Paolo De Cristofaro - Academia.edu (original) (raw)
Papers by Paolo De Cristofaro
Documento di Consensus. Obesità e Disturbi dell'Alimentazione Indicazioni per i diversi livelli di trattamento
Eating and Weight Disorders-studies on Anorexia Bulimia and Obesity, Mar 1, 2010
![Research paper thumbnail of [Obesity and Eating Disorders. Indications for the different levels of care. An Italian Expert Consensus Document]](https://attachments.academia-assets.com/116018796/thumbnails/1.jpg)
](Eating and weight disorders : EWD
This paper is an Italian Expert Consensus Document on multidimensional treatment of obesity and e... more This paper is an Italian Expert Consensus Document on multidimensional treatment of obesity and eating disorders. The Document is based on a wide survey of expert opinion. It presents, in particular, considerations regarding how clinicians go about choosing the most appropriate site of treatment for a given patient suffering from obesity and/or eating disorders: outpatient, partial hospitalization, residential rehabilitation centre, inpatient hospitalization. In a majority of instances obesity and eating disorders are long-term diseases and require a multiprofessional team-approach. In determining an initial level of care or a change to a different level of care, it is essential to consider together the overall physical condition, medical complications, disabilities, psychiatric comorbidity, psychology, behaviour, family, social resources, environment, and available services. We first created a review manuscript, a skeleton algorithm and two rating scales, based on the published gui...
Infectious Disease Reports, 2021
We aimed to determine whether neck circumference predicts mortality among hospitalized COVID-19 p... more We aimed to determine whether neck circumference predicts mortality among hospitalized COVID-19 patients with respiratory failure. We performed a prospective multicenter (Italy and Brasil) study carried out from March to December 2020 on 440 hospitalized COVID-19 patients with respiratory failure. Baseline neck circumference was measured. The study outcome was 30- and 60-days mortality. Female and male participants were classified as “large neck” when exceeding fourth-quartile. Patients had a median age of 65 years (IQR 54–76), 68% were male. One-quarter of patients presented with grade-1 or higher obesity. The median neck circumference was 40 cm (IQR 38–43): 38 cm (IQR 36–40) for female and 41 cm (IQR 39–44) for male subjects. “Large neck” patients had a significantly higher prevalence of hypertension (63 vs. 48%), diabetes (33 vs. 19%), obesity (26 vs. 14%), and elevated C-reactive protein (CRP) (98 vs. 88%). The cumulative mortality rate was 13.1% (n = 52) and 15.9% (n = 63) at 3...
Le infezioni in medicina, 2020
Gender distribution of COVID-19 is unbalanced. Higher mortality rates are reported in men (60-70%... more Gender distribution of COVID-19 is unbalanced. Higher mortality rates are reported in men (60-70% deaths in men). We briefly point out pros and cons elements for underlying mechanisms. We believe this SUMMARY can offer a point of reflection for further investigations.
Total Energy Expenditure in Morbidly Obese Subjects: A New Device Validation
Nutrition, Metabolism and Cardiovascular Diseases, 2007
Background and aim: Lifestyle change targeted towards increasing daily resting energy expenditure... more Background and aim: 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 AE SD, age 38 AE 14 years; body mass index (BMI) 23 AE 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 (%FFM) were assessed by skinfold thickness measurements (SF), bioelectrical 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 ¼ 0.42 and r ¼ 0.40 (p < 0.0001) respectively, with BMI. No significant difference was found in mean REE between SenseWear (1540 AE 280 kcal/day) and Sensor Medics Vmax (1700 AE 330 kcal/day) (p ¼ ns) and the correlation between REE measured by SenseWear and Sensor Medics Vmax was high (r ¼ 0.86, p < 0.0001). BlandeAltman plot showed no difference in REE determination
Nutrients, 2009
Prevalence of pediatric obesity continues to rise worldwide. Increasing the number of health care... more Prevalence of pediatric obesity continues to rise worldwide. Increasing the number of health care practitioners as well as pediatricians with expertise in obesity treatment is necessary. Because many obese patients suffer obesity-associated cardiovascular, metabolic and other health complications that could increase the severity of obesity, 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 the potential 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.
