood levels of glucose, lipids and thyroid-stimulating hormone were measured using automatized laboratory procedures. Dietary and urinary selenium were correlated (beta coefficient (β) = 0.19). Despite this, the association of the two indicators with health endpoints tended to diverge. Using linear regression analysis adjusted for age, sex, body mass index, cotinine levels and alcohol intake, we observed a positive association between urinary selenium and blood triglyceride (β = 0.14), LDL-cholesterol (β = 0.07) and glucose levels (β = 0.08), and an inverse one with HDL-cholesterol (β = −0.12). Concerning dietary selenium, a slightly positive association could be found with glycemic levels only (β = 0.02), while a negative one emerged for other endpoints. The two selenium indicators showed conflicting and statistically highly imprecise associations with circulating TSH levels. Our findings suggest that higher selenium exposure is adversely associated with blood glucose levels and lipid profile. This is the case even at selenium exposures not exceeding tolerable upper intake levels according to current guidelines.
2021
- Atrial fibrillation and other risk factors for early-onset dementia: an Italian case-control study
[Abstract in Rivista]
Filippini, T; Adani, G; Garuti, C; Malavolti, M; Vinceti, G; Zamboni, G; Tondelli, M; Galli, C; Costa, M; Chiari, A; Vinceti, M
abstract
2021
- Blood Pressure Effects of Sodium Reduction: Dose-Response Meta-Analysis of Experimental Studies
[Articolo su rivista]
Filippini, Tommaso; Malavolti, Marcella; Whelton, Paul K; Naska, Androniki; Orsini, Nicola; Vinceti, Marco
abstract
2021
- Response by Filippini et al to Letter Regarding Article, "Blood Pressure Effects of Sodium Reduction: Dose-Response Meta-Analysis of Experimental Studies"
[Articolo su rivista]
Filippini, Tommaso; Malavolti, Marcella; Whelton, Paul K; Naska, Androniki; Orsini, Nicola; Vinceti, Marco
abstract
2021
- Seroprevalence of anti-SARS-CoV-2 antibodies after the first COVID-19 wave: a cross-sectional study in the province of Modena, city of a Northern Italy region
[Abstract in Rivista]
Berselli, N; Filippini, T; Paduano, S; Malavolti, M; Modenese, A; Gobba, F; Borella, P; Marchesi, I; Vivoli, R; Perlini, P; Bellucci, R; Bargellini, A; Vinceti, M
abstract
2021
- Seroprevalence of anti-SARS-CoV-2 antibodies in the Northern Italy population before the COVID-19 second wave
[Articolo su rivista]
Berselli, Nausicaa; Filippini, Tommaso; Paduano, Stefania; Malavolti, Marcella; Modenese, Alberto; Gobba, Fabriziomaria; Borella, Paola; Marchesi, Isabella; Vivoli, Roberto; Perlini, Paola; Bellucci, Rossana; Bargellini, Annalisa; Vinceti, Marco
abstract
The COVID-19 pandemic is due to SARS-CoV-2 coronavirus infections. It swept across the world in the spring of 2020, and so far it has caused a huge number of hospitalizations and deaths. In the present study, the authors investigated serum anti-SARS-CoV-2 antibody prevalence in the period of June 1-September 25, 2020, in 7561 subjects in Modena, Northern Italy.
2021
- Sodium and potassium content of foods consumed in an italian population and the impact of adherence to a mediterranean diet on their intake
[Articolo su rivista]
Malavolti, M.; Naska, A.; Fairweather-Tait, S. J.; Malagoli, C.; Vescovi, L.; Marchesi, C.; Vinceti, M.; Filippini, T.
abstract
High sodium and low potassium intakes are associated with increased levels of blood pressure and risk of cardiovascular diseases. Assessment of habitual dietary habits are helpful to evaluate their intake and adherence to healthy dietary recommendations. In this study, we determined sodium and potassium food-specific content and intake in a Northern Italy community, focusing on the role and contribution of adherence to Mediterranean diet patterns. We collected a total of 908 food samples and measured sodium and potassium content using inductively coupled plasma mass spectrometry. Using a validated semi-quantitative food frequency questionnaire, we assessed habitual dietary intake of 719 adult individuals of the Emilia-Romagna region. We then estimated sodium and potassium daily intake for each food based on their relative contribution to the overall diet, and their link to Mediterranean diet patterns. The estimated mean sodium intake was 2.15 g/day, while potassium mean intake was 3.37 g/day. The foods contributing most to sodium intake were cereals (33.2%), meat products (24.5%, especially processed meat), and dairy products (13.6%), and for potassium they were meat (17.1%, especially red and white meat), fresh fruits (15.7%), and vegetables (15.1%). Adherence to a Mediterranean diet had little influence on sodium intake, whereas potassium intake was greatly increased in subjects with higher scores, resulting in a lower sodium/potassium ratio. Although we may have underestimated dietary sodium intake by not including discretionary salt use and there may be some degree of exposure misclassification as a result of changes in food sodium content and dietary habits over time, our study provides an overview of the contribution of a wide range of foods to the sodium and potassium intake in a Northern Italy community and of the impact of a Mediterranean diet on intake. The mean sodium intake was above the dietary recommendations for adults of 1.5–2 g/day, whilst potassium intake was only slightly lower than the recommended 3.5 g/day. Our findings suggest that higher adherence to Mediterranean diet patterns has limited effect on restricting sodium intake, but may facilitate a higher potassium intake, thereby aiding the achievement of healthy dietary recommendations.
2020
- Cadmium exposure and risk of breast cancer: A dose-response meta-analysis of cohort studies
[Articolo su rivista]
Filippini, T.; Torres, D.; Lopes, C.; Carvalho, C.; Moreira, P.; Naska, A.; Kasdagli, M. -I.; Malavolti, M.; Orsini, N.; Vinceti, M.
abstract
Background: Cadmium is a toxic heavy metal that has been implicated in breast cancer etiology, albeit with inconsistent results. Objective: To investigate the shape of the relation between cadmium exposure and breast cancer incidence and mortality in cohort studies. Data sources: Following a literature search through April 14, 2020, we carried out a systematic review and dose-response meta-analysis to investigate the shape of the relation between cadmium exposure (assessed either through diet or urine excretion) and disease incidence and mortality. Study eligibility criteria: For inclusion, a study had to report incidence or mortality for breast cancer according to baseline cadmium exposure category; be a prospective cohort, case-cohort or nested case-control study with a minimum one-year follow-up, and reporting effect estimates for all exposure categories. Study appraisal and synthesis methods: Studies were evaluated using the ROBINS-E risk of bias tool. The effects in humans were assessed quantitatively using one-stage dose-response meta-analysis in a random effects meta-analytical model. Results: We identified 10 studies eligible for inclusion in the dose-response meta-analysis, six based on cadmium dietary intake, and four on urinary excretion levels. We found a marginal and imprecise positive relation between dietary cadmium intake and breast cancer, and no association when urinary cadmium excretion was used for exposure assessment. Compared to no exposure, at 20 µg/day of cadmium intake the summary risk ratio was 1.12 (95% confidence interval 0.80–1.56), while at 2 µg/g creatinine of cadmium excretion the summary risk ratio was 0.89 (95% confidence interval 0.38–2.14). Analysis restricted to post-menopausal women showed no association between either dietary or urinary cadmium and subsequent breast cancer incidence and mortality. Limitations and conclusions: Overall, we found scant evidence of a positive association between cadmium and breast cancer. Available data were too limited to carry out stratified analyses according to age, smoking and hormone receptor status. Therefore, possible associations between cadmium exposure and breast cancer in selected subgroups cannot be entirely ruled out.
2020
- Dietary Estimated Intake of Trace Elements: Risk Assessment in an Italian Population
[Articolo su rivista]
Filippini, T.; Tancredi, S.; Malagoli, C.; Malavolti, M.; Bargellini, A.; Vescovi, L.; Nicolini, F.; Vinceti, M.
abstract
Dietary intake to trace elements may represent the most relevant source of exposure for the general, non-occupationally population, but some of them have been rarely evaluated. We measured content of fifteen trace elements (antimony, barium, beryllium, boron, cobalt, lithium, molybdenum, nickel, silver, strontium, tellurium, thallium, titanium, uranium, and vanadium) in 908 food and beverage samples through inductively coupled plasma mass spectrometry. We estimated their dietary intake using a validated semi-quantitative food frequency questionnaire collected from a population of the Emilia-Romagna Region in Northern Italy. We compared our estimates with tolerable upper intake levels reported by international agencies and we assessed the non-carcinogenic risk through calculation of total hazard quotient for each trace element according to the US-EPA approach. Overall, estimates of their dietary intake were substantially similar to those reported from other countries, and they fell below the tolerable upper intake levels provided by international agencies. The total hazard quotient for each trace element was below 1. Our findings provide updated estimates of food levels and dietary intake of trace elements far frequently evaluated in a sample of Italian adult consumers. They also suggest that any non-carcinogenic risk associated with intake of investigated trace elements may be ruled out in our population.
2020
- Dietary Habits and Risk of Early-Onset Dementia in an Italian Case-Control Study
[Articolo su rivista]
Filippini, Tommaso; Adani, Giorgia; Malavolti, Marcella; Garuti, Caterina; Cilloni, Silvia; Vinceti, Giulia; Zamboni, Giovanna; Tondelli, Manuela; Galli, Chiara; Costa, Manuela; Chiari, Annalisa; Vinceti, Marco
abstract
Risk of early-onset dementia (EOD) might be modified by environmental factors and lifestyles, including diet. The aim of this study is to evaluate the association between dietary habits and EOD risk. We recruited 54 newly-diagnosed EOD patients in Modena (Northern Italy) and 54 caregivers as controls. We investigated dietary habits through a food frequency questionnaire, assessing both food intake and adherence to dietary patterns, namely the Greek-Mediterranean, the Dietary Approaches to Stop Hypertension (DASH), and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets. We modeled the relation between dietary factors and risk using the restricted cubic spline regression analysis. Cereal intake showed a U-shaped relation with EOD, with risk increasing above 350 g/day. A high intake (>400 g/day) of dairy products was also associated with excess risk. Although overall fish and seafood consumption showed no association with EOD risk, we found a U-shaped relation with preserved/tinned fish, and an inverse relation with other fish. Similarly, vegetables (especially leafy) showed a strong inverse association above 100 g/day, as did citrus and dry fruits. Overall, sweet consumption was not associated with EOD risk, while dry cake and ice-cream showed a positive relation and chocolate products an inverse one. For beverages, we found no relation with EOD risk apart from a U-shaped relation for coffee consumption. Concerning dietary patterns, EOD risk linearly decreased with the increasing adherence to the MIND pattern. On the other hand, an inverse association for the Greek-Mediterranean and DASH diets emerged only at very high adherence levels. To the best of our knowledge, this is the first study that explores the association between dietary factors and EOD risk, and suggests that adherence to the MIND dietary pattern may decrease such risk.
2020
- Environmental Risk Factors for Early-Onset Alzheimer's Dementia and Frontotemporal Dementia: A Case-Control Study in Northern Italy
[Articolo su rivista]
Adani, G.; Filippini, T.; Garuti, C.; Malavolti, M.; Vinceti, G.; Zamboni, G.; Tondelli, M.; Galli, C.; Costa, M.; Vinceti, M.; Chiari, A.
abstract
Background: Early-onset dementia (EOD) is defined as dementia with symptom onset before 65 years. The role of environmental risk factors in the etiology of EOD is still undefined. We aimed at assessing the role of environmental risk factors in EOD etiology, taking into account its different clinical types. Methods: Using a case-control study, we recruited all EOD cases referred to Modena hospitals from 2016 to 2019, while the referent population was drawn from cases' caregivers. We investigated residential history, occupational and environmental exposures to chemicals and lifestyle behaviors through a self-administered questionnaire. We computed the odds ratios of EOD risk (overall and restricting to the Alzheimer's dementia (AD) or frontotemporal dementia (FTD) diagnoses) and the corresponding 95% confidence intervals using an unconditional logistic regression model. Results: Fifty-eight EOD patients (19 FTD and 32 AD) and 54 controls agreed to participate. Most of the investigated exposures, such as occupational exposure to aluminum, pesticides, dyes, paints or thinners, were associated with an increased odds ratio (OR) for FTD but not for AD. Long-term use of selenium-containing dietary supplements was associated with increased OR for EOD and, particularly, for FTD. For both EOD forms, smoking and playing football showed an increased odds ratio, while cycling was associated with increased risk only in FTD. Overall sports practice appeared to be a protective factor for both types. Conclusions: Our results suggest a role of environmental and behavioral risk factors such as some chemical exposures and professional sports in EOD etiology, in particular with reference to FTD. Overall sports practice may be associated with a reduced EOD risk.
2020
- Environmental and occupational risk factors for early onset dementia in an Italian community
[Abstract in Rivista]
Adani, G.; Filippini, T.; Garuti, C.; Malavolti, M.; Vinceti, G.; Zamboni, G.; Tondelli, M.; Galli, C.; Costa, M.; Vinceti, M.; Chiari, A.
abstract
Background: Early onset dementia (EOD) is defined as dementia with symptoms onset before 65 years. Little is known about the etiological role of environmental and occupational risk factors. We aimed at assessing the role of these factors in disease etiology.Methods: Using a case-control design, we recruited all EOD cases resident in Modena province from October, 2016 to October, 2019, as well as a referent population drawn from patients’ care-givers. We investigated residential history of study participants, and their occupational and environmental exposures to pesticides, solvents and metals through a self-administered questionnaire. We computed the odds ratios (ORs) of disease risk, and the corresponding 95% confidence intervals (CIs), according to exposure to the investigated risk factors, using an unconditional logistic regression model adjusted for sex, age, and education. Results: Fifty-eight EOD cases and fifty-four controls agreed to participate. Among occupational factors, disease risk was associated with exposure to aluminum (OR 2.6, 95% CI 0.4-15.7), pesticides (OR 2.3, 95% CI 0.7-7.8) particularly from agricultural occupational exposure (OR 3.1, 95% CI 0.7-13.3) and dyes, paints or thinners (OR 1.7, 95% CI 0.6-5.0). Among lifestyles factors, smoking (OR 1.3, 95% CI 0.6-2.9) and playing football (OR 2.2, 95% CI 0.5-9.3) or cycling (OR 2.3, 95% CI 0.4-13.4) were associated with higher EOD risk, although overall sports practice appeared to be protective factor (OR 0.4, 95% CI 0.2-0.9). Risk was also positively associated with history of head trauma (OR 1.2, 95% CI 0.3-4.1) and particularly upper arm trauma (OR 2.2, 95% CI 0.7-7.5), but not overall trauma. No association emerged for exposure to electromagnetic fields. Conclusions:Despite the study limitations, our results appear to support a role of environmental risk factors in EOD etiology, particularly of some chemical exposures and professional sports, while overall sports practice may have a beneficial effect.
2020
- Green tea (Camellia sinensis) for the prevention of cancer
[Articolo su rivista]
Filippini, T.; Malavolti, M.; Borrelli, F.; Izzo, A. A.; Fairweather-Tait, S. J.; Horneber, M.; Vinceti, M.
abstract
Background: This review is an update of a previously published review in the Cochrane Database of Systematic Reviews (2009, Issue 3).Tea is one of the most commonly consumed beverages worldwide. Teas from the plant Camellia sinensis can be grouped into green, black and oolong tea, and drinking habits vary cross-culturally. C sinensis contains polyphenols, one subgroup being catechins. Catechins are powerful antioxidants, and laboratory studies have suggested that these compounds may inhibit cancer cell proliferation. Some experimental and nonexperimental epidemiological studies have suggested that green tea may have cancer-preventative effects. Objectives: To assess possible associations between green tea consumption and the risk of cancer incidence and mortality as primary outcomes, and safety data and quality of life as secondary outcomes. Search methods: We searched eligible studies up to January 2019 in CENTRAL, MEDLINE, Embase, ClinicalTrials.gov, and reference lists of previous reviews and included studies. Selection criteria: We included all epidemiological studies, experimental (i.e. randomised controlled trials (RCTs)) and nonexperimental (non-randomised studies, i.e. observational studies with both cohort and case-control design) that investigated the association of green tea consumption with cancer risk or quality of life, or both. Data collection and analysis: Two or more review authors independently applied the study criteria, extracted data and assessed methodological quality of studies. We summarised the results according to diagnosis of cancer type. Main results: In this review update, we included in total 142 completed studies (11 experimental and 131 nonexperimental) and two ongoing studies. This is an additional 10 experimental and 85 nonexperimental studies from those included in the previous version of the review. Eleven experimental studies allocated a total of 1795 participants to either green tea extract or placebo, all demonstrating an overall high methodological quality based on 'Risk of bias' assessment. For incident prostate cancer, the summary risk ratio (RR) in the green tea-supplemented participants was 0.50 (95% confidence interval (CI) 0.18 to 1.36), based on three studies and involving 201 participants (low-certainty evidence). The summary RR for gynaecological cancer was 1.50 (95% CI 0.41 to 5.48; 2 studies, 1157 participants; low-certainty evidence). No evidence of effect of non-melanoma skin cancer emerged (summary RR 1.00, 95% CI 0.06 to 15.92; 1 study, 1075 participants; low-certainty evidence). In addition, adverse effects of green tea extract intake were reported, including gastrointestinal disorders, elevation of liver enzymes, and, more rarely, insomnia, raised blood pressure and skin/subcutaneous reactions. Consumption of green tea extracts induced a slight improvement in quality of life, compared with placebo, based on three experimental studies. In nonexperimental studies, we included over 1,100,000 participants from 46 cohort studies and 85 case-control studies, which were on average of intermediate to high methodological quality based on Newcastle-Ottawa Scale 'Risk of bias' assessment. When comparing the highest intake of green tea with the lowest, we found a lower overall cancer incidence (summary RR 0.83, 95% CI 0.65 to 1.07), based on three studies, involving 52,479 participants (low-certainty evidence). Conversely, we found no association between green tea consumption and cancer-related mortality (summary RR 0.99, 95% CI 0.91 to 1.07), based on eight studies and 504,366 participants (low-certainty evidence). For most of the site-specific cancers we observed a decreased RR in the highest category of green tea consumption compared with the lowest one. After stratifying the analysis according to study design, we found strongly conflicting results for some cancer sites: oesophageal, prostate and urinary tract cancer, and leukaemia showed an increased RR in cohort studies and a d
2020
- Insights into the association of potassium intake with blood pressure: results of a dose-response meta-analysis of randomized controlled trials
[Abstract in Atti di Convegno]
Filippini, T; Torres, D; Lopes, C; Carvalho, C; Moreira, P; Naska, A; Kasdagli, M-I; Malavolti, M; Orsini, N; Vinceti, M
abstract
Introduction: Observational studies provide evidence for an association between potassium intake and BP levels. However, uncertainties still exist about the size and the shape of this relation. Conversely, experimental studies have not been used to estimate dose-response curves, since standard methods can only be applied in trials including at least three exposure groups.
Materials and Methods: We carried out a systematic review of the evidence concerning the effect of potassium supplementation on blood pressure in epidemiologic experimental studies. Following a PubMed search up to June 20, 2019, we included randomized controlled trials (RCTs) encompassing potassium supplementation as the only intervention for at least four weeks. We used a restricted cubic spline model and the ‘one-stage’ approach to perform a dose-response meta-analysis, a newly-developed statistical procedure which allows inclusion of studies with as few as two categories of exposure (Stat Methods Med Res. 2019;28:1579-1596). Finally, we repeated the analyses stratifying for hypertensive status and use of anti-hypertensive medication.
Results: Overall, we included 33 studies carried out in adult population, with potassium supplementation ranging from 30 to 140 mmol/day. RCTs’ duration ranged from 4 up to 26 weeks. Most of the studies have a cross-over design (N=24), include hypertensive individuals (N=27) and subjects not under anti-hypertensive medication (N=27). Overall, an increase of 40, 80 and 120 mmol/day of potassium resulted in reductions of SBP by -5.64 (95% CI - 8.78, -2.50), -4.62 (-6.41, -2.84) and -2.54 mmHg (95% CI -5.14, +0.06), respectively. Higher potassium intakes also resulted in reduced DBP levels by -3.57 (95% CI -5.55, -1.59), -3.07 (95% CI -5.07, -1.08), and -1.92 mmHg (95% CI -5.65, 1.81). The effect of increasing potassium intake on BP was larger among hypertensives than normotensives, and among pharmacologically untreated hypertensives compared to their treated counterparts. Subgroup analyses according to study design (parallel vs. crossover) yielded similar results.
Discussion: With the application of advanced dose-response modeling on RCT results, we found a U-shaped relation between potassium intake and blood pressure. A low to moderate increase in potassium intake resulted in a progressive reduction in blood pressure, which was reversed at higher levels of potassium supplementation. The effect was stronger among untreated hypertensives.
