“Downstream” considerations…

We are part of an ecosystem … but what exactly is an ecosystem? Any vocabulary defines it as: “a set of living beings and non-living matter that interact in an environment, constituting a self-sufficient system in dynamic balance”.

This is the first reason that should lead us to approach food with a vision that goes beyond the purchase price of what we bring to the table. A greater demand leads a more rapid change organic farming should not exist as a ‘niche product’ because the whole agri-food system should be based on respect for the ecosystem.

The choice of organic and seasonal products, are not only synonymous with ‘healthy’ but also aims to support an agriculture based on the intrinsic fertility of the soil, on the use of rotational crops or poly-culture, that is different cultivations that coexist in the same land or that are alternated from one year to the next, the set-aside of the land or even the coexistence of ‘protective plants‘, often leguminous or annual herbaceous plants that increase the natural biological control capacity of parasites, also improving the microclimates of crops . Without going too long, we must also consider the reduction of emissions in the environment of climate-changing gases typical of conventional crops / farms, considered one of the main causes of climate change.

The virtuous link between organic farming and biodiversity is supported by a growing number of scientific evidences. A comparative study between organic and conventional arable crops found that in the first case there is 57% more species of spontaneous plants, with a doubling of rare species; as well as a doubling of the species of invertebrate animals (e.g. earthworms, insects) useful for crop maintenance.

…Organic for everyone…

Organic farming is synonymous with sustainable development, but above all sustainable development, since it is an agriculture that supports the maintenance of ecosystems and biodiversity. This leads to the recovery of a self-sustaining balance and, if it is sustained and respected, it will also benefit future generations. The organic supports crops and livestock that respect as much as possible the natural habitat of plants and animals, the seasonality and the use of renewable energies.

Many small realities, easily available in local markets managed by direct producers or through GAS (sustainable buying groups), are increasing the cultivation of local varieties of plants and breeding of native breeds of animals, respecting their nature. A greater number of organic farms in a given geographical area leads to an enrichment of the territory’s biodiversity and landscape. Certainly the conversion is not immediate but takes from 1 to 5 years, depending on the starting conditions (exploitation / overcropping, use of pesticides / zoopharmaceuticals, etc.).

…from the field to the table

Starting from the fact that the daily intake of food per capita, at least for the industrialized countries, is in excess and that the incorrect diet is considered a cause of chronic pathologies and deaths, we try to give us some basic rules to make a conscious shopping.

A food produced in ‘organic regime’ provides the consumer with healthy food, free of toxic substances and richer in nutrients, both in macronutrients terms (carbohydrates, proteins and fats, including essential fatty acids, PUFA mainly of the omega 6 series), that of micronutrients (vitamins, mineral and in general bioactive substances that support metabolic processes).

Biodiversity also lies in starting with raw materials, such as ancient cereals, which guarantee nutritionally richer and less harmful products. It is always good to reduce the assumption of over-processed foods in favor of raw materials; better grains in grain than baked products, fresh and not frozen or packaged vegetables, fresh fruit than fruit juices, fresh fish, fished, meat from animals fed with cereals and not flours, preferably ‘closed circuit’ products from the same company .

There is also a seasonality for fish; there are species that are mainly found in autumn / winter such as turbot and mullet, others in spring / summer such as anchovies, seabream and sea bass and others all year round. It is always better to buy small-sized fish caught and not bred, respecting the fishing of small-fish.

In conclusion, the rules of conscious shopping must consider 0 kilometer rule, respect for ecosystems and seasonality. Choosing the food we consume is a great form of freedom.

The American journalist Michael Pollan in one of his books gives us a fundamental advice “… when you go shopping, take your great-grandmother with you (as the grandmother may be too young) and buy only what she recognizes as food “.

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Bibliography:

(1) Il manuale del Biologico; D.Caccioni, L. Colombo – Edagricole
(2) Michael Pollan ‘ In difesa del cibo’ – Adelphi
(3) https://www.slowfood.it/wp-content/uploads/2014/09/Mangiamoli_Giusti_no_abb.pdf
(4) https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30041-8/fulltext

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Article by:

Dr.ssa Maria Elena Cafagna – Nutritionist Biologist
The dietary advice in this article is not intended to replace a personalised dietary plan and should be adapted to specific cases.

