Search Results (34)

Background: Serum concentrations of 25-hydroxyvitamin D [25(OH)D] are associated with the risk of several chronic and acute diseases. However, updated data on vitamin D status in Mediterranean countries, including Italy, remain limited, hindering effective public health strategies. Objective: To assess serum 25(OH)D levels and their seasonal variation in healthy blood donors aged 18–65 years living in Northern Italy and not taking vitamin D supplements. Given the latitude and the high levels of environmental pollution, cutaneous vitamin D synthesis may be impaired in this population. Recent Italian guidelines on supplementation emphasize the need for updated data on the prevalence of hypovitaminosis D and seasonal variation in endogenous vitamin D synthesis. Methods: In this exploratory retrospective cross-sectional study, 534 blood donors (268 men and 266 women) attending the Transfusion Medicine Unit of the Verona University Hospital were enrolled between April 2016 and May 2018. Serum 25(OH)D concentrations were analyzed by season. Clinical, lifestyle, pharmacological and dietary characteristics were also collected. Results: Among healthy, normal-weight individuals, the prevalence of vitamin D insufficiency (25(OH)D < 50 nmol/L) was low and limited to one-two months per year. Overweight and obesity significantly reduced the likelihood of achieving adequate 25(OH)D levels through cutaneous synthesis for several months. Mean 25(OH)D concentrations were higher than those previously reported in the same area, while seasonal variation remained preserved. Conclusions: In a relatively small non-supplemented population of blood donors living in a high polluted urban area of Northern Italy, seasonal vitamin D synthesis seems to be preserved. These updated data show higher 25(OH)D levels compared to past findings. Although these data certainly warrant further validation through a national survey involving other regions of Italy and in not selected population, they appear to be in line with the SIOMMMS recommendations against indiscriminate serum 25(OH)D testing and against routine supplementation for healthy normal-weight individuals under 70 years. Full article

Objective: Nutrition is a key determinant of women’s health across all life stages. Clinical practice remains heterogeneous because of lack of evidence and non-homogeneous guidelines. Despite growing research on micronutrient supplementation, skeptical opinions persist around universal versus individualized approaches, optimal dosages, and life-stage-specific recommendations. Material and methods: This is a modified Delphi process conducted under the supervision of the Italian Association of University Gynecologists and Obstetricians (AGUI). Thirteen Italian experts in gynecology and obstetrics completed two rounds of anonymous online surveys (September–November 2025). The questionnaire, developed through a scoping review, covered six domains: pre-/periconception, pregnancy, postpartum, routine supplementation in non-pregnant women, nutrition in gynecological conditions, and menopause. Consensus was defined as ≥75% agreement on a 10-point Likert scale. Quantitative data were summarized descriptively, and qualitative comments contextualized findings. Results: Experts strongly supported personalized nutritional strategies across all life stages. Consensus was reached on individualized micronutrient supplementation in the preconception period and on the prescription of active folates for women undergoing assisted reproduction. In pregnancy, agreement emerged for universal DHA supplementation (200–300 mg/day); however, universal vitamin D supplementation lacked consensus except in gestational diabetes. In the postpartum period, iron supplementation for non-breastfeeding women reached consensus, while micronutrient recommendations for breastfeeding women remained uncertain. Strong agreement supported personalized dietary approaches for PCOS, endometriosis, and gestational diabetes, including inositol use, while evidence for interventions in severe premenstrual syndrome remained insufficiently supported. In menopause, consensus was reached for macronutrient adjustments and universal calcium and vitamin D supplementation. Conclusions: This Delphi consensus highlights shared expert perspectives on nutritional care in women and identifies key evidence gaps, particularly regarding vitamin D in physiological pregnancy, postpartum micronutrient needs during breastfeeding, and nutritional strategies for premenstrual disorders. Unified life-course guidelines and future research on standardized nutritional assessments are necessary for nutritional approach management. Full article