Supported by grant GP-EFSA-AFSCO-2017-01 GA09 of the European Food Safety Authority - EFSA. The text reflects only the authors' view; and EFSA is not responsible for any use that may be made of the information it contains.
Conflict of Interest: There is no conflict of interest
2020
- Lead exposure in an Italian population: Food content, dietary intake and risk assessment
[Articolo su rivista]
Malavolti, M.; Fairweather-Tait, S. J.; Malagoli, C.; Vescovi, L.; Vinceti, M.; Filippini, T.
abstract
Background and aim: Lead is a highly toxic heavy metal released into the environment after natural and anthropogenic activities. Excluding populations in occupations where there is possible lead contamination, food is the major source of human exposure. In this study, we determined lead contamination in food and beverages consumed in a Northern Italy community and performed a health risk assessment. Methods: We collected a total of 908 food samples and measured lead levels using inductively coupled plasma mass spectrometry. Using a validated food frequency questionnaire, we assessed the dietary habits and estimated daily lead dietary intakes in a sample of 719 adult individuals. We performed risk assessment using a benchmark dose and margin of exposure approach, based on exposure levels for both adverse effect of systolic blood pressure and chronic kidney disease. Results: Foods with the highest lead levels include non-chocolate confectionery (48.7 µg/kg), leafy (39.0 µg/kg) and other vegetables (42.2 µg/kg), and crustaceans and molluscs (39.0 µg/kg). The estimated mean lead intake was 0.155 µg/kg bw-day in all subjects, with little lower intakes in men (0.151 µg/kg bw-day) compared to women (0.157 µg/kg bw-day). Top food contributors were vegetables, cereals, and beverages, particularly wine. In relation to risk assessment, the estimated dietary intake was lower than levels associated with cardiovascular risk and nephrotoxicity. Conclusions: Our study provides an updated assessment of lead food contamination and dietary exposure in a Northern Italian community. The margin of exposure risk assessment approach suggests that risk of detrimental effects due to dietary lead intake is low in the investigated population. Nonetheless, these exposure levels for adverse effects are not reference health standards, and no safety threshold value can be established for lead. As a consequence, other and more subtle adverse effects may still occur in vulnerable and occupationally exposed individuals, particularly in relation to the nervous system.
2020
- Potassium Intake and Blood Pressure: A Dose-Response Meta-Analysis of Randomized Controlled Trials
[Articolo su rivista]
Filippini, T.; Naska, A.; Kasdagli, M. -I.; Torres, D.; Lopes, C.; Carvalho, C.; Moreira, P.; Malavolti, M.; Orsini, N.; Whelton, P. K.; Vinceti, M.
abstract
Background Epidemiologic studies, including trials, suggest an association between potassium intake and blood pressure (BP). However, the strength and shape of this relationship is uncertain. Methods and Results We performed a meta-analysis to explore the dose-response relationship between potassium supplementation and BP in randomized-controlled trials with a duration ≥4 weeks using the recently developed 1-stage cubic spline regression model. This model allows use of trials with at least 2 exposure categories. We identified 32 eligible trials. Most were conducted in adults with hypertension using a crossover design and potassium supplementation doses that ranged from 30 to 140 mmol/d. We observed a U-shaped relationship between 24-hour active and control arm differences in potassium excretion and BP levels, with weakening of the BP reduction effect above differences of 30 mmol/d and a BP increase above differences ≈80 mmol/d. Achieved potassium excretion analysis also identified a U-shaped relationship. The BP-lowering effects of potassium supplementation were stronger in participants with hypertension and at higher levels of sodium intake. The BP increase with high potassium excretion was noted in participants with antihypertensive drug-treated hypertension but not in their untreated counterparts. Conclusions We identified a nonlinear relationship between potassium intake and both systolic and diastolic BP, although estimates for BP effects of high potassium intakes should be interpreted with caution because of limited availability of trials. Our findings indicate an adequate intake of potassium is desirable to achieve a lower BP level but suggest excessive potassium supplementation should be avoided, particularly in specific subgroups.
2019
- Alimentazione, ambiente e malattie cronico-degenerative: nuove metodologie di valutazione del rischio
[Articolo su rivista]
Vinceti, Marco; Filippini, Tommaso; Malavolti, Marcella
abstract
Introduzione La valutazione del rischio sanitario associato a fattori di interesse nutrizionale e/o tossicologico (risk assessment) rappresenta un ambito di grande interesse per la popolazione generale, la comunità scientifica e gli operatori di sanità pubblica. Tale processo mira a definire adeguate misure ed indicazioni di sicurezza alimentare, ambientale e occupazionale, e favorire un’appropriata comunicazione del rischio ed efficaci interventi di medicina preventiva. Alla valutazione dei rischi sanitari attribuibili ai diversi fattori di tipo chimico e fisico presenti negli alimenti e negli ambienti di vita e di lavoro (‘fattori ambientali’ in senso lato) contribuiscono da un lato i singoli ricercatori attraverso i loro lavori originali di ricerca o meta-analisi, dall’altro gli enti e le istituzioni specificatamente deputati al processo di risk assessment, quali nello specifico per l’Unione Europea la European Food Safety Authority (EFSA), con sede nel nostro Paese a Parma. La valutazione del rischio attribuibile ai fattori ambientali e nutrizionali prevede diverse fasi metodologiche, tre delle quali sono state soggette a profonde innovazioni nel corso degli ultimi anni e sono di seguito brevemente analizzate: 1) l’identificazione e la valutazione metodologica della letteratura epidemiologica; 2) l’analisi ed interpretazione dei risultati di tale letteratura; 3) la formulazione di valutazioni finali condivise, superando eventuali differenze di opinione tra gli esperti. Identificazione e valutazione della letteratura pertinente al risk assessment Non vi è dubbio come ogni processo di valutazione del rischio sanitario debba basarsi in primo luogo sull’identificazione della letteratura scientifica pertinente. A tal fine, è naturalmente necessario effettuare una ricerca bibliografica rigorosa, completa ed infine illustrata in modo ‘trasparente’. In questa prospettiva, la metodologia adottata dai processi di valutazione del rischio sanitario si avvicina molto a quella adottata per le rassegne sistematiche, caratterizzandosi per una scelta il più possibile estensiva delle ‘parole chiave’ per identificare la letteratura di interesse, e per una strategia di ricerca e selezione degli studi facilmente riproducibile da chiunque. Ciò comporta l’uso di archivi bibliografici quali PubMed e la nota banca dati da esso contenuta Medline, EMBASE, Scopus e Web of Science (anche quest’ultimi contenenti Medline), ed eventualmente Google Scholar (in realtà più motore di ricerca che archivio bibliografico in senso proprio). Viene talora utilizzata per il risk assessment anche la letteratura ‘grigia’, ritrovabile però mediante ricerche complesse e non facilmente riproducibili attraverso archivi quali Conference Proceedings Citation Indexes di WoS, ERIC, PsycINFO, CINHAL, ProQuest Dissertations & Theses Global, International Guideline Library, e l’URL http://www.opengrey.eu/. L’appropriatezza dell’uso di tale letteratura grigia è tuttavia controversa, trattandosi di materiale bibliografico talora di limitata qualità e non sottoposto a valutazione ‘tra pari’. Dopo aver identificato gli articoli di interesse, occorre valutarne la pertinenza mediante l’esame del loro testo integrale, ed infine compiere una valutazione della qualità metodologica (critical appraisal o risk of bias assessment). Quest’ultimo processo è estremamente delicato ed influenza in modo sostanziale l’intero processo di valutazione del rischio. Esso prevede la valutazione delle principali distorsioni metodologiche degli studi, quali errori nella stima espositiva, presenza di confondimento, distorsione di selezione e di classificazione degli esiti sanitari, descrizione incompleta dei risultati e improprietà dell’elaborazione statistica. Valutazioni di questo tipo vengono frequentemente effettuate mediante l’uso di ‘griglie’ precodificate (quali il Risk of Bias della Cochrane Coll
2019
- Aluminum and tin: Food contamination and dietary intake in an Italian population
[Articolo su rivista]
Filippini, Tommaso; Tancredi, Stefano; Malagoli, Carlotta; Cilloni, Silvia; Malavolti, Marcella; Violi, Federica; Vescovi, Luciano; Bargellini, Annalisa; Vinceti, Marco
abstract
Aluminum and tin are ubiquitous in the environment. In normal biological systems, however, they are present
only in trace amounts and have no recognized biological functions in humans. High exposure to these metals can
result in adverse health effects such as neurodegenerative diseases. In non-occupationally exposed subjects, diet
is the primary source of exposure. In this study, we aimed at estimating dietary aluminum and tin intake in an
Italian adult population.
We measured aluminum and tin concentrations through inductively-coupled plasma mass spectrometry in
908 food samples. We also estimated dietary intake of these two metals, by using a validated semi-quantitative
food-frequency questionnaire administered to 719 subjects (319 men and 400 women) recruited from the
general population of the Emilia Romagna region, Northern Italy.
We found the highest aluminum levels in legumes, sweets, and cereals, while the highest tin levels were in
sweets, meat and seafood. The estimated median daily dietary intake of aluminum was 4.1 mg/day (Interquartile
range – IQR: 3.3–5.2), with a major contribution from beverages (28.6%), cereals (16.9%), and leafy vegetables
(15.2%). As for tin, we estimated a median intake of 66.8 μg/day (IQR: 46.7–93.7), with a major contribution
from vegetables (mainly tomatoes) (24.9%), fruit (15.5%), aged cheese (12.2%), and processed meat (10.4%).
This study provides an updated estimate of the dietary intake of aluminum and tin in a Northern-Italy adult
population, based on data from a validated food-frequency questionnaire. The intake determined for this population
does not exceed the established thresholds of tolerable intake.
2019
- Cadmium exposure and breast cancer risk: a systematic review and dose-response meta-analysis of cohort studies
[Abstract in Atti di Convegno]
Filippini, T; Kasdagli, Mi; Naska, A; Torres, D; Lopes, C; Carvalho, C; Moreira, P; Malavolti, M; Orsini, N; Vinceti, M
abstract
Background and aim: Cadmium is a heavy metal which has been implicated in breast cancer etiology because of its toxic properties such as endocrine disruption. The general population is exposed to cadmium through dietary intake, cigarette smoking, emissions of motorized traffic and industrial facilities. We carried out a systematic review and dose-response meta-analysis of the cohort studies investigating the association between cadmium exposure and breast cancer risk, for which inconsistent results have been reported in the literature.
Methods: Following online database search up to January 2019, we carried out a dose-response meta-analysis to identify the relation between cadmium exposure and disease risk. We used a restricted cubic spline model and the ‘one-stage’ approach, stratifying for exposure assessment method and menopausal status.
Results: We identified 12 studies, 9 using breast cancer incidence and 3 mortality as an outcome. In six studies cadmium exposure was assessed through dietary questionnaires, in five through urinary excretion levels, and in one based on environmental air levels. Seven studies included post-menopausal women only. Overall, we observed a positive linear relation between breast cancer risk and dietary cadmium intake (relative risk (RR) 1.04, 95% confidence interval (CI) 0.81-1.33 at 10 µg/day, and RR 1.12, 95% CI 0.80-1.56 at 20 µg/day). On the converse, risk was not associated with urinary excretion. Analysis restricted to post-menopausal women showed a positive association between cadmium exposure assessed through either dietary intake and urinary excretion, for levels higher than 20 µg/day and 1.65 µg/g creatinine, respectively.
2019
- Cadmium exposure and risk of breast cancer: a dose-response meta-analysis of cohort studies
[Abstract in Atti di Convegno]
Filippini, T; Torres, D; Lopes, C; Carvalho, C; Moreira, P; Naska, A; Kasdagli, M-I; Malavolti, M; Orsini, Nicola; Vinceti, M
abstract
Background: Cadmium is a toxic heavy metal that has been implicated in breast cancer etiology, albeit with inconsistent results. The general population is exposed to cadmium through dietary intake, cigarette smoking, emissions of motorized traffic and industrial facilities. We carried out a systematic review and dose-response meta-analysis of the cohort studies investigating the association between cadmium exposure and breast cancer risk.
Methods: Following a literature search through September 10, 2019, we carried out a systematic review and a dose-response meta-analysis to investigate the relation between cadmium exposure and disease risk. We used a restricted cubic spline model and the ‘one-stage’ approach, stratifying for exposure assessment method and menopausal status.
Results: We identified eleven studies on breast cancer risk, six based on cadmium dietary intake, and five on urinary excretion levels. In dose-response analysis, we observed a positive, statistically imprecise linear relation between dietary cadmium intake and disease risk. The risk ratio at 20 µg/day compared with no intake was 1.12 (95% confidence interval 0.80-1.56). Conversely, we detected a very imprecise negative association between urinary cadmium excretion and risk (risk ratio=0.89, 95% confidence interval 0.37-2.14 at 2 µg/g creatinine of cadmium excretion). Analysis restricted to post-menopausal women showed substantially no association, as was true for all meta-analyses carried out by comparing the highest versus the lowest exposure category.
Conclusions: Overall, we found scant evidence of positive association between cadmium and breast cancer. Available data were too limited to carry out stratified analyses according to age, smoking and hormone receptor status. Therefore, possible associations between cadmium exposure and breast cancer risk in selected subgroups cannot be entirely ruled out.
Keywords: cadmium, breast cancer, dietary intake, urine excretion, dose-response meta-analysis
2019
- Dietary cadmium and risk of breast cancer subtypes defined by hormone receptor status: a prospective cohort study
[Articolo su rivista]
Grioni, Sara; Agnoli, Claudia; Krogh, Vittorio; Pala, Valeria; Rinaldi, Sabina; Vinceti, Marco; Contiero, Paolo; Vescovi, Luciano; Malavolti, Marcella; Sieri, Sabina
abstract
Diet is the primary source of cadmium - a proven Group 1 human carcinogen - for non-smokers. Observational studies investigating the effect of cadmium from food sources on breast cancer risk have produced inconsistent results. We examined the association between dietary cadmium and risk of breast cancer defined by estrogen receptor (ER), progesterone receptor (PR) and HER2 status, in 8,924 women recruited to a prospective study between 1987 and 1992. Dietary cadmium intake was estimated using a semi-quantitative food frequency questionnaire at baseline. During a median of 22 years of follow-up, 451 incident cases of breast cancer were identified through the Varese Cancer Registry. Multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for breast cancer and receptor-defined breast cancer subtypes were estimated for quintiles of dietary cadmium intake, adjusting for confounding factors. Mean dietary cadmium intake was 7.8 (standard deviation 1.4) μg/day. Women with highest quintile of cadmium intake had a greater risk of breast cancer (HR 1.54; 95% CI, 1.06 - 2.22; p-trend = 0.028) than those with lowest quintile of intake. Women premenopausal at recruitment had HR = 1.73 (95% CI, 1.10 - 2.71, highest vs. lowest quintile); postmenopausal women had HR = 1.32 (95% CI, 1.05 - 1.66 for each standard deviation increase in cadmium). Cadmium-related risk of breast cancer did not vary with ER, PR or HER2 status (p-heterogeneity not significant). These findings support the hypothesis that dietary cadmium is a risk factor for breast cancer. This article is protected by copyright. All rights reserved.
2019
- Dietary cadmium exposure and risk of melanoma: an Italian population-based case-control study
[Abstract in Atti di Convegno]
Filippini, T; Malagoli, C; Malavolti, M; Vinceti, M
abstract
Background and aim. The heavy metal cadmium could be highly toxic to humans, and its environmental exposure has been linked to many adverse health effects, such as atherosclerosis, diabetes, and cancer, including melanoma. Although the underlying mechanisms need yet to be clearly identified, recent findings suggested that cadmium can specifically promote the malignant transformation of melanoma cells through the aberrant DNA methylation inducing dysregulation of specific gene expression. Since in the non-occupationally exposed population, in addition to smoking, food intake is the major source of cadmium exposure, we aimed at assessing the risk of cutaneous melanoma in relation to dietary cadmium intake.
Methods. Using a population-based study design, we recruited 380 incident cases of newly-diagnosed melanoma and 719 sex- and age-matched controls in the Emilia-Romagna Region, Northern Italy. We evaluated their dietary habits through a semi-quantitative food frequency questionnaire and we computed the odds ratio (OR) and its 95% confidence interval (CI) for melanoma according to quintile distribution of cadmium intake, using a conditional logistic regression model, matching by sex, age and province of residence, and adjusting also for phototype, non-alcoholic energy intake, body mass index, and Italian Mediterranean Diet Index.
Results: Median intake of cadmium was 5.81 µg/day (interquartile range 4.46-7.59) in cases, and 5.63 µg/day (4.46-7.34) in controls. OR of melanoma associated with 1-unit increase in cadmium intake was 1.11 (95% CI 1.00-1.24). Melanoma risk increased with increasing quintile of cadmium exposure, with ORs of 1.55 (95% CI 0.99-2.42), 1.54 (95% CI 0.99-2-40), 1.75 (95% CI 1.12-2.75), and 1.65 (95% CI 1.05-2.61) in the second to the highest quintile compared to the lowest quintile. Sex-stratified analysis showed substantially comparable results and a generally higher risk in female population, with continuous ORs of 1.10 (95% CI 0.93-1-29), and 1.15 (95% CI 0.99-1.33) in men and women, respectively.
Conclusions: Our results suggest a positive association between cadmium exposure through diet and risk of cutaneous melanoma in a Northern Italy population. Such association started to occur at a level of exposure lower than the tolerable intake established by the World Health Organization, and considered to be safe for humans.
2019
- Dietary cadmium intake and risk of cutaneous melanoma: An Italian population-based case-control study
[Articolo su rivista]
Filippini, T.; Malagoli, C.; Wise, L. A.; Malavolti, M.; Pellacani, G.; Vinceti, M.
abstract
Introduction: Exposure to the heavy metal cadmium has been associated with many adverse health effects, such as atherosclerosis, diabetes, and cancer, possibly melanoma. In non-occupationally exposed individuals, food intake is a major source of cadmium exposure, after smoking. We aimed to assess the risk of melanoma in relation to dietary cadmium intake. Methods: Using a population-based case-control study design, we recruited 380 incident cases of newly-diagnosed cutaneous melanoma and 719 matched controls in the Emilia-Romagna Region, Northern Italy in the years 2005-2006. We evaluated dietary intake using a semi-quantitative food frequency questionnaire. We used conditional logistic regression to compute odds ratios (ORs) and 95% confidence intervals (CIs) for melanoma according to quintiles of dietary cadmium intake, adjusting for several potential confounders, and we modeled the association non-parametrically, using restricted cubic splines. Results: Median energy-adjusted intake of cadmium was 6.11 μg/day (interquartile range 5.38–6.91) among cases and 5.97 μg/day (5.15–6.79) among controls. For each 1 μg/day-increase in cadmium intake, the OR for melanoma was 1.11 (95% CI 1.00–1.24). Melanoma risk generally increased with increasing quintile of cadmium exposure, with ORs of 1.55 (95% CI 0.99–2.42), 1.54 (95% CI 0.99-2-40), 1.75 (95% CI 1.12–2.75), and 1.65 (95% CI 1.05–2.61) for the second through fifth quintiles, compared with the lowest quintile. Sex-stratified analysis showed ORs per 1 μg/day-increase in cadmium intake of 1.10 (95% CI 0.93-1-29) among men and 1.15 (95% CI 0.99–1.33) among women. Using spline regression analysis, we observed a generally linear increase in melanoma risk up to 6 μg/day of cadmium intake, after which the risk appeared to plateau. Conclusions: We observed a positive non-linear association between dietary cadmium intake and risk of cutaneous melanoma in a Northern Italy population. However, further studies are needed to elucidate this association, due to concerns about exposure misclassification, unmeasured confounding, and the limited and conflicting evidence from epidemiological findings.