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Healthy ageing: from Lifespan to Healthspan

A few weeks ago, an article was published in The New Yorker magazine entitled: Can We Live Longer but Stay Younger? The question of a not only longer but healthier life is emerging as a result of the aging of populations. In this regard, both government agencies and international organizations, together with the medical-scientific world, are focusing the attention on how to have a healthy life rather than just a pure extension of average life. The European Commission, for example, has established a specific strategic program called Active and Healthy Aging for active and healthy aging (1).

In the last 100 years we have witnessed a considerable increase in life expectancy in Western countries, in many cases increased by over 20 years, thanks to the progress that led to a reduction in early mortality (infantile, perinatal, infectious diseases, among the most relevant) that represented in Italy, at the beginning of the 20th century, over 30% of the causes of death. This lengthening of life expectancy – which in Italy we remember is currently 80,2 years for men and 85 years for women (2) – is recently showing a negative side effect due to a lower number of years lived in health. According to data from the Ambrosetti Institute, the years lived in unhealthy conditions have gone from 13.7 in 2005 to 20.8 in 2014; this data is in accordance with the increasingly early onset of chronic degenerative diseases, a multifactorial phenomenon and not only linked to age as a risk factor.

Blue Zones

In the 2000s Dan Buettner, a National Geographic journalist together with a team of experts, based on studies of gerontology, carried out researches all over the world identifying the 5 geographical areas where the population is the most long-lived and enjoys excellent health. These regions, with the greatest number of happy long-lived, were called Blue Zones (figure 1) (3) and were as follows: Okinawa (Japan), Ogliastra (Sardinia – Italy), Nicoya (Costa Rica), Ikaria (Greece) and Loma Linda (California).

Figure 1: Blue Zones map

Once the “secret” of this longevity in health was discovered, the researchers tried to identify the key factors, such as the eating habits and lifestyle that these areas share, and then encourage them to propose a sort of “health recipe”.

What’s their “health recipe”?

The diet in these areas “Blue Zone Diet” (figure 2) is based mainly on vegetable foods, with a high frequency of legume consumption, a low presence of meat and the almost total absence of processed foods rich in fat and refined sugars. The exact opposite of the American Standard Diet (figure 3) which has a prevalence of animal sources of protein and fat, many simple sugars, refined foods and very few vegetables.

Figure 2: Blue zones Standard diet – Figure 3: American Standard diet

Physical activity in these populations is not planned and does not have a sequence of exercises, but is part of their daily activities: movement, gardening, vegetable garden care, etc. One aspect that strikes about the eighty-year-olds of Okinawa, for example, is the good psycho-physical form that allows them to perform normally the activities typical of those who are 50-60 years old.

The body mass index (BMI, ratio of weight to height squared) of the Blue Zones long-lived is medium / low and varies between 18 to 22, indicative of a diet without excess calories. The blood lipid profile (LDL, homocysteine, etc.) is optimal, as are the level of oxidative stress.

Other common characteristics of the Blue Zones are the absence of excessive stress, the strong sense of community, the presence of healthy relationships with friends and family, the connection with the environment and a spiritual vision of life which is given a reason and a deep meaning.

Lifestyle Medicine

The key to longevity therefore lies not only in favorable genetics but in a set of elements that that are among the modifiable factors of lifestyle including:

• the food \
• physical activity;
• sleep;
• stress management;
• the absence of smoke;
• the presence of healthy interpersonal relationships;
• the presence of a purpose in life.

The effectiveness in terms of health of of these lifestyle factors is supported by scientific evidence, among these are noteworthy those concerning the epigenetic mechanisms, because they have effects of modulation of the expression of our genes, expanding the deterministic view that binds our fortunes to the DNA inherited.

Being modifiable elements, lifestyle factors do not represent the destiny of an individual, but the possibility, through their adoption, of an extension of the healthy life period, from the point of view of Healthspan.

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Bibliography:

(1) European Partnership for improving Health, Equity & Wellbeing: http://www.healthyageing.eu/
(2) World Health Statistics 2014 https://www.who.int/mediacentre/news/releases/2014/world-health-statistics-2014/en/
(3) Mishra B.N. Secret of Eternal Youth; Teaching from the Centenarian Hot Spots (“Blue Zones”). Indian J Community Med. 2009 Oct; 34(4): 273–275.

