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Abstract: The relative effects of prenatal and postnatal low-level mercury exposure and fish intake on child neurodevelopment are still controversial. Limited evidence is available from Mediterranean populations. In this prospective study, we measured the Verbal and Performance IQ in Italian children at school-age who were resident in an area declared as a National contaminated site because of mercury pollution, taking into account the possible beneficial effect of fish consumption and potential confounders. A mother–child cohort made up of 242 children was established at birth in Northeastern Italy in 2001. Their mothers were interviewed approximately 2 months after delivery to determine type, quantity, and origin of fish consumed during pregnancy and about a number of mother, child and family characteristics. Total mercury (THg) and methyl mercury (MeHg) were assessed in maternal hair and breast milk and in the child's hair. When children reached 7–9 years of age, 154 (63.6%) parents gave consent to participate in a follow-up evaluation. On that occasion, a child's hair sample was collected to determine the current concentration of THg, mothers were asked to complete a self-administered questionnaire, and children underwent neuropsychological testing. Verbal IQ, performance IQ and full scale IQ were measured by the Wechsler Intelligence Scale for Children (WISC III) administered by psychologists at school or local health centers. Demographic, socioeconomic and lifestyle information, medical information of the child's family and the child's dietary habits were collected using a questionnaire filled in by mothers. Multivariable linear regression models were used to evaluate the association between prenatal THg exposure through fish consumption of mothers in pregnancy and children's IQ after adjustment for possible confounders such as fish consumption of mothers in pregnancy, child's fish consumption at follow-up, child's birthweight, maternal cigarette smoking during pregnancy, house size and property place of residence during pregnancy and gender. THg in the child's hair at 7 years of age was fairly correlated with THg in maternal hair at delivery (r s =0.35; p <0.0001) and was strongly correlated with child's seafood consumption (r s =0.50, p <0.0001). No differences in maternal THg levels were found when comparing children with low or extremely low or high or extremely high scores vs others, considering separately full scale, verbal, and performance IQs. Children born from mothers with hair THg levels greater than or equal to 2000ng/g had full scale, verbal and performance IQs which were 4–5 points lower than children born from women with lower THg levels, but these differences were not statistically significant. Fresh fish intake of mothers in pregnancy was slightly positively associated with full scale and performance but not so with verbal IQs. Canned fish showed to be negatively associated with all the outcome variables. Unexpectedly, children born to mothers from one town showed IQ scores significantly lower than the other children; however, none of the many variables considered in these analyses could explain this result. The relatively low Hg levels found in the biological samples did not provide evidence of high and extensive Hg exposure in this population. Although THg levels in maternal and child's biological samples are correlated with fish consumption, the effects of THg and fish on neurological outcomes go in opposite directions. These results do not allow to develop recommendations regarding fish consumption in pregnancy but suggest that keeping THg hair levels<2000ng/g might be desirable. [Copyright &y& Elsevier]

Background:Evidence for the possible effect of vitamin E on head and neck cancers (HNCs) is limited.Methods:We used individual-level pooled data from 10 case-control studies (5959 cases and 12 248 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium to assess the association between vitamin E intake from natural sources and cancer of the oral cavity/pharynx and larynx. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression models applied to quintile categories of nonalcohol energy-adjusted vitamin E intake.Results:Intake of vitamin E was inversely related to oral/pharyngeal cancer (OR for the fifth vs the first quintile category=0.59, 95% CI: 0.49-0.71; P for trend <0.001) and to laryngeal cancer (OR=0.67, 95% CI: 0.54-0.83, P for trend <0.001). There was, however, appreciable heterogeneity of the estimated effect across studies for oral/pharyngeal cancer. Inverse associations were generally observed for the anatomical subsites of oral and pharyngeal cancer and within covariate strata for both sites.Conclusion:Our findings suggest that greater vitamin E intake from foods may lower HNC risk, although we were not able to explain the heterogeneity observed across studies or rule out certain sources of bias. [ABSTRACT FROM AUTHOR]