Introduction: The potential role of food hypersensitivity in the insurgence of inflammatory activity in arthritis such as Rheumatoid Arthritis (RA) has received intermittent attention, also supported by theoretical links involving mucosal immunity, mast-cell activation, and microbiome–immune interactions. Despite biological plausibility, the clinical significance of dietary antigens in RA remains uncertain. Methods: A systematic review was conducted following the PRISMA guidelines. Searches using PubMed, Scopus, and Web of Science identified studies exploring dietary interventions or food hypersensitivity in RA. Eligible articles included clinical trials, case reports, and observational studies, in English or Italian, up to the 10 December 2025. Data extraction and quality assessment were performed using the Newcastle–Ottawa Scale. Results: Eight studies met the inclusion criteria. Findings indicate that elimination or elemental diets occasionally yielded subjective improvements—such as a reduction in pain, morning stiffness, and functional improvements—yet objective inflammatory markers rarely changed. Small, highly selected, cohorts demonstrated immuno-histological alterations, including reduced mast-cell density, while long-term diets (e.g., gluten-free or vegan) have reduced specific IgG levels without altering radiographic progression. Conclusions: Evidence suggests that dietary interventions may offer symptomatic relief only in a minority of RA patients. Due to methodological constraints, inconsistent outcomes, and limited applicability to contemporary treatments, dietary approaches need further exploration and investigation. Rigorous trials in modern cohorts are warranted to clarify whether food hypersensitivity meaningfully influences RA pathophysiology. Full article

Background/Objectives: The Fourth Italian National Food Consumption Survey (IV SCAI 2017–2020) provides updated and comprehensive data on the dietary habits of the Italian population. The study aimed to assess nutrient intakes and their main food sources among individuals aged 3 months to 74 years and to evaluate the adequacy of intakes against the Italian dietary reference values (DRVs). Methods: A nationally representative sample of 1969 participants were surveyed using two non-consecutive food diaries (ages 3 months–9 years) and 24 h recalls (ages 10–74 years) in accordance with the European Food Safety Authority’s EU Menu guideline. The multiple source method was used to estimate the usual intakes accounted for intra-individual variability. Nutrient adequacy was assessed against age- and sex-specific DRVs, and the main food sources of macro- and micronutrients were identified. Results: Energy intake was below DRVs for adults, particularly women, while protein intake exceeded recommendations across all ages, mainly from animal sources (67% of total). Total fat (38%En) and saturated fat (12%En) exceeded the recommendations, whereas carbohydrates (45%En) and dietary fibre were suboptimal. Vitamin D and calcium intake were markedly below DRVs for all age groups; iron inadequacy was prevalent among females. The main energy sources were cereals (39%), milk and dairy (15%), oils and fats (13%), and meat (10%). Vegetables and fruits were leading contributors to vitamins A and C, while meat, fish, and dairy provided vitamin B12 and D. Conclusions: The Italian diet remains cereal-based but shows nutritional imbalances: notably, excessive protein and fat intake and widespread deficiencies in vitamin D, calcium, iron, and fibre. These findings underline the need for targeted nutrition policies to realign dietary patterns with the national recommendations. Full article

Background: The worldwide prevalence of obesity in children and adolescents quadrupled in the past decades, becoming a public health priority. Following the recommendation by the Italian Minister of Health, the Emilia-Romagna Region started a community-based program aimed at reducing pediatric overweight through children and family behavioral counseling on nutrition and physical activity. Methods: Children with excess weight, aged 2–17 years, and without severe diseases were visited five times by a multidisciplinary team, who provided dietary advice, exercise plans, and psychosocial support, according to Italian guidelines. The outcomes were the median pre–post change in Δ₃₀BMI (distance between children’s BMI and age- and sex-specific obesity threshold values) and the proportion of children who moved to a lower weight class. Logistic regression was used to identify potential predictors of weight improvement. Results: Up to March 2025, 1331 participants completed the follow-up. In total, 17.5% of the children showed an improvement in weight class, and 32.5% had a reduction of more than one unit of Δ₃₀BMI. The program was significantly and substantially more effective among the children with obesity at baseline (overweight vs. obese children adjusted odds ratio—aOR—of weight class improvement: 0.28; p < 0.001), older than eight years (9–11 years vs. 2–8 years children aOR: 1.41; p < 0.05), who adhered to breakfast recommendations (aOR: 1.60; p < 0.01) and had no obese parents (≥1 vs. 0 obese parents aOR: 0.62; p < 0.05). Conclusions: The multidisciplinary model was associated with an overall positive impact on the weight status of the enrolled children. Given the varying response, however, in order to maximize cost-effectiveness, future programs could be reserved for children with obesity, older than eight years. Further randomized research is needed to investigate the efficacy of this intervention in different settings and on late clinical endpoints. Full article