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Article by:

Dr. Francesco Bonucci – Nutrizionist[/vc_column_text][vc_column_text css=”.vc_custom_1559773750638{padding-top: 10px !important;padding-bottom: 10px !important;}”]The diet advise, written in the article, are not intended to be a substitute for a personal nutrition plan and should be adapted to specific cases

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The biological activity of dietary supplements:

“Do not use dietary supplements as a substitute for a varied and balanced diet, in a healthy and active lifestyle context. Remember that a dietary supplement cannot “compensate” for bad habits. ” (from the Decalogue of the Ministry of Health) (1)

The assertion that no multivitamin or supplement can replace the health effect of a balanced diet is confirmed, among others, by a recent prospective cohort study of over 30,000 people conducted for about 11 years in the United States (2).

Food supplements are substances that, as the name suggests, supplement normal nutrition with a nutritional or physiological effects. This category also includes nutraceuticals, products that contain substances present in food, appropriately dosed, concentrated and purified, in order to offer specific health benefits.

The standard diet of modern man

The modern Western diet, among the various negative elements, is providing excess calories (simple sugars, animal proteins, saturated fatty acids and refined oils) on the one hand and micronutrient deficiencies on the other. An increase in the incidence of overweight and obesity is therefore observed, even in the presence of cases of malnutrition.

In this scenario, diets that are unbalanced and far from the famous reference of the Harvard school’s healthy dish, we are witnessing a paradoxical growth in the consumption of supplements and nutraceuticals, with the idea of ​​compensating for incorrect dietary habits. According to US Consumer Survey on Dietary Supplements (2018) data, 75% of American adults use supplements and a large part of them to ensure the nutrients they need.

Omega 3 levels in the population

Among the nutrients at risk of deficiency are the essential fatty acids of the Omega 3 series and in particular those with a long chain EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), which presence in the body depends exclusively on food sources.

Remember that essential means a nutrient that must necessarily be introduced with the diet because the body is unable to synthesize it independently.Figure 1: in the cartography of this study (3) the blood levels of EPA + DHA related to their presence in human plasma (triglycerides or phospholipids), whole blood and erythrocytes are grouped together. The lowest levels of omega 3 are found in U.S.A., in Central and South America, in parts of Europe, Asia and Africa. Higher values ​​of LC Omega 3 are observed in Eastern countries from the Japanese sea site, in the Scandinavian countries, in Alaska and in the regions where the indigenous populations have not adopted a Western food style.

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Some insights on the role of Omega-3:

DHA: essential fatty acid

Synergy and personalization: the lipidomic nutraceuticals

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Main critical points of the integrators

If a product is natural it does not mean that it is healthy regardless or that it is free of side effects.

• assumptions of excess quantities, which exceed the tolerable upper intake level;
• poor bioavailability of the principle we want to integrate;
• presence of unwanted substances with possible side effects.

Regarding this last point, the US the Food and Drug Administration (FDA) recently warned of the unwanted presence of pharmacological substances in 776 food supplements. These substances include: steroids for muscle growth, anorectic drugs for weight loss and other pharmacological active ingredients for erectile dysfunction (4).

“One size doesn’t fit all”

The recent automation of molecular analytical techniques has paved the way to the customization of interventions, whether they are pharmacological, nutritional, integration or nutraceutical. For supplements it is important to consider, among other things, the bioavailability (molecular shape, presence of cofactors, etc.), the quantity and methods of intake and also the quality of the raw material.

It would be desirable to prescribe fatty acid supplements, after a careful dietary history and, if possible, an assessment of individual nutritional status by a health professional.

For a specific qualitative-quantitative analysis of the fatty acids that make up cellular membranes, there is the possibility of performing the lipidomics test with standardized methods (FAT PROFILE, fatpharmacy) in a metabolic-nutritional reading key. With this molecular medicine exam, useful information is obtained to restore the balance of erythrocyte cell membranes, through integration and personalized nutrition.

