Gennaro Clemente - Academia.edu (original) (raw)

Papers by Gennaro Clemente

Research paper thumbnail of An integrated care pathway for cancer patients with diabetes: A proposal from the Italian experience

Diabetes Research and Clinical Practice

Research paper thumbnail of The DiaCoVAb Study in South Italy: Immune Response to SARS-CoV-2 Vaccination in Dialysis Patients

Kidney and Blood Pressure Research, 2022

Introduction: Since the pandemic of COVID-19 started from December 2019, remarkable numbers of in... more Introduction: Since the pandemic of COVID-19 started from December 2019, remarkable numbers of infections and deaths associated with COVID-19 have been recorded worldwide. End-stage kidney disease patients on dialysis are particularly at high risk of infections due to impairments in the innate and adaptive immune systems. Vaccination on dialysis patients (DP) still remains challenging because of the variable response and a low seroconversion rate compared with healthy participants (HP). Therefore, it is urgently necessary to establish a different vaccination strategy for DP, in terms of the dose and administration time. Methods: Here, we report an observational prospective cohort study in which the immunogenic efficacies of SARS-CoV-2 vaccine BNT162b2 on DP and HP were evaluated by absolute quantification of IgG levels in the blood. Results: DP showed a delayed seroconversion after two vaccine doses, with a low absolute IgG levels compared to HP. While HP reached complete seroconver...

Research paper thumbnail of Polyphenol intake and cardiovascular risk factors in a population with type 2 diabetes: The TOSCA.IT study

Clinical Nutrition, 2016

Background: The role of polyphenol intake on cardiovascular risk factors is little explored, part... more Background: The role of polyphenol intake on cardiovascular risk factors is little explored, particularly in people with diabetes. Aim: To evaluate the association between the intake of total polyphenols and polyphenol classes with the major cardiovascular risk factors in a population with type 2 diabetes.

Research paper thumbnail of Influence of dietary fat and carbohydrates proportions on plasma lipids, glucose control and low-grade inflammation in patients with type 2 diabetes—The TOSCA.IT Study

European Journal of Nutrition, 2015

of the diet-within the ranges recommended by different guidelines-with metabolic risk factors. Me... more of the diet-within the ranges recommended by different guidelines-with metabolic risk factors. Methods We studied 1785 people with type 2 diabetes, aged 50-75, enrolled in the TOSCA.IT Study. Dietary habits were assessed using a validated food-frequency questionnaire (EPIC). Anthropometry, fasting lipids, HbA1c and C-reactive protein (CRP) were measured. Results Increasing fat intake from <25 to ≥35 % is associated with a significant increase in LDL-cholesterol, triglycerides, HbA1c and CRP (p < 0.05). Increasing carbohydrates intake from <45 to ≥60 % is associated with significantly lower triglycerides, HbA1c and

Research paper thumbnail of Unexplained Hypoglycaemia and Large Glycaemic Variability: Skin Lipohypertrophy as a Predictive Sign

Diabetes Research - Open Journal, 2016

Strollo F, Guarino G, Armentano V, et al on behalf of AMD-OSDI Italian Study Group on Injection T... more Strollo F, Guarino G, Armentano V, et al on behalf of AMD-OSDI Italian Study Group on Injection Techniques. Unexplained hypoglycaemia and large glycaemic variability: Skin lipohypertrophy as a predictive sign.

Research paper thumbnail of Effects of a multifactorial ecosustainable isocaloric diet on liver fat in patients with type 2 diabetes: randomized clinical trial

BMJ Open Diabetes Research & Care

IntroductionTreatment options for non-alcoholic fatty liver disease (NAFLD) in patients with type... more IntroductionTreatment options for non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes (T2D) are still a matter of debate. We compared the effects of a diet including different components versus a proven beneficial diet rich in monounsaturated fatty acids (MUFAs) on liver fat in T2D.Research design and methodsAccording to a parallel design, 49 individuals with T2D, overweight/obese, with high waist circumference, 35–75 years-old, in satisfactory blood glucose control with diet or drugs not affecting liver fat content, were randomly assigned to an 8-week isocaloric intervention with a MUFA diet (n=26) or a multifactorial diet rich in fiber, MUFA, n-6 and n-3 polyunsaturated fatty acids, polyphenols, and vitamins D, E, and C (n=23). Before and after the intervention, liver fat content was evaluated by proton magnetic resonance spectroscopy (1H-MRS). 1H-MRS complete data were available for n=21 (MUFA diet) and n=18 (multifactorial diet) participants.ResultsAdheren...