Angiology, 2008
A major concern related to childhood obesity is that obese children tend to become obese adults, ... more A major concern related to childhood obesity is that obese children tend to become obese adults, with all the risks/ comorbidities associated (ie, diabetes, cardiovascular diseases among many others). The challenges of childhood obesity are not limited to one country but confront most nations around the world. Efforts to manage and to prevent childhood obesity involve education, research, and intervention. Research could drive new directions in prevention and could develop public policy that might help manage the problem. Additionally, research is needed to test these issues. Looking into the future, 6 relevant levels may be involved in the prevention and treatment of pediatric obesity, and each of these needs investigation: family, schools, health care, government, industry, and media. Together, these 6 levels could promote childhood obesity as a high research priority and put it as the first point in the international public agenda.
Dynamic monitoring of restricted eating disorders by indirect calorimetry: a useful cognitive approach
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 2006
Outpatient treatment in restricted eating disorder: indirect calorimetry during dynamic monitorin... more Outpatient treatment in restricted eating disorder: indirect calorimetry during dynamic monitoring. A retrospective observational study. Twenty seven women affected by restricted eating disorder (essentially anorexia nervosa) with a body mass index [weight (kg)/height (m2)] of 17.29+/-2.47 were studied. The sample was compared as itself control during rehabilitative way. Fat mass (FM) and fat free mass (FFM) were determined by anthropometry technique. REE/day and respiratory quotient (RQ,VCO2/VO2) were measured by indirect calorimetry using a Calorimeter Vmax 29n-Sensor Medics-California. Skinfold thickness and circumferences were also measured. Arm muscle area (AMA) and fat area were calculated by formulas reported in Frisancho. The data indicated a positive correlation between AMA, VO2/ml/min and resting energy expenditure (REE)/day values examined during follow-up of patients. The increase of these parameters indicated a good monitoring index correlated to a FFM recovery during psychonutritional rehabilitation. Indirect calorimetry represents a useful approach for determining REE and prescribing diets in these patients. Moreover, the combined use of anthropometric techniques allows to accurately assess and adjust therapy according to the patient&amp;#39;s progress. This study shows that restricted eating disorders are characterized by a recovery of FFM related to improvement of body weight and REE/day. On the contrary, the increase of AFA revealed a recovery of fat-metabolism (corresponding to RQ decrease) and lipid/carbohydrates oxidation improvement, only in the presence, at the same time, of O2 consumption increase.
Mediterranean Journal of Nutrition and Metabolism, 2010
Obesity is a multidimensional chronic and progressive disease that requires long-term follow-up b... more Obesity is a multidimensional chronic and progressive disease that requires long-term follow-up by an integrated approach. The aim of our work was, through a retrospective observational study, to confirm that obesity treatment needs of a long-term multidimensional approach. We observed the data collected in the past from 205 patients (body mass index[25) from the medical records at our Nutritional Centre. Fat mass and fat-free mass were determined by anthropometry. Resting energy expenditure and respiratory quotient were measured by indirect calorimetry. Dietary programmes were established on the basis of metabolic analysis. Physical activity was encouraged in term of lifestyle change. The observed patients were divided into five groups. All groups showed a reduction of weight, waist circumference and arm fat area. There was correlation between all parameters. Our approach results in a long-term sustainment of the weight loss achieved up to a 5-year period, through psychological improvements as well as improved eating behaviour and general wellbeing.
Monitoraggio nutrizionale dinamico in gravidanza : intervento di prevenzione personalizzato
Recenti progressi in medicina, 2008
... Tutti gli studi in merito sono osservazionali e mostrano strategie di in-tervento sul miglior... more ... Tutti gli studi in merito sono osservazionali e mostrano strategie di in-tervento sul miglioramento del guadagno di peso durante la gestazione, un tema di gran-de attualità, ma ancora controverso. ... Beatrice Dragani Viale Bovio, 85 65124 Pescara E-mail: b.dragani@virgilio.it
Neck circumference as reliable predictor of mechanical ventilation support in adult inpatients with COVID‐19: A multicentric prospective evaluation
COVID‐19 is especially severe for elderly subjects with cardiometabolic and respiratory comorbidi... more COVID‐19 is especially severe for elderly subjects with cardiometabolic and respiratory comorbidities. Neck circumference (NC) has been shown to be strongly related to cardiometabolic and respiratory illnesses even after adjustment for body mass index (BMI). We performed a prospective study to investigate the potential of NC to predict the need for invasive mechanical ventilation (IMV) in adult COVID‐19 inpatients.