Objective: Eating habits established during adolescence play a crucial role in shaping both current and future health status. However, adolescents today appear to be increasingly adopting poorer dietary and lifestyle habits. This study aims to investigate eating behaviors and supplement use among adolescent students who participated in the EduALI nutrition education project. Methods: The project included first-year students from six sports-oriented scientific high schools in Florence. The students participated in six nutrition sessions, completing the International Physical Activity Questionnaire to assess physical activity performance, a questionnaire on dietary supplement use, and, to assess eating habits a Food Frequency Questionnaire (FFQ), as well as the Medi-Lite questionnaire to specifically assess adherence to the Mediterranean diet (MD). The data from the FFQ were compared with national dietary guidelines. Results: The study sample consisted of 83 students (69.9% male; average age: 13.8 ± 0.4 y). The results showed that 61.4% of participants had used supplements in the past year, most commonly mineral salts (56.6%) and vitamins (54.2%), followed by botanical products (22%), sports drinks (16%), proteins/amino acids (8%), and creatine (2%). Alarmingly, 27.7% used supplements without medical supervision. Students involved in individual sports had higher supplement consumption than those in team sports, especially creatine use. Eating habits revealed poor adherence to both the MD and Italian dietary guidelines, with deficiencies in fruits, vegetables, olive oil, fish, and legumes, and excessive intake of cheese, meat, especially red and processed meats. Conclusions: A high prevalence of supplement use among adolescents was observed, along with poor adherence to dietary guidelines and MD. These findings underscore the need for targeted, school- and sport-based interventions to enhance adolescents’ nutritional awareness and responsible supplement use. Full article

Background/Objectives: Maternal nutrition during pregnancy exerts a significant influence on both maternal and foetal health, as well as long-term child development. Despite its importance, adherence to dietary guidelines among pregnant women remains low. The present study aimed to develop and validate the Italian Pregnancy Nutrition Knowledge Questionnaire (ItPreNKQ), based on national dietary guidelines for the pregnant Italian population, assessing its reliability and validity. Methods: The ItPreNKQ comprised 15 questions covering key topics on nutrition during pregnancy. The questionnaire was validated through item analysis (difficulty and discrimination indices), construct validity, internal consistency, and reliability tests. Results: A total of 145 pregnant Italian women participated in the study. The reliability of the questionnaire was confirmed through a Pearson’s correlation of R = 0.790 and a Cronbach’s alpha of 0.682, indicating strong temporal stability and acceptable internal consistency. Despite good overall performance, the mean knowledge score was 10.6 ± 2.5 out of 15, indicating significant knowledge gaps in specific topics. Conclusions: The ItPreNKQ has been demonstrated to be a reliable and valid tool for the assessment of nutrition knowledge among pregnant Italian women. The tool could be used for assessing nutritional knowledge in prenatal education settings and could be administered in future studies aimed at evaluating the impact of nutritional interventions among pregnant women. Full article