Research paper thumbnail of Pasta Consumption and Connected Dietary Habits: Associations with Glucose Control, Adiposity Measures, and Cardiovascular Risk Factors in People with Type 2 Diabetes—TOSCA.IT Study

Nutrients

Background: Pasta is a refined carbohydrate with a low glycemic index. Whether pasta shares the m... more Background: Pasta is a refined carbohydrate with a low glycemic index. Whether pasta shares the metabolic advantages of other low glycemic index foods has not really been investigated. The aim of this study is to document, in people with type-2 diabetes, the consumption of pasta, the connected dietary habits, and the association with glucose control, measures of adiposity, and major cardiovascular risk factors. Methods: We studied 2562 participants. The dietary habits were assessed with the European Prospective Investigation into Cancer and Nutrition (EPIC) questionnaire. Sex-specific quartiles of pasta consumption were created in order to explore the study aims. Results: A higher pasta consumption was associated with a lower intake of proteins, total and saturated fat, cholesterol, added sugar, and fiber. Glucose control, body mass index, prevalence of obesity, and visceral obesity were not significantly different across the quartiles of pasta intake. No relation was found with LDL...

Research paper thumbnail of An integrated care pathway for cancer patients with diabetes: A proposal from the Italian experience

Diabetes Research and Clinical Practice

Research paper thumbnail of Diabetologists and Oncologists attitudes towards treating diabetes in the oncologic patient: Insights from an exploratory survey

Diabetes research and clinical practice, Jan 26, 2018

Diabetes and cancer frequently coexist in the same subject, often having relevant effects on the ... more Diabetes and cancer frequently coexist in the same subject, often having relevant effects on the management and prognosis of the oncologic patient. However, existing guidelines do not deal with many clinical issues in this setting appropriately. In evaluating the opinions of Diabetologists and Oncologists dealing with diabetes care in people with cancer, the Italian Association of Diabetologists (AMD) promoted a dedicated exploratory survey. The survey was carried out through the web or handily delivered printed copies between October 2014 and April 2015, in Italy. It was composed of 27 questions intended to gather information on the characteristics of participants and to examine their clinical habits in this context, and participation was totally free and anonymous. A total of 252 physicians participated in the survey. Diabetologists accounted for 51.1% of respondents. According to survey results, in spite of the presence of diabetes (or diabetic complications) worsening the outcom...

Research paper thumbnail of Effects on the incidence of cardiovascular events of the addition of pioglitazone versus sulfonylureas in patients with type 2 diabetes inadequately controlled with metformin (TOSCA.IT): a randomised, multicentre trial

The Lancet Diabetes & Endocrinology

Research paper thumbnail of Visceral adiposity and subclinical atherosclerosis in healthy young men

International Journal of Food Sciences and Nutrition, May 28, 2015

Atherosclerosis begins in childhood and develops silently for decades before clinical events such... more Atherosclerosis begins in childhood and develops silently for decades before clinical events such as myocardial infarction or stroke occur. Only few studies have evaluated the relationship between CVD risk factors and carotid artery Intimal Media Thickness (IMT) in young asymptomatic people. The aim of this study is to investigate risk factors for cardiovascular disease associated with higher Carotid Intimal Media Thickness (IMT) in healthy young subjects. A cohort of 106 healthy young men, mean age 21 ± 2 years (mean ± SD), BMI 24.4 ± 2.8 (kg/m(2)), on military duty, participated in this cross-sectional study. Waist circumference, carotid intima-media thickness (IMT), blood pressure, and plasma concentrations of relevant metabolic parameters were measured at fasting. Smoking and habitual dietary patterns were evaluated by a semiquantitative questionnaire. The population was divided into two groups on the basis of IMT values: the lowest three quartiles versus the highest quartile (cut-off value = 0.7 mm). BMI, waist circumference, systolic (SBP), and diastolic (DBP) blood pressure were significantly higher in the group with higher IMT (p = 0.02). All other variables, including dietary parameters and smoking, were similar in the two groups. Data analysis showed that IMT values correlated positively with SBP (r = 0.22; p = 0.025), DBP (r = 0.27; p = 0.005), waist circumference (r = 0.29; p = 0.002), and fat mass (r = 0.24; p = 0.01), and negatively with kcal/kg of body weight (r = -0.220.22; p = 0.022) - an indirect marker of physical activity. Based on multiple regression analysis, waist circumference and DBP were the only variables independently associated with IMT (p = 0.029). In a non-selected sample of healthy young adult males, a larger waist circumference and a higher diastolic blood pressure - albeit within normal values - are the only parameters independently associated with higher IMT.