2019
- Dietary cadmium intake and risk of cutaneous melanoma: a population-based case-control study in Northern Italy
[Abstract in Rivista]
Filippini, T; Malagoli, C; Malavolti, M; Vinceti, M
abstract
BACKGROUND AND AIM. Cadmium is a toxic heavy metal for humans, and its environmental exposure has been linked to many adverse health effects, including cancer, atherosclerosis and diabetes. In particular, recent findings suggest that cadmium may increase risk of cutaneous melanoma, possibly through the promotion of the malignant transformation of melanoma cells through aberrant DNA methylation and by inducing gene expression dysregulation. Since in non-occupational exposed and non-smoking subjects dietary exposure is the major source of cadmium exposure, we aimed to assess melanoma risk in relation to dietary cadmium intake. METHODS. We recruited 380 newly-diagnosed incident cases of cutaneous melanoma and 719 sex- and age-matched population controls in four North Italian provinces (Parma, Reggio Emilia, Modena, and Bologna) of Emilia-Romagna Region. We estimated their dietary habits using a semi-quantitative food frequency questionnaire and we evaluated melanoma risk by computing the odds ratio (OR) and its 95% confidence interval (CI) according to quintile distribution of cadmium intake. We used a conditional logistic regression model to compute ORs, matching by sex, age and province of residence, and adjusting also for phototype, non-alcoholic energy intake, body mass index, and Italian Mediterranean Diet Index. Also a spline regression model was used in order to evaluated possible dose-response relation. RESULTS: Median cadmium intake was 5.81 µg/day (interquartile range 4.46-7.59) in cases, and 5.63 µg/day (4.46-7.34) in controls. OR of melanoma associated with 1-unit increase in cadmium intake was 1.11 (95% CI 1.00-1.24). Melanoma risk increased with increasing quintile of cadmium exposure, with ORs of 1.55 (95% CI 0.99-2.42), 1.54 (95% CI 0.99-2-40), 1.75 (95% CI 1.12-2.75), and 1.65 (95% CI 1.05-2.61) from second to highest quintile compared to lowest quintile. Sex-stratified analysis showed substantially comparable results and a generally higher risk in women, with continuous ORs of 1.10 (95% CI 0.93-1-29), and 1.15 (95% CI 0.99-1.33) in men and women, respectively. Spline regression analysis showed a non-linear risk increase, with possible plateau at 5-6 µg/day of cadmium intake. Slightly higher risk estimates in women and older subjects were detected. CONCLUSIONS: Our results seem to point out a positive association between dietary cadmium exposure and melanoma risk in the study population. Such association started to occur at a level of exposure lower than the tolerable intake established for food safety by international authorities.
2019
- Dietary exposure estimates to fifteen trace elements in an adult population of Emilia Romagna region, Northern Italy
[Abstract in Atti di Convegno]
Filippini, T; Tancredi, S; Malagoli, C; Malavolti, M; Vescovi, L; Bargellini, A; Vinceti, M
abstract
The health effects and the exposure levels of trace elements in humans are important public health topics. Assessing their dietary intake is fundamental to evaluate the long-term risks for public health and for food safety assessment. Since a priority of food safety regulatory agencies is to ensure the protection of consumers and to assess the health risks for the general population, to estimate the actual dietary intake of trace elements for comparison with the upper and lower tolerable levels is very important. In this study, we aimed to evaluate the dietary intake of several trace elements in an Italian community, namely of antimony, barium, beryllium, boron, cobalt, lithium, molybdenum, nickel, silver, strontium, tellurium, thallium, titanium, uranium, and vanadium. To do that, in 2016-2017 we collected a total of 908 food samples available in Italian markets and groceries from two Northern Italy provinces (Modena and Reggio Emilia), and we measured their trace element content through inductively-coupled plasma mass spectrometry. We also administered a validated semi-quantitative food frequency questionnaire to 708 residents (300 men and 48 women) in the Emilia-Romagna Region, to assess their dietary habits and eventually to estimate their dietary intake of the aforementioned trace elements. Overall, study results showed that in our population the dietary exposure levels to selected trace elements could be considered similar to that observed in other European and non-European populations. Though we cannot rule out the possibility that the dietary exposure estimates in the present study may not be representative of the population as a whole, our results provide a good and updated assessment of trace elements far frequently evaluated in a sample of Italian adult consumers from the Emilia Romagna region. Our findings finally suggest that our population should not be at risk of adverse health effects in relation to excess or deficiency of the investigated trace elements since the estimated dietary intake generally point out exposure levels within the safe range as far as indicated by recommendations of international agencies.
2019
- Food and beverage consumption and melanoma risk: a population-based case-control study in Northern Italy
[Articolo su rivista]
Malagoli, C; Malavolti, M; Agnoli, C; Farnetani, F; Longo, C; Filippini, T; Pellacani, G; Vinceti, M
abstract
It has been suggested that diet may influence the risk of melanoma, but few studies are available on this topic. We assessed the relation between food consumption and the risk of cutaneous melanoma in a Northern Italy population. We carried out a population-based case-control study involving 380 cases of melanoma and 719 age- and sex-matched controls. Dietary habits were established through a self-administered semi-quantitative food frequency questionnaire. We computed the odds ratios (ORs) of melanoma and the corresponding 95% confidence intervals (CIs) according to tertiles of daily intake of each food item, using multiple logistic regression models adjusted for major confounding factors. We observed an indication of a positive association between melanoma risk and consumption of cereals and cereal products (OR = 1.32; 95% CI 0.89–1.96, higher vs. lowest tertile), sweets (OR = 1.22; 95% CI 0.84–1.76), chocolate, candy bars. etc., (OR = 1.51; 95% CI 1.09–2.09) and cabbages (OR = 1.51; 95% CI 1.09–2.09). Conversely, an inverse association with disease risk was found for the intake of legumes (OR = 0.77; 95% CI 0.52–1.13), olive oil (OR = 0.77; 95% CI 0.51–1.16), eggs (OR = 0.58; 95% CI 0.41–0.82), and onion and garlic (OR = 0.80; 95% CI 0.52–1.14). No relationship was observed with beverage consumption. Our results suggest potentially adverse effects on melanoma risk of foods characterized by high contents of refined flours and sugars, while suggesting a protective role for eggs and two key components of the Mediterranean diet, legumes and olive oil. These associations warrant further investigation and, if confirmed, they might have important public health implications for the reduction of melanoma incidence through dietary modification.
2019
- Green tea consumption and risk of cancer: a systematic review and meta-analysis of observational studies
[Abstract in Rivista]
Filippini, Tommaso; Malavolti, Marcella; Vinceti, Marco
abstract
Introduction
Tea is one of the most highly consumed drink in the world after water. Between 2007 and 2016, world tea production grew by an average annual rate of 4.4%. Global tea consumption was 5.53 million tonnes in 2016 with an annual growth rate of 4.5 percent between 2007 and 2016 1. Brewed tea is obtained from the infu- sion of leaves and buds of Camellia sinensis. The most common- ly consumed type of tea varies cross-culturally, but green and black tea are the main ones. It has been described that Camellia sinensis contains polyphenols, particularly green tea that contain a high amount of catechins, powerful antioxidants. Laboratory studies have suggested that these compounds may inhibit cancer cell proliferation and 2 and some experimental and nonexperi- mental epidemiologic studies have suggested that green tea may have cancer-preventative effects 3 4. We aimed to assess associa- tions between green tea consumption and the risk of cancer incidence and mortality.
Materials and methods
We searched eligible studies up to January 2019 online databases as well as from reference lists of previous reviews and included studies. We included all observational epidemiological stud- ies (both cohort and case-control studies), that investigated the association of green tea consumption with cancer risk. Two or more authors independently applied the study criteria, extracted data and assessed methodological quality of studies. We also per- formed a meta-analysis using a random effects model comparing the highest category of green tea intake with the lowest, and us- ing the most adjusted multivariable model. We summarized the results according to cancer type diagnosis
Results
In this review update, we included 131 studies, including 46 co- hort and 85 case-control studies with over 1,100,000 participants., we found a lower overall cancer incidence. Regarding overall cancer mortality we found no difference in risk For most of the site-specific cancers we observed a decreased sRR. However, af- ter stratifying the analysis according to study design, we found strongly conflicting results for some cancer sites: esophageal, prostate and urinary tract cancer showed an increased sRR in co- hort studies and a decreased/null sRR in case-control studies.
Conclusions
Overall, findings from observational epidemiological studies yielded inconsistent and even contrasting results for the effect of
green tea consumption on cancer risk. In addition, since observa- tional studies generally suffered from the inherent limitation of this study design, potential unmeasured confounding and expo- sure misclassification, well conducted and adequately powered experimental studies are clearly needed to elucidate the possible beneficial effects of green tea consumption on cancer risk in hu- mans.
2019
- Occupational risk factors for early onset dementia (EOD) in the Modena population: a case-control study
[Abstract in Rivista]
Adani, Giorgia; Filippini, Tommaso; Garuti, Caterina; Vinceti, Giulia; Chiara, Galli; Zamboni, Giovanna; Tondelli, Manuela; Manuela, Costa; Malavolti, Marcella; Vinceti, Marco; Chiari, Annalisa
abstract
Introduction
Dementia is a clinical condition generally affecting subjects in the elderly. However, it may occur also at younger age, yielding a condition called early-onset dementia (EOD) characterized by an onset before 65 years 1 2. Despite the limited epidemiological data and the paucity of information regarding possible risk fac- tors 3 4, there is a general agreement that clinical presentation and consequences on daily life are different than late-onset demen- tia, due to the occurrence when subjects are still involved within occupational activities as well as familiar responsibilities 5. The aim of this work is to assess the epidemiological, clinical and prognostic role of occupational risk factors in EOD.
Materials and methods
Using a case-control design, we recruited newly-diagnosed EOD cases from the two Centers of Cognitive Disease of the Neurol- ogy Units of Modena-Baggiovara and Carpi Hospitals, as well as from the community health centers and general practitioners, October 1, 2016 to May 31, 2019. Referent population have been recruited from care-givers of EOD and LOD (late onset demen- tia) subjects. We investigated as possible risk factors of the dis- ease the occupational history, by administering a questionnaire collecting information about personal characteristics, family his- tory of diseases, clinical history and comorbidities, occupation activities, hobbies and other leisure activities, residential history, domestic use of pesticides, and dental care. We computed the odds ratios (ORs) of EOD risk, and the corresponding 95% con- fidence intervals (CIs), according to exposure to the investigated risk factors using an unconditional logistic regression model ad- justing for sex, age, and educational attainment.
Results
Fifty-six cases and fifty-three controls agreed to participate, with generally higher number of women (60% cases and 55% controls) and people over 65 (60% cases compared to 49% con- trols). About occupational factors, working in the agricultural sector seemed to be only slightly associated with risk of EOD (OR 1.31, 95% CI 0.26-6.59), while an increased risk was found for industrial sector (OR 2.23, 95% CI 0.85-5.88). Occupational exposure to contaminants showed positive association for occupational exposure to selenium (OR 2.23, 95% CI 0.11-46.42), aluminum (OR 2.75, 95% CI 0.42-18.11), pesticides (OR 2.10, 95% CI 0.60-7.36), dyes, paints or thinners (OR 2.07, 95% CI 0.70-6.05), while no association was found for exposure to or use of electric and electronic system or electromagnetic fields.
Conclusions
Results of this study suggest that some occupational factors, namely use of pesticides, dyes/paints, and metalloids such as alu- minum and selenium, could be associated with increased disease risk. Despite study limitations due to case-control design, includ- ing possible occurrence of selection and recall bias, our findings support the hypothesis of an environmental etiology of EOD.
2019
- Risk of early onset dementia (EOD) in relation to fruit and vegetable consumption: a case-control study
[Abstract in Rivista]
Filippini, Tommaso; Garuti, Caterina; Adani, Giorgia; Vinceti, Giulia; Chiara, Galli; Zamboni, Giovanna; Tondelli, Manuela; Manuela, Costa; Malavolti, Marcella; Vinceti, Marco; Chiari, Annalisa
abstract
Introduction
Early onset dementia (EOD) is a condition characterized by the onset of severe cognitive impairment before 65 year 1. There is a general agreement that clinical presentation and conse- quences on daily life are different than late-onset dementia, due to the occurrence when subjects are still involved within occupational activities as well as familiar responsibilities 2. Previous studies have raised the possibility that the risk factors may also differ between the two forms, including the role of environmental and life-style determinants such as diet 3. There is some epidemiologic evidence of an association between dietary habits and protective relations to cognitive decline and incident dementia 4 5. The aim of this study is to evaluate, for the first time to our knowledge, the association between diet and EOD risk.
Materials and methods
Using a case-control design, we recruited newly-diagnosed EOD cases from 2016 to 2019 in Modena province, Northern Italy. We recruited controls from care-givers of dementia patients referring the Neurology Units of Modena-Baggiovara and Carpi Hospi- tals. We investigated dietary habits through a self-administered semi-quantitative food frequency questionnaire, designed and validated to capture eating behaviors in Italy, and specifically developed as part of the European Prospective Investigation into Cancer and Nutrition (EPIC) study for the Northern Italy pop- ulation 6. Participants were asked to respond to 248 questions about 188 different food items, in order to assess frequency and quantity of daily consumption for each food item. We specifically focused on consumption of fruits and vegetables that were categorized into major and sub-group categories as previously reported 7. We computed the odds ratios (ORs) of EOD risk, and the corresponding 95% confidence intervals (CIs), according to increasing tertile of intake using an unconditional logistic regres- sion model and we also modeled the relation using restricted cu- bic splines with three knots (10, 50 and 90%). We implemented a model adjusted for sex, age (years), educational attainment (years), and total energy intake (kcal/day).
Results
We recruited 56 (men/women: 22/34) and 53 (men/women: 24/29) controls who agreed to participate and returned study ma- terial. Regarding food intake, cases showed a lower intake than controls of vegetables (119 g/day versus 148 g/day), pulses (19 g/day versus 22 g/day), potatoes (15 g/day versus 23 g/day), and dry fruits (2.6 g/day versus 4.0 g/day). Conversely cases showed a higher intake than controls of fresh fruits (256 g/day versus 240 g/day). In the analysis of EOD risk according to increasing tertile we found an inverse association with all vegetables overall considered and also for individual subgroup, particularly leafy vegetables and other vegetables (e.g. eggplant, zucchini or sweet pepper). Also, an inverse association was found for potatoes and slightly for legumes. Conversely, the higher tertile of intake of fresh fruits was associated with no difference in EOD risk, but in the stratified analysis for non-citrus and citrus fruits we found inverse association for the latter. Interestingly, for non-citrus fruits we found inverse association in the second tertile of consumption, and an opposite positive association in the third tertile. Finally, with increasing tertile of dry fruits intake, we found a strong inverse association with EOD risk. Similarly in the spline analysis, the increasing consumption of vegetables, particularly leafy vegetables showed a strong inverse association, as simi- larly also increased pulse intake. Regarding fruit consumption, fresh fruit overall considered showed ambivalent relation, while higher consumption of citrus fruits only, as well as dry fruits, showed a negative association with EOD risk.
Conclusions
In this study, we found an association of consumption of vegeta- bles and to some extent fruit with EOD risk in an Italian popula- tio
2019
- [The dose-response relationship between potassium intake and blood pressure levels. Results of meta-analysis of randomized clinical trials]
[Abstract in Rivista]
Kasdagli, Μι; Filippini, T; Lopes, C; Carvalho, C; Moreira, P; Malavolti, M; Orsini, N; Vinceti, M; Naska, A
abstract
2018
- Assessment of food contamination and dietary intake of lead and thallium in a Northern Italy population.
[Abstract in Atti di Convegno]
Filippini, T; Malavolti, M; Cilloni, S; Violi, F; Malagoli, C; Vescovi, L; Vinceti, M.
abstract
Lead and thallium are heavy metals released in the environment after natural and anthropogenic activities. Food and water intake are the major sources of human exposure to these elements. In this study, we aimed at characterizing lead and thallium content in foods consumed in Northern Italy population, in order to estimate the dietary intake of these metals. To do that we bought food samples in markets and groceries collected during the period from October 2016 to February 2017 in the Emilia Romagna region, and we measured their element content using inductively coupled plasma-mass spectrometry. Finally, after assessing dietary habits of an Emilia-Romagna community by using a validated food frequency questionnaire, we eventually estimated dietary intake of these metals in that community. In the 890 analyzed food samples, the highest lead contamination levels were found in seafood, vegetables, sweets and beverages. The estimated dietary intake of lead was 5.758 (interquartile range-IQR: 4.547-7.427) µg/day, corresponding to 0.089 (IQR: 0.069-0.113) µg/kg of body weight per day, with cereals, beverages and vegetables as major contributors. About thallium, one third of specimens showed very low levels below the limit of detection, with the highest contamination levels in vegetables, dry fruits and sweets. The dietary intake of thallium was 0.236 (IQR: 0.183-0.312) µg/day, mainly from vegetables, beverages, cereals and sweets. In conclusion, our study provides an estimation of lead and thallium intake in a Northern Italian community and shows a generally low exposure levels from dietary sources.
2018
- Cancer incidence following long-term consumption of drinking water with high inorganic selenium content
[Articolo su rivista]
Vinceti, Marco; Vicentini, Massimo; Wise, Lauren A.; Sacchettini, Claudio; Malagoli, Carlotta; Ballotari, Paola; Filippini, Tommaso; Malavolti, Marcella; Rossi, Paolo Giorgi
abstract
Selenium, a trace element to which humans are exposed mainly through diet, has been involved in the etiology of human cancer. We investigated the long-term effects of selenium exposure on cancer incidence using data from a natural experiment in Northern Italy. During the 1970s–1980s, in a part of the Italian municipality of Reggio Emilia, residents were inadvertently exposed to unusually high levels of inorganic hexavalent selenium (selenate) through drinking water. We followed the exposed residents for 28 years, generating data on incidence (when available) and mortality rates for selected cancer sites; the remaining municipal residents comprised the unexposed (reference) group. We observed no substantial difference in overall cancer incidence comparing exposed and unexposed cohorts. We detected, however, a higher incidence of cancer at some sites, and for a few of them, namely cancers of the buccal cavity and pharynx, melanoma, urinary tract and lymphoid tissue, the excess incidence was particularly evident in the first period of follow-up but decreased over time. Overall, these results suggest that consumption of water with levels of selenium in its inorganic hexavalent form close to the European standard, 10 μg/L, may have unfavourable effects on cancer incidence.
2018
- Contaminazione alimentare da piombo e stima dell’assunzione giornaliera in una popolazione del Nord Italia.
[Abstract in Atti di Convegno]
Cilloni, S; Filippini, T; Violi, F; Malavolti, M; Malagoli, C; Ferrari, A; Vescovi, L; Vinceti, M.
abstract
.
2018
- Diet composition and serum levels of selenium species: A cross-sectional study
[Articolo su rivista]
Filippini, Tommaso; Michalke, Bernhard; Wise, Lauren A.; Malagoli, Carlotta; Malavolti, Marcella; Vescovi, Luciano; Salvia, Chiara; Bargellini, Annalisa; Sieri, Sabina; Krogh, Vittorio; Ferrante, Margherita; Vinceti, Marco
abstract
Selenium is a trace element of both nutritional and toxicological interest, depending on its dose and chemical form. Diet is the primary source of exposure for most individuals. We sought to investigate the influence of food intake on serum levels of selenium species. Among fifty subjects randomly selected from a Northern Italian population, we assessed dietary habits using a validated semi-quantitative food frequency questionnaire. We also measured circulating levels of selenium species in serum using high pressure liquid chromatography associated with inductively-coupled plasma dynamic reaction cell mass spectrometer. Circulating levels of inorganic selenium, the most toxic selenium species, were positively associated with intake of fish, legumes and dry fruits, and inversely associated with intake of dairy products and mushrooms. Concerning the organic selenium species, selenoproteinP-bound selenium was inversely associated with intake of fish, fresh fruits, vegetables, and legumes, while selenocysteine-bound selenium positively associated with intake of fresh fruit, potato, legume and mushroom. In the present study, intakes of different foods were correlated with different types of selenium species. These results have important public health implications when assessing the nutritional and toxicological potential of diet composition with reference to selenium exposure.
2018
- Dietary intake of cadmium, chromium, copper, manganese, selenium and zinc in a Northern Italy community
[Articolo su rivista]
Filippini, T; Cilloni, S; Malavolti, M; Violi, F; Malagoli, C; Tesauro, M; Bottecchi, I; Ferrari, A; Vescovi, L; Vinceti, M
abstract
This study provides the dietary intakes of six trace elements (cadmium, chromium, copper, manganese, selenium and zinc), generally characterized by both nutritional and toxicological features depending on their exposure. Being diet the most relevant source of exposure to trace elements in non-professionally exposed subjects, we measured content of these trace elements in foods composing the typical Italian diet using inductively coupled plasma-mass spectrometry, and assessing dietary habits using a validated semi-quantitative food frequency questionnaire we eventually estimated dietary daily intake of trace elements in a Northern Italian community.
In the 890 analyzed food samples, the main contributors to cadmium intake are cereals, vegetables and sweets, while cereals, beverages and vegetable are to primary source of manganese. The primary contributors for copper are cereals, fresh fruits and vegetables, while for chromium are beverages, cereals and meat. The main source of selenium intake are cereals and meat, followed by fish, seafood and milk and dairy products, while of zinc intake are meat, cereals, milk and dairy products. In our Italian population sample, the estimated median (interquartile range) dietary daily intakes are 5.00 (3.17-7.65), 56.70 (36.08-86.70) and 66.53 (40.04-101.32) µg/day for cadmium, chromium and selenium, and corresponding figures are 0.98 (0.61-1.49), 2.34 (1.46-3.52) and 8.50 (5.21-12.48) mg/day for copper, manganese and zinc.
