Papers by Marilena Vitale
The 14th European Nutrition Conference FENS 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
The 14th European Nutrition Conference FENS 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
The global prevalence of type 2 diabetes mellitus (T2DM) has surged in recent decades and the ide... more The global prevalence of type 2 diabetes mellitus (T2DM) has surged in recent decades and the identification of differential glycemic responders can aid tailored treatment for prevention of pre-diabetes and T2DM. A mixed meal tolerance test (MMTT) based on regular foods offers potential to uncover differential responders in dynamical postprandial events. We aimed to fit a simple mathematical model on dynamic postprandial glucose data from repeated MMTTs among partic-ipants with elevated T2DM risk, to identify response clusters and investigate their association with T2DM risk factors and gut microbiota. Data were used from a 12-week multi-center dietary inter-vention trial involving high-risk T2DM adults, comparing high- versus low-glycemic index foods within a Mediterranean diet context (MEDGICarb). Model-based analysis of MMTTs from 155 participants (81 females, 74 males) revealed two distinct plasma glucose response clusters that were associated with baseline gut microbiota. Clust...
European journal of nutrition, Dec 21, 2016
Methods We studied 2573 men and women aged 50-75 years. Among others, anthropometry was measured ... more Methods We studied 2573 men and women aged 50-75 years. Among others, anthropometry was measured by standard protocol and dietary habits were investigated by food frequency questionnaire (EPIC). The intake of polyphenols was evaluated using US Department of Agriculture and Phenol-Explorer databases. Results The mean total polyphenol intake was 683.3 ± 5.8 mg/day. Non-alcoholic beverages represented the main food source of dietary polyphenols and provided 35.5% of total polyphenol intake, followed by fruits Abstract Purpose Proper evaluation of polyphenols intake at the population level is a necessary step in order to establish possible associations with health outcomes. Available data are limited, and so far no study has been performed in people with diabetes. The aim of this work was to document the intake of polyphenols and their major food sources in a cohort of people with type 2 diabetes and in socio-demographic subgroups.
International Journal of Food Sciences and Nutrition, Jul 16, 2023
Research Square (Research Square), Jun 14, 2023
Background The role of dietary Glycemic Index (GI), independently of ber intake, in modulating ca... more Background The role of dietary Glycemic Index (GI), independently of ber intake, in modulating cardiovascular disease (CVD) risk among non-diabetic individuals has not been fully elucidated. Objective To evaluate the effects of a low-versus a high-GI diet, based on a Mediterranean dietary pattern, on cardiometabolic risk factors in individuals at high CVD risk, participating in the MEDGI-Carb intervention study. Subjects and methods : 160 individuals, aged 30-69 years, BMI 25-37 kg/m 2 , with a waist circumference > 102 cm (males) or > 88 cm (females) and one feature of the metabolic syndrome, participated in a multinational (Italy, Sweden, USA) randomized controlled parallel group trial. Participants were assigned to a low GI (< 55) or high-GI MedDiet (> 70) for 12 weeks. The diets were isoenergetic and similar for available carbohydrate (270g/d) and ber (35g/d) content. Fasting metabolic parameters were evaluated in the whole cohort, while an 8-hour postprandial triglyceride pro le was evaluated only in the Italian cohort. Results Blood pressure and most fasting metabolic parameters improved at the end of MedDiet intervention (time effect, p < 0.05 for all); however, no differences were observed between the low-and the high-GI MedDiet groups (time x group effect; p > 0.05 for all). Conversely, the low-GI diet, compared with high-GI diet, signi cantly reduced postprandial triglycerides (iAUC) after lunch (-80%; p = 0.013). Conclusions Consuming a low-GI in comparison with a high-GI MedDiet does not differentially affect any of the cardiometabolic risk factors at fasting in individuals at increased cardiometabolic risk. Conversely, the low-GI diet reduces the postprandial plasma triglyceride pro le. Clinical Trial Registry Number: NCT03410719, (https://clinicaltrials.gov).
HAL (Le Centre pour la Communication Scientifique Directe), Jun 25, 2017
Nutrients, Feb 8, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
International Journal of Food Sciences and Nutrition, Jun 21, 2018
Overall, similar to other Mediterranean diet score, for MEDI-Quest nine food categories were cons... more Overall, similar to other Mediterranean diet score, for MEDI-Quest nine food categories were considered: (1) fruit, (2) vegetables, (3) wholegrain cereals, (4) legumes and nuts, (5) fish and fish products, (6) meat and meat products, (7) foods rich in animal fat, as butter, cake, pastries, dairy products (not milk and yogurt), (8) alcohol intake, and (9) olive oil. Each food category provides three answers (a, b, c) with three different scores (2, 1, 0): answer "a" gets "2" points, "b" "1" point, and "c" gets "0" points. For food groups typical of the Mediterranean diet (fruit, vegetables, wholegrain cereals, legumes and nuts, and fish), a value * P<0.