Research paper thumbnail of Sex differences in food choices, adherence to dietary recommendations and plasma lipid profile in type 2 diabetes – The TOSCA.IT Study

Nutrition, Metabolism and Cardiovascular Diseases, 2016

Research paper thumbnail of Diabetology and oncology meet in a network model: union is strength

Acta Diabetologica, 2016

Diabetes and cancer are increasingly common conditions, and the management of cancer patients wit... more Diabetes and cancer are increasingly common conditions, and the management of cancer patients with diabetes is often challenging. Diabetes in cancer patients poses several complex clinical issues, including which treatment is suitable to control hyperglycemia, how to better counteract glucocorticoid-induced hyperglycemia, and how to manage nutritional problems of cachectic patients and glucose variability linked to artificial nutrition. A key aspect to consider is the patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; position on the trajectory of the oncologic disease, both to establish which level of glycemic control should be pursued and to decide the most suitable antidiabetic treatment to recommend. Endocrinologists are rarely involved in the management of patients with advanced cancer. Furthermore, lack of guidelines results in a &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;trial-and-error&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; approach, often with suboptimal disease management. Lastly, cancer survivors represent a frequently underestimated category of patients at higher cardiometabolic risk. A practical solution for these challenges lies in the implementation of care networks based on a close partnership and ongoing communication between oncologists, endocrinologists, and nutritionists, placing the patient at the center of the care process. At the same time, universities and scientific societies should play a key role in promoting research into areas of intersection of oncology and endocrinology, in raising awareness of common possibilities of primary and secondary prevention of metabolic and oncologic diseases, as well as specific challenges of managing diabetes and cancer, and proper training of health workers, while also supporting the shared implementation of effective management strategies.

Research paper thumbnail of Visceral adiposity and subclinical atherosclerosis in healthy young men

International Journal of Food Sciences and Nutrition, 2015

Atherosclerosis begins in childhood and develops silently for decades before clinical events such... more Atherosclerosis begins in childhood and develops silently for decades before clinical events such as myocardial infarction or stroke occur. Only few studies have evaluated the relationship between CVD risk factors and carotid artery Intimal Media Thickness (IMT) in young asymptomatic people. The aim of this study is to investigate risk factors for cardiovascular disease associated with higher Carotid Intimal Media Thickness (IMT) in healthy young subjects. A cohort of 106 healthy young men, mean age 21 ± 2 years (mean ± SD), BMI 24.4 ± 2.8 (kg/m(2)), on military duty, participated in this cross-sectional study. Waist circumference, carotid intima-media thickness (IMT), blood pressure, and plasma concentrations of relevant metabolic parameters were measured at fasting. Smoking and habitual dietary patterns were evaluated by a semiquantitative questionnaire. The population was divided into two groups on the basis of IMT values: the lowest three quartiles versus the highest quartile (cut-off value = 0.7 mm). BMI, waist circumference, systolic (SBP), and diastolic (DBP) blood pressure were significantly higher in the group with higher IMT (p = 0.02). All other variables, including dietary parameters and smoking, were similar in the two groups. Data analysis showed that IMT values correlated positively with SBP (r = 0.22; p = 0.025), DBP (r = 0.27; p = 0.005), waist circumference (r = 0.29; p = 0.002), and fat mass (r = 0.24; p = 0.01), and negatively with kcal/kg of body weight (r = -0.220.22; p = 0.022) - an indirect marker of physical activity. Based on multiple regression analysis, waist circumference and DBP were the only variables independently associated with IMT (p = 0.029). In a non-selected sample of healthy young adult males, a larger waist circumference and a higher diastolic blood pressure - albeit within normal values - are the only parameters independently associated with higher IMT.