The estimated intakes are generally within the average intake reported in other European populations, and in such cases well above the daily dietary intakes recommended by national international agencies, avoiding the risk of excess or deficiency. The present estimated intake data can be used to examine a specific trace element of interest and would afford enhanced health protection from those trace elements characterized by both nutritional and toxicological effects.
2018
- Dietary intake of calcium, phosphorus and magnesium in a Northern Italian community.
[Abstract in Atti di Convegno]
Malavolti, M; Filippini, T; Malagoli, C; Cilloni, S; Violi, F; Vescovi, L; Vinceti, M.
abstract
Minerals are essential micronutrients for growth, development, and maintenance of healthy tissues, the long term insufficient intake of minerals may lead to bone demineralization and often requires the use of food supplements. The ratios of certain minerals intake like calcium and phosphorus are also proved to can affect the bioavailability of calcium and even lead to adverse health consequence. This study was designed to explore the dietary sources of calcium (Ca), phosphorus (P), and magnesium (Mg) and the ratios between different minerals (Ca/P). We measured the content of these elements in foods composing typical Italian diet using inductively coupled plasma-mass spectrometry and we estimated their daily dietary intakes assessing through a semi-quantitative food frequency questionnaire specifically developed within the European Prospective Investigation into Cancer and Nutrition (EPIC) study in a Northern Italian Community. In 890 analyzed food samples the main contributors to calcium are milk and dietary products, dry fruits, legumes and sweet products. Important sources of phosphorus are represented by dry fruits, legumes, milk and dairy products and meat. While dry fruits, legumes, cereals and fish symbolized the most important sources for magnesium. In our Italian population sample, the estimated median (interquartile range) dietary daily intakes are 786.3 (592.2-1062.7) μg/day for calcium; 1291.7 (1017.2-1591.4) mg/day for phosphorus and 323.2 (260.3-396.6) mg/day for magnesium. The calcium-phosphorus (Ca/P) ratio in this study was 0.63 (0.52-0.73). These values are in agreement with those suggested by European and International recommended intake for adult population, with the exception of calcium which is slightly lower than recommended values and suggest that this population does not present nutritional deficiencies requiring any supplementation.
2018
- Food contamination from the food packaging metals aluminum and tin: estimation of their dietary exposure in an Italian adult community.
[Abstract in Atti di Convegno]
Filippini, T; Tancredi, Stefano; Malagoli, C; Cilloni, S; Malavolti, M; Violi, F; Vescovi, L; Bargellini, A; Vinceti, M.
abstract
2018 Scientific meeting Italian Association for the Study of Trace Elements in living Organisms – AISETOV. Ozzano Emilia, Bologna, October 12, 2018 (ISBN: 9788894309812)
2018
- Impact of referral sources and waiting times on the failure to quit smoking: One-year follow-up of an italian cohort admitted to a smoking cessation service
[Articolo su rivista]
Borsari, Lucia; Storani, Simone; Malagoli, Carlotta; Filippini, Tommaso; Tamelli, Marco; Malavolti, Marcella; Nicolini, Fausto; Vinceti, Marco
abstract
In Italy, the National Health Service offers specialized evidence-based support to smokers who would like to quit through smoking cessation (SC) services. We conducted a two-year prospective study, involving all 288 subjects treated for smoking cessation at the SC service of Reggio Emilia, to assess the association of referral sources and waiting times with the risk of treatment failure, by following participants up to one year after the quit date. We performed Cox-regression analysis, including demographic and smoking-related characteristics as confounding variables. The treatment failure rate at 12 months was 59.4% (171/288), including only 12 subjects lost to follow-up. The main mode of entry was self-referral (42.4%), followed by 32.6% from general practice, 17.4% from hospital and 7.6% from other sources. Only 27.8% participants were involved in the SC-program within 60 days of the first contact, as the guidelines suggest. The risk of treatment failure at 12 months showed little association with the type of referral source, while it correlated with waiting times ≥ 60 days (hazard ratio = 1.59; 95% confidence interval 1.10-2.29). This study provides evidence of long-term high quit rates from a SC service, with few subjects lost to follow-up and biochemical verification of almost all abstinent subjects. Timeliness in care provision could further improve the outcome.
2018
- Intake of arsenic and mercury from fish and seafood in a Northern Italy community
[Articolo su rivista]
Filippini, Tommaso; Malavolti, Marcella; Cilloni, Silvia; Wise, Lauren A.; Violi, Federica; Malagoli, Carlotta; Vescovi, Luciano; Vinceti, Marco
abstract
Regular consumption of fish is generally recommended by authorities because fish is an important source of essential nutrients. However, the presence of potentially toxic contaminants in fish has raised many concerns about the food's safety for human health. In the present study, we used a validated semi-quantitative food frequency questionnaire to assess the dietary habits of a representative sample of 719 individuals (319 males and 400 females) aged 18â87 years residing in Northern Italy. We estimated weekly dietary intakes of Arsenic (As) and Mercury (Hg), and we compared them with safety standards set by the European Food Safety Authority. In this population, fish was the main contributor to As and Hg intake. The highest levels of As were in sardine, sole/flounder and cephalopods, and of Hg in the biggest, predatory fish. About the other foods, cereals were the second contributor to the intake of these elements, especially rice for As and bread for Hg, and high levels of As and Hg were also found in mushrooms, coffee and wine. Average weekly intake of both contaminants was below recommended safety limits.
2018
- Investigating the environmental risk factors for childhood leukaemia: the research activity at the University of Modena and Reggio Emilia, Northern Italy.
[Abstract in Atti di Convegno]
Vinceti, M; Malagoli, C; Filippini, T; Violi, F; Cilloni, S; Malavolti, M; Borsari, L; Storani, S; Arcolin, E; Palazzi, G; Teggi, S; Fabbi, S; Costanzini, Sofia; Ghermandi, G; Bagni, Enrico
abstract
.
2018
- Is there a relation between birth of month and risk of childhood leukaemia? A case-control study in two Italian provinces.
[Abstract in Atti di Convegno]
Malavolti, M; Filippini, T; Malagoli, C; Cilloni, S; Borsari, L; Vinceti, M.
abstract
.
2018
- Joint Effect of Maternal Tobacco Smoking and Pregestational Diabetes on Preterm Births and Congenital Anomalies: A Population-Based Study in Northern Italy
[Articolo su rivista]
Borsari, Lucia; Malagoli, Carlotta; Werler, Martha M.; Rothman, Kenneth J.; Malavolti, Marcella; Rodolfi, Rossella; De Girolamo, Gianfranco; Nicolini, Fausto; Vinceti, Marco
abstract
Smoking and pregestational diabetes (PGD) are recognized risk factors for adverse pregnancy outcomes, but to date, no population-based study has investigated their joint effects. Using hospital discharges, we identified all women with PGD delivering in Emilia-Romagna region during 2007-2010 matched 1: 5 with parturients without diabetes. Our study endpoints were preterm births and congenital anomalies. We measured interaction between PGD and maternal smoking, by calculating excess prevalence and prevalence ratio due to interaction, relative excess risk due to interaction (RERI), attributable proportion (AP), and the synergy index (S). Analyses were performed in the overall study population and in the subgroup whose PGD was validated through diabetes registers. The study included 992 women with PGD (10.5% smokers) and 4788 comparison women (11.9% smokers). The effects of PGD and maternal tobacco smoking were greater than additive for both preterm birth (excess prevalence due to interaction = 11.7%, excess ratio due to interaction = 1.5, RERI = 2.39, AP = 0.51, S = 2.82) and congenital anomalies (excess prevalence due to interaction = 2.2%, excess ratio due to interaction = 1.3, RERI = 1.33, AP = 0.49, S = 5.03). Joint effect on both endpoints was confirmed in the subgroup whose PGD status was validated. In conclusion, we found that maternal tobacco smoking and PGD intensify each other's effect on preterm birth and congenital anomalies.
2018
- Livelli di esposizione alimentare a cadmio e correlazione con parametri metabolici ed ormonali: uno studio cross-sectional in una popolazione emiliana.
[Abstract in Atti di Convegno]
Filippini, T; Lasagni, D; Bruzziches, F; Baraldi, C; Malavolti, M; Grioni, S; Sieri, S; Santachiara, A; De Luca, T; Pertinez, T; Baricchi, R; Vinceti, M
abstract
.
2018
- Maternal pregestational diabetes and risk of childhood leukaemia in the offspring: a population-based study in Northern Italy.
[Abstract in Atti di Convegno]
Borsari, L; Malagoli, C; della Torre, F; Palazzi, G; Rodolfi, R; Filippini, T; Violi, F; Cilloni, S; Malavolti, M; Nicolini, F; Vinceti, M.
abstract
.
2018
- Non-chromosomal congenital anomalies and risk of childhood leukaemia: An Italian population-based case-control study
[Abstract in Atti di Convegno]
Malagoli, C; Filippini, T; Malavolti, M; Volpato, S; Astolfi, G; Palazzi, G; Vinceti, M
abstract
Introduction: The association between chromosomal conditions such as Down syndrome and increased CL risk of childhood leukemia (CL) is well established, while the association between non-chromosomal birth defects is far less clear. We conducted a population-based case-control study in two provinces of Northern Italy to evaluate CL risk in children born with non-chromosomal anomalies.
Methods: We identified all leukemia cases diagnosed in children (<15 years) in the Modena and Reggio Emilia provinces through the Italian National Childhood Cancer Register in the period 1998-2013. For each case, we randomly selected four population controls matched by age, sex, province of residence and calendar year. Through the Emilia-Romagna Region population-based Birth Defects Registry, we retrieved information about occurrence and type of congenital malformations for each study subject. We computed the odds ratio (OR) of CL for children affected by non-chromosomal birth defects using a multivariable conditional logistic regression model.
Results: We eventually included 132 cases and 528 controls, 5 of which (2 cases and 3 controls) were affected by a non-chromosomal congenital malformation. We found an increased risk of CL in children born with non-chromosomal anomalies, with an OR of 2.7 (95% confidence interval 0.4–16.0).
Conclusions: Despite the limited stability of the risk estimates and the risk of unmeasured and residual confounding, our study appears to suggest an association between non-chromosomal birth defects and risk of childhood leukemia.
2018
- Non-chromosomal congenital anomalies and risk of childhood leukaemia: a Italian population-based case-control study.
[Abstract in Atti di Convegno]
Malagoli, C; Filippini, T; Malavolti, M; Volpato, S; Astolfi, G; Palazzi, G; Vinceti, M.
abstract
.
2018
- The new-old exposure to lead: assessment of food contamination and estimation of dietary intake in a Northern Italy population.
[Abstract in Atti di Convegno]
Filippini, T; Malavolti, M; Cilloni, S; Violi, F; Malagoli, C; Vescovi, L; Vinceti, M.
abstract
.
2017
- Correlation between intake and biomarker levels of cadmium and selenium in an Italian population: implications for biomonitoring studies.
[Abstract in Atti di Convegno]
Malavolti, M; Filippini, T; Malagoli, C; Cilloni, S; Venturelli, M; Michalke, B; Vinceti, M.
abstract
.
2017
- Correlazione tra cadmio e selenio in un campione di popolazione modenese: implicazioni per studi di biomonitoraggio
[Abstract in Atti di Convegno]
Malavolti, M; Filippini, T; Malagoli, C; Cilloni, S; Venturelli, M; Michalke, B; Vinceti, M.
abstract
.
2017
- Determinants of serum manganese levels in an Italian population.
[Articolo su rivista]
Filippini, Tommaso; Michalke, B; Grill, P; Malagoli, Carlotta; Malavolti, Marcella; Vescovi, L; Sieri, S; Krogh, V; Cherubini, A; Maffeis, G; Lucchini, R; Ferrante, M; Vinceti, Marco
abstract
Manganese (Mn) is both essential and toxic for humans, mainly depending on the total levels and its species. Main sources of exposure include food and air pollution, particularly motorized traffic. We sought to determine the potential influence of these sources on serum total levels of Mn and Mn species. We selected a random sample of municipality residents from an Italian urban municipality, from whom we collected detailed personal information, dietary habits and a blood sample for serum Mn determination. We also assessed outdoor air Mn exposure, by modeling levels of particulate matter ≤10 µm (PM10) from motorized traffic at the residence of geocoded subjects. Serum Mn species generally showed higher levels in males and positive correlation with age, while no such differences were found according to smoking habits or use of dietary supplements. Among nutrients, only iron intake showed a relation with Mn [an inverse correlation with Mn‑ferritin (Mn‑Fer) and a direct one with inorganic‑Mn (Inorg‑Mn)]. Meat consumption directly correlated and fish and seafood inversely correlated with total Mn, Mn‑transferrin (Mn‑Tf) and Mn-citrate (Mn-Cit). Fruits and vegetables, including legumes and nuts, generally showed a positive correlation with all Mn species, especially Mn‑Cit, and an inverse one with Inorg‑Mn. Odds ratios (ORs) of having serum Mn levels above median value increased with increasing PM10 tertiles, with an OR for highest‑to‑lowest tertile of 7.40 (1.36‑40.25) in multivariate analysis. Analyses for Mn species did not highlight a clear comparable pattern. In conclusion, our results seem to demonstrate that PM10 exposure positively influences total Mn serum levels, while single Mn species show conflicting results.
2017
- Dietary determinants of serum selenium species in Italian populations
[Abstract in Rivista]
Filippini, Tommaso; Michalke, Bernhard; Salvia, Chiara; Malagoli, Carlotta; Malavolti, Marcella; Grill, Peter; Vescovi, Luciano; Sieri, Sabina; Krogh, Vittorio; Vinceti, Marco
abstract
We investigated the correlation between dietary habits with
serum levels of selenium (Se) species collected from an Italian
community. Consumption of food items was assessed using a food
frequency questionnaire. Cereal intake showed a positive relation
with total and organic Se, but null/negative with inorganic Se.
Fish and seafood positively correlated with inorganic Se and negatively
with organic Se. Correlations were generally negative/null in
vegetables (only Se-Cys was positively correlated), while in fruits
they were positive with organic species, mainly Se-Cys. Legumes
showed inverse relation with overall organic Se, but positive with
Se-Cys, Se-TrXr and inorganic Se. Correlation of potatoes intake was
negative with Se forms, except a positive one with Se-Cys and selenate.
Our results show highly specific associations between intake
of selected foods and circulating Se species levels.
2017
- Glycaemic index, glycaemic load and risk of cutaneous melanoma in a population-based, case-control study
[Articolo su rivista]
Malavolti, Marcella; Malagoli, Carlotta; Crespi, Cm; Brighenti, F; Agnoli, C; Sieri, S; Krogh, V; Fiorentini, Chiara; Farnetani, Francesca; Longo, Caterina; Ricci, C; Albertini, G; Lanzoni, A; Veneziano, L; Virgili, A; Pagliarello, C; Feliciani, C; Fanti, Pa; Dika, E; Pellacani, Giovanni; Vinceti, Marco
abstract
Glycaemic index (GI) and glycaemic load (GL) are indicators of dietary carbohydrate quantity and quality and have been associated with increased risk of certain cancers and type 2 diabetes. Insulin resistance has been associated with increased melanoma risk. However, GI and GL have not been investigated for melanoma. We present the first study to examine the possible association of GI and GL with melanoma risk. We carried out a population-based, case-control study involving 380 incident cases of cutaneous melanoma and 719 age- and sex-matched controls in a northern Italian region. Dietary GI and GL were computed for each subject using data from a self-administered, semi-quantitative food frequency questionnaire. We computed the odds ratio (OR) for melanoma according to quintiles of distribution of GL and GL among controls. A direct association between melanoma risk and GL emerged in females (OR 2·38; 95 % CI 1·25, 4·52 for the highest v. the lowest quintile of GL score, P for trend 0·070) but not in males. The association in females persisted in the multivariable analysis after adjusting for several potential confounders. There was no evidence of an association between GI and melanoma risk. GL might be associated with melanoma risk in females.
2017
- Inorganic selenium exposure in drinking water and cancer incidence: a natural experiment
[Abstract in Atti di Convegno]
Vinceti, M; Malagoli, C; Malavolti, M; Filippini, T; Cilloni, S; Wisen, L; Sacchettini, C; Vicentini, M; Ballotari, Paola; Giorgi Rossi, P.
abstract
.
2017
- Selenium, zinc and copper content of foods consumed in an Italian community
[Abstract in Rivista]
Cilloni, Silvia; Malavolti, Marcella; Malagoli, Carlotta; Violi, Federica; Filippini, Tommaso; Vescovi, Luciano; Vinceti, Marco
abstract
This study aimed to determine the concentrations of selenium,
zinc and copper in foods generally composing the diet of Northern
Italy population in order to implement a database of the quantitative
content for each of the three trace elements, according to
food category intake. Food samples were collected from (small to
large) distribution markets in triplicates and trace elements determination
was performed with ICP-MS after sample mineralization.
We found the highest levels of selenium in meat (202g/kg),
fish and seafood (489), dry fruits (314) and legumes (220). The
level of zinc was higher in cereal products (11.7 mg/kg), meat
(28.4), dairy products (18.8), legumes (21.2) and dry fruits (37.8).
Finally, the highest concentration of copper was found in dry fruits
(14.9 mg/kg), legumes (6.2), sweets (4.1) and meat (3.7). Our findings
will allow to estimate dietary trace elements exposure which
could be useful for both toxicological and epidemiological studies.
2017
- Toenail selenium as an indicator of environmental exposure: A cross-sectional study.
[Articolo su rivista]
Filippini, Tommaso; Ferrari, Angela; Michalke, B; Grill, P; Vescovi, L; Salvia, Chiara; Malagoli, Carlotta; Malavolti, Marcella; Sieri, S; Krogh, V; Bargellini, Annalisa; Martino, Antonio; Ferrante, M; Vinceti, Marco
abstract
The relation between toxicity and essentiality of selenium (Se) is of growing interest in human health, as the effects may widely differ depending of its different chemical species and the exposure levels. Toenail Se has been proposed as a reliable biomarker of long-term Se exposure, but few studies investigated the correlation between its toenail content and environmental determinants (i.e., dietary food intake). We aimed to determine the relation of toenail Se levels with serum Se species as well as food items. We recruited a random sample of Modena (Northern Italy) municipal residents, from whom we collected detailed personal information, dietary habits, toenail specimen for Se determination and a blood sample for serum Se speciation analysis. Toenail Se mean value was 0.96 µg/g (range, 0.47‑1.60), with slightly higher levels in females, in non-obese subjects and in Se supplements users, while it was lower in current smokers. Toenail Se positively correlated with organic Se forms, mainly selenoprotein P and selenocysteine, and inversely with the inorganic forms (selenite and selenate). Toenail Se was not associated with meat, cereals and dairy products consumption, positively correlated with fruit and slightly with vegetable intake, and negatively with fish and seafood consumption. Finally, no clear association emerged with estimated air Se exposure.
2016
- Determinants of serum cadmium levels in a Northern Italy community: A cross-sectional study.
[Articolo su rivista]
Filippini, Tommaso; Michalke, B; Malagoli, Carlotta; Grill, P; Bottecchi, Iliaria; Malavolti, Marcella; Vescovi, L; Sieri, S; Krogh, V; Cherubini, A; Maffeis, G; Modenesi, M; Castiglia, P; Vinceti, Marco
abstract
Introduction
Cadmium (Cd) is a heavy metal and a serious environmental hazard to humans. Some uncertainties still exist about major sources of Cd exposure in non-occupationally exposed subjects in addition to cigarette smoking, such as diet and outdoor air pollution. We sought to determine the influence of these sources on a biomarker of exposure, serum Cd concentration.
Methods
We recruited 51 randomly selected residents from an Italian urban community, from whom we obtained detailed information about dietary habits and smoking habits, and a blood sample for serum Cd determination. We also assessed outdoor air Cd exposure, by modeling outdoor air levels of particulate matter ≤10 µm (PM10) from motorized traffic at geocoded subjects’ residence.
Results
In crude analysis, regression beta coefficients for dietary Cd, smoking and PM10 on serum Cd levels were 0.03 (95% CI -0.83 to 0.88), 6.96 (95% CI -0.02 to 13.95) and 0.62 (95% CI -0.19 to 1.43), respectively. In the adjusted analysis, regression beta coefficients were -0.34 (95% CI -1-40 to 0.71), 5.81 (95% CI -1.43 to 13.04) and 0.47 (95% CI -0.35 to 1.29), respectively.
Conclusion
Cigarette smoking was the most important factor influencing serum Cd in our non-occupationally exposed population, as expected, while dietary Cd was not associated with this biomarker. Outdoor air pollution, as assessed through exposure to particulate matter generated by motorized traffic, was an additional source of Cd exposure.