Elsevier eBooks, 2016
Pasta is a key component of the traditional Mediterranean diet. The best pasta is produced using ... more Pasta is a key component of the traditional Mediterranean diet. The best pasta is produced using durum wheat semolina, which confers excellent rheological and organoleptic properties. Among carbohydrate-rich foods, pasta has a low glycemic index, which has beneficial effects on the regulation of body weight, blood glucose and insulin metabolism, and plasma lipid control. In order to favor whole grain product consumption, whole grain durum wheat and other grains can also be used to make regular pasta. Moreover, recently, several additional ingredients such as fibers, proteins, and vitamins have been used to improve the nutritional properties of pasta.
Nutrition Metabolism and Cardiovascular Diseases, Oct 1, 2021
Nutrients
Background: Our aims were to evaluate the relationship of habitual legume consumption with blood ... more Background: Our aims were to evaluate the relationship of habitual legume consumption with blood pressure (BP) control in a large cohort of people with T2D and hypertension, and to investigate whether specific nutritional components of legumes or other foods may contribute to regulate BP levels. Methods: We studied 1897 participants with T2D and hypertension. Dietary habits were assessed through a validated food frequency questionnaire. Sex-specific quartiles of legume consumption were created. Results: Higher legume consumption was associated with a lower intake of energy, carbohydrates, glycaemic load, alcohol, and sodium, and a significantly greater intake of proteins, fat, monounsaturated, polyunsaturated, fibre, potassium, and polyphenols. Significantly lower systolic and diastolic BP values were observed in the highest vs. lowest quartile of legume consumption (132.9 ± 6.7 vs. 137.3 ± 7.0 mmHg, p < 0.001; 78.9 ± 4.1 vs. 81.0 ± 4.2 mmHg, p = 0.002; respectively), as well as ...
Nutrients
A Mediterranean-style healthy eating pattern (MED-HEP) supports metabolic health, but the utility... more A Mediterranean-style healthy eating pattern (MED-HEP) supports metabolic health, but the utility of including low-glycemic index (GI) foods to minimize postprandial glucose excursions remain unclear. Therefore, we investigated the relative contribution of GI towards improvements in postprandial glycemia and glycemic variability after adopting a MED-HEP. We conducted a randomized, controlled dietary intervention, comparing high- versus low-GI diets in a multi-national (Italy, Sweden, and the United States) sample of adults at risk for type 2 diabetes. For 12 weeks, participants consumed either a low-GI or high-GI MED-HEP. We assessed postprandial plasma glucose and insulin responses to high- or low-GI meals, and daily glycemic variability via continuous glucose monitoring at baseline and post-intervention. One hundred sixty adults (86 females, 74 males; aged 55 ± 11 y, BMI 31 ± 3 kg/m2, mean ± SD) with ≥two metabolic syndrome traits completed the intervention. Postprandial insulin c...
Nutrients
Background: There are still open questions with respect to the optimal dietary treatment in patie... more Background: There are still open questions with respect to the optimal dietary treatment in patients with type 2 diabetes (T2D) and coexisting non-alcoholic steatohepatitis (NASH). The aim of this study is to investigate, in patients with T2D, the association between NASH, dietary component intake, food groups and adherence to the Mediterranean diet. Methods: Cross-sectional analysis of 2026 people with T2D (1136 men and 890 women). The dietary habits were assessed with the European Prospective Investigation into Cancer and Nutrition (EPIC) questionnaire. NASH was identified by the Index Of NASH (ION). Based on the cluster analysis two dietary patterns were identified: the NASH and the NO-NASH pattern. Results: The macronutrient composition of the diet was similar in the two patterns. However, the NASH pattern compared with the NO-NASH pattern was characterized by a significantly lower content of fibre (p < 0.001), β-carotene (p < 0.001), vitamin C (p < 0.001), vitamin E (p...