Background: Globally, the progressive increase in the aging population has led to social and health problems associated with age-related chronic diseases, such as type 2 diabetes mellitus (T2DM) and sarcopenia. Recent studies have highlighted that sarcopenia and diabetes have a bidirectional relationship. Nutritional therapy is a key element in the treatment of both sarcopenia and diabetes. To date, there are no nutritional guidelines for the management of sarcopenia in T2DM. The aim of this study was to evaluate the efficacy of a muscle-targeted nutritional intervention in older people with sarcopenia and type 2 diabetes based on the Italian nutrition guidelines. Methods: A total of 211 subjects (117 M and 94 F) affected by T2DM with a mean age of 74 ± 6.0 years were screened for sarcopenia, using EWGSOP2 diagnosis criteria, and enrolled to receive personalized dietary plans with two main targets: a daily energy intake of 25–30 kcal/kg body weight and a daily protein intake of at least 1.1–1.2 g/kg body weight. Results: In total, 34 subjects (24 M and 10 F) were sarcopenic with a prevalence of 16%, which was higher in men. After six months of treatment, handgrip strength increased by 0.83 kg (19.57 ± 5.70 kg vs. 20.40 ± 6.10 kg, p = 0.649), protein intake improved (0.91 ± 0.28 g/kg body weight vs. 1.03 ± 0.40 g/kg body weight, p = 0.115), and the glycated hemoglobin decreased (7.39 ± 0.49% to 6.82 ± 0.98%, p = 0.010). Seven younger subjects had an improvement of sarcopenia with a decrease in HbA1c (7.50 ± 0.59% vs. 6.91 ± 0.79, p = 0.19). The difference over time in the consumption of saturated fatty acids (OR 0.6, 95% CI 0.33–1.09, p = 0.096) and simple sugars (OR 0.91, 95% CI 0.80–1.01, p = 0.090) appeared to be associated with an improvement of sarcopenia status. A total of 177 subjects did not meet the criteria for a diagnosis of sarcopenia, and 148 subjects were assessed. The handgrip strength (26.22 ± 9.36 vs. 26.18 ± 9.24 kg, p0.974) and the glycated hemoglobin (7.21 ± 1.07 vs. 7.27 ± 0.98%, p = 0.735) remained stable over time, while protein intake at six months increased (0.81 ± 0.29 vs. 0.91 ± 0.29 g/kg body weight, p = 0.024). Four people were diagnosed with sarcopenia at follow-up, with a lower handgrip strength test result. These subjects were older and had worse glycemic control (HbA1c + 0.5%). Conclusions: Lifestyle modification is important to prevent or reverse the development of the disease. Nutritional therapy in this population is therefore aimed at meeting all nutritional needs and promoting better glycemic control, in terms of glycated hemoglobin, in order to reduce the development of sarcopenia. Although promising, the intervention requires validation in larger studies with control groups. Full article

Background/Objectives: The water footprint (WF) provides information on the impact of individual foods on water consumption, but to better direct food production toward water saving, we need to understand how to reduce the WF of our diets while keeping it healthy. In this study, we compared the WF of healthy diets based on national food-based dietary guidelines with the aim of highlighting changes in dietary patterns that could reduce water requirements without compromising nutritional adequacy. Methods: Three 2000 kcal/day dietary patterns were elaborated following the Italian, Spanish, and American dietary guidelines, and their total, green, blue, and grey WFs were calculated. Results: The Italian dietary pattern showed the lowest total WF (2806 L per capita/day), with the American and Spanish patterns being 8% and 10.5% higher, respectively. The food groups contributed differently to the total WF. In the USA, animal foods were the main contributor (56% versus 41% in Spain and 38% in Italy). The contribution of plant foods was higher in Italy (61%) than in Spain (54%) and the USA (38%). The distribution of the total WF between WF_green, WF_blue, and WF_grey was similar across the dietary patterns. Within each food group, and mainly in the animal-origin food group, the type of product significantly modulated the WF. Conclusions: Different diets can be equally nutritionally sustainable but have different impacts on environmental sustainability. The comparison of their WFs can be the starting point to promote dialogue between nutritionists, operators in the environmental sector, and the agri-food industry to ensure a healthy and balanced approach. Full article