Critical aspects of omega 3 supplements

In the Italian reference standards for nutrition (LARN), with regard to fats to be considered, it is specified to keep the presence of saturated fatty acids low (SFA <10% total energy) and to eliminate trans fatty acids from the diet. The reference target for ALA is from 0.2 to 5% of the total energy, while for EPA and DHA it is 250 mg. It seems obvious that these criteria must also be taken into account for integrators.

The certification on a voluntary basis called IFOS can be useful as a guarantee of product quality, even if not indispensable. It is an independent organization, specialized in the analysis of omega 3-based products and which, after careful analysis, certifies their purity. Since the food matrix of omega 3 supplements are fish species oil (fish, crustaceans, algae), this by its nature may be subject to the presence of pollutants present in the seas or xenobiotics of fish farms.

Let’s see some products regularly on the market through the critical reading of his label.

	Percentage of omega 3	Type of omega3	Other fatty acids	Presence of antioxidants	Presence of co-factors
SUPPLEMENT A	53%	EPA-DHA ratio:1,5; other ALAs	of which saturated fatty acids 6.8%	Vit. E, Vit. C, Astaxantina	Alfa-GPC
SUPPLEMENT B	75%	EPA-DHA ratio:1,0; other omega3 not defined	not specified, 25% of other fatty acids	not indicated	not indicated
SUPPLEMENT C	35%	EPA-DHA ratio:1,7; other DPA, ALA	not specified, 65% of other fatty acids	Vit. E	not indicated
SUPPLEMENT D	43%	EPA DHA ratio:1,5	not specified, 58% of other fatty acids	not indicated	not indicated

The table shows, by way of example, the compositions of four omega-3 supplements for free sale, contained within the single capsule.

The contents of saturated fatty acids are rarely reported on the label and, in our sample of products, only one clearly indicates this. In other cases it can be assumed that the main component not indicated is monounsaturated fatty acids, saturated fatty acids, and a small part of omega 6. Remember that the intake of saturated fatty acids should be low and knowing its content would be extremely useful information for the consumer. Unfortunately, it is a fact that is almost never declared in this type of products.

The presence of any antioxidants and cofactors represents an advantage for the stability of the product and to encourage the incorporation into the cell membranes of omega 3, a fundamental condition to make them functional. This peculiarity has been found only in product A.

The toxicity of trans fatty acids and their deleterious effect on health is scientifically known. Since trans-isomerization is a reaction involving double bonds, even polyunsaturated fatty acids (PUFAs) under certain conditions can potentially contain them. Noteworthy is a study conducted on Omega 3 supplements that found the presence of EPA trans in fish oil products that underwent deodorization (5). The destiny of these compounds is forming phospholipids and in this study the trans fatty acids were found in the mitochondrial membranes of the liver, causing dysregulations of organ functions in animal models.

Personalized integration

Even at the molecular level it is possible to verify that one size doesn’t fit all and that for example, a person might need DHA and not EPA, or GLA (a fatty acid from the Omega-6 series), or even from ALA to restore the right ratio Omega-6 / Omega-3, SFA / MUFA, etc.

In molecular terms, the choice of fatty acid supplements must be made in order to obtain the membrane balance. This level of detail can be verified by examining the lipidomics.

Positive health effects of omega-3

The beneficial effects of these fatty acids are many, being precisely the main constituents of the cellular membranes and characterizing some tissues, such as the nervous and retina, play a fundamental role in the growth and neurodevelopment phases. We must not forget that our cells are subjected to continuous replacement and therefore the contributions of these essential nutrients must never be lacking not only in growth, but also in all stages of life.

Nutritional Claims

The European food safety authority EFSA, through its expert panels, has validated claims or health claims that can be used for omega-3:

ALA: contributes to the normalization of circulating cholesterol levels;

DHA: contributes to the maintenance of normal vision.

EPA and DHA: contribute to the maintenance of brain function, normal triglyceride values, blood pressure and cardiac function.

The advice of the pharmacist and nutritionist biologist for the choice of the omega-3 supplement

• avoid DIY (do it yourself) or advice from friend and family or even information found on the internet;
• Be wary of miracle products, well that goes are useless
• check the ingredients on the label;
• do not follow only the price criterion when choosing the product;
• rely on the indications of qualified health personnel;
• remember that the dosage must be personalized;
• rely on official sales channels;
• if in doubt, check that the product is registered with the Ministry of Health.