Background:Because of their antioxidant and antimutagenic properties, flavonoids may reduce cancer risk. Some flavonoids have antiestrogenic effects that can inhibit the growth and proliferation of endometrial cancer cells.Methods:In order to examine the relation between dietary flavonoids and endometrial cancer, we analysed data from an Italian case-control study including 454 incident, histologically confirmed endometrial cancers and 908 hospital-based controls. Information was collected through a validated food-frequency questionnaire. We applied data on food and beverage composition to estimate the intake of flavanols, flavanones, flavonols, anthocyanidins, flavones, isoflavones, and proanthocyanidins. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated from multiple logistic regression models conditioned on age and study centre and adjusted for major confounding factors.Results:Women in the highest quartile category of proanthocyanidins with 3 mers vs the first three quartile categories had an OR for endometrial cancer of 0.66 (95% CI=0.48-0.89). For no other class of flavonoids, a significant overall association was found. There was a suggestion of an inverse association for flavanones and isoflavones among women with body mass index <25 kg m−2, and, for flavanones, among parous or non-users of hormone-replacement therapy women.Conclusion:High consumption of selected proanthocyanidins may reduce endometrial cancer risk. [ABSTRACT FROM AUTHOR]

BACKGROUND:: Folate and vitamin B6 intake has been associated with reduced risk of coronary heart disease, but studies are not consistent. OBJECTIVE:: The relation between folate and vitamin B6 intake and the risk of acute myocardial infarction (AMI) was assessed in a Mediterranean population. DESIGN:: A hospital-based case-control study was conducted in Milan, Italy, between 1995 and 1999. Information was collected by interviewer-administered questionnaires. Adjusted odds ratios (ORs) and 95% confidence intervals (CI) were obtained by multiple logistic regression models. SUBJECTS:: Cases were 507 patients with a first episode of nonfatal AMI, and controls were 478 patients admitted to hospital for acute conditions. RESULTS:: Compared to patients in the lowest tertile of intake, the ORs for those in the highest tertile were 0.56 (95% CI 0.35-0.88) for folate and 0.34 (95% CI 0.19-0.60) for vitamin B6. The OR was consistently below unity in strata of sex, age, alcohol, methionine, tobacco smoking, coffee, hypertension and family history of AMI; the inverse association was apparently stronger for vitamin B6 in regular alcohol drinkers than in no or occasional drinkers. Compared to subjects with a low intake of both micronutrients, the OR was 0.29 for those with a high intake of both. Compared to subjects reporting no or occasional alcohol drinking and low methionine and folate intake, the OR was 0.28 in regular drinkers with high methionine and high folate intake. The corresponding value for vitamin B6 was 0.25. CONCLUSIONS:: A high intake of folates, vitamin B6 and their combination is inversely associated with AMI risk. SPONSORSHIP:: Partly supported by “Ministero della Salute” (Contract No. 177, RF 2001).European Journal of Clinical Nutrition (2004) 58, 1266-1272. doi:10.1038/sj.ejcn.1601960 Published online 31 March 2004 [ABSTRACT FROM AUTHOR]

Metabolic Syndrome (MS) is a multifactorial condition that increases the risk of cardio-vascular events, it's frequent in Heart transplant (HTx) candidates and worsens with immunosuppressive therapy. Aim of the study was to analyse the impact of MS on long-term outcome of HTx patients. MS was defined through the presence of at least 3 of the following factors: • -Triglyceride ≥150mg/dl or drug treatment for hypertriglyceridemia • -HDL <40mg/dl for men and <50mg/dl for women • -Blood glucose ≥100mg/dl or diabetes mellitus • -Arterial pressure ≥130/80 or hypertensive drug treatment • -BMI>30 In 349 HTx patients since 2007, mortality and morbidity predictors were evaluated. MS was present in 35% of patients pre-HTx and 47% within the first year of follow-up. Five-year survival in patients with pre-HTx MS was worst (65% vs 78%, p<0.01), as well as in those with MS in the first year of follow-up (78% vs 89%, p<0.01). At the univariate analysis, risk factors for mortality were recipient age (HR 1.07, 1.04-1.09, p<0.01), pre-HTx MS (HR 1.86, 1.29-2.69, p<0.01), pre-HTx hypertension (HR 2.46, 1.70-3.55, p<0.01), pre-HTx hypertriglyceridemia (HR 1.50, 1.04-2.18, p=0.03), chronic renal failure (HR 2.95, 2.03-4.27, p<0.01), MS and diabetes at 1-year follow-up (HR 2.00, 1.25-3.19, p<0.01; HR 2.02, 1.27-3.23, p<0.01, respectively). The last two resulted also risk factors for CAV (HR 1.86, 1.16-2.99, p=0.01; HR 1.67, 1.03-2.69, p=0.04, respectively). MS at 1-year follow-up determined a significant higher risk to develop CAV at 5- and 10-year follow-up (25% vs 14% and 44% vs 25%, p<0.01). MS is an important risk factor for both mortality and morbidity post-HTx, suggesting the need for a strict monitoring of metabolic disorders with a careful nutritional follow-up in HTx patients. [ABSTRACT FROM AUTHOR]