Research paper thumbnail of Insulin sensitivity is increased and fat oxidation after a high-fat meal is reduced in normal-weight healthy men with strong familial predisposition to overweight

International Journal of Obesity, 2003

Research paper thumbnail of Glycemic Index of Local Foods and Diets: The Mediterranean Experience

Research paper thumbnail of Effects of different dairy products on postprandial lipemia

Nutrition, Metabolism and Cardiovascular Diseases, 2003

To evaluate the effects on postprandial lipemia (PPL), of three fat rich meals, with similar comp... more To evaluate the effects on postprandial lipemia (PPL), of three fat rich meals, with similar composition but different physical structure (liquid, semisolid and solid). Eight type 2 diabetic patients of both genders (6M/2F), age 51+/-9 yrs (M+/-SD), BMI 29+/-3 kg/m2, with fasting plasma glucose levels 145+/-24 mg/dL, cholesterol 200+/-38 mg/dL and triglyceride 110+/-45 mg/dL. Participants consumed in the morning, after a 12-hour fast and at 1-week intervals, three test meals with similar volume and composition [protein 36 g, lipid 30 g, carbohydrate 115 g, energy 3556 kJ (850 Kcal)] but with the main source of fat represented by foods with different physical structure (milk, mozzarella-cheese, butter). Each patient underwent gastric emptying measurements by echography; plasma FFA, triglycerides, glucose and insulin were evaluated at baseline and every hour for six hours after each meal. Fasting plasma glucose, cholesterol and triglyceride concentrations were similar at the baseline of the three test meals. Average increases in postprandial plasma triglyceride levels after butter (88+/-8 mg/dL) and mozzarella-cheese (104+/-56 mg/dL) were not different than after milk (98+/-53 mg/dL). The plasma triglyceride peak was also similar after the three test meals but peak time after butter (315+/-42 min; p&lt;0.01) and mozzarella-cheese (277+/-31 min; p&lt;0.02) was significantly delayed compared to milk (225+/-28 min). Gastric emptying rate was similar after butter and milk (14+/-2, 13+/-6 mL/h) and significantly faster after mozzarella-cheese (18+/-5 mL/h; p&lt;0.03). While the physical structure of fat-rich foods has no major effect on postprandial plasma triglyceride concentrations, it is able to influence the timing of triglyceride peak; gastric emptying time does not play a major role in modulating the postprandial response of triglycerides and glucose.

Research paper thumbnail of Effects of the regular consumption of wholemeal wheat foods on cardiovascular risk factors in healthy people

Nutrition, Metabolism and Cardiovascular Diseases, 2010

The intake of wholemeal foods is consistently associated with reduced risk of type 2 diabetes and... more The intake of wholemeal foods is consistently associated with reduced risk of type 2 diabetes and cardiovascular diseases in epidemiological studies, although the mechanisms of this association are unclear. Here we aim to compare in healthy subjects the metabolic effects of a diet rich in wholemeal wheat foods versus one based on the same products in refined form. Fifteen healthy individuals (12 M/3 F), mean age 54.5+/-7.6 years, BMI 27.4+/-3.0 kg/m(2) (mean+/-SD), participated in a randomized sequential crossover study. After 2 weeks run-in, participants were randomly assigned to two isoenergetic diets with similar macronutrient composition, one rich in wholemeal wheat foods and the other with the same foods but in refined form (cereal fibre 23.1 vs. 9.8 g/day). After the two treatment periods (each lasting 3 weeks) plasma glucose and lipid metabolism, antioxidant activity, acetic acid, magnesium, adipokines, incretins and high-sensitivity C-reactive protein (hs-CRP) were measured at fasting and for 4h after a standard test meal (kcal 1103, protein 12%, CHO 53%, fat 35%) based on wholemeal or refined wheat foods, respectively. After the two diets there were no differences in fasting nor in postprandial plasma parameter responses; only glucose was slightly but significantly lower at 240 min after the refined wheat food meal compared to the wholemeal wheat food meal. Conversely, after the wholemeal diet both total (-4.3%; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.03) and LDL (-4.9%; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.04) cholesterol levels were lower than after the refined wheat diet at fasting. Consumption of wholemeal wheat foods for 3 weeks reduces significantly fasting plasma cholesterol as well as LDL cholesterol levels in healthy individuals without major effects on glucose and insulin metabolism, antioxidant status and sub-clinical inflammation markers.

Research paper thumbnail of Dietary fibre in treatment of diabetes: myth or reality?