2016
- Does maternal exposure to benzene and PM10 during pregnancy increase the risk of congenital anomalies? A population-based case-control study
[Articolo su rivista]
Vinceti, Marco; Malagoli, Carlotta; Malavolti, Marcella; Cherubini, Andrea; Maffeis, Giuseppe; Rodolfi, Rossella; Heck, Julia E; Astolfi, Gianni; Calzolari, Elisa; Nicolini, Fausto
abstract
A few studies have suggested an association between maternal exposure to ambient air pollution from vehicular traffic and risk of congenital anomalies in the offspring, but epidemiologic evidence is neither strong nor entirely consistent. In a population-based case-control study in a Northern Italy community encompassing 228 cases of birth defects and 228 referent newborns, we investigated if maternal exposure to PM10 and benzene from vehicular traffic during early pregnancy, as estimated through a dispersion model, was associated with excess teratogenic risk. In conditional logistic regression analysis, and with adjustment for the other pollutant, we found that higher exposure to PM10 but not benzene was associated with increased risk of birth defects overall. Anomaly categories showing the strongest dose-response relation with PM10 exposure were musculoskeletal and chromosomal abnormalities but not cardiovascular defects, with Down syndrome being among the specific abnormalities showing the strongest association, though risk estimates particularly for the less frequent defects were statistically very unstable. Further adjustment in the regression model for potential confounders did not considerably alter the results. All the associations were stronger for average levels of PM10 than for their maximal level. Findings of this study give some support for an excess teratogenic risk following maternal exposure during pregnancy to PM10, but not benzene. Such association appears to be limited to some birth defect categories.
2016
- Esposizione passiva a pesticidi e rischio di leucemia infantile.
[Abstract in Atti di Convegno]
Malagoli, Carlotta; Malavolti, Marcella; Costanzini, Sofia; Fabbi, Sara; Teggi, Sergio; Arcolin, Elisa; De Girolamo, G; Oleari, P; Palazzi, G; Vinceti, Marco
abstract
Esposizione passiva a pesticidi e rischio di leucemia infantile.
2016
- FOOD INTAKE OF ZINC AND CADMIUM IN NORTHERN ITALY POPULATION
[Abstract in Atti di Convegno]
Malagoli, Carlotta; Malavolti, Marcella; Sieri, Sabina; Krogh, Vittorio; Bottecchi, Ilaria; Filippini, Tommaso; Modenesi, Marina; Vescovi, Luciano; Vinceti, Marco
abstract
Background:
Some trace elements are essential for humans; their deficiency may cause
abnormal biological functions, whereas excessive intakes may produce adverse
health effects. The aim of this study was to estimate the daily intake through diet
of zinc (Zn) and cadmium (Cd) in a Northern Italy population and verify the
compliance with recommended levels of intake for Italian population recently
updated by Italian Society of Human Nutrition (SINU).
Methods:
We investigated dietary intake of Zn, and Cd in 719 residents of five provinces
of Emilia Romagna region in Northern Italy, using a validated semi-quantitative
food frequency questionnaire designed to capture eating behaviors in Italy,
specifically developed as part of the European Prospective Investigation into
Cancer and Nutrition study, for the Northern Italy population.
Results: We analyzed the diet of 319 men and 400 women, mean (±SD) aged
59.0 (± 14.0) and 52.3 (±14.1) respectively. The daily average (±SD) intake of
Zn and Cd was 11.99 (±4.31) mg/day and 15.06 (±8.41) μg/day in men and 10.83
(±4.06) mg/day and 13.23 (±7.23) μg/day in women. Dietary intake levels of Zn
were above the recommended values and well below the upper safe levels set by
SINU for healthy adults. Cd intake did not exceed the safety limits established by
European Food Safety Authority (EFSA).
Conclusions: Our analysis suggested that dietary intake of the above-mentioned
essential and toxic trace elements characterizing this Northern Italy population is
within the range defined as safe by SINU and EFSA.
2016
- INTAKE OF IRON IN A NORTHERN ITALY POPULATION
[Abstract in Atti di Convegno]
Malavolti, Marcella; Malagoli, Carlotta; Sieri, Sabina; Krogh, Vittorio; Vinceti, Marco
abstract
Backgrounds: Globally an estimated two billion people suffer from a chronic
deficiency of micronutrients. Iron deficiency and related anaemia is a significant
public health problem in several countries, and it becomes a very serious condition
in poor resources countries.
Methods: We investigated dietary iron intake of 719 residents of five provinces of
the Emilia Romagna region in Northern Italy, using a validated semi-quantitative
food frequency questionnaire designed to capture eating behaviors in Italy. This
questionnaire was specifically developed as part of the European Prospective
Investigation into Cancer and Nutrition study for the Northern Italy population.
We focused our attention especially in non-menopausal women (considered as
aged <50), a population at high risk for anemia, to assess if their iron intake
is adequate taking into account the population reference intake (PRI) recently
established by the European Food Safety Authority (EFSA).
Results: We found an average iron intake of 13.68 (±4.43) mg/day in males and
11.93 (±4.12) mg/day in females without any differences between younger and
older women (<50 or ≥ 50). These intakes by young women were lower the
intakes recommended by EFSA for non-menopausal women (16 mg/day).
Conclusions: Our analysis suggested that women iron intake in this northern
Italy population is much lower than the recommended levels. Public health
interventions should be considered to increase iron intake in this population and
counteract the risk of iron deficiency anaemia.
2016
- Long-term mortality patterns in a residential cohort exposed to inorganic selenium in drinking water.
[Articolo su rivista]
Vinceti, Marco; Ballotari, P; Steinmaus, C; Malagoli, Carlotta; Luberto, F; Malavolti, Marcella; Rossi Giorgi, P.
abstract
Selenium (Se) is a metalloid of considerable nutritional and toxicological importance in humans. To date, limited epidemiologic evidence exists about the health effects of exposure to this trace element in drinking water. We investigated the relationship between Se levels in water and mortality in the municipality of Reggio Emilia, Italy, where high levels of Se were previously observed in drinking water. From 1974 to 1985, 2065 residents consumed drinking water with Se levels close to the European standard of 10 μg/l, in its inorganic hexavalent form (selenate). Follow-up was conducted for the years 1986–2012 in Reggio Emilia and a lesser exposed comparison group of around 100,000 municipal residents, with comparable socio-demographic characteristics. Overall mortality from all causes, cardiovascular disease and cancer showed little evidence of differences. However, excess rate ratios were seen for some site specific cancers such as neoplasms of buccal cavity and pharynx, urinary tract, lymphohematopoietic tissue, melanoma, and two neurodegenerative diseases, Parkinson's disease and amyotrophic lateral sclerosis. Excess mortality in the exposed cohort for specific outcomes was concentrated in the first period of follow-up (1986–1997), and waned starting 10 years after the high exposure ended. We also found lower mortality from breast cancer in females during the first period of follow-up. When we extended the analysis to include residents who had been consuming the high-selenium drinking water for a shorter period, mortality rate ratios were also increased, but to a lesser extent. Overall, we found that the mortality patterns related to long-term exposure to inorganic hexavalent selenium through drinking water were elevated for several site-specific cancers and neurodegenerative disease.
2016
- Passive exposure to agricultural pesticides and risk of childhood leukemia in an Italian community
[Articolo su rivista]
Malagoli, Carlotta; Costanzini, Sofia; Heck, Julia E.; Malavolti, Marcella; De Girolamo, Gianfranco; Oleari, Paola; Palazzi, Giovanni; Teggi, Sergio; Vinceti, Marco
abstract
Background Exposure to pesticides has been suggested as a risk factor for childhood leukemia, but definitive evidence on this relation and the specific pesticides involved is still not clear. Objective We carried out a population-based case-control study in a Northern Italy community to assess the possible relation between passive exposure to agricultural pesticides and risk of acute childhood leukemia. Methods We assessed passive pesticide exposure of 111 childhood leukemia cases and 444 matched controls by determining density and type of agricultural land use within a 100-m radius buffer around children's homes. We focused on four common crop types, arable, orchard, vineyard and vegetable, characterized by the use of specific pesticides that are potentially involved in childhood induced leukemia. The use of these pesticides was validated within the present study. We computed the odds ratios (OR) of the disease and their 95% confidence intervals (CI) according to type and density of crops around the children's homes, also taking into account traffic pollution and high-voltage power line magnetic field exposure. Results Childhood leukemia risk did not increase in relation with any of the crop types with the exception of arable crops, characterized by the use of 2.4-D, MCPA, glyphosate, dicamba, triazine and cypermethrin. The very few children (n = 11) residing close to arable crops had an OR for childhood leukemia of 2.04 (95% CI 0.50–8.35), and such excess risk was further enhanced among children aged <5 years. Conclusions Despite the null association with most crop types and the statistical imprecision of the estimates, the increased leukemia risk among children residing close to arable crops indicates the need to further investigate the involvement in disease etiology of passive exposure to herbicides and pyrethroids, though such exposure is unlikely to play a role in the vast majority of cases.
2016
- Rischio di leucemia infantile in relazione al mese di nascita: studio caso-controllo basato sui dati del Registro AIEOP.
[Abstract in Atti di Convegno]
Malavolti, Marcella; Filippini, Tommaso; Malagoli, Carlotta; Arcolin, Elisa; De Girolamo, G; Oleari, P; Palazzi, G; Vinceti, Marco
abstract
Rischio di leucemia infantile in relazione al mese di nascita: studio caso-controllo basato sui dati del Registro AIEOP.
2015
- Are glycemic index and glycemic load associated with risk of cutaneous melanoma? A case-control study in an Italian population.
[Abstract in Atti di Convegno]
Malavolti, Marcella; Malagoli, Carlotta; Furio, Brighenti; Sabina, Sieri; Vittorio, Krogh; Farnetani, Francesca; Longo, Caterina; Pellacani, Giovanni
abstract
Are glycemic index and glycemic load associated with risk of cutaneous melanoma? A case-control study in an Italian population.
2015
- Assessing multiple sources of cadmium exposure in an Italian population.
[Abstract in Atti di Convegno]
Filippini, Tommaso; Cherubini, Alessandro; Maffeis, Giuseppe; Malagoli, Carlotta; Malavolti, Marcella; Sieri, Sabina; Krogh, Vittorio; Vescovi, Luciano; Modenesi, Marina; Michalke, Bernhard
abstract
Assessing multiple sources of cadmium exposure in an Italian population.
2015
- Assessment of cadmium levels in serum, toenails and diet: A cross sectional study in Modena, Northern Italy.
[Abstract in Atti di Convegno]
Filippini, Tommaso; Bottecchi, Iliaria; Arcolin, Elisa; Iacuzio, Laura; Malagoli, Carlotta; Vescovi, L; Ferrari, Angela; Martino, Antonio; Malavolti, Marcella; Cavazzuti, L; Sieri, S; Krogh, V; Michalke, B; Vinceti, Marco
abstract
Assessment of cadmium levels in serum, toenails and diet: A cross sectional study in Modena, Northern Italy.
2015
- Cadmium dietary intake in a Northern Italy population.
[Abstract in Atti di Convegno]
Malavolti, Marcella; Malagoli, Carlotta; Bottecchi, Ilaria; Vescovi, Luciano; Sieri, Sabina; Krogh, Vittorio; Modenesi, M; Vinceti, Marco
abstract
Cadmium dietary intake in a Northern Italy population
2015
- Diet Quality and Risk of Melanoma in an Italian Population
[Articolo su rivista]
Malagoli, Carlotta; Malavolti, Marcella; Agnoli, Claudia; Crespi, Catherine M; Fiorentini, Chiara; Farnetani, Francesca; Longo, Caterina; Ricci, Cinzia; Albertini, Giuseppe; Lanzoni, Anna; Veneziano, Leonardo; Virgili, Annarosa; Pagliarello, Calogero; Santini, Marcello; Fanti, Pier Alessandro; Dika, Emi; Sieri, Sabina; Krogh, Vittorio; Pellacani, Giovanni; Vinceti, Marco
abstract
Background: Some results from laboratory and epidemiologic studies suggest that diet may influence the risk of melanoma, but convincing evidence for a role of single nutrients or food items is lacking. Diet quality, which considers the combined effect of multiple food items, may be superior for examining this relation. Objective: We sought to assess whether diet quality, evaluated with the use of 4 different dietary indexes, is associated with melanoma risk. Methods: In this population-based case-control study, we analyzed the relation between 4 diet quality indexes, the Healthy Eating Index 2010 (HEI-2010), Dietary Approaches to Stop Hypertension (DASH) index, Greek Mediterranean Index (GMI), and Italian Mediterranean Index (IMI), and melanoma risk in a northern Italian community, with the use of data from 380 cases and 719 matched controls who completed a semiquantitative food frequency questionnaire. Results: In the overall sample, we found an inverse association between disease risk and the HEI-2010 and DASH index, but not the Mediterranean indexes, adjusting for potential confounders (skin phototype, body mass index, energy intake, sunburn history, skin sun reaction, and education). However, in sex stratified analyses, the association appeared only in women (P-trend: 0.10 and 0.04 for the HEI-2010 and DASH index, respectively). The inverse relations were stronger in women younger than age 50 y than in older women, for whom the GMI and IMI scores also showed an inverse association with disease risk (P-trend: 0.05 and 0.02, respectively). Conclusions: These results suggest that diet quality may play a role in cutaneous melanoma etiology among women.
2015
- Dietary cadmium intake in an Italian population.
[Abstract in Rivista]
Malavolti, Marcella; Malagoli, Carlotta; Ilaria, Bottecchi; Luciano, Vescovi; Massimo, Modenesi; Paolo, Castiglia; Sabina, Sieri; Vittorio, Krogh; Vinceti, Marco
abstract
Dietary cadmium intake in an Italian population.
2015
- Increased incidence of childhood leukemia in urban areas: a population-based case-control study
[Articolo su rivista]
Malagoli, Carlotta; Malavolti, Marcella; Costanzini, Sofia; Fabbi, Sara; Teggi, Sergio; Palazzi, Giovanni; Arcolin, Elisa; Vinceti, Marco
abstract
Objective. We carried out a population-based case-control study to assess the possibility of an excess risk of childhood leukemia in urban areas, independently from road traffic pollution. Methods. Study subjects were the 111 cases of childhood leukemia diagnosed from 1998 to 2011 among residents of two provinces of the northern Italian Emilia-Romagna region, and 444 controls matched by age and sex. Through mapping of the region carried out by remote sensing, we examined the percentage of urban or rural area in the 100-meter circular buffer around each child's house. We also modeled annual average exposure to benzene and PM10 from vehicular traffic at each residence. Results. In a multivariate model adjusting for benzene and PM10, the odds ratio of leukemia associated with residence in a highly urbanized area and residential area (≥95% land use of this type near the child's home) was 1.4 (95% confidence intervals 0.8-2.4) and 1.3 (0.8-2.2), respectively. An increased risk was also found in association with the proximity to "dumps, scrap yards, and building sites". No association emerged with residence in rural areas or near industrial plants. Conclusions. These results indicate that children living in urban areas experience an excess leukemia risk, independently from exposure to pollutants from vehicles.
2015
- Indice Glicemico e Carico Glicemico e rischio di melanoma in una popolazione della Emilia-Romagna.
[Abstract in Atti di Convegno]
Malavolti, Marcella; Malagoli, Carlotta; Brighenti, F; Sieri, S; Krogh, V; Farnetani, Francesca; Longo, Caterina; Pellacani, Giovanni; Vinceti, Marco
abstract
.
2015
- Long-term mortality in a population exposed to inorganic selenium through drinking water.
[Abstract in Atti di Convegno]
Vinceti, Marco; Ballotari, Paola; Malagoli, Carlotta; Luberto, Ferdinando; Malavolti, Marcella; Vicentini, Massimo; Filippini, Tommaso; Giorgi Rossi, Paolo
abstract
Long-term mortality in a population exposed to inorganic selenium through drinking water.
2015
- Long-term mortality in a residential cohort exposed to inorganic hexavalent selenium through drinking water.
[Abstract in Atti di Convegno]
Vinceti, Marco; Paola, Ballotari; Malagoli, Carlotta; Ferdinando, Luberto; Malavolti, Marcella; Massimo, Vicentini; Violi, Federica; Paolo, Giorgi Rossi
abstract
Long-term mortality in a residential cohort exposed to inorganic hexavalent selenium through drinking water
2015
- Maternal exposure to benzene and PM10 during pregnancy influences the risk of congenital anomalies in the offspring. A population-based case-control study in a Northern Italy community.
[Abstract in Rivista]
Malagoli, Carlotta; Malavolti, Marcella; Cherubini, A; Maffeis, G; Rodolfi, R; Astolfi, G; Calzolari, E; Nicolini, F; Vinceti, Marco
abstract
.
2015
- Passive exposure to agricultural pesticides and risk of childhood leukemia in an Italian community.
[Abstract in Atti di Convegno]
Malagoli, Carlotta; Malavolti, Marcella; Costanzini, Sofia; Teggi, Sergio; Giovanni, Palazzi; Vinceti, Marco
abstract
Passive exposure to agricultural pesticides and risk of childhood leukemia in an Italian community
2015
- Selenium in humans: which is the safe range of intake?
[Abstract in Atti di Convegno]
Vinceti, Marco; Filippini, Tommaso; Violi, Federica; Malavolti, Marcella; Malagoli, Carlotta; Bargellini, Annalisa; Borella, Paola
abstract
Selenium in humans: which is the safe range of intake?
2015
- Selenium speciation in human serum and its implications for epidemiologic research: a cross-sectional study
[Articolo su rivista]
Vinceti, Marco; Grill, Peter; Malagoli, Carlotta; Filippini, Tommaso; Storani, Simone; Malavolti, Marcella; Michalke, Bernhard
abstract
Observational studies addressing the relation between selenium and human health, particularly cancer risk, yielded inconsistent results, while most recent randomized trials showed a fairly consistent pattern suggesting null or adverse effects of the metalloid. One of the most plausible explanations for such inconsistencies is inadequate exposure assessment in observational studies, commonly carried out by measuring total Se content without taking into account the specific exposure to the individual chemical forms of the metalloid, whose toxic and nutritional properties may vary greatly. Data on the distribution of these species in human blood and their correlation with overall selenium levels are very limited. The concentrations of organic and inorganic selenium species were analyzed in serum of fifty subjects sampled from the general population of the municipality of Modena, northern Italy, aged from 35 to 70 years. Samples were collected during a 30-month period, and determinations of selenium species were carried out using high pressure liquid chromatography coupled with inductively coupled plasma dynamic reaction cell mass spectrometry. The majority of selenium was found to be present as organic species, but the inorganic forms showed higher levels than expected. These species showed limited correlations with age, sex and body mass index, while the organic forms increased in subjects consuming selenium-containing dietary supplements and decreased in smokers. The length of the sample storage period strongly influenced the distribution of selenium compounds, with a clear tendency towards higher inorganic and lower organic selenium levels over time. In multivariate analysis adjusting for potential confounders, total serum selenium correlated with human serum albumin-bound selenium and, in males, with two organic species of the metalloid (selenocysteine and glutathione peroxidase-bound selenium), while little association existed with the other organic forms and the inorganic ones. These findings highlight the potential for exposure misclassification of observational epidemiologic investigations based on overall selenium content in blood and possibly other tissues, and the critical role of the storage conditions for speciation analysis.
2015
- Sources of cadmium exposure in an Italian population: a cross-sectional study
[Abstract in Atti di Convegno]
Filippini, Tommaso; Cherubini, A; Greco, S; Maffeis, G; Malagoli, Carlotta; Bottecchi, Iliaria; Malavolti, Marcella; Sieri, S; Krogh, V; Vescovi, L; Modenesi, M; Castiglia, P; Michalke, B; Vinceti, Marco
abstract
Sources of cadmium exposure in an Italian population: a cross-sectional study.
2015
- The influence of outdoor air pollution on cadmium exposure assessment: a cross-sectional population-based Italian study.
[Abstract in Atti di Convegno]
Filippini, Tommaso; Cherubini, A; Maffeis, G; Greco, S; Malagoli, Carlotta; Malavolti, Marcella; Sieri, S; Krogh, V; Vescovi, L; Modenesi, M; Michalke, B; Vinceti, Marco
abstract
The influence of outdoor air pollution on cadmium exposure assessment: a cross-sectional population-based Italian study.