Background: Dietary habits during infancy and early childhood could have short and long-term health effects and could influence future adults’ dietary habits. Acting during this sensitive period of life could be crucial. In 2006 a prospective infants cohort study was established at the Maternal and Child Institute - Burlo Garofolo in Trieste, Italy (Trieste Infant Feeding Cohort - TIF cohort) to assess energy and nutrients intake during the first three years of infants’ life. This nutritional analysis focused on dietary habits of infants at 24 months of age. Methods: Dietary data were collected using a 3-day dietary record (3-d DR) and data were analysed using a nutritional software containing the Italian Food Composition database and integrated with data from nutritional labels and literature. Energy and macronutrients intake were compared with the Italian Dietary Reference Values (DRV) and the WHO recommendation. Differences by sex were also assessed. Results: 3d-DR was filled for 157 infants. Available carbohydrates (CHO) and starch intakes were significantly significant higher in males (p<0.05). The percentage contribution of CHO to total energy intake was in line with DRV (75.8% of infants within the reference interval (RI)) similarly 75.2% of infants are within the RI for fats. Proteins’ contribution to energy intake, instead, was above the RI for 53.5% of infants over the RI and the daily protein intake was greater than the estimated DRV (median 43.9g/d, IQR of 16.2g/d vs median DRV 10.3g/ d, IQR 1.3g/d). Conclusions: The results show a substantial adherence with recommendations for macronutrient intakes except for the excess protein intake. Elevated protein intake play a role in developing longterm health consequences and seems linked to overweight and obesity. Further evaluation of protein intake should be desirable. [ABSTRACT FROM AUTHOR]

Prebiotic fiber may have a beneficial effect on the human's microbiota. However, due to the lack of comprehensive food composition data (FCD), it is challenging to assess their dietary intake. The aim of present study is to quantify naturally occurring prebiotics, such as inulin-type fructans (ITFs), fructo-oligosacharides (FOSs), and galacto-oligosacharides (GOSs), in raw and processed Italian foods and to estimate their intake in a healthy population (N = 4154) belonging to an Italian case-control study on colorectal cancer. ITFs were determined using enzymatic method and high-performance anion exchange chromatography coupled with pulsed amperometric detection (HPAEC-PAD). FOSs and GOSs were determined by alkaline hydrolysis and HPAEC-PAD. Garlic (25.1 g/100 g) and jerusalem artichoke (16.7 g/100 g) were the ITFs-richest foods. Jerusalem artichoke was also the richest in FOSs (4.45 g/100 g). GOSs were mainly detected in dry and canned pulses (0.01–2.04 g/100 g). In our population, the median intake of ITFs, FOSs and GOSs was 0.797, 0.187 and 0.283 g/day, respectively. Given the unclear definition of inulin due to the heterogenicity of methodologies, it was challenging to compare published prebiotic fiber's FCD and use them in epidemiological research. Within the present work we produced novel FCD able to preliminary estimate the intake of prebiotic fiber. • There is a lack of comprehensive food composition data on prebiotic fibers. • Jerusalem artichoke and garlic, were the foods richest in ITFs and FOSs. • GOSs were mainly detected in pulses. • The dietary intakes of prebiotics were very low in a healthy Italian population. [ABSTRACT FROM AUTHOR]