Digestive and Liver Disease, 2002

Research paper thumbnail of Effects of short-chain fructooligosaccharides on satiety responses in healthy men and women

Research paper thumbnail of An integrated care pathway for cancer patients with diabetes: A proposal from the Italian experience

Diabetes Research and Clinical Practice

Research paper thumbnail of The DiaCoVAb Study in South Italy: Immune Response to SARS-CoV-2 Vaccination in Dialysis Patients

Kidney and Blood Pressure Research, 2022

Introduction: Since the pandemic of COVID-19 started from December 2019, remarkable numbers of in... more Introduction: Since the pandemic of COVID-19 started from December 2019, remarkable numbers of infections and deaths associated with COVID-19 have been recorded worldwide. End-stage kidney disease patients on dialysis are particularly at high risk of infections due to impairments in the innate and adaptive immune systems. Vaccination on dialysis patients (DP) still remains challenging because of the variable response and a low seroconversion rate compared with healthy participants (HP). Therefore, it is urgently necessary to establish a different vaccination strategy for DP, in terms of the dose and administration time. Methods: Here, we report an observational prospective cohort study in which the immunogenic efficacies of SARS-CoV-2 vaccine BNT162b2 on DP and HP were evaluated by absolute quantification of IgG levels in the blood. Results: DP showed a delayed seroconversion after two vaccine doses, with a low absolute IgG levels compared to HP. While HP reached complete seroconver...

Research paper thumbnail of Polyphenol intake and cardiovascular risk factors in a population with type 2 diabetes: The TOSCA.IT study

Clinical Nutrition, 2016

Background: The role of polyphenol intake on cardiovascular risk factors is little explored, part... more Background: The role of polyphenol intake on cardiovascular risk factors is little explored, particularly in people with diabetes. Aim: To evaluate the association between the intake of total polyphenols and polyphenol classes with the major cardiovascular risk factors in a population with type 2 diabetes.

Research paper thumbnail of Influence of dietary fat and carbohydrates proportions on plasma lipids, glucose control and low-grade inflammation in patients with type 2 diabetes—The TOSCA.IT Study

European Journal of Nutrition, 2015

of the diet-within the ranges recommended by different guidelines-with metabolic risk factors. Me... more of the diet-within the ranges recommended by different guidelines-with metabolic risk factors. Methods We studied 1785 people with type 2 diabetes, aged 50-75, enrolled in the TOSCA.IT Study. Dietary habits were assessed using a validated food-frequency questionnaire (EPIC). Anthropometry, fasting lipids, HbA1c and C-reactive protein (CRP) were measured. Results Increasing fat intake from <25 to ≥35 % is associated with a significant increase in LDL-cholesterol, triglycerides, HbA1c and CRP (p < 0.05). Increasing carbohydrates intake from <45 to ≥60 % is associated with significantly lower triglycerides, HbA1c and

Research paper thumbnail of Unexplained Hypoglycaemia and Large Glycaemic Variability: Skin Lipohypertrophy as a Predictive Sign

Diabetes Research - Open Journal, 2016

Strollo F, Guarino G, Armentano V, et al on behalf of AMD-OSDI Italian Study Group on Injection T... more Strollo F, Guarino G, Armentano V, et al on behalf of AMD-OSDI Italian Study Group on Injection Techniques. Unexplained hypoglycaemia and large glycaemic variability: Skin lipohypertrophy as a predictive sign.

Research paper thumbnail of Effects of a multifactorial ecosustainable isocaloric diet on liver fat in patients with type 2 diabetes: randomized clinical trial

BMJ Open Diabetes Research & Care

IntroductionTreatment options for non-alcoholic fatty liver disease (NAFLD) in patients with type... more IntroductionTreatment options for non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes (T2D) are still a matter of debate. We compared the effects of a diet including different components versus a proven beneficial diet rich in monounsaturated fatty acids (MUFAs) on liver fat in T2D.Research design and methodsAccording to a parallel design, 49 individuals with T2D, overweight/obese, with high waist circumference, 35–75 years-old, in satisfactory blood glucose control with diet or drugs not affecting liver fat content, were randomly assigned to an 8-week isocaloric intervention with a MUFA diet (n=26) or a multifactorial diet rich in fiber, MUFA, n-6 and n-3 polyunsaturated fatty acids, polyphenols, and vitamins D, E, and C (n=23). Before and after the intervention, liver fat content was evaluated by proton magnetic resonance spectroscopy (1H-MRS). 1H-MRS complete data were available for n=21 (MUFA diet) and n=18 (multifactorial diet) participants.ResultsAdheren...