[Nutritional dynamic monitoring during pregnancy: a personalized intervention of prevention]
Obesity is an increasing condition spreading out in all of the world, independently by race, sex ... more Obesity is an increasing condition spreading out in all of the world, independently by race, sex and age. Obesity in pregnancy represent a risk condition for both mother and her offspring. All of the studies are observational and show intervention strategies on weight gain improvement during gestational period, a current topic, but still controversial. Our study is based on nutritional dynamic monitoring during pregnancy in order to improve health and wellbeing status of both mother and her offspring, through an early and efficacy prevention.
International Journal of Molecular Sciences
Different neuromodulatory systems are involved in long-term energy balance and body weight and, a... more Different neuromodulatory systems are involved in long-term energy balance and body weight and, among these, evidence shows that the endocannabinoid system, in particular the activation of type-1 cannabinoid receptor, plays a key role. We here review current literature focusing on the role of the gene encoding type-1 cannabinoid receptors in the CNS and on the modulation of its expression by food intake and specific eating behaviors. We point out the importance to further investigate how environmental cues might have a role in the development of obesity as well as eating disorders through the transcriptional regulation of this gene in order to prevent or to treat these pathologies.
Neck circumference as reliable predictor of mechanical ventilation support in adult inpatients with COVID‐19: A multicentric prospective evaluation
Diabetes/Metabolism Research and Reviews
Monitoraggio nutrizionale dinamico in gravidanza: intervento di prevenzione personalizzato
Recenti Progressi in Medicina, Jun 1, 2008
... Tutti gli studi in merito sono osservazionali e mostrano strategie di in-tervento sul miglior... more ... Tutti gli studi in merito sono osservazionali e mostrano strategie di in-tervento sul miglioramento del guadagno di peso durante la gestazione, un tema di gran-de attualità, ma ancora controverso. ... Beatrice Dragani Viale Bovio, 85 65124 Pescara E-mail: b.dragani@virgilio.it
Data on the management of eating disorders on the level of outpatient treatment in Italy in the Abruzzo Region
Mediterranean Journal of Nutrition and Metabolism
Documento di Consensus. Obesità e Disturbi dell'Alimentazione Indicazioni per i diversi livelli di trattamento
Eating and Weight Disorders-studies on Anorexia Bulimia and Obesity, Mar 1, 2010
Eating and weight disorders : EWD
This paper is an Italian Expert Consensus Document on multidimensional treatment of obesity and e... more This paper is an Italian Expert Consensus Document on multidimensional treatment of obesity and eating disorders. The Document is based on a wide survey of expert opinion. It presents, in particular, considerations regarding how clinicians go about choosing the most appropriate site of treatment for a given patient suffering from obesity and/or eating disorders: outpatient, partial hospitalization, residential rehabilitation centre, inpatient hospitalization. In a majority of instances obesity and eating disorders are long-term diseases and require a multiprofessional team-approach. In determining an initial level of care or a change to a different level of care, it is essential to consider together the overall physical condition, medical complications, disabilities, psychiatric comorbidity, psychology, behaviour, family, social resources, environment, and available services. We first created a review manuscript, a skeleton algorithm and two rating scales, based on the published gui...
Infectious Disease Reports, 2021
We aimed to determine whether neck circumference predicts mortality among hospitalized COVID-19 p... more We aimed to determine whether neck circumference predicts mortality among hospitalized COVID-19 patients with respiratory failure. We performed a prospective multicenter (Italy and Brasil) study carried out from March to December 2020 on 440 hospitalized COVID-19 patients with respiratory failure. Baseline neck circumference was measured. The study outcome was 30- and 60-days mortality. Female and male participants were classified as “large neck” when exceeding fourth-quartile. Patients had a median age of 65 years (IQR 54–76), 68% were male. One-quarter of patients presented with grade-1 or higher obesity. The median neck circumference was 40 cm (IQR 38–43): 38 cm (IQR 36–40) for female and 41 cm (IQR 39–44) for male subjects. “Large neck” patients had a significantly higher prevalence of hypertension (63 vs. 48%), diabetes (33 vs. 19%), obesity (26 vs. 14%), and elevated C-reactive protein (CRP) (98 vs. 88%). The cumulative mortality rate was 13.1% (n = 52) and 15.9% (n = 63) at 3...