Objectives - The increasing incidence of multiple sclerosis (MS) worldwide, especially in women, points to the crucial role of environmental and lifestyle risk factors in determining the disease occurrence. An international multicentre case-control study of Environmental Risk Factors In Multiple Sclerosis (EnvIMS) has been launched in Norway, Sweden, Italy, Serbia and Canada, aimed to examine MS environmental risk factors in a large study population and disclose reciprocal interactions. To ensure equivalent methodology in detecting age-related past exposures in individuals with and without MS across the study sites, a new questionnaire (EnvIMS-Q) is presented. Materials and methods - EnvIMS-Q builds on previously developed guidelines for epidemiological studies in MS and is a 6-page self-administered postal questionnaire. Participants are de-identified through the use of a numerical code. Its content is identical for cases and controls including 'core' and population-specific questions as proxies for vitamin D exposure (sun exposure, dietary habits and supplementation), childhood infections (including infectious mononucleosis) and cigarette smoking. Information on possible confounders or effect modifiers is also obtained. EnvIMS-Q was initially drafted in English and subsequently translated into Italian, Serbian, Norwegian, Swedish and French-Canadian. EnvIMS-Q has been tested for acceptability, feasibility and reliability. Results and Conclusions - EnvIMS-Q has shown cross-cultural feasibility, acceptability and reliability in both patients with MS and healthy subjects from all sites. EnvIMS-Q is an efficient tool to ensure proper assessment of age-specific exposure to environmental factors in large multinational population-based case-control studies of MS risk factors. [ABSTRACT FROM AUTHOR]

Background:Dietary habits have been related to the risk of nasopharyngeal carcinoma (NPC), but information on a wide range of macro- and micronutrients is still lacking, particularly for low-incidence countries.Methods:We conducted a hospital-based case-control study in Italy on 198, histologically confirmed, NPC cases of Caucasian ethnicity of 18-76 years of age. Controls were 594 Caucasian cancer-free patients admitted to general hospitals for acute conditions. Nutrients intake was assessed through a validated food-frequency questionnaire. Adjusted odds ratios (ORs) and the corresponding confidence intervals (CIs) were estimated through logistic regression.Results:Dietary intake of carotenoids were inversely related to NPC risk, notably carotene (OR for highest vs lowest quartile=0.46; 95% CI: 0.26-0.79), α-carotene (OR=0.57; 95% CI: 0.33-0.97), and β-carotene (OR=0.42; 95% CI: 0.24-0.75). Increased NPC risk was observed for elevate cholesterol intake (OR=1.85; 95% CI: 1.12-3.05).Conclusion:Study findings suggest a protective effect of carotenoids against NPC in a low-risk population, adding further support to a possible beneficial role of a diet rich in fruits and vegetables in cancers of the head and neck. [ABSTRACT FROM AUTHOR]

Background The association between dietary patterns and head and neck cancer has rarely been addressed. Patients and methods We used individual-level pooled data from five case–control studies (2452 cases and 5013 controls) participating in the International Head and Neck Cancer Epidemiology consortium. A posteriori dietary patterns were identified through a principal component factor analysis carried out on 24 nutrients derived from study-specific food-frequency questionnaires. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using unconditional logistic regression models on quintiles of factor scores. Results We identified three major dietary patterns named ‘animal products and cereals’, ‘antioxidant vitamins and fiber’, and ‘fats’. The ‘antioxidant vitamins and fiber’ pattern was inversely related to oral and pharyngeal cancer (OR = 0.57, 95% CI 0.43–0.76 for the highest versus the lowest score quintile). The ‘animal products and cereals’ pattern was positively associated with laryngeal cancer (OR = 1.54, 95% CI 1.12–2.11), whereas the ‘fats’ pattern was inversely associated with oral and pharyngeal cancer (OR = 0.78, 95% CI 0.63–0.97) and positively associated with laryngeal cancer (OR = 1.69, 95% CI 1.22–2.34). Conclusions These findings suggest that diets rich in animal products, cereals, and fats are positively related to laryngeal cancer, and those rich in fruit and vegetables inversely related to oral and pharyngeal cancer. [ABSTRACT FROM PUBLISHER]