Research paper thumbnail of Pasta Consumption and Connected Dietary Habits: Associations with Glucose Control, Adiposity Measures, and Cardiovascular Risk Factors in People with Type 2 Diabetes—TOSCA.IT Study

Nutrients

Background: Pasta is a refined carbohydrate with a low glycemic index. Whether pasta shares the m... more Background: Pasta is a refined carbohydrate with a low glycemic index. Whether pasta shares the metabolic advantages of other low glycemic index foods has not really been investigated. The aim of this study is to document, in people with type-2 diabetes, the consumption of pasta, the connected dietary habits, and the association with glucose control, measures of adiposity, and major cardiovascular risk factors. Methods: We studied 2562 participants. The dietary habits were assessed with the European Prospective Investigation into Cancer and Nutrition (EPIC) questionnaire. Sex-specific quartiles of pasta consumption were created in order to explore the study aims. Results: A higher pasta consumption was associated with a lower intake of proteins, total and saturated fat, cholesterol, added sugar, and fiber. Glucose control, body mass index, prevalence of obesity, and visceral obesity were not significantly different across the quartiles of pasta intake. No relation was found with LDL...

Research paper thumbnail of An integrated care pathway for cancer patients with diabetes: A proposal from the Italian experience

Diabetes Research and Clinical Practice

Research paper thumbnail of Diabetologists and Oncologists attitudes towards treating diabetes in the oncologic patient: Insights from an exploratory survey

Diabetes research and clinical practice, Jan 26, 2018

Diabetes and cancer frequently coexist in the same subject, often having relevant effects on the ... more Diabetes and cancer frequently coexist in the same subject, often having relevant effects on the management and prognosis of the oncologic patient. However, existing guidelines do not deal with many clinical issues in this setting appropriately. In evaluating the opinions of Diabetologists and Oncologists dealing with diabetes care in people with cancer, the Italian Association of Diabetologists (AMD) promoted a dedicated exploratory survey. The survey was carried out through the web or handily delivered printed copies between October 2014 and April 2015, in Italy. It was composed of 27 questions intended to gather information on the characteristics of participants and to examine their clinical habits in this context, and participation was totally free and anonymous. A total of 252 physicians participated in the survey. Diabetologists accounted for 51.1% of respondents. According to survey results, in spite of the presence of diabetes (or diabetic complications) worsening the outcom...

Research paper thumbnail of Effects on the incidence of cardiovascular events of the addition of pioglitazone versus sulfonylureas in patients with type 2 diabetes inadequately controlled with metformin (TOSCA.IT): a randomised, multicentre trial

The Lancet Diabetes & Endocrinology

Research paper thumbnail of Visceral adiposity and subclinical atherosclerosis in healthy young men

International Journal of Food Sciences and Nutrition, May 28, 2015

Atherosclerosis begins in childhood and develops silently for decades before clinical events such... more Atherosclerosis begins in childhood and develops silently for decades before clinical events such as myocardial infarction or stroke occur. Only few studies have evaluated the relationship between CVD risk factors and carotid artery Intimal Media Thickness (IMT) in young asymptomatic people. The aim of this study is to investigate risk factors for cardiovascular disease associated with higher Carotid Intimal Media Thickness (IMT) in healthy young subjects. A cohort of 106 healthy young men, mean age 21 ± 2 years (mean ± SD), BMI 24.4 ± 2.8 (kg/m(2)), on military duty, participated in this cross-sectional study. Waist circumference, carotid intima-media thickness (IMT), blood pressure, and plasma concentrations of relevant metabolic parameters were measured at fasting. Smoking and habitual dietary patterns were evaluated by a semiquantitative questionnaire. The population was divided into two groups on the basis of IMT values: the lowest three quartiles versus the highest quartile (cut-off value = 0.7 mm). BMI, waist circumference, systolic (SBP), and diastolic (DBP) blood pressure were significantly higher in the group with higher IMT (p = 0.02). All other variables, including dietary parameters and smoking, were similar in the two groups. Data analysis showed that IMT values correlated positively with SBP (r = 0.22; p = 0.025), DBP (r = 0.27; p = 0.005), waist circumference (r = 0.29; p = 0.002), and fat mass (r = 0.24; p = 0.01), and negatively with kcal/kg of body weight (r = -0.220.22; p = 0.022) - an indirect marker of physical activity. Based on multiple regression analysis, waist circumference and DBP were the only variables independently associated with IMT (p = 0.029). In a non-selected sample of healthy young adult males, a larger waist circumference and a higher diastolic blood pressure - albeit within normal values - are the only parameters independently associated with higher IMT.