2015
- Toenail selenium and risk of type 2 diabetes: the ORDET cohort study
[Articolo su rivista]
Vinceti, Marco; Grioni, S.; Alber, D.; Consonni, D.; Malagoli, Carlotta; Agnoli, C.; Malavolti, Marcella; Pala, V.; Krogh, V.; Sieri, S.
abstract
Epidemiologic studies, particularly randomized controlled trials, have shown a direct relation between dietary and environmental exposure to the metalloid selenium and risk of type 2 diabetes. We investigated the association between baseline toenail selenium levels and diabetes occurrence in a case-control study nested in ORDET, a population-based female cohort in Northern Italy. After a median follow-up of 16 years, we identified 226 cases of type 2 diabetes cases and 395 age-matched control women with available toenail samples at baseline. The multivariate odds ratios of diabetes in increasing a priori defined categories of toenail selenium exposure were 1.09 (95% confidence interval 0.61, 1.96), 0.71 (0.38, 1.34) and 1.14 (0.46, 2.80) compared with the lowest category. The results were not substantially altered when quartile distribution of toenail selenium in controls was used to define exposure categories. Spline regression analysis did not show homogeneous risk trends. Overall, we did not find an association between toenail selenium and subsequent development of diabetes. Since the diabetogenic activity of selenium is strongly supported by experimental studies and some observational investigations, our null results might be explained by the limitations of overall selenium toenail content to assess environmental exposure to selenium species of etiologic relevance in the study population.
2014
- Fecal water genotoxicity in healthy free-living young Italian people
[Articolo su rivista]
Erba, Daniela; Soldi, Sara; Malavolti, Marcella; Aragone, Giovanni; Alexandra, Meynier; Vinoy, Sophie; Casiraghi M, Cristina
abstract
Dietary habit affects the composition of human feces thus determining intestinal environment and exposure of colon mucosa to risk factors. Fecal water (FW) citotoxicity and genotoxicity were investigated in 33 healthy young Italian people, as well as the relationship between genotoxicity and nutrient intake or microflora composition. Two fecal samples were collected at 2 weeks apart and 3-d dietary diary was recorded for each volunteer. Cytotoxicity was measured using the Trypan Blue Dye Exclusion assay and genotoxicity using the Comet Assay (alkaline single-cell electrophoresis). Fecal bifidobacteria, total microbial count and nutrient intakes were also assessed.High intra- and inter-variability in genotoxicity data and in bacteria counts were found. None of the FW samples were citotoxic, but 90% of FW samples were genotoxic. Seventy five percent indicated intermediate and 15% were highly genotoxic. There was a different sex-related distribution. Genotoxicity was positively correlated to the total lipid intake in females and to the bifidobacteria/total bacteria count ratio in male volunteers.These results demonstrate that the majority of FW samples isolated from free-living Italian people show intermediate level of genotoxicity and sustain a relation between this possible non-invasive marker of colorectal cancer risk with both dietary habits and colonic ecosystem. (C) 2013 Elsevier Ltd. All rights reserved.
2014
- Gestational weight gain in overweight and obese women enrolled in a healthy lifestyle and eating habits program
[Articolo su rivista]
Petrella, Elisabetta; Malavolti, M; Bertarini, V; Pignatti, Lucrezia; Neri, Isabella; Battistini, N. C; Facchinetti, Fabio
abstract
OBJECTIVES:
To determine whether changes in lifestyle in women with BMI > 25 could decrease gestational weight gain and unfavorable pregnancy outcomes.
METHODS:
Women with BMI > 25 were randomized at 1st trimester to no intervention or a Therapeutic Lifestyle Changes (TLC) Program including diet (overweight: 1700 kcal/day, obese: 1800 kcal/day) and mild physical activity (30 min/day, 3 times/week). At baseline and at the 36th week women filled-in a Food Frequency Questionnaire.
OUTCOMES:
gestational weight gain, gestational diabetes mellitus, gestational hypertension, preterm delivery. Data stratified by BMI categories.
RESULTS:
Socio-demographic features were similar between groups (TLC: 33 cases,
CONTROLS:
28 cases). At term, gestational weight gain in obese women randomized to TLC group was lower (6.7 ± 4.3 kg) versus controls (10.1 ± 5.6 kg, p = 0.047). Gestational diabetes mellitus, gestational hypertension and preterm delivery were also significantly lower. TLC was an independent factor in preventing gestational weight gain, gestational diabetes mellitus, gestational hypertension. Significant changes in eating habits occurred in the TLC group, which increased the number of snacks, the intake of fruits-vegetables and decreased the consumption of sugar.
CONCLUSIONS:
A caloric restriction associated to changes in eating behavior and constant physical activity, is able to reduce gestational weight gain and related pregnancy complications in obese women.
2014
- Pattern alimentari e rischio di melanoma cutaneo: studio epidemiologico multicentrico in una popolazione del nord-Italia.
[Abstract in Atti di Convegno]
Malavolti, Marcella; Malagoli, Carlotta; Agnoli, C; Fiorentini, Chiara; Longo, Caterina; Farnetani, Francesca; Sieri, S; Krogh, V; Pellacani, Giovanni; Vinceti, Marco
abstract
.
2014
- Stato della ricerca scientifica in materia di alimentazione e nutrizione
[Articolo su rivista]
Guglielmo, Bonaccorsi; Chiara, Lorini; Barbara Rita, Porchia; Leonardo, Capecchi; Malavolti, Marcella; Aggazzotti, Gabriella
abstract
La sanità pubblica italiana sta vivendo una difficile fase di ripensamento dei suoi assetti organizzativi e della capacità di dare risposta ai bisogni dei cittadini. Il razionamento delle prestazioni, insieme con la riduzione delle risorse umane e tecnologiche, sembrano farsi particolarmente sentire in uno dei capisaldi del Dipartimento di prevenzione, il Servizio di igiene degli alimenti e della nutrizione (SIAN). Il sostegno alla ricerca in igiene alimentare e nutrizionale trova la sua ragione anche nella pericolosa deriva efficientista imboccata
dal nostro Paese. Per comprendere l’orientamento della ricerca in materia di igiene degli alimenti e igiene della nutrizione abbiamo interrogato Pubmed e utilizzato Google Ngram Viewer©, grazie ai quali abbiamo approfondito alcune aree tematiche di interesse in termini di novità e di miglioramento potenziale della pratica professionale. Il contributo italiano alla ricerca alimentare è, nel complesso, ancora limitato. Tale esplorazione ha permesso di delineare come, oggi, ricerca e servizi territoriali debbano creare un’alleanza virtuosa per la creazione di sistemi sanitari sostenibili.
2013
- Accuracy of SenseWear Pro2 armband to predict resting energy expenditure in childhood obesity.
[Articolo su rivista]
Predieri, Barbara; Bruzzi, Patrizia; Lami, Francesca; Vellani, Giulia; Malavolti, Marcella; Battistini, Nc; Iughetti, Lorenzo
abstract
OBJECTIVE: We evaluate the accuracy of the SenseWear Pro2 Armband (SWA) in estimating resting energy expenditure (REE) in children and adolescents with obesity, using indirect calorimetry (IC) as a reference.
DESIGN AND METHODS: REE was assessed using both the SWA and IC in 40 obese subjects (26 M/14 F, age 11.5±2.57 years, z-score BMI 3.14±0.53). The agreement between methods was assessed by the Bland-Altman procedure. The relationship between REE assessments and patients' characteristics was also analyzed.
RESULTS: SWA- and IC-derived estimates of REE showed a significant correlation (r=0.614; P<0.001), but the SWA overestimated mean REE by 13% (P<0.001). Age and kg of fat-free mass (kgFFM) were significantly correlated with both REE estimation by SWA (r=0.434 and r=0.564; respectively) and IC (r=0.401 and r=0.518; respectively). Only kgFFM was demonstrated to be the main predictor factor of REE variability (r2 79% SWA; 75% IC).
CONCLUSIONS: The SWA overestimated mean REE in childhood obesity, suggesting that the SWA and IC are not yet interchangeable methods. This would require improving the SWA by developing better algorithms for predicting REE and, probably, bias in each individual REE could be reduced by an adjustment for subjects' kgFFM.
2013
- Association between dietary vitamin C and risk of cutaneous melanoma in a population of Northern Italy
[Articolo su rivista]
Malavolti, Marcella; Malagoli, Carlotta; Fiorentini, Chiara; Longo, Caterina; Farnetani, Francesca; Ricci, Cinzia; Albertini, Giuseppe; Lanzoni, Anna; Reggiani, Camilla; Virgili, Annarosa; Pagliarello, Calogero; Santini, Marcello; Fanti, Pier A; Dika, Emi; Sieri, Sabina; Krogh, Vittorio; Pellacani, Giovanni; Vinceti, Marco
abstract
Cutaneous melanoma incidence has been increasing during the last few years, and diet has been suggested as one of the lifestyle factors responsible for this increase. Since antioxidant nutrients such as ascorbic acid might prevent skin carcinogenesis, we investigated the risk of cutaneous melanoma related to vitamin C intake in a population-based case-control study in Northern Italy based on 380 melanoma patients and 719 matched controls, to whom we administered a semiquantitative food-frequency questionnaire. After adjusting for potential confounders, odds ratio of melanoma were 0.86 (95 % confidence interval 0.65 - 1.15) and 0.59 (95 % confidence interval 0.37 - 0.94) in the intermediate and highest categories of vitamin C dietary intake respectively, compared with the bottom one. The association between vitamin C and decreased risk persisted after adjustment for some potential confounders. In age- and gender-stratified analyses, this association was seen in young females (< 60 years old), and was found to be enhanced in subjects with phototypes II and III. These results suggest a possible protective activity of vitamin C intake against cutaneous melanoma in specific subgroups of this population of Northern Italy.
2013
- Associazione tra vitamina C e rischio di melanoma cutaneo: studio epidemiologico multicentrico in una popolazione del nord Italia.
[Abstract in Atti di Convegno]
Malavolti, Marcella; Malagoli, Carlotta; Fiorentini, Chiara; Sieri, S; Krogh, V; Pellacani, Giovanni; Vinceti, Marco
abstract
.
2013
- Il consumo di legumi riduce il rischio di melanoma cutaneo: studio caso-controllo nella regione Emilia Romagna.
[Abstract in Atti di Convegno]
Malagoli, Carlotta; Malavolti, Marcella; Fiorentini, Chiara; Sieri, S; Krogh, V; Pellacani, Giovanni; Vinceti, Marco
abstract
.
2013
- Physical activity for the prevention and treatment of metabolic disorders
[Articolo su rivista]
Luca, Montesi; Simona, Moscatiello; Malavolti, Marcella; Rebecca, Marzocchi; MARCHESINI REGGIANI, Giulio
abstract
Metabolic syndrome and its various features 10 (obesity, hypertension, dyslipidemia, diabetes, and nonal- 11 coholic fatty liver disease) are increasing worldwide and 12 constitute a severe risk for the sustainability of the present 13 universal Italian health care system. Lifestyle interventions 14 should be the first therapeutic strategy to prevent/treat 15 metabolic diseases, far before pharmacologic treatment. 16 The role of diet and weight loss has been fully ascertained, 17 whereas the role of physical activity is frequently over- 18 looked both by physicians and by patients. Physical activity 19 has favorable effects on all components of the metabolic 20 syndrome and on the resulting cardiovascular risk, the 21 cornerstone in the development of cardiometabolic dis- 22 eases. The quantity and the frequency of physical activity 23 necessary to produce beneficial effects has not been defined 24 as yet, but brisk walking is considered particularly appro- 25 priate, as it can be practiced by a large number of indi- 26 viduals, without any additional cost, and has a low rate of 27 injury. The effects of exercise and leisure time physical 28 activity extend from prevention to treatment of the various 29 components of the metabolic syndrome, as well as to mood 30 and quality of life. Any effort should be done to favor adherence to protocols of physical activity in the 31 community.
2013
- Short-term multidisciplinary non-pharmacological intervention is effective in reducing liver fat content assessed non-invasively in patients with nonalcoholic fatty liver disease (NAFLD)
[Articolo su rivista]
Scaglioni, Federica; Marino, Mariano; Ciccia, Stefania; Procaccini, Alessia; Busacchi, Marcello; Loria, Paola; Lonardo, Amedeo; Malavolti, Marcella; Battistini, Nino Carlo; Pellegrini, Massimo; Carubbi, Francesca; Bellentani, Stefano
abstract
Non-alcoholic fatty liver disease (NAFLD) ranges from simple steatosis to steatohepatitis, and cirrhosis in patients with alcohol intake less than 20 g/day, and is usually associated with insulin resistance (IR).
We tested the efficacy of a non-pharmacological multidisciplinary intervention based on a personalized diet, physical activity and behavior therapy.
In this open non-randomized study, personalized diet, physical exercise and behaviour therapy for 3 months were prescribed in 12 consecutive patients with NAFLD.
Data show that the multidisciplinary intervention produced a significant reduction of total caloric intake, a 8% reduction in body weight, a modest increase in daily physical activity, a significant (P<0.001) reduction of aminotransferases and a decrease of total hepatic fat content.
2012
- Influence of lifestyle habits, nutritional status and insulin resistance in NAFLD
[Articolo su rivista]
Malavolti, Marcella; Battistini, Nino Carlo; L., Miglioli; Bagni, Ilaria; L., Borelli; M., Marino; F., Scaglioni; S., Bellentani
abstract
Non alcoholic fatty liver disease (NAFLD) is associated with obesity, diabetes and insulin resistance (IR). The aim of our study was to assess the relationship between IR, anthropometry, lifestyle habits, resting energy expenditure (REE) and degree of fatty liver at ultrasound in 48 overweight patients with NAFLD as compared to 24 controls without fatty liver, matched for age. Nutritional status, alcohol intake and physical activity were assessed by skinfold thickness measurements, a 7-day diary, and SenseWear armband (SWA). REE was assessed by both SWA (REE-SWA) and a Vmax metabolic cart (REE-Vmax). Fatty liver was measured by US and the Doppler Power Index was calculated. IR was assessed using the HOMA index. There was significant correlation between waist circumference, HOMA, Doppler power index and fatty liver grade at US. Multivariate analysis showed that alteration of waist circumference, Doppler power index, and HOMA were the major significant predictors of fatty liver. Our data demonstrated a significant association between NAFLD and central adiposity and IR.
2012
- La composizione corporea: dal laboratorio alla clinica
[Capitolo/Saggio]
Pellegrini, Massimo; Malavolti, Marcella; Busacchi, M; Battistini, Nino Carlo
abstract
I nutrienti influenzano lo stato di nutrizione di un soggetto attraverso diverse variabili quali l’introduzione, l’assorbimento e l’utilizzazione degli stessi. Indagare queste variabili, tuttavia, risulta essere poco funzionale mentre possiamo efficacemente concentrarci soltanto su una di queste tre, l’utilizzazione, che risulta direttamente influenzata dalle due precedenti. Illustrando il concetto di utilizzazione possiamo vedere, secondo un modello operativo dinamico, come lo stato di salute sia legato in modo biunivoco allo stato nutrizionale (OMS/WHO, 1998) attraverso due grandi variabili: quella psico-sociale e quella biologica. Di queste due macrocomponenti la variabile biologica risulta costituita da composizione corporea, bilancio energetico e funzioni corporee che sono valutabili dal nutrizionista attraverso metodiche invasive e metodiche non-invasive. Lo studio della composizione corporea è il miglior indicatore a lungo termine dello stato nutrizionale della persona poiché riflette la disponibilità pregressa di nutrienti. Queste caratteristiche risultano particolarmente evidenti in una popolazione altamente specifica e ben caratterizzata.
2012
- Reliability of Multisensor Armband in Estimating Energy Expenditure According to Degree of Obesity
[Articolo su rivista]
Malavolti, Marcella; S., Bellentani; A., Pietrobelli; L., Tardini; Bellucci, Alessandro; Busacchi, Marcello; Battistini, Nino Carlo
abstract
Resting energy expenditure (REE) represents the amount of calories required by the body to maintain vital bodyfunctions. One of the most commonly used methods for estimating REE is indirect calorimetry. Recent studies ondifferent populations have validated a highly innovative instrument, the SenseWear® Armband (SWA), which evaluatestotal energy expenditure and, when used in resting conditions, could also evaluate REE. The purpose of this study wasto determine the agreement of the SWA in assessing REE in obese subjects and, see how this agreement varies withdifferent obesity degree.89 obese subjects (59 women and 30 men), with an age range from 35-65 years and body mass index (BMI)34.5 4.5 kg/m2 were studied. REE was measured by IC Sensor Medics Vmax (SM-29N) and by SWA. Fat mass(FM) and fat-free mass (FFM) was determined by anthropometry and bio-impedance measurements. No statisticaldifference was found between REE measured by SWA (1693±276) and REE measured by SM-29N (1627±293). Thetwo methods showed similar assessments (r=0.8, p<0.0001). When the BMI range is limited to 30 to 35 kg/m2, thisagreement increases (r = 0.85, p<0.0001). However, at higher BMIs (BMI> 35 kg/m2), the agreement decreases (r =0.6 p <0.0001). FFM, measured using different methods, and REE measured using SWA and SM-29N are very closelycorrelated.The accuracy of the SWA is affected by BMI, in fact it appears to be good in obese subjects with a BMI range of30 to 35, but this accuracy decreases with higher BMIs (BMI> 35)
2010
- I fattori umani e la sicurezza alla guida: studio dei rapporti tra alcune variabili individuali (età, metabolismo basale, variabili antropometriche, composizione corporea, variabili biochimiche) e performance psico-motoria.
[Abstract in Rivista]
Licitra, Giuseppe; R., Vivoli; Malavolti, Marcella; Ferrari, Angela; Martino, Antonio; S., Lugli; Bergomi, Margherita
abstract
Considerando che è ancora scarsamente indagato il ruolo che potrebbero avere alcune variabili individuali sulla sicurezza alla guida, anche in relazione al momento della giornata e all’eventuale assunzione dei pasti, ci siamo proposti di valutare, in differenti orari della giornata, l’influenza di alcuni fattori individuali sui livelli di performance psicomotoria.Sono stati presi in esame14 soggetti di età compresa tra i 19 e 45 anni, di cui sono stati acquisiti preliminarmente i seguenti dati: età, tipologia circadiana Composite Scale of Morningness), misure antropometriche, composizione corporea (massa magra e massa grassa) e spesa energetica basale. In 3 differenti giornate, sono state effettuate le misurazioni dei tempi di reazione a stimoli semplici (RT e RT motorio) e complessi (DT) (Vienna Test System), in tarda mattinata e nel primo pomeriggio, dopo l’assunzione di pasti calibrati, per un totale di 84 acquisizioni . Sono stati inoltre misurati i seguenti parametri biochimici: glucosio, insulina, glucagone, colesterolo totale e trigliceridi (ematici) e serotonina (urinaria). I risultati hanno evidenziato interessanti rapporti associativi tra l’età, alcuni dei parametri biochimici esaminati e i livelli di performance (tempi di reazione). Nello specifico è stata rilevata una relazione diretta tra età e tempi di reazione a stimoli complessi (DT). Prendendo in considerazione invece le variabili biochimiche, una relazione inversa è stata evidenziata tra livelli ematici di glucagone e tempi di reazione a stimoli complessi (DT ), in entrambi gli orari considerati.. Una relazione inversa è emersa inoltre tra livelli ematici di glucagone, RT e tempo di reazione motorio (RT mot.), e nel contempo tra glicemia e RT mot., limitatamente alla prima rilevazione. Rapporti associativi inversi sono infine emersi dopo il pasto, tra massa magra, metabolismo basale, livelli urinari di serotonina e RT e RT mot.Considerando che la guida di un veicolo è un’attività molto complessa, che richiede prestazioni psicofisiche costantemente efficienti da parte del guidatore, i risultati conseguiti possono avere interessanti risvolti nei confronti della sicurezza stradale. Degno di nota è il reperto di un’influenza negativa dell’età sui livelli di performance. Rispetto ai parametri biochimici i risultati ottenuti evidenziano che l’omeostasi del glucosio gioca un ruolo importante nella performance ed in particolare adeguati livelli glicemici sembrano necessari per il mantenimento di una buona performance psicomotoria. Di particolare interesse sono anche le relazioni emerse tra metabolismo basale, composizione corporea e tempi di reazione.
