FLAVONOLImele, pere, bacche, piselli, broccoli, cavoli, cipolla, vino rosso, pomodoro, te..... FLAVONIsedano, prezzemolo... FLAVANONIagrumi... FLAVANOLI (catechine) vino rosso, te, cacao, cioccolata, uva, mele, bacche... PROANTOCIANIDINEbacche, ciliegie, prugne, cavolo rosso, cipolla rossa, uva nera, vino rosso, te... ANTOCIANIDINEciliegie, prugne, bacche, cavolo rosso, cipolla rossa, uva nera, vino rosso... ISOFLAVONIsoia e derivati Appartengono al gruppo dei polifenoli Migliaia di molecole FLAVONOIDI

CAROTENOIDI E RISCHIO CV STUDI EPIDEMIOLOGICI Rapporti tra introiti alimentari e CVD Effetto protettivo > 600 molecole α-carotene, β-carotene, licopene, luteina, zeaxantina..... TRIALS CLINICI Supplementazione mortalità in alcuni trials Kristenson M et al. BMJ 1997 Rapola JM et al, Lancet 1997 Osganian SK et al Am J Clin Nutr 2003 Hak AE et al. Circulation 2003 Knekt P et al. Am J Clin Nutr 2004 Sesso HD et al. Am J Clin Nutr 2005 Tavani A et al. Free Radic Res 2006 Ito Y et al. J Epidemiol 2006 Vivekananthan DP et al. Lancet 2003 