Atherosclerosis, 2018
Aim: Several recent studies have reported that sodium-glucose cotransporter-2 (SGLT-2) inhibitors... more Aim: Several recent studies have reported that sodium-glucose cotransporter-2 (SGLT-2) inhibitors increase both low-density lipoprotein (LDL) and high-density lipoprotein (HDL)-cholesterol (C). In this study, we determined the effect of SGLT-2 inhibitors on LDL and HDL-C subspecies. Methods: Single center, open-label, randomized, prospective design was employed. 80 patients with type 2 diabetes taking prescribed oral agents were allocated to receive dapagliflozin (n¼40) or sitagliptin (n¼40) as addon treatment. Fasting blood samples were collected before and 12 weeks after this intervention. Small,dense (sd) LDL-C, large buoyant (lb) LDL-C, HDL2-C, and HDL3-C were measured using our established homogeneous assays. Results: Dapagliflozin significantly decreased body weight, systolic blood pressure, plasma triglycerides and liver transaminases, and increased adiponectin; sitagliptin did not affect these measurements. For the patients with dapagliflozin treatment, no significant change was observed in their LDL-C and apolipoprotein (apo) B levels, whilst their HDL-C and apo AI were increased. Interestingly, however, we found that sd LDL-C decreased by 20% and lb LDL-C increased by 18%. The level of lb LDL-C was remarkably elevated (53%) in individuals (n¼20) with elevated LDL-C by dapagliflozin, whilst sd LDL-C remained suppressed (20%). Dapagliflozin increased HDL2-C by 18% without affecting HDL3-C. Sitagliptin did not alter plasma lipids or lipoprotein subspecies. Conclusions: Dapagliflozin SGLT-2 inhibitor suppressed potent atherogenic sd LDL-C and increased HDL2-C, a favorable cardiometabolic marker. Although LDL-C levels are elevated by treatment with dapagliflozinan, this was due to increased concentrations of the less atherogenic lb LDL-C.
Clinical Nutrition, 2018
Background & aims: Dietary polyphenols have beneficial effects on glucose/lipid metabolism in sub... more Background & aims: Dietary polyphenols have beneficial effects on glucose/lipid metabolism in subjects at high risk to develop type 2 diabetes; however, the underlying mechanisms are not clear. We aimed to evaluate: 1) the acute effects of the consumption of a drink rich in polyphenols from red grape pomace (RGPD) on glucose/insulin and triglyceride responses to a standard meal in healthy individuals, and, 2) the relationship between plasma levels of phenolic metabolites and metabolic parameters. Methods: Twelve healthy men, aged 20e40 years participated in a randomized, controlled study according to a cross-over design. After a 3-day lowepolyphenol diet, all participants consumed, on two different days and separated by a one week interval, after an overnight fast, a drink rich in polyphenols (1.562 g gallic acid equivalents (GAE)) or a control drink (CD, no polyphenols), followed after 3 h by a standard meal (960 kcal, 18% protein, 30% fat, 52% CHO). Blood samples were taken at fasting, 3 h after the drink, over 5 h after the standard meal and at fasting on the next day to measure plasma concentrations of glucose, insulin, triglyceride and phenolic metabolites. Results: Glycemic and triglyceride post-meal responses were similar after both the RGPD and the control drink. In contrast, postprandial insulin incremental area (iAUC 0e5h) was 31% lower (p < 0.05), insulin secretion index was 18% lower (p < 0.016) and insulin sensitivity (S I) index was 36% higher (p ¼ 0.037) after the RGPD compared to CD. Among phenolic metabolites, gallic acid correlated inversely with the insulin response (r ¼ À0.604; p ¼ 0.032) and positively with the S I index (r ¼ 0.588, p ¼ 0.037). Conclusions: RGPD consumption acutely reduced postprandial insulin levels and improved insulin sensitivity. This effect could be likely related to the increase in gallic acid levels. This drink, added to usual diet, could contribute to increase the daily intake of polyphenols, with potential health benefits. Clinicaltrials.gov identifier: NCT02865278.
Nutrition, Metabolism and Cardiovascular Diseases
Background and aims: Human and planetary health are inextricably interconnected through food syst... more Background and aims: Human and planetary health are inextricably interconnected through food systems. Food choices account for 50% of all deaths for cardiovascular diseases (CVD) e the leading cause of death in Europe e and food systems generate up to 37% of total greenhouse gas (GHG) emissions. Methods and results: Based on a systematic revision of meta-analyses of prospective studies exploring the association between individual foods/food groups and the incidence of CVD, we identified a dietary pattern able to optimize CVD prevention.. This dietary pattern was compared to the current diet of the European population. The nutritional adequacy of both diets was evaluated according to the European Food Safety Authority (EFSA) recommended nutrient intake for the adult population, and their environmental impact was evaluated in terms of carbon footprint (CF). As compared to the current diet, the desirable diet includes higher intakes of fruit, vegetables, wholegrains, low glycemic index (GI) cereals, nuts, legumes and fish, and lower amounts of beef, butter, high GI cereals or potatoes and sugar. The diet here identified provides appropriate intakes of all nutrients and matches better than the current Europeans' one the EFSA requirements. Furthermore, the CF of the proposed diet is 48.6% lower than that of the current Europeans' diet. Conclusion: The transition toward a dietary pattern designed to optimize CVD prevention would improve the nutritional profile of the habitual diet in Europe and, at the same time, contribute to mitigate climate change by reducing the GHG emissions linked to food consumption almost by half.
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Papers by Marilena Vitale