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Bibliography:

(1) http://www.salute.gov.it/imgs/C_17_opuscoliPoster_191_allegato.pdf
(2) Chen F. Association Among Dietary Supplement Use, Nutrient Intake, and Mortality Among U.S. Adults: A Cohort Study. Ann Intern Med. 2019 Apr
(3) Stark KD et al. Global survey of the omega-3 fatty acids, docosahexaenoic acid and eicosapentaenoic acid in the blood stream of healthy adults. Progress in Lipid Research 2016
(4) Unapproved Pharmaceutical Ingredients Included in Dietary Supplements Associated with US Food and Drug Administration Warnings. JAMA Netw Open. 2018;1(6)
(5) Ferreri C. et al. Trans fatty acids: chemical synthesis of eicosapentaenoic acid isomers and detection in rats fed a deodorized fish oil diet. Chem Res Toxicol. 2012 Mar 19;25(3):687-94.

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Article by:

Francesco Bonucci – Nutrizionist
Dr.ssa Federica Oreglia – Pharmacist

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What can be seen as “allergies”:

Spring is the time of year when all the nature come back to life, but with it reawakes the symptomatology of mane persons who suffer from inhalant allergy, such as pollen. Exists furthermore, cross-reactive alimonies, when ingests, they can amplify the reaction.

Allergy is an immune response, predominantly antibody type, characterized by a rapid appearance (within a few hours, sometimes even a few minutes) of acute symptoms such as respiratory disorders (for example asthma or rhinitis), oral allergic syndrome, rush and angioedema, gastrointestinal disorders up to the anaphylactic shock if not pharmacologically action is taken.

The allergen is the substance that stimulated the reaction is a protein (e.g. milk caseins).

Some other disorders beside allergies:

Otherwise there are people who suffer all year round from continuous disturbs attributable to an immunity system stimulation, known as sub-clinical inflammation which consequently leads to gastro intestinal disorders, swelling feeling, difficult digestion, up to a full overt pathology such us gastritis, intestinal syndrome, frequent headaches. This condition often becomes a purchase for companies and “health professionals” who propose intolerance tests, non-scientifically validated for diagnostic purposes. The validated tests have been published by the Department of Health in the “food allergies and consumer safety” report.

The intolerance scenario:

Let’s start by defining what an intolerance actually is or what lies behind those frequently increasing “food intolerance”. The intolerance is enzymatic lack/absence, like the lactose intolerance, a sugar present in milk, does not allow the absorption and digestion of it into the small intestine. The lactase breaks down the lactose disaccharide in glucose and galactose, two monosaccharides able to be absorbed. Condition that can be verified through lactose breath test, which consists in the collection of the breath after the assumption of a lactose mixture.

The amount of hydrogen produced by bacterial fermentation of undigested lactose, determines tolerance/intolerance.

Another form of intolerance, much more rare, is Favism, which consists in the absence of an enzyme, normally present in red blood cells (glucose 6-phosphate-dehydrogenase) which comes in in the metabolic pathway of pentose-phosphate sugars. This condition has been wrongly named Favism since present in those subjects, mostly males, when consuming fava beans or simply inhaling the pollens neara fava bean fields, leads to hemolytic crises.

However,we must say, that even Lactobacilli, bacteria present in the intestinal tract or in foods like milk kefir, produce lactase, so even a dysbiotic condition, an imbalance of the intestinal microbial population, could make us more sensitive.

This condition, but even the real allergy can became worse due to a ‘ leaky intestine’, known as Leaky Gut Syndrome, meaning a more permeable gut to many other substances, including food particles that intended to come in contact with the intestinal immune system (GALT) and became a silent inflammation cause and a disease. Also NCGS, non celiac gluten sensitivity, is related to intestinal permeability.

Which is therefore the best way to restore a state of health?

Certainly eliminate the foods which you are allergic to, whose allergy that has been diagnosed by validated tests (prick test, pricky by prick, patch test, oral simulation test, …) or intolerant (dairy products containing lactose, fava beans); in all other cases it is advisable to consult a specialist who evaluate the patient’s lifestyle, including food habits, and take the necessary measures.