2010
- La valutazione dello stress lavoro correlato: protocollo per stimare lo stress in conducenti professionisti mediante misure soggettive ed oggettive
[Abstract in Rivista]
Bergomi, Margherita; Busacchi, Marcello; Ferrari, Angela; Ferretti, Enrica; Licitra, Giuseppe; Malavolti, Marcella; R., Vivoli
abstract
Obiettivi specifici: Stimare l’entità dello stress generato dalla guida e individuare le variabili ad esso correlate, sia individuali che legate all’organizzazione del lavoro, valutando nel contempo le relazioni tra diverse metodologie di valutazione dello stress sia con misure soggettive che oggettive. Protocollo dello studio. Saranno reclutati sia conducenti di autobus urbani che di veicoli commerciali per il trasporto di merci.Il protocollo dello studio prevede l’esecuzione delle seguenti indagini: visita medica e somministrazione di questionari per stimare le caratteristiche di personalità (EPQ-R), lo stile di vita, le abitudini alimentari, lo stress percepito (Perceived Stress Scale) e l’entità dello stress da guida (DSI), l’ eventuale presenza di sonnolenza diurna e di segni e/o sintomi indicativi di apnee ostruttive nel sonno o di altre alterazioni del ciclo sonno-veglia (Questionario sui Disturbi della Vigilanza ). Su campioni di saliva raccolti prima, durante e al termine del turno di guida e nella stessa fascia oraria di un giorno di riposo saranno determinate le concentrazioni di melatonina (marcatore del ciclo sonno-veglia), oltre che di cortisolo e alfa-amilasi quali indicatori biochimici dei due principali sistemi coinvolti nella reazione da stress. Contestualmente, per 72 ore, sarà applicato all’avambraccio degli autisti l’holter motorio-metabolico Sensewear Armband, in grado di derivare alcune variabili elettrofisiologiche quali la temperatura cutanea, la risposta galvanica della cute, il calore dissipato, e il movimento corporeo.I risultati conseguiti dovrebbero permettere di approfondire le conoscenze sui seguenti aspetti:•entità dello stress legato alla guida nei guidatori professionisti e variabili individuali e lavorative ad esso maggiormente correlate;•relazioni tra stima dello stress lavorativo ottenuta con misure soggettive (questionari) e oggettive (indicatori biochimici e parametri elettrofisiologici registrati dall’holter metabolico);•ruolo dello stress o di altre variabili (debito di sonno, cronotipo, alimentazione, consumo di alcol o assunzione di farmaci, organizzazione del lavoro…) nel condizionare la percezione i stanchezza e sonnolenza durante il turno di lavoro.I risultati dello studio dovrebbero quindi fornire le basi conoscitive per identificare i metodi più idonei per una valutazione accurata dello stress lavorativo oltre che per programmare interventi volti a modificare le variabili, sia individuali che occupazionali che possono condizionare il rischio di incidenti stradali nei guidatori professionisti.
2009
- A role for bioipendace analisys (BIA)
[Articolo su rivista]
A., Pietrobelli; Malavolti, Marcella; Battistini, Nino Carlo
abstract
The measurement of body components is central to the study of body composition in animals and humans. The principle underlying the use of bioimpedance analysis (BIA) for assessing body composition is the relationship between body composition and the water content of the body. Resistance and reactance, the two main determinants of impedance, respond differently at any given frequency to intra-cellular and extra-cellular fluids. Estimation of fat and fat free mass is discussed. Footpad Vs lying position in term of measurement approach as well as accuracy are presented.Using BIA we can measure water content of the body at population level and using specific and appropriate equations we will have the possibility of detecting subjects at risk of overweight and obesity.
2009
- Pediatric Obesity: Looking into Treatment
[Articolo su rivista]
A., Pietrobelli; S., Rugolotto; P., De Cristofaro; Malavolti, Marcella
abstract
Abstract: Prevalence of pediatric obesity continues to rise worldwide. Increasing the number of health care practitioners as well as pediatricians with expertise in obesitytreatment is necessary. Because many obese patients suffer obesity-associated cardiovascular, metabolic and other health complications that could increase the severity ofobesity, it is fundamental not only to identify the child prone to obesity as early as possible, but to recognize, treat and monitor obesity-related diseases during adolescence.This short review outlines the treatment of pediatric obesity that may have applications in the primary care setting. It examines current information on eating behavior, sedentary behavior, and details studies of multidisciplinary, behavior-based, obesity treatment programs. We also report the less common and more aggressive forms of treatment, such as medication and bariatric surgery. We emphasize that health care providers have thepotential to improve outcomes by performing early identification, helping families create the best possible home environment, and by providing structured guidance to obese children and their families
2008
- Effect of intense military training on body composition
[Articolo su rivista]
Malavolti, Marcella; Battistini, Nino Carlo; Dugoni, Manfredo; S., Panico; Bagni, Bruno; Bagni, Ilaria; A., Pietrobelli
abstract
Individuals in a structural physical training program can show beneficial changes in body composition, such as body fat reduction and muscle mass increase. This study measured body composition changes by using 3 different techniques-skinfold thickness (SF) measurements, air displacement plethysmography (BOD-POD), and dual-energy x-ray absorptiometry (DXA)-during 9 months of intense training in healthy young men engaged in military training. Twenty-seven young men were recruited from a special faction of the Italian Navy. The program previewed three phases: ground combat, sea combat, and amphibious combat. Body composition was estimated at the beginning, in the middle, and at the end of the training. After the subjects performed the ground combat phase, body composition variables significantly decreased: body weight (P < 0.05), fat-free mass (FFM) (P < 0.001), and fat mass (FM) (P < 0.03). During the amphibious combat phase, body weight increased significantly (P < 0.01), mainly because of an increase in FFM (P < 0.001) and a smaller mean decrease in FM. There was a significant difference (P < 0.05) in circumferences and SF at various sites after starting the training course. Bland-Altman analysis did not show any systematic difference between FM and FFM measured with the 3 different techniques on any occasion. On any visit, FFM and FM correlation measured by BOD-POD (P = 0.90) and DXA was significantly greater than measured by SF. A significant difference was found in body mass index (BMI) measured during the study. BOD-POD and SF, compared with DXA, provide valid and reliable measurement of changes in body composition in healthy young men engaged in military training. In conclusion, the findings suggest that for young men of normal weight, changes in body weight alone and in BMI are not a good measure to assess the effectiveness of intense physical training programs, because lean mass gain can masquerade fat weight loss.
2008
- Metabolic Syndrome: a child is not a small adult
[Articolo su rivista]
A., Pietrobelli; Malavolti, Marcella; Battistini, Nino Carlo; N., Fuiano
abstract
Obesity is associated with increased all-cause mortality rate and even small weight losses can be associated with short-term reduction in risk factors for disease. There is strong evidence that weight loss in obese subjects improves risk factors for diabetes and cardiac vascular diseases.Metabolic syndrome (MS) in adults is defined as a cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus, which include abdominal obesity, dyslipidemia, glucose intolerance and hypertension. Application of the MS concept in children and adolescents is controversial, in fact no consensus exists on a specific definition for pediatric MS. Lack of consensus is in part due to body evolution associated with childhood and puberty that is related to changes in metabolic and clinical characteristics. Aim of this article is to try to clarify the differences between MS as a concept and MS as a diagnosis category as well as to develop a theory related to its pathophysiology. We comment the relationship between obesity, regional fat distribution and MS and finally we offer some insights MS methodological approach for estimating metabolic risk-factor clustering in children and adolescents.
2007
- A new device for measuring resting energy expenditure (REE) in healthy subjects.
[Articolo su rivista]
Malavolti, Marcella; A., Pietrobelli; Dugoni, Manfredo; M., Poli; Romagnoli, Elisa; Battistini, Nino Carlo
abstract
Lifestyle change targeted towards increasing daily resting energy expenditure (REE) is one of the cornerstones of obesity treatment. Measurements of energy expenditure and substrate utilization are essential to understanding the metabolic basis of obesity, and the physiological responses to perturbations in habitual food intake. REE is the largest part of human energy expenditure (60-70%) and an increase or decrease in REE would have a large impact on total energy. Accurate and easy-to-use methods for measuring REE are needed, to be applied by clinicians in daily clinical settings to assess the validity of a new instrument to estimate REE in normal weight, healthy adults. METHODS: Ninety-nine subjects (52 females and 47 males) (mean+/-SD, age 38+/-14 years; body mass index (BMI) 23+/-3 kg/m(2)) were tested. REE was assessed using a Sensor Medics Vmax metabolic cart with a ventilated canopy and with the SenseWear armband. Body composition, percentage fat mass (%FM) and percentage fat free mass (ÿM) were assessed by skinfold thickness measurements (SF), bio-electrical impedance analysis (BIA) and air displacement plethysmography (BOD-POD). RESULTS: No significant difference was found among measurements of FFM using the three different techniques. Both SenseWear and Sensor Medics Vmax showed a high correlation, r=0.42 and r=0.40 (p<0.0001) respectively, with BMI. No significant difference was found in mean REE between SenseWear (1540+/-280 kcal/day) and Sensor Medics Vmax (1700+/-330 kcal/day) (p=ns) and the correlation between REE measured by SenseWear and Sensor Medics Vmax was high (r=0.86, p<0.0001). Bland-Altman plot showed no difference in REE determination between SenseWear and Sensor Medics Vmax. ÿM determined by BOD-POD correlated with SenseWear (r=0.42, p<0.0001) as well as Sensor Medics Vmax (r=0.38, p<0.001). CONCLUSION: SF, BIA and BOD-POD provide valid and reliable measurements of FFM. Our results suggest that the SenseWear armband is an acceptable device to accurately measure REE in healthy subjects. Its characteristics have the potential to reduce measurement times and make the SenseWear armband useful for epidemiological studies.
2007
- The invisible fat
[Articolo su rivista]
Pietrobelli, A; Malavolti, Marcella; Fuiano, N; Faith, Ms
abstract
Childhood and adolescence are decisive periods in human life. Body composition and psychological changes determine nutritional requirements as well as eating and physical activity behavior variability. Aims of the present paper are to discuss recent advances in measurements for quantifying total body and regional adiposity, and for mapping adipose tissue distribution in order to evaluate metabolic risk factors in children. Among the new methods available for assessing pediatric body composition, magnetic resonance imaging (MRI) can serve as a reference method for measuring tissue and organ volumes because estimates is reliable independent of age. MRI is the method of choice for calibrating field methods designed to measure adipose tissue and skeletal muscle in vivo and is the only method available for measurement of internal tissues and organs. MRI can be used to validate measures of important molecular level components such as fat measured by dual energy X-ray absorptiometry and bioimpedance analysis. Moreover, the large gap in available information for certain topics makes MRI measurement a dynamic and growing scientific area of body composition investigation.
2006
- Esposizione a cadmio,selenio,rame e zinco nella popolazione emiliana e pugliese
[Abstract in Atti di Convegno]
Venturelli, Marianna; Malavolti, Marcella; Trerotoli, P; Ferrari, Angela; Luisi, Mariateresa; Bussetti, Pamela; Bonvicini, Francesca; Vinceti, Marco; Battistini, Nino Carlo; Bergomi, Margherita; Serio, G; Vivoli, Gianfranco; Dugoni, Manfredo; Farinetti, Alberto
abstract
Introduzione Poche informazioni sono attualmente disponibili sulla esposizione cronica ad elementi in traccia di interesse nutrizionale e tossicologico nella popolazione italiana e sui fattori che influenzano tale esposizione. Abbiamo condotto uno studio su tale problematica in soggetti residenti in due diverse province italiane.Metodologia Abbiamo reclutato 126 soggetti su base volontaria, scelti tra i residenti nelle province di Bari e di Modena che si sono recati ai Policlinici locali nel primo semestre del 2004, per sottoporsi a visite ambulatoriali od interventi di piccola chirurgia (asportazione di cisti, medicazione post-intervento, visite proctologiche). Tra questi, 104 residenti nella provincia di Modena (65 maschi e 39 femmine) e 22 della provincia di Bari tutti di sesso maschile. Abbiamo raccolto da tali soggetti i dati relativi a peso, altezza, abitudine tabagica ed un campione di unghie dei piedi al fine di determinare le concentrazioni di Cd, Se, Cu e Zn. Le determinazioni sono state effettuate, previa digestione acida del campione, mediante spettrofotometria di assorbimento atomico a fornetto di grafite (Cd, Se, Cu) ed a fiamma (Zn). Per ottimizzare le procedure analitiche abbiamo utilizzato i campioni di riferimento della matrice biologica più simili alle unghie, owero campioni certificati di capelli umani CRM 397 e GBW 09101. L'analisi dei dati è stata condotta utilizzando il software statistico Stata (versione 9.1), mediante procedure parametri che e non-parametriche per la comparazione delle medie e l'analisi delle associazioni.Risultati Confrontando le concentrazioni osservate nei maschi modenesi e in quelli baresi, i livelli di Se sono risultati lievemente più elevati nella popolazione pugliese (0.582 ug/g vs. i 0.490 ug/g dei soggetti emiliani; p=0.02) mentre non abbiamo osservato differenze per quanto riguarda le concentrazioni degli altri elementi in traccia. Paragonando le concentrazioni degli oligoelementi tra i due sessi nella popolazione modenese, abbiamo riscontrato, nei soggetti di sesso femminile, livelli più elevati di Zn (112.20 ug/g vs 121.5 ug/g; p=0.06) e di Cd (0.023 ug/g vs 0.064 ug/g; p=0.13), mentre le concentrazioni di Se e Cu non hanno evidenziato differenze di rilievo. In riferimento alle abitudini tabagiche, nel sesso maschile i fumatori hanno evidenziato minori livelli di Cd e maggior livelli di Zn e Cu rispetto ai non fumatori, mentre le concentrazioni di Se sono risultate simili. Sempre per quanto riguarda il Se, tuttavia, le concentrazioni determinate nei non-fumatori del campione barese sono risultate più elevate (0.608 vs 0.473 ug/g dei fumatori), come atteso, di quelle riscontrate nei fumatori della medesima popolazione. Il BMI e l'età non sono risultati associati alle concentrazioni di oligoelementi sia nella popolazione complessiva presa in esame sia nei due sottogruppi identificati su base geografica, con l'unica eccezione dei livelli di Se, i quali sono risultati correlati inversamente all'età nella casistica modenese e nel totale della casistica.Conclusioni La nostra indagine è caratterizzata dall'utilizzazione di un indicatore di esposizione particolarmente adeguato a riflettere l'esposizione a medio termine ad oligoelementi, le unghie, e nel contempo da una significativa limitazione sotto il profilo metodologico, la ridotta potenza statistica. La casistica da noi esaminata è infatti numericamente assai limitata, rendendo di conseguenza difficile l'evidenziazione di associazioni di limitata entità ed un controllo adeguato dei fattori confondenti. Nelcomplesso, l'unico oligoelemento le cui concentrazioni sono risultate associate alla regione di residenza è risultato essere il Se, suggerendo livelli espositivi più elevati nelje regioni meridionali, con ogni probabilità a causa di un maggiore apporto dietetico. Il consumo di tabacco è risultato associato, come atteso, a differenze nell'esposizione a Se, Cu e Zn, mentre più d
2006
- Fattori di rischio ambientali e comportamentali del tumore alla prostata in due popolazioni italiane.
[Abstract in Atti di Convegno]
Venturelli, Marianna; Vinceti, Marco; Bergomi, Margherita; Sighinolfi, Maria Chiara; Bianchi, Giampaolo; Malavolti, Marcella; Battistini, Nino Carlo; Farinetti, Alberto; Trerotoli, P; Serio, A; Vivoli, Gianfranco
abstract
Obiettivi: Ci siamo proposti di valutare il ruolo della dieta e di alcuni elementi in traccia di interesse tossicologico e nutrizionale (cadmio, selenio, rame e zinco) nell'eziologia della neoplasia prostatica in due popolazioni italiane, quella emiliana e quella pugliese.Metodi: Abbiamo reclutato un campione di 45 pazienti affetti da neoplasia prostatica di diagnosi recente e di 68 controlli di popolazione presso i Policlinici universitari di Bari e di Modena, limitando la selezione ai soggetti di età superiore a 45 anni e residenti da almeno 10 anni nelle due province. I controlli sono stati selezionati con metodo casuale tra i soggetti afferenti alle Divisioni chirurgiche dei due ospedali per sottoporsi ad interventi di piccola chirurgia, appaiandoli per età ai pazienti (±5anni). Per la determinazione quantitativa degli oligoelementi, previo lavaggio e mineralizzazione delle unghie con HN03 in forno a microonde, abbiamo utilizzato la tecnica AAS con atomizzazione in fometto di grafite (Cd,Se,Cu) e in fiamma (Zn), utilizzando quale materiale di riferimento campioni certificati di capelli umani CRM 397 e GBW 09101. La valutazione della dieta è stata effettuata mediante la somministrazione dei questionari semiquantitativi di frequenza alimentare dello studio europeo 'EPIC'.Risultati: Abbiamo osservato nei casi, rispetto ai controlli, livelli più elevati di cadmio (0.108 vs. 0.034 ug/g) e di rame (5.07 vs. 3.78 ug/lg), mentre non abbiamo riscontrato differenze particolari per selenio e zinco. Il rischio di neoplasia prostatica non è tuttavia risultato associato a nessuno degli elementi studiati. L'analisi dei dati disaggregati sotto il profilo geografico ci ha mostrato rilevanti differenze soprattutto per quanto riguardo il cadmio. I pazienti di Bari hanno infatti evidenziato concentrazioni medie pari a 0.168 ug/g contro i 0.044 ug/g dei controlli, mentre per i soggetti modenesi abbiamo osservato rispettivamente 0.042 e 0.027 ug/g. Per quanto riguarda la dieta, il rischio di tumore pro statico è apparso direttamente associato all'apporto di alcune variabili alimentari, in particolare proteine animali, lipidi animali, acidi grassi saturi totali, alcool, calcio e vitamina D, mentre l'introduzione di proteine vegetali, carboidrati e amido è risultata inversamente corre lata col rischio di patologia.Conclusioni: I risultati di questo studio debbono essere valutati con una certa cautela a causa delle dimensioni limitate della casistica, anche se l'utilizzazione di un bioindicatore particolarmente adatto a stimare l'esposizione a medio termine, le unghie, e di un questionario alimentare completo e validato sotto il profilo epidemiologico ne favoriscono l'attendibilità. I risultati delle determinazioni effettuate sulle unghie non suggeriscono che cadmio, selenio, rame e zinco esercitino un ruolo nelI'eziopatogenesi della neoplasia prostatica. Per quanto riguarda la dieta, abbiamo individuato incrementi del rischio in associazione a variabili alimentari già corre late in studi condotti in altri Paesi a questo tipo di neoplasia, che sembrano confermare come anche in queste due popolazioni italiane, caratterizzate da sensibili differenze sul piano della dieta abituale e presumibilmente delle esposizioni ambientali, la dieta eserciti un ruolo non marginale nel determinismo di questa patologia.
2006
- Healthy status and energy balance in pediatrics
[Relazione in Atti di Convegno]
Battistini, Nino Carlo; M., Poli; Malavolti, Marcella; Dugoni, Manfredo; A., Pietrobelli
abstract
During growth, the human body increases in size and changes proportion of various components due to hormones mediators. Nutritional status is the result of introduction, absorption and utilization of the nutrients and it has a new definition in the relationship between nutritional status and healthy status. In this view energy balance, body function and body composition are three entities correlated each other. This mini-review article examines issues and techniques specifically related to a pediatric population in the field of body composition and energy expenditure. It is broadly divided into two sections. The first section discusses body composition measurements underlying principles, advantages, disadvantages and consensus. The second section reviews energy expenditure and physical activity measurement techniques. In conclusion general clinical suggestions are offered regarding pediatric body composition, healthy status and energy balance.
2005
- Accuracy of eight-polar bioelectrical impedance analysis for the assessment of total and appendicular body composition in peritoneal dialysis patients
[Articolo su rivista]
G., Medici; Mussi, Chiara; Al, Fantuzzi; Malavolti, Marcella; Albertazzi, Alberto; G., Bedogni
abstract
Objective: To establish the accuracy of bioelectrical impedance analysis (BIA) for the assessment of total and appendicular body composition in peritoneal dialysis (PD) patients. Design: Cross-sectional study. Setting: University Nephrology Clinic. Subjects: In all, 20 PD patients and 77 healthy controls matched for gender, age and body mass index. Methods: Whole-body fat-free mass (FFM) and appendicular lean tissue mass (LTM) were measured by dual-energy X-ray absorptiometry. Resistance ( R) of arms, trunk and legs was measured by eight-polar BIA at frequencies of 5, 50, 250 and 500 kHz. Whole-body resistance was calculated as the sum of R of arms, trunk and legs. The resistance index ( RI) was calculated as the ratio between squared height and whole-body or segmental R. Results: RI at 500 kHz was the best predictor of FFM, LTMarm and LTMleg in both PD patients and controls. Equations developed on controls overestimated FFM and LTMarm and underestimated LTMleg when applied to PD patients. Specific equations were thus developed for PD patients. Using these equations, the percent root mean-squared errors of the estimate for PD patients vs controls were 5 vs 6% for FFM, 8 vs 8% for LTMarm and 7 vs 8% for LTMleg. Conclusion: Eight-polar BIA offers accurate estimates of total and appendicular body composition in PD patients, provided that population-specific equations are used.