Background/Objective:The European Food Safety Authority (EFSA) recently published dietary guidelines for the intakes of carbohydrates, fiber, fats and water. We evaluated their role on the risk of a specific disease, known to be related to diet.Subjects/Methods:We used data from an Italian case-control study including 1953 colorectal cancer (CRC) cases and 4154 controls. We developed a so-called EFSA index summing up 1 point for adherence to each EFSA guideline. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) of CRC and its subsites were derived from unconditional multiple logistic regression models, for both the index and its components.Results:When each EFSA index component was analyzed separately, we found significant increased risks of CRC for non adherence to the guidelines on linoleic (OR=1.20, 95% CI, 1.07-1.36) and alpha-linolenic fatty acids (OR=1.19, 95% CI, 1.06-1.34). When all the guidelines were included in the same model, no significant association emerged. Compared with minimal adherence, the ORs of CRC for subsequent EFSA index scores were 1.03 (95% CI, 0.72-1.47), 1.05 (95% CI, 0.75-1.48), 1.04 (95% CI, 0.81-1.60), 0.99 (95% CI, 0.69-1.43), and 1.04 (95% CI, 0.67-1.61). No significant association emerged for colon and rectal cancer separately, and for males and females.Conclusions:Overall adherence to the EFSA dietary guidelines is not associated to colorectal, colon and rectal cancer risk in our population. Adherence to guidelines on linoleic and alpha-linolenic fatty acids may have a modest beneficial role on CRC risk. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus (HBV) and hepatitis C virus (HCV) are the major risk factors for hepatocellular carcinoma (HCC). The association of diabetes mellitus with HCC suggests that dietary glycemic load (GL) may influence HCC risk. We have examined the association between dietary GL and HCC. [ABSTRACT FROM PUBLISHER]

Objective:This paper describes the ad hoc methodological concepts and procedures developed to improve the comparability of Nutrient databases (NDBs) across the 10 European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). This was required because there is currently no European reference NDB available.Design:A large network involving national compilers, nutritionists and experts on food chemistry and computer science was set up for the ‘EPIC Nutrient DataBase’ (ENDB) project. A total of 550–1500 foods derived from about 37 000 standardized EPIC 24-h dietary recalls (24-HDRS) were matched as closely as possible to foods available in the 10 national NDBs. The resulting national data sets (NDS) were then successively documented, standardized and evaluated according to common guidelines and using a DataBase Management System specifically designed for this project. The nutrient values of foods unavailable or not readily available in NDSs were approximated by recipe calculation, weighted averaging or adjustment for weight changes and vitamin/mineral losses, using common algorithms.Results:The final ENDB contains about 550–1500 foods depending on the country and 26 common components. Each component value was documented and standardized for unit, mode of expression, definition and chemical method of analysis, as far as possible. Furthermore, the overall completeness of NDSs was improved (99%), particularly for β-carotene and vitamin E.Conclusion:The ENDB constitutes a first real attempt to improve the comparability of NDBs across European countries. This methodological work will provide a useful tool for nutritional research as well as end-user recommendations to improve NDBs in the future.European Journal of Clinical Nutrition (2007) 61, 1037–1056; doi:10.1038/sj.ejcn.1602679; published online 21 March 2007 [ABSTRACT FROM AUTHOR]

Objective: To analyse the association between macronutrient intake and body mass index (BMI).Design: A series of hospital-based case-control studies.Settings: Selected teaching and general hospitals in several Italian regions.Subjects: A total of 6619 subjects from the comparison groups of the case-control studies were included in the analysis.Methods: We obtained data from a validated 78-item food-frequency questionnaire submitted between 1991 and 2002. For various macronutrients, the partial regression coefficient (variation of BMI (kg m(-2)) per 100 kcal increment of energy intake) was derived from multiple linear regression models, after allowance for age, study centre, education, smoking habits, number of eating episodes and mutual adjustment for macronutrients.Results: BMI was directly associated with protein intake among women only (beta = 0.68) and with unsaturated fats in both genders (for monounsaturated fats beta = 0.27 for men and 0.26 for women; for polyunsaturated fats beta = 0.27 for men and 0.54 for women), and inversely related to carbohydrates (beta = -0.05 for men and -0.21 for women) and number of eating episodes in both genders (beta = -0.42 for men and -0.61 for women) and to saturated fats among women only (beta = -0.57).Conclusions: These results confirm and provide convincing evidence that, after allowance for selected covariates including total energy intake, a protein-rich diet is not inversely related to BMI, and a carbohydrate-rich diet is not directly related to BMI. [ABSTRACT FROM AUTHOR]