Nutrition and the food choice have a fundamental part; abandon sugars rich foods, hydrogenated fats, industrial foods in favor of low-processed foods, rich in fiber, source of short-chain fatty acids and useful fats, with an anti-inflammatory activity, such as those present in fish, in nuts, wheat germ of whole grains of cereals or whole wheat flour, which are not the result of mixtures of white flour and bran.

It is also very important to learn reading the label, especially the ingredients list, to verify the absence of the allergen, or the presence of additives or a large quantity of ‘useless’ ingredients, if not ‘harmful’, from a nutritional point of view.

Must pay attention also to the expiry date; a whole wheat flour, for example, cannot have a shelf-life of more than 10/12 months, since the presence of wheat germ increases humidity and therefore the deterioration of the product.

Be intolerant of overwrought food and a sedentary lifestyle!

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Bibliography:

http://www.salute.gov.it/imgs/C_17_pubblicazioni_2788_allegato.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6148544/ Diet induced changes in the microbiota and cell composition of rabbit gut associated lymphoid tissue (GALT)
https://www.ncbi.nlm.nih.gov/pubmed/22955358 Mucosal permeability and immune activation as potential therapeutic targets of probiotics in irritable bowel syndrome.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4517012/ Gluten Psychosis: Confirmation of a New Clinical Entity

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Article by:

Dr.ssa Maria Elena Cafagna – Nutritionist Biologist
info@nutrizionistacafagna.it
The dietary advice in this article is not intended to replace a personalised dietary plan and should be adapted to specific cases.

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Circadian cycle: does the biological clock exist and is it related with metabolism?

The 2017 Nobel Prize for the Medicine or physiology has been assigned to three north Americans researchers for their discovery on the molecular mechanisms which controls the circadian rhythms.

The circadian term is attributed to the physiological phenomenon related to day-night rhythm; the origin is Latin and came from two words: “circa” approximately and “dies” day. The human being like any other living being has an internal clock that has developed during the evolution on this planet as a result of the nature cycles.

For example, following an ideal rhythm, early in the morning, we assist a body temperature increase, a reduction of circulating melatonin, a pick of cortisol and the predominance of the sympathetic nervous system (SNS). These neuro-hormonal changes predispose the body to the assumption of a good energetic meal and the performance of all the daily activities with the predominance of the glycolytic metabolism. At dusk begin a sequin of opposite mechanism that lead to the nightly faze of fasting, allowing, during this time lapse, the secretion of leptin and all the energetic antioxidant phenomenon, like the fats catabolism. A good quality and quantity of sleep assure the production of GH (growth hormone), guarantees the correct operating of restoration and cleaning cellular mechanism, including the neuronal one (BDNF brain neurotrophic factor), needed for the efficiency preservation of human biological machine. (1)

Modulation of the Circadian Rhythms with the lifestyle:

Nutrition, physical activity and sleeping are three lifestyle pillars that contribute to the safeguarding of the human health and are important circadian rhythms modulators.

In this integrated health vision with the physiology and chronobiology it is all about what, how much and when do we have to eat, exercise and sleep during the 24 hours.

If the natural rhythms are ignored and unsynchronized from itself, the internal metabolism will alternate, for example the glucose metabolism and the insulin resistance, contributing to a major susceptibility compared to pathologies, like cardio metabolic and neurodegenerative ones (1,2).

Circadian Rhythm in the 21st Century:

The current lifestyles are characterized by a poor natural light exposure and the use of the artificial light prolonged within the late-night hours. Regarding the nutrition, comparing it even only with two past generations, exist a much longer food intake time laps, which do not provide a long night fasting and not permitting the optimal energy purposes oxidation of the fat ‘storage.

How does the Circadian system work?

When a ray of light heats our retina, it induces a neuronal signal that activate the suprachiasmatic core of the hypothalamus, where resides so-called Master Clock and form here leaves the hormonal messages turned to the rest of the human body. Every single organ owns a periphery clock, which it’s synchronized from the central signal that works like a metronome. At the molecular level, every single cell has an internal clock that regulate the transcription of thousands of genes.