Background/Objectives: Pegvaliase, a subcutaneous therapy to treat phenylketonuria (PKU), has allowed these patients to maintain adequate phenylalanine (Phe) blood values without following a Phe-controlled diet; this brings up the challenge of promoting healthy eating while moving away from prescription diets. In our center, every patient treated with Pegvaliase undergoes routine nutritional counseling aimed at promoting adherence to the Mediterranean diet (MedDiet) during regular inpatient visits. This study aims to assess adherence to MedDiet and the adequacy of the diets of patients treated with Pegvaliase regarding micro- and macronutrients. Methods: Seven patients on chronic therapy with Pegvaliase underwent a dietetic evaluation to assess the composition of their diets in terms of micro- and macronutrients; they were also administered the Mediterranean Diet Score (MDS) questionnaire. Subcategories from MDS were extracted to evaluate the consumption of foods typically included (vegetables, olive oil, etc.) and typically excluded (red meat, etc.) in the MedDiet. To assess the adequacy of the diet, nutrient and energy levels were compared with guidelines for the Italian population. Results: MedDiet adherence in our sample was comparable to the general population; in terms of macronutrients, good adherence to the recommendations was observed, with every one of them met except for excessive simple sugar consumption. Micronutrient dietary intake was inadequate for zinc, iron, selenium, folate, thiamine, and riboflavin. Conclusions: While more work is necessary to help patients treated with Pegvaliase to progress toward healthy eating, our study suggests that nutritional counseling routinely performed during inpatient visits, typically twice a year, effectively promotes healthier eating habits than those observed in the general population. Full article

Transgender and gender-diverse (TGD) individuals continue to experience harassment and discrimination across various aspects of life, significantly impacting their physical and mental health. The scarcity of data on their general health, particularly regarding dietary habits, remains a challenge in developing effective healthcare strategies for this population. To address this gap, we analyzed selected dietary habits, physical activity (PA), and body mass index (BMI) among Italian TGD adults compared to the Italian general population (IGP). An online anonymous survey was conducted via the Computer Assisted Web Interviewing technique from June 2020 to June 2021. Participants were enrolled through clinical centers and TGD organizations. Data from 959 TGD adults were analyzed using chi-squared tests and logistic regression models. Key findings indicated that approximately 70% of TGD individuals consumed fewer servings of fruit and vegetables (FV) than recommended (five or more servings per day). Although red meat consumption was lower overall, a greater percentage of TGD individuals reported consuming more than three servings per week. Additionally, 58% of TGD participants indicated that they did not engage in any PA, compared to 36% of the IGP. Notably, significant differences in BMI were identified, with higher rates of overweight and obesity among TGD individuals assigned female at birth. These results underscore the urgent need for tailored nutritional guidelines and inclusive public health strategies to meet the specific health needs of the Italian TGD population. Expanding access to targeted interventions could contribute to improving overall well-being in this marginalized group. Full article

More consumers are replacing cow’s milk (CM) with plant-based drinks (PBD), but data indicating the nutritional impact are limited. This theoretical study aims to assess the effect of substituting CM with PBD sold in Italy on nutrient intake within two dietary patterns: one aligned with the EAT-Lancet Commission reference diet adapted to Italian food habits (EAT-IT) and another one in line with the Italian Dietary Guidelines (IDG). Nutrition information from 368 PBD were collected and categorized according to their descriptive name and their fortification or not with calcium (Ca- and nCa-fortified). The substitution of CM with each PBD category in both dietary patterns was conducted, and an analysis of nutrient content and adequacy was performed. Substituting CM with all PBD resulted in reduced protein intake, except for nCa-fortified soy drinks, decreased saturated fat and vitamins B2 and B12, and increased fiber intake. Replacing CM with nCa-fortified PBD within both diets decreased Ca intake. Following the substitution of CM with Ca-fortified PBD, variations in vitamin D intake depended on the PBD category. The main risk of nutritional inadequacy was observed in Ca and vitamin D levels, which may even be amplified considering the different bioavailability based on the source of nutrients. This study highlighted the important role of CM in meeting calcium requirements and the potential unintended consequences of substituting CM with PBD without considering their nutritional differences. Full article