Flavonoids have been associated with a reduced risk of lung, digestive tract, and certain hormone-related cancers. With reference to prostate cancer, a few epidemiological studies have found an inverse relation with intake of isoflavones, flavonols, and flavones, although the evidence remains limited and inconsistent. The role of six principal classes of flavonoids on prostate cancer was investigated using data from a multicentric case-control study conducted between 1991 and 2002 in Italy. This included 1,294 incident, histologically confirmed carcinomas of the prostate and 1,451 controls admitted to the same hospitals as cases for a wide spectrum of acute, non-neoplastic conditions. The patients 'usual diet was assessed using a validated and reproducible food frequency questionnaire; food and beverage content of six major classes of flavonoids was obtained from the U. S. Department of Agriculture. No association between prostate cancer risk was found with any of the flavonoids analyzed. the multivariate odds ratios for the highest versus the lowest quintile of intake were 0.96 (95% confidence interval, CI = 0.75-1.23) for flavanones, 1.3 (95% CI = 1.01-1.69) for flavan-3-ols, 1.23 (95% CI = 0.95-1.61) for flavonols, 1.09 (95% CI = 0.85-1.40) for flavonols, 1.18 (95% CI = 0.91-1.53) for anthocyanidins, 0.98 (95% CI = 0.76-1.26) for isoflavones, and 1.20 (95% CI = 0.92-1.58) for total flavonoids, all nonstatistically significant. Thus, the results of the present study do not support a protective effect of flavonoids on prostate cancer in this Italian population, characterized by a high intake olavonoid-containing foods (except isoflavone-rich foods). [ABSTRACT FROM AUTHOR]

Objective: The relation between several measures of body iron and atherosclerotic disease, particularly acute myocardial infarction (AMI), is debated. This is of specific interest since iron is frequently included in supplementation and fortification of foods. We assessed the relation between dietary iron intake and the risk of non-fatal AMI.Design: Case-control study. The information was collected by interviewers using a food-frequency questionnaire tested for validity and reproducibility. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were obtained by multiple unconditional logistic regression models, including terms for energy and alcohol intake, as well as for sociodemographic factors, tobacco and other major recognised risk factors for AMI.Setting: Milan, Italy, between 1995 and 1999.Subjects: Cases were 507 patients, below age 79 years, with a first episode of non-fatal AMI, and controls were 478 patients admitted to hospital for a wide spectrum of acute conditions unrelated to known or potential AMI risk factors.Results: Compared with patients in the lowest tertile of total iron intake, the OR was 0.48 (95% CI 0.29-0.82) for those in the highest tertile. The corresponding value for haem iron was 0.71 (95% CI 0.48-1.06), for non-haem, non-alcohol iron was 0.80 (95% CI 0.51-1.24) and for iron derived from alcoholic beverages was 0.60 (95% CI 0.40-0.90). Sex-specific OR for total iron intake were not heterogeneous.Conclusions: In this Italian population dietary iron intake was inversely related to AMI risk. This inverse association may depend on other nutrients present in the major sources of iron in the Italian diet. [ABSTRACT FROM AUTHOR]