Are all light types identical?

The melanopsin, a protein produce by the eye retina, is activated only by some luminous frequency ranges. The photoreceptors are stimulated by the natural day light, and only partially by the artificial light of the incandescent bulbs, while on the contrary the screens blue light and the cold led lights lead to the stimulus activation.

It exits special lenses that act as a filter for the light frequencies and stimulate the retinal photo receptors and therefore the Central Nervous System (CNS). This kind of glasses serve not to inhibit, due to the light, the melatonin secretion that normally take place in the very first night hours and provide the regular sleep circle.

Food as a circadian regulator:

The food is an important circadian regulator because it is able to synchronize the Central Nervous System (CNS) clock with all the periphery clocks. Remember that most of the organs possess a biological clock and has its own rhythm which also occurs for the microbiome. The optimization of circadian synchronicity is linked to the meal intake signal, which should be maximum during the day phases when the glucocorticoids activation and the SNS is high (breakfast and lunch) for supporting the major human activity periods. Towards evening, in reverse, the dinner should have a light energy load and should be consumed early in the evening. It is obviously that this kind of “timing” it is very different from that one that our society has adopt, but it is alike to that of our grandparents and it is steel diffuse in some rural and mountain areas.

Experiments conducted at north American Salk Institute for Biological Study show interesting results regarding, in particular, the same diet on an animal model divided into two groups:

• the first group feed within a 15 hours’ time leaps
• the second one, with a shorter time leap (time-restricted feeding) of 8-10 hours

After 18 weeks, the first group subjects were obeses and show signs of pathologies; meanwhile the second group subjects were in good health. The interesting part of this experiment is the return at the normal weight and good health of the first group subjects following the time restricted feeding (3).

Although being in an continues evolution, it is clear that the use of the time leaps (time restricted feeding) and the circadian have an extremely impotence for the human being health and for the maximum performance achievement. Practically, the science confirms that fact that the traditional cultural heritage faded over the centuries has been interrupted by the recent technological development.

A look at lipids from the point of view of circadian rhythms:

The metabolic effects of circadian rhythms also involve the homeostasis of lipids, affecting the levels of circulating fats and their deposits and/or liver accumulation. Dyslipidemia and obesity are found in those who have disturbed circadian rhythms, as in shift workers or in laboratory animal models. A recent study conducted on a population of over 1,000 subjects shows a correlation between the intake of more abundant meals in the late evening (over 8:30 pm) with higher circulating values of total cholesterol and LDL (bad). This result seems to be explained by the higher degree of intestinal absorption of fats in the evening hours and by the increased liver synthesis of cholesterol in the late evening (4).

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Bibliography:

(1) Figure taken from: Stenvers D.J. et al. Circadian clocks and insulin resistance. Nature Reviews Endocrinology. 2019. Volume 15, pages75–89 (2019).
(2) Abbott S.M. et al. Health implications of sleep and circadian rhythm research in 2017. The Lancet neurology Vol 17 January 2018.
(3) Hatori M. et al. Time-restricted feeding without reducing caloric intake prevents metabolic diseases in mice fed a high-fat diet. Cell Metab. 2012 Jun 6;15(6):848-60.
(4) Chen H.J. et al. Energy intake at different times of the day: Its association with elevated total and LDL cholesterol levels. Nutr Metab Cardiovasc Dis. 2019 Jan 14. [Epub ahead of print]

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Article by:

Dr. Francesco Bonucci – Nutrizionist

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World Health Organization calls for a ban on trans fats by 2023

Non-communicable diseases represent the greatest health risk and the leading cause of death worldwide. Of these, cardiovascular diseases account for the largest share of this worrying situation (1).

Prevention is the “key weapon” in reducing the main risk factors for the spread of these diseases, including: tobacco consumption, physical inactivity, harmful alcohol consumption and poor eating habits.

Since scientific consensus has been reached on the fact that the consumption of trans fats is related to cardiovascular risk, the World Health Organization (WHO) proposed in 2018 a global ban on these compounds by 2023 (2). According to WHO estimates, this intervention could save about 10 million lives.