2005
- Body composition and nutritional habits in professional ballet dancers
[Articolo su rivista]
Malavolti, Marcella; M., Poli; A., Pietrobelli; Dugoni, Manfredo; Trunfio, Ornella; Battistini, Nino Carlo
abstract
Object of this study was the analysis of fat mass (FM), fat free mass (FFM) and nutritional habits in professional ballet dancers. Our secondary aim was to evaluate daily energy intake and to compare nutritional habits with level of daily recommended assumption (LARN) or recommended dietary allowance (RDA). Twelve ballet dancers (7 males and 5 females), aged between 23-42 were studied. All the subjects trained at least 5 hours per day (8±3 hours).We used four different techniques to asses body composition: skinfold thickness measurements (TH), bioimpedance analysis (BIA) air displacement pletismography (BOD-POD) and dual energy X-ray absorptiometry (DXA). The latter was considered as a criterion method. FM using DXA was 6.2±2.0 kg and FFM 56.3±12.4 kg in the total population. FM was 5.2±1.1 kg and 6.9±2.3 kg in females and males using DXA, respectively. FFM in females was 44.6±4.8 kg and 64.7±8.2 kg in males. Correlation between FM derived by skinfolds Vs FM measured by DXA was significantly higher (p = 0.90) than between FM estimated by BIA (p = 0.54) and by BOD-POD (p = 0.48). Positive correlations were found between DXA FFM measurements and FFM anthropometric (p = 0.99), between DXA FFM and FFM estimated by BIA (p = 0.98) and between FFM measured by BOD-POD (p = 0.99). Total energy intake in male subjects was less than LARN or RDA recommendation (2464±256 Vs 3100±379 cal/day). On the other hand, total energy intake in female subjects was slightly higher than LARN or RDA recommendation (2439±391 Vs 2120±130 cal/day). This was probably due to a higher energy assumption from lipids in female subjects (32±7% in males Vs 36±7% in females). Our results may suggest that FM estimated by anthropometry could be preferred to BIA in this specific population, possibly because the main part of FM in this specific population is only subcutaneous.
2005
- Body water distribution in severe obesity and its assessment from eight-polar bioelectrical impedance analysis
[Articolo su rivista]
A., Sartorio; Malavolti, Marcella; F., Agosti; P. G., Marinone; O., Caiti; Battistini, Nino Carlo; G., Bedogni
abstract
Objective: To measure body water distribution and to evaluate the accuracy of eight-polar bioelectrical impedance analysis (BIA) for the assessment of total body water (TBW) and extracellular water (ECW) in severe obesity. Design: Cross-sectional study. Setting: Obesity clinic. Subjects: In all, 75 women aged 18-66 y, 25 with body mass index (BMI) between 19.1 and 29.9 kg/m(2) (ie not obese), 25 with BMI between 30.0 and 39.9 kg/m(2) (ie class I and II obese), and 25 with BMI between 40.0 and 48.2 kg/m(2) (ie class III obese). Methods: TBW and ECW were measured by (H2O)-H-2 and Br dilution. Body resistance (R) was obtained by summing the resistances of arms, trunk and legs as measured by eight-polar BIA (InBody 3.0, Biospace, Seoul, Korea). The resistance index at a frequency of x kHz (RIx) was calculated as height 2/R-x. Results: ECW: TBW was similar in women with class III (46 +/- 3%, mean +/- s.d.) and class I-II obesity (45 +/- 3%) but higher than in nonobese women (39 +/- 3%, P < 0.05). In a random subsample of 37 subjects, RI500 explained 82% of TBW variance (P < 0.0001) and cross-validation of the obtained algorithm in the remaining 38 subjects gave a percent root mean square error (RMSE%) of 5% and a pure error (PE) of 2.1 l. In the same subjects, RI5 explained 87% of ECW variance (P < 0.0001) and cross-validation of the obtained algorithm gave a RMSE% of 8% and a PE of 1.4 l. The contribution of weight and BMI to the prediction of TBW and ECW was nil or negligible on practical grounds. Conclusions: ECW: TBW is similar in women with class I-II and class III obesity up to BMI values of 48.2 kg/m(2). Eight-polar BIA offers accurate estimates of TBW and ECW in women with a wide range of BMI (19.1-48.2 kg/m(2)) without the need of population-specific formulae.
2005
- Growth-Healthy status and active food model in pediatrics
[Articolo su rivista]
Battistini, Nino Carlo; Malavolti, Marcella; M. POLI, A. PIETROBELLI
abstract
OBJECTIVE: The brain integrates peripheral signals of nutrition in order to maintain a stable body weight. Nutritional status defined as the results of introduction, absorption, and utilization of the nutrients could be interpreted with the base of the relationship between nutritional status and healthy status. In this view, energy balance, body function, and body composition are three entities correlated to each other to the healthy status. AIM: To discuss the nutritional status in relation with healthy status, and its relationship with growth and nutrients. METHODS: A review of the available literature on food patterns and active food model was carried out. RESULTS: In the reviewed studies, strategies that could offer promising results to prevent overweight and obesity were discussed, in particular in the light of functional foods that effect energy metabolism and fat partitioning. CONCLUSION: At this moment it is necessary to proactively discuss and promote healthy eating behaviors among children at an early age and empower parents to promote children's ability to self-regulate energy intake while providing appropriate structure and boundaries around eating.
2005
- Studio caso-controllo sui rapporti tra neoplasia prostatica e elementi in traccia
[Abstract in Rivista]
Bergomi, Margherita; Venturelli, Marianna; Serio, G; Bianchi, Giampaolo; Trerotoli, G; Sighinolfi, Maria Chiara; Malavolti, Marcella; Bonvicini, Francesca; Ferrari, Angela; Farinetti, Alberto; Vinceti, Marco; Castiglia, P; Sansebastiano, G; Vivoli, Gianfranco
abstract
OBIETTIVI: Abbiamo condotto uno studio multicentrico caso-controllo al fine di valutare il ruolo di alcuni elementi in traccia di interesse tossicologico e nutrizionale (cadmio, selenio, rame e zinco) ed altri fattori ambientali e comportamentali nell’eziopatogenesi della neoplasia prostatica. La valutazionedell’esposizione a tali elementi è stata effettuata misurandone le concentrazioni nelle unghie quali bioindicatori di esposizione a medio-lungo termine.METODI: Sia i casi che i controlli, appaiati per età, sono stati reclutati dalle unità operative di Bari e Modena presso le cliniche urologiche e quelle chirurgiche dei rispettivi policlinici universitari. La determinazione degli oligoelementi è stata effettuata, previo lavaggio e mineralizzazione delle unghie con HNO3 in forno amicroonde, mediante spettrofotometria di assorbimento atomico con atomizzazione in fornetto di grafite per cadmio, selenio e rame, e in fiamma per lo zinco. RISULTATI:Nella popolazione complessiva presa in esame, abbiamo osservato livelli medi più elevati sia di cadmio che di rame nei 45 casi rispetto ai 68 controlli, mentre non abbiamo riscontrato particolari differenze per selenio e zinco. Le concentrazionimedie nelle unghie dei casi e dei controlli sono risultate rispettivamente per il cadmio pari a 0,108 e 0,068μg/g e per il rame pari a 5,07 e 3,78μg/g, mentre per lo zinco abbiamo riscontrato una media di 119.06μg/g per i casi e 111.04μg/g neicontrolli. Abbiamo successivamente effettuato il calcolo dell’OR quale stima del rischio relativo, utilizzando le concentrazioni quali variabili continue (ptrend) nonché dicotomiche (con cut-off pari alla mediana nei controlli). Nella popolazione complessiva presa in esame, l’OR è risultato pari a 2.57 (p=0.026) per il cadmio, OR=1.31 (0.548) per il selenio, OR=1.3 (p=0.529) per ilrame ed infine OR=1.81 (p=0.161) per lo zinco. L’analisi sui valori continui ha inoltre suggerito una possibile relazione tra esposizione a rame e rischio di neoplasia prostatica.L’analisi dei dati disaggregati sotto il profilo geografico ha fattoemergere rilevanti differenze soprattutto per quanto riguardo il cadmio. I pazienti di Bari hanno infatti evidenziato concentrazioni medie pari a 0.168 μg/g contro i 0.045 μg/g dei controlli, mentre per i soggetti dell’unità modenese abbiamo osservato rispettivamente 0.042 e 0.08μg/g. Il selenio ha invece evidenziatoconcentrazioni medie pari a 0.466μg/g nei casi e 0.468μg/g nei controlli a Modena, mentre i corrispondenti valori per la popolazione barese sono risultati pari a 0.627μg/g e 0.583μg/g. Le concentrazioni di rame nella popolazione baresesono risultate, rispettivamente nei casi e nei controlli, pari a 4.72 e 4.08μg/g, mentre per i soggetti modenesi abbiamo riscontrato 5.43 e 3.66μg/g. Infine le concentrazioni di zinco riscontrate nei pazienti affetti da neoplasia prostatica sono risultate pari a 116.98μg/g nei pazienti di Bari e 115.67μg/g nei relativi controlli,con corrispondenti valori nella casistica modenese pari a 121.14μg/g e108.83μg/g. Per quanto riguarda i rischi relativi di neoplasia, gli unici incrementi di un certo rilievo sono relativi alla casistica di Bari in associazione all’esposizione a cadmio (p-trend 0.054) e nella popolazione di Modena in associazione all’esposizione a rame (p-trend 0.096) e zinco (p-trend 0.092).CONCLUSIONI:I nostri risultati, considerando le limitate dimensioni del campione, sembrano supportare l’ipotesi, già avanzata da altri Autori, che l’ esposizione a cadmio può esercitare un ruolo nell’eziopatogenesi della neoplasia prostatica, mentre non sonoemerse indicazioni che suggeriscano un coinvolgimento del selenio. Per quello che riguarda il rame e lo zinco è necessario approfondire i dati attraverso un ampliamento del campione.
2003
- Comparison of bioelectrical impedance analysis and
dual-energy X-ray absorptiometry for the assessment
of appendicular body composition in anorexic women
[Articolo su rivista]
G., Bedogni; M., Marra; L., Bianchi; Malavolti, Marcella; E., Nicolai; E., De Filippo; L., Scalfi
abstract
Objective: To establish the accuracy of bioelectrical impedance analysis (BIA) for the assessment of appendicular body
composition in anorexic women.
Design: Cross-sectional study.
Setting: Outpatient University Clinic.
Subjects: A total of 39 anorexic and 25 control women with a mean (s.d.) age of 21 (3) y.
Methods: Total, arm and leg fat-free mass (FFM) were measured by dual-energy X-ray absorptiometry and predicted from total
and segmental BIA at 50 kHz. The predictor variable was the resistance index (Rl), that is, the ratio of height 2 to body resistance
for the whole body and the ratio of length2/limb resistance for the arm and leg.
Results: Predictive equations developed on controls overestimated total, arm and leg FFM in anorexics (Po0.0001). Populationspecific
equations gave a satisfactory estimate of total and appendicular FFM in anorexics (P¼NS) but had higher percent root
mean square errors (RMSEs%) as compared to those developed on controls (8% vs 5% for whole body, 12% vs 10% for arm and
10% vs 8% for leg). The accuracy of the estimate of total and leg FFM in anorexics was improved by adding body weight (Wt) as
a predictor with Rl (RMSE%¼5% vs 8% and 7% vs 10%, respectively). However, the same accuracy was obtained using Wt
alone, suggesting that in anorexics, BIA at 50 kHz is not superior to Wt for assessing total and leg FFM.
Conclusion: BIA shows some potential for the assessment of appendicular body composition in anorexic women. However, Wt
is preferable to BIA at 50 kHz on practical grounds. Further studies should consider whether frequencies 450 kHz give better
estimates of appendicular composition in anorexics as compared to Wt.
2003
- Cross-calibration of eight-polar bioelectrical impedance analysis versus dual-energy X-ray absorptiometry for the assessment of total and appendicular body composition in healthy subjects aged 21-82 years
[Articolo su rivista]
Malavolti, Marcella; Mussi, Chiara; Poli, Marco; Fantuzzi, Anna Laura; Salvioli, Gianfranco; Battistini, Nino Carlo; G., Bedogni
abstract
Aim: To calibrate eight-polar bioelectrical impedance analysis (BIA) against dual-energy X-ray absorptiometry (DXA) for the assessment of total and appendicular body composition in healthy adults.Research design: A cross-sectional study was carried out.Subjects: Sixty-eight females and 42 males aged 21-82 years participated in the study.Methods: Whole-body fat-free mass (FFM) and appendicular lean tissue mass (LTM) were measured by DXA; resistance (R) of arms, trunk and legs was measured by eight-polar BIA at frequencies of 5, 50, 250 and 500 kHz; whole-body resistance was calculated as the sum R of arms, trunk and legs.Results: The resistance index (RI), i.e. the height(2)/resistance ratio, was the best predictor of FFM and appendicular LTM. As compared with weight (Wt), RI at 500 kHz explained 35% more variance of FFM (R-adj(2) =0.92 vs 0.57), 45% more variance of LTMarm (R-adj(2) = 0.93 vs 0.48) and 36% more variance of LTleg (R-adj(2) = 0.86 vs 0.50) (p < 0.001 for all). The contribution of age to the unexplained variance of FFM and appendicular LTM was nil or negligible and the RI x sex interactions were either not significant or not important on practical grounds. The percent root mean square error of the estimate was 6% for FFM and 8% for LTMarm and LTMleg.Conclusion: Eight-polar BIA offers accurate estimates of total and appendicular body composition. The attractive hypothesis that eight-polar BIA is influenced minimally by age and sex should be tested on larger samples including younger individuals.
2003
- Sensitivity and specificity of body mass index and skinfold thicknesses in detecting excess adiposity in children aged 8-12 years
[Articolo su rivista]
Bedogni, G; Iughetti, Lorenzo; Ferrari, M; Poli, M; Bernasconi, S; Battistini, Nino Carlo; Malavolti, Marcella
abstract
Primary objective: The study aimed to evaluate the sensitivity (SN) and specificity (SP) of body mass index (BMI) and skinfold thicknesses in detecting excess adiposity in children. Research design: Cross-sectional. Materials and methods: 986 children (500 females and 486 males) aged 10 +/- 1 years (mean +/- SD; range: 8-12 years) were studied. All underwent anthropometric measurements and bioelectrical impedance analysis (BIA). Dual-energy X-ray absorptiometry (DXA) was performed in 52 children to develop a population-specific algorithm for the assessment of fat-free mass (FFM) from BIA. The algorithm was applied to the remaining 934 children to estimate their FFM. Fat mass (FM) was obtained by subtracting FFM from weight (Wt). Values of FM:Wt were transformed in Z-scores and converted into 19 percentile categories (from 5 to 95 in steps of 5). The same procedure was performed with BMI and the log-transformed sum of four skinfold thicknesses (triceps, biceps, subscapular and suprailiac; lt-4SF). Excess adiposity was defined as a level of FM:Wt greater than the internally derived 85th percentile. SN and SP of each internally derived percentile of BMI and lt-4SF in detecting excess adiposity were calculated. Results: In the pooled sample (n = 934), SN and SP were 0.39 and 0.99 for the 95th percentile of BMI, 0.65 and 0.95 for the 85th percentile of BMI, and 0.75 and 0.94 for the 85th percentile of lt-4SF. Conclusions: BMI percentiles employed in the present study have a high SP but a low SN in detecting excess adiposity in 8-12-year-old children. The use of the sum of four skinfolds has the potential to increase the SN of a screening programme for excess adiposity in children of this age.
2002
- Accuracy of an eight-point tactile-electrode impedance method in the assessment of total body water
[Articolo su rivista]
Bedogni, G.; Malavolti, Marcella; Severi, S.; Poli, M.; Mussi, Chiara; Fantuzzi, A. L.; Battistini, Nino Carlo
abstract
OBJECTIVE: To establish the accuracy of an eight-polar tactile-electrode impedance method in the assessment of total body water (TBW). DESIGN: Transversal study. SETTING: University department. SUBJECTS: Fifty healthy subjects (25 men and 25 women) with a mean (s.d.) age of 40 (12) y. METHODS: TBW measured by deuterium oxide dilution; resistance (R) of arms, trunk and legs measured at frequencies of 5, 50, 250 and 500 kHz with an eight-polar tactile-electrode impedance-meter (InBody 3.0, Biospace, Seoul, Korea). RESULTS: An algorithm for the prediction of TBW from the whole-body resistance index at 500 kHz (height (2)/R(500) where R is the sum of the segmental resistances of arms, trunk and legs) was developed in a randomly chosen subsample of 35 subjects. This algorithm had an adjusted coefficient of determination (r2(adj)) of 0.81 (P<0.0001) and a root mean square error (RMSE) of 3.6 l (9%). Cross-validation of the predictive algorithm in the remaining 15 subjects gave an r2(adj) of 0.87 (P<0.0001) and an RMSE of 3.0 l (8%). The precision of eight-polar BIA, determined by measuring R three times a day for five consecutive days in a fasting subject, was < or =2.8% for all segments and frequencies. CONCLUSION: Eight-polar BIA is a precise method that offers accurate estimates of TBW in healthy subjects. This promising method should undergo further studies of precision and its accuracy in assessing extracellular water and appendicular body composition should be determined. SPONSORSHIP: Modena and Reggio Emilia University.
2002
- Association of waist circumference and body mass
index with fasting blood insulin in severely obese
children: A cross-sectional study
[Articolo su rivista]
G., Bedogni; Iughetti, Lorenzo; M., Ferrari; Malavolti, Marcella; M., De Simone; G., Fiori; Battistini, Nino Carlo; S., Bemasconi
abstract
We tested whether body mass index (BMI) and waist circumference (WC) are associated
with fasting insulin in severely obese children. A number of 391 (204 female and 187 male) obese
children were consecutively enrolled in the study at a Paediatric outpatient clinic. They were aged
10±3 yr (mean±SD; range: 3-17 yr) and had a relative weight for age of 160±27% (mean±SD). BMI
and WC explained respectively 9 and 13% of the variance of log-transformed (It) insulin (p<O.OOOI
for both). After correction for age, however, BMI lost its association with It-insulin (p=NS) and WC
explained only 3% (p<0.001) of It-insulin variance. Sex and pubertal status did not influence the relationship
between WC, BMI and It-insulin (p=NS, ANCOVA). We conclude that in severely obese
children: 1) WC is a marginaUy better predictor of fasting blood insulin than BMI, 2) age has a substantial
influence on the relationship between BMI, WC and insulin and, 3) the contribution of BMI
and WC to insulin is of doubtful clinical relevance because it leaves a substantial portion (~87%) of It-insulin variance unexplained
2002
- Relationship between body composition and bone mineral content in young and elderly women.
[Articolo su rivista]
Bedogni, G.; Mussi, Chiara; Malavolti, Marcella; Borghi, Athos; Poli, M.; Battistini, Nino Carlo; Salvioli, Gianfranco
abstract
PRIMARY OBJECTIVE: To study the relationship between bone mineral content (BMC), lean tissue mass (LTM) and fat mass (FM) in a large sample of young and elderly women. RESEARCH DESIGN: Cross-sectional. METHODS AND PROCEDURES: BMC, LTM and FM were measured by dual-energy X-ray absorptiometry in 2009 free-dwelling Caucasian women aged 63 +/- 7 years (mean +/- SD; range: 37-88 years). The majority of women were postmenopausal (96%). RESULTS: LTM explained 13% more variance of BMC than FM (R(2)(adj) = 0.39 vs 0.26, p < 0.0001) but weight (Wt) explained 5% more variance of BMC than LTM (R(2)(adj) = 0.44, p < 0.0001). The prediction of BMC obtained from LTM and FM (R(2)(adj)= 0.46, p < 0.0001) was only slightly better than that obtained from Wt. After the effects of age, Wt and height (Ht) on BMC were taken into account by multiple regression, the contribution of LTM and FM to BMC was just one-fifth of that of Wt (R(2)(adj) for full models < or =0.56, p < 0.0001). After a further correction for bone area (BA), the contribution of LTM and FM to BMC was just one-tenth of that of BA and not different from that of Wt and Ht on practical grounds (R(2)(adj) for full models = 0.84, p < 0.0001). Thus, after inter-individual differences in age, Wt, Ht (and bone size) are taken into account, the relationship between body composition and BMC is substantially weakened. CONCLUSIONS: In Caucasian women, (1) LTM is a stronger predictor of BMC than FM, but (2) Wt is a better predictor of BMC than body composition for practical purposes, and (3) Wt and body composition are not able to explain more than 46% of BMC variance.
2001
- Some applications of indirect calorimetry to sports medicine
[Articolo su rivista]
Severi, S; Malavolti, Marcella; Battistini, Nino Carlo; Bedogni, G.
abstract
Some applications of indirect calorimetry to sports medicine are discussed and exemplified by case reports. In particular, it is suggested that oxigen consumption can be employed to assess the effects of physical activity on fat-free tissues and that the respiratory quotient may offer some insights into the food habits of athletes.