Objective: As intake of flavonoids has been associated with reduced risk of coronary heart disease but data on the relation with specific classes of flavonoids are scarce, we assessed the relation between dietary intake of specific classes of flavonoids and the risk of acute myocardial infarction (AMI) in an Italian population.Design: Case-control study. Dietary information was collected by interviewers on a questionnaire tested for validity and reproducibility. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were obtained by multiple logistic regression models including terms for energy and alcohol intake, as well as sociodemographic factors, tobacco and other major recognised risk factors for AMI.Setting: Milan, Italy, between 1995 and 2003.Subjects: Cases were 760 patients, below age 79 years, with a first episode of non-fatal AMI, and controls were 682 patients admitted to hospital for acute conditions unrelated to diet.Results: A reduced risk of AMI was found for increasing intake of anthocyanidins (OR=0.45, 95% CI 0.26-0.78 for the highest vs. the lowest quintile, Ptrend=0.003) and flavonols (OR=0.65, 95% CI 0.41-1.02, Ptrend=0.02). A tendency towards reduced risks, although not significant, was observed for flavan-3-ols (OR=0.73, 95% CI 0.48-1.10) and total flavonoids (OR=0.74, 95% CI 0.49-1.14). No meaningful heterogeneity was found between the sexes. No association emerged for other flavonoids, including isoflavones, flavanones and flavones.Conclusions: High intake of anthocyanidins reduced the risk of AMI even after allowance for alcohol, fruit and vegetables, supporting a real inverse association between this class of flavonoids and AMI risk. [ABSTRACT FROM AUTHOR]

OBJECTIVE:: The reproducibility and validity of coffee, decaffeinated coffee and tea intake has not been adequately studied, particularly in Italy, where coffee drinking is peculiar in terms of type and amount of coffee consumed. DESIGN:: We compared coffee and tea consumption, measured by two interviewer-administered food frequency questionnaires (FFQ), with average intake derived from two 7-day dietary (DD) records (the reference method) on 395 volunteers. The Pearson correlation coefficients (r) were used to assess both reproducibility and validity of information on coffee intake. RESULTS:: A satisfactory level of reproducibility and validity of the pattern consumption was observed for coffee, decaffeinated coffee and tea. The reproducibility for both sex combined showed r of 0.74-0.78 for coffee, 0.57-0.65 for decaffeinated coffee and 0.61-0.67 for tea. The validity was about 0.70 for coffee, around 0.58 for decaffeinated coffee and 0.56-0.60 for tea intake. CONCLUSIONS:: The FFQ is a satisfactorily reliable and valid instrument for collecting information on coffee, decaffeinated coffee and tea intake. SPONSORSHIP:: Supported by the Italian Association for Research on Cancer, Milan, Italy, and by the Commission of the European Communities (Contract No.: QLKI-CT-2000-00069).European Journal of Clinical Nutrition (2004) 58, 674-680. doi:10.1038/sj.ejcn.1601864 [ABSTRACT FROM AUTHOR]

Background: Even if the food supplement industry is one of the fastest growing worldwide, the inappropriate use of these products can potentially cause harms. Considering the key role played by pharmacists in advising citizens on the purchase of food supplements, this cross-sectional observational study evaluates pharmacists’ knowledge, attitudes and practice on this topic. Methods: From September 2020 to February 2021, an online questionnaire implemented through the EU-Survey tool, was administered to pharmacists of both public and private authorized pharmacies of the Friuli-Venezia Giulia (FVG) Region (Italy). The 47 multiple-choice questions about pharmacists’ knowledge (20), attitudes and practice (27), were followed by a sociodemographic section (7 items) collecting data about sex, age, years of experience, degree, role within pharmacy (owner, employee). Descriptive analyses, Chi-square, Shapiro-Wilk and Mann Whitney tests were used and a p-value<0.05 was considered as statistically significant. Results: A sample of 232 questionnaires was collected, 70.7% of which from women. Most responders (77.2%) had a Pharmacy degree, with owners representing the 34.5%. The 61.2% of pharmacists had at least 10 years of experience. Knowledge was generally poor with just 49.2% of the sample scoring above the median value of 11 but higher among pharmacists with more than 11 years of experience. Lesser-known aspects were the possible link between cancer and multivitamin’s abuse and presence of non-labeled agents in food supplements. Responders<=10 years of experience felt more unprepared about vitamin’s dosage and in counselling particular groups of patients (p<0.05). Employees more frequently reported the attitude to purchase food supplements under patient specifical request (p<0.05). Conclusions: Pharmacists’ knowledge about food supplements is scarce and young professionals in particular need further education to ensure a safe and effective purchase of these products to patients. [ABSTRACT FROM AUTHOR]