Some states such as Denmark, Switzerland, Canada and California or municipalities such as New York have already banned the use of these dietary fats, and other countries such as Thailand are planning to follow these guidelines. Unfortunately, many countries, both in the West and in Asia and Africa, are delaying the implementation of this important preventive action. In this scenario, still far from safeguarding public health, the WHO’s call to governments seems appropriate: the preparation of a real action program called REPLACE.

What are trans fats?

This category of fats takes its name from the arrangement of carbon atoms around a double chemical bond and differs from the bond normally present at conformation called cis. Most trans fats are artificially created to make vegetable oils more solid, workable and durable, as in the case of margarines. The chemical process involves the addition of hydrogen atoms and therefore the presence of trans with the ingredient “partially hydrogenated fats” can be recognized.

Trans are also formed during the deodorisation of polyunsaturated fats, e.g. in fish oil and supplements, or during cooking/fractures that subject oils to high temperatures (> 220°C).

Why are trans fats used in food?

Trans are inexpensive and make the products easy to process, palatable and extend their shelf life. They are also used for frying because they can be recycled for a long time. In India, for example, a frying oil called vanaspati, made from palm oil, is very common in restaurants or street foods. This fat is reused over and over again by accumulating large amounts of trans.

There are no sustainable reasons not to replace these fats with other types of healthy oils.

How do trans fats harm health?

These fats increase the risk of heart disease and stroke and are also associated with an increased risk of developing type 2 diabetes.

The action of these compounds is expressed through the raising of bad cholesterol (LDL) and the reduction of good cholesterol (HDL). There is also research linking trans-fats to infertility and systemic inflammation.

Where are the trans fats?

Trans fats can be present in many packaged foods, whether they contain them as an ingredient or are formed during the thermal processes to which are subjected. In the first case, products such as frozen pizza, snacks, crackers, biscuits, etc. In the second case, chips, fries, tempura, and most of the street food.

It should be noted that the current EU Labelling Regulation does not impose to declare the trans-fat content of foods. For this reason, we will not find this important indication on food packaging, making the consumer unaware of the content of trans fats in a product.

Do trans natural fats exist?

Trans fats can also form in the gastrointestinal system of herbivorous animals, through metabolic processes carried out by commensal bacteria, and from there enter a small part of the food chain through milk and its derivatives or meat. Note that hydrogenation in natural trans fats occurs in a different double-bonded position than in artificially produced fats. There is currently no evidence that naturally produced trans fats have a negative effect on heart health.

How many trans fats can be eaten?

The current reference intake levels for the Italian population (LARN), as well as the latest U.S. guidelines (USDA), indicate to consume as little as possible. In other European Union countries, the permitted trans values range from < 2% of the daily calories in France and the United Kingdom to < 1% of almost all other countries.

How to reduce the consumption of these compounds?

• Through the adoption of the Mediterranean diet that contains few processed foods, as indicated by the balanced dish and the indications of Harvard Medical School.
• Follow a diet rich in vegetables, fruits, whole grains, seeds and dried fruits, fish products.
• Restrict red meat and sugary foods.
• Buy oils obtained by mechanical processes (cold) and prefer extra virgin olive oil. Exclude margarines from your pantry.
• Avoid junk food and frying.
• Limit bakery products because they can contain varying amounts of trans fats, depending on the fats used in production and the temperatures to which have been subjected.
• Preference should be given to packaged products with a label bearing the words ‘low in saturated fat’. This claim is one of the voluntary nutritional claims and is therefore not widespread.
• Pay attention to the presence on the label of any partially hydrogenated fats and prefer products that use olive oil as an ingredient.

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Bibliography:

(1) Noncommunicable diseases (WHO): https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
(2) WHO plan to eliminate industrially-produced trans-fatty acids from global food supply. 14 May 2018 News Release. http://www.who.int/news-room/detail/14-05-2018-who-plan-to-eliminate-industrially-produced-trans-fatty-acids-from-global-food-supply

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Article by:

Dr. Francesco Bonucci – Nutritionist

The diet advise, written in the article, are not intended to be a substitute for a personal nutrition plan and should be adapted to specific cases.

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Photo: 123RF Archivio Fotografico | @lightwise, 19703988, 2019-07-02 | @olegdudko, 48236855, 2019-07-02

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