Research paper thumbnail of Sex differences in food choices, adherence to dietary recommendations and plasma lipid profile in type 2 diabetes – The TOSCA.IT Study

Nutrition, Metabolism and Cardiovascular Diseases, 2016

Research paper thumbnail of Diabetology and oncology meet in a network model: union is strength

Acta Diabetologica, 2016

Diabetes and cancer are increasingly common conditions, and the management of cancer patients wit... more Diabetes and cancer are increasingly common conditions, and the management of cancer patients with diabetes is often challenging. Diabetes in cancer patients poses several complex clinical issues, including which treatment is suitable to control hyperglycemia, how to better counteract glucocorticoid-induced hyperglycemia, and how to manage nutritional problems of cachectic patients and glucose variability linked to artificial nutrition. A key aspect to consider is the patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; position on the trajectory of the oncologic disease, both to establish which level of glycemic control should be pursued and to decide the most suitable antidiabetic treatment to recommend. Endocrinologists are rarely involved in the management of patients with advanced cancer. Furthermore, lack of guidelines results in a &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;trial-and-error&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; approach, often with suboptimal disease management. Lastly, cancer survivors represent a frequently underestimated category of patients at higher cardiometabolic risk. A practical solution for these challenges lies in the implementation of care networks based on a close partnership and ongoing communication between oncologists, endocrinologists, and nutritionists, placing the patient at the center of the care process. At the same time, universities and scientific societies should play a key role in promoting research into areas of intersection of oncology and endocrinology, in raising awareness of common possibilities of primary and secondary prevention of metabolic and oncologic diseases, as well as specific challenges of managing diabetes and cancer, and proper training of health workers, while also supporting the shared implementation of effective management strategies.

Research paper thumbnail of Visceral adiposity and subclinical atherosclerosis in healthy young men

International Journal of Food Sciences and Nutrition, 2015

Atherosclerosis begins in childhood and develops silently for decades before clinical events such... more Atherosclerosis begins in childhood and develops silently for decades before clinical events such as myocardial infarction or stroke occur. Only few studies have evaluated the relationship between CVD risk factors and carotid artery Intimal Media Thickness (IMT) in young asymptomatic people. The aim of this study is to investigate risk factors for cardiovascular disease associated with higher Carotid Intimal Media Thickness (IMT) in healthy young subjects. A cohort of 106 healthy young men, mean age 21 ± 2 years (mean ± SD), BMI 24.4 ± 2.8 (kg/m(2)), on military duty, participated in this cross-sectional study. Waist circumference, carotid intima-media thickness (IMT), blood pressure, and plasma concentrations of relevant metabolic parameters were measured at fasting. Smoking and habitual dietary patterns were evaluated by a semiquantitative questionnaire. The population was divided into two groups on the basis of IMT values: the lowest three quartiles versus the highest quartile (cut-off value = 0.7 mm). BMI, waist circumference, systolic (SBP), and diastolic (DBP) blood pressure were significantly higher in the group with higher IMT (p = 0.02). All other variables, including dietary parameters and smoking, were similar in the two groups. Data analysis showed that IMT values correlated positively with SBP (r = 0.22; p = 0.025), DBP (r = 0.27; p = 0.005), waist circumference (r = 0.29; p = 0.002), and fat mass (r = 0.24; p = 0.01), and negatively with kcal/kg of body weight (r = -0.220.22; p = 0.022) - an indirect marker of physical activity. Based on multiple regression analysis, waist circumference and DBP were the only variables independently associated with IMT (p = 0.029). In a non-selected sample of healthy young adult males, a larger waist circumference and a higher diastolic blood pressure - albeit within normal values - are the only parameters independently associated with higher IMT.