This study aims were (i) to describe Italian celiac patients who agreed to participate in the latest web survey and their attitudes toward the GF diet (compliance, perceived limitations, and worries) and (ii) to compare the answers given by the 2011 and 2022 responders. The self-administered questionnaire was distributed through the Italian Coeliac Association channels (link on social media, websites, and newsletters) to all of the celiac patients willing to participate in 2011 and 2022 (2427 and 3529 responders who answered the same questions, respectively). Descriptive analyses and the Pearson’s chi-squared test were performed. The responders were 1 to 84 years old and mainly female. The prevalence of adherent patients in 2022 was 91%, with the highest value (94%) in children (≤10 years old) and adolescents (15−17 years old). Overall, young adults were the most worried group. About a decade after the first survey, we observed a decreasing prevalence of transgression events (−5%) and (at least) occasional temptation (−17%), a decreasing prevalence of health-related and general worries, but an increasing prevalence of social life withdrawal. In conclusion, it is important to periodically monitor celiac patients’ compliance and attitudes towards the gluten-free diet. As also highlighted in international guidelines, a reorganization of the diagnosis/follow-up visits, including an expert dietary consultation, is needed. Full article

Background and objectives: Adhering to healthy dietary guidelines plays an essential role in maintaining population health, but data on older people exploring the gender dimension are scarce. We aimed to investigate the gender differences in adherence to dietary recommendations among an Italian population of older men and women. Methods: We included participants aged ≥ 65 years from the cross-sectional NutBrain study, recruited in 2019–2023 in northern Italy. Dietary habits were assessed using a 102- semi-quantitative food frequency questionnaire. Adherence to recommendations was allocated for the intake of 23 food groups as described in the Italian Healthy Eating Guidelines-CREA. Variables were dichotomized as 0 = no adherence and 1 = adherence. The ‘Italian Dietary Recommendations Adherence Score (IDRAS)’ was calculated as an indicator of overall adherence to the dietary guidelines, by summing up each food group and then dividing them into tertiles. We compared the adherence to the recommendations and the IDRAS between men and women using the Chi-squared test. Results: A total of 802 participants were analysed (mean age 73.4 years ± 6.2 SD, 59.2% women, 60.3% at least high education). Consumption of legumes (67.5%), fish (51.4%), bread (66.7%), milk and yoghurt (71.8%), fruit and vegetables (63.0%), and water (56.7%) was significantly lower than recommended values in the total sample. In contrast, consumption of cheese (54.1%), animal fats (54.0%), sweets and snacks (90.9%), red (54.0%) and processed meat (84.2%), and bakery products (85.9%) exceeded the recommendations. Women were more likely than men to meet the recommendations for non-alcoholic (70.5% vs. 57.8%) and alcoholic beverages (81.1% vs. 51.4%), red (32.8% vs. 26.3%) and processed meat (18.3% vs. 12.2%), potatoes (65.3% vs. 57.8%), and sugars (70.5% vs. 62.7%) and less likely to meet the recommendations for bread (26.3% vs 42.8%) and pasta (60.2% vs 64.5%). Overall, only 19,3% had high adherence to IDRAS (highest tertile); women had higher adherence than men (22.1% vs 15.3%). Discussion: Overall adherence to recommendations was low in the total sample, with women more likely than men to adhere to recommended dietary guidelines. Identifying gender differences in dietary intake and adherence to dietary recommendations is crucial for tailoring interventions and improving population nutrition strategies. Full article

The popularity of veganism and plant-based diets is rapidly increasing worldwide, including in Italy, where more individuals and families are adopting this lifestyle. However, medical and health professionals often lack the necessary knowledge and are skeptical about this diet despite the scientific evidence. It is important for them to provide support and expertise to those following this diet. The survey evaluated various aspects of the lifestyle of Italian vegans living in Italy and abroad, including food frequency, vitamin and mineral supplementation, relationship with medical and health professionals, and perceived difficulties in daily life. The emphasis was on potentially critical aspects for those following this dietary choice. A cross-sectional survey was conducted in Italy between March and April 2022. A questionnaire was distributed through social media platforms such as Instagram, Facebook, and Telegram, and 2180 Italian adults who follow a vegan diet completed it. The survey found that most of the vegan population surveyed were female, showed a greater sensitivity to ethical issues, were aware of the need for vitamin B12 supplementation, and followed healthy-eating guidelines. It is evident that despite the increasing popularity of plant-based diets, many medical and health professionals remain cautious and hesitant to recommend them. Full article