Le infezioni in medicina, 2020
Gender distribution of COVID-19 is unbalanced. Higher mortality rates are reported in men (60-70%... more Gender distribution of COVID-19 is unbalanced. Higher mortality rates are reported in men (60-70% deaths in men). We briefly point out pros and cons elements for underlying mechanisms. We believe this SUMMARY can offer a point of reflection for further investigations.
Total Energy Expenditure in Morbidly Obese Subjects: A New Device Validation
Nutrition, Metabolism and Cardiovascular Diseases, 2007
Background and aim: Lifestyle change targeted towards increasing daily resting energy expenditure... more Background and aim: 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 AE SD, age 38 AE 14 years; body mass index (BMI) 23 AE 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 (%FFM) were assessed by skinfold thickness measurements (SF), bioelectrical 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 ¼ 0.42 and r ¼ 0.40 (p < 0.0001) respectively, with BMI. No significant difference was found in mean REE between SenseWear (1540 AE 280 kcal/day) and Sensor Medics Vmax (1700 AE 330 kcal/day) (p ¼ ns) and the correlation between REE measured by SenseWear and Sensor Medics Vmax was high (r ¼ 0.86, p < 0.0001). BlandeAltman plot showed no difference in REE determination
Nutrients, 2009
Prevalence of pediatric obesity continues to rise worldwide. Increasing the number of health care... more Prevalence of pediatric obesity continues to rise worldwide. Increasing the number of health care practitioners as well as pediatricians with expertise in obesity treatment is necessary. Because many obese patients suffer obesity-associated cardiovascular, metabolic and other health complications that could increase the severity of obesity, 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 the potential 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.
Angiology, 2008
A major concern related to childhood obesity is that obese children tend to become obese adults, ... more A major concern related to childhood obesity is that obese children tend to become obese adults, with all the risks/ comorbidities associated (ie, diabetes, cardiovascular diseases among many others). The challenges of childhood obesity are not limited to one country but confront most nations around the world. Efforts to manage and to prevent childhood obesity involve education, research, and intervention. Research could drive new directions in prevention and could develop public policy that might help manage the problem. Additionally, research is needed to test these issues. Looking into the future, 6 relevant levels may be involved in the prevention and treatment of pediatric obesity, and each of these needs investigation: family, schools, health care, government, industry, and media. Together, these 6 levels could promote childhood obesity as a high research priority and put it as the first point in the international public agenda.
Dynamic monitoring of restricted eating disorders by indirect calorimetry: a useful cognitive approach
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 2006
Outpatient treatment in restricted eating disorder: indirect calorimetry during dynamic monitorin... more Outpatient treatment in restricted eating disorder: indirect calorimetry during dynamic monitoring. A retrospective observational study. Twenty seven women affected by restricted eating disorder (essentially anorexia nervosa) with a body mass index [weight (kg)/height (m2)] of 17.29+/-2.47 were studied. The sample was compared as itself control during rehabilitative way. Fat mass (FM) and fat free mass (FFM) were determined by anthropometry technique. REE/day and respiratory quotient (RQ,VCO2/VO2) were measured by indirect calorimetry using a Calorimeter Vmax 29n-Sensor Medics-California. Skinfold thickness and circumferences were also measured. Arm muscle area (AMA) and fat area were calculated by formulas reported in Frisancho. The data indicated a positive correlation between AMA, VO2/ml/min and resting energy expenditure (REE)/day values examined during follow-up of patients. The increase of these parameters indicated a good monitoring index correlated to a FFM recovery during psychonutritional rehabilitation. Indirect calorimetry represents a useful approach for determining REE and prescribing diets in these patients. Moreover, the combined use of anthropometric techniques allows to accurately assess and adjust therapy according to the patient&amp;#39;s progress. This study shows that restricted eating disorders are characterized by a recovery of FFM related to improvement of body weight and REE/day. On the contrary, the increase of AFA revealed a recovery of fat-metabolism (corresponding to RQ decrease) and lipid/carbohydrates oxidation improvement, only in the presence, at the same time, of O2 consumption increase.