Research paper thumbnail of Insulin sensitivity is increased and fat oxidation after a high-fat meal is reduced in normal-weight healthy men with strong familial predisposition to overweight

International Journal of Obesity, 2003

Research paper thumbnail of Glycemic Index of Local Foods and Diets: The Mediterranean Experience

Research paper thumbnail of Effects of different dairy products on postprandial lipemia

Nutrition, Metabolism and Cardiovascular Diseases, 2003

To evaluate the effects on postprandial lipemia (PPL), of three fat rich meals, with similar comp... more To evaluate the effects on postprandial lipemia (PPL), of three fat rich meals, with similar composition but different physical structure (liquid, semisolid and solid). Eight type 2 diabetic patients of both genders (6M/2F), age 51+/-9 yrs (M+/-SD), BMI 29+/-3 kg/m2, with fasting plasma glucose levels 145+/-24 mg/dL, cholesterol 200+/-38 mg/dL and triglyceride 110+/-45 mg/dL. Participants consumed in the morning, after a 12-hour fast and at 1-week intervals, three test meals with similar volume and composition [protein 36 g, lipid 30 g, carbohydrate 115 g, energy 3556 kJ (850 Kcal)] but with the main source of fat represented by foods with different physical structure (milk, mozzarella-cheese, butter). Each patient underwent gastric emptying measurements by echography; plasma FFA, triglycerides, glucose and insulin were evaluated at baseline and every hour for six hours after each meal. Fasting plasma glucose, cholesterol and triglyceride concentrations were similar at the baseline of the three test meals. Average increases in postprandial plasma triglyceride levels after butter (88+/-8 mg/dL) and mozzarella-cheese (104+/-56 mg/dL) were not different than after milk (98+/-53 mg/dL). The plasma triglyceride peak was also similar after the three test meals but peak time after butter (315+/-42 min; p&lt;0.01) and mozzarella-cheese (277+/-31 min; p&lt;0.02) was significantly delayed compared to milk (225+/-28 min). Gastric emptying rate was similar after butter and milk (14+/-2, 13+/-6 mL/h) and significantly faster after mozzarella-cheese (18+/-5 mL/h; p&lt;0.03). While the physical structure of fat-rich foods has no major effect on postprandial plasma triglyceride concentrations, it is able to influence the timing of triglyceride peak; gastric emptying time does not play a major role in modulating the postprandial response of triglycerides and glucose.

Research paper thumbnail of Effects of the regular consumption of wholemeal wheat foods on cardiovascular risk factors in healthy people

Nutrition, Metabolism and Cardiovascular Diseases, 2010

The intake of wholemeal foods is consistently associated with reduced risk of type 2 diabetes and... more The intake of wholemeal foods is consistently associated with reduced risk of type 2 diabetes and cardiovascular diseases in epidemiological studies, although the mechanisms of this association are unclear. Here we aim to compare in healthy subjects the metabolic effects of a diet rich in wholemeal wheat foods versus one based on the same products in refined form. Fifteen healthy individuals (12 M/3 F), mean age 54.5+/-7.6 years, BMI 27.4+/-3.0 kg/m(2) (mean+/-SD), participated in a randomized sequential crossover study. After 2 weeks run-in, participants were randomly assigned to two isoenergetic diets with similar macronutrient composition, one rich in wholemeal wheat foods and the other with the same foods but in refined form (cereal fibre 23.1 vs. 9.8 g/day). After the two treatment periods (each lasting 3 weeks) plasma glucose and lipid metabolism, antioxidant activity, acetic acid, magnesium, adipokines, incretins and high-sensitivity C-reactive protein (hs-CRP) were measured at fasting and for 4h after a standard test meal (kcal 1103, protein 12%, CHO 53%, fat 35%) based on wholemeal or refined wheat foods, respectively. After the two diets there were no differences in fasting nor in postprandial plasma parameter responses; only glucose was slightly but significantly lower at 240 min after the refined wheat food meal compared to the wholemeal wheat food meal. Conversely, after the wholemeal diet both total (-4.3%; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.03) and LDL (-4.9%; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.04) cholesterol levels were lower than after the refined wheat diet at fasting. Consumption of wholemeal wheat foods for 3 weeks reduces significantly fasting plasma cholesterol as well as LDL cholesterol levels in healthy individuals without major effects on glucose and insulin metabolism, antioxidant status and sub-clinical inflammation markers.

Research paper thumbnail of Dietary fibre in treatment of diabetes: myth or reality?

Digestive and Liver Disease, 2002

Research paper thumbnail of Effects of short-chain fructooligosaccharides on satiety responses in healthy men and women