Mediterranean Journal of Nutrition and Metabolism, 2010
Obesity is a multidimensional chronic and progressive disease that requires long-term follow-up b... more Obesity is a multidimensional chronic and progressive disease that requires long-term follow-up by an integrated approach. The aim of our work was, through a retrospective observational study, to confirm that obesity treatment needs of a long-term multidimensional approach. We observed the data collected in the past from 205 patients (body mass index[25) from the medical records at our Nutritional Centre. Fat mass and fat-free mass were determined by anthropometry. Resting energy expenditure and respiratory quotient were measured by indirect calorimetry. Dietary programmes were established on the basis of metabolic analysis. Physical activity was encouraged in term of lifestyle change. The observed patients were divided into five groups. All groups showed a reduction of weight, waist circumference and arm fat area. There was correlation between all parameters. Our approach results in a long-term sustainment of the weight loss achieved up to a 5-year period, through psychological improvements as well as improved eating behaviour and general wellbeing.
Monitoraggio nutrizionale dinamico in gravidanza : intervento di prevenzione personalizzato
Recenti progressi in medicina, 2008
... Tutti gli studi in merito sono osservazionali e mostrano strategie di in-tervento sul miglior... more ... Tutti gli studi in merito sono osservazionali e mostrano strategie di in-tervento sul miglioramento del guadagno di peso durante la gestazione, un tema di gran-de attualità, ma ancora controverso. ... Beatrice Dragani Viale Bovio, 85 65124 Pescara E-mail: b.dragani@virgilio.it
Neck circumference as reliable predictor of mechanical ventilation support in adult inpatients with COVID‐19: A multicentric prospective evaluation
COVID‐19 is especially severe for elderly subjects with cardiometabolic and respiratory comorbidi... more COVID‐19 is especially severe for elderly subjects with cardiometabolic and respiratory comorbidities. Neck circumference (NC) has been shown to be strongly related to cardiometabolic and respiratory illnesses even after adjustment for body mass index (BMI). We performed a prospective study to investigate the potential of NC to predict the need for invasive mechanical ventilation (IMV) in adult COVID‐19 inpatients.
[Nutritional dynamic monitoring during pregnancy: a personalized intervention of prevention]
Obesity is an increasing condition spreading out in all of the world, independently by race, sex ... more Obesity is an increasing condition spreading out in all of the world, independently by race, sex and age. Obesity in pregnancy represent a risk condition for both mother and her offspring. All of the studies are observational and show intervention strategies on weight gain improvement during gestational period, a current topic, but still controversial. Our study is based on nutritional dynamic monitoring during pregnancy in order to improve health and wellbeing status of both mother and her offspring, through an early and efficacy prevention.
International Journal of Molecular Sciences
Different neuromodulatory systems are involved in long-term energy balance and body weight and, a... more Different neuromodulatory systems are involved in long-term energy balance and body weight and, among these, evidence shows that the endocannabinoid system, in particular the activation of type-1 cannabinoid receptor, plays a key role. We here review current literature focusing on the role of the gene encoding type-1 cannabinoid receptors in the CNS and on the modulation of its expression by food intake and specific eating behaviors. We point out the importance to further investigate how environmental cues might have a role in the development of obesity as well as eating disorders through the transcriptional regulation of this gene in order to prevent or to treat these pathologies.
Neck circumference as reliable predictor of mechanical ventilation support in adult inpatients with COVID‐19: A multicentric prospective evaluation
Diabetes/Metabolism Research and Reviews
Monitoraggio nutrizionale dinamico in gravidanza: intervento di prevenzione personalizzato
Recenti Progressi in Medicina, Jun 1, 2008
... Tutti gli studi in merito sono osservazionali e mostrano strategie di in-tervento sul miglior... more ... Tutti gli studi in merito sono osservazionali e mostrano strategie di in-tervento sul miglioramento del guadagno di peso durante la gestazione, un tema di gran-de attualità, ma ancora controverso. ... Beatrice Dragani Viale Bovio, 85 65124 Pescara E-mail: b.dragani@virgilio.it
Data on the management of eating disorders on the level of outpatient treatment in Italy in the Abruzzo Region
Mediterranean Journal of Nutrition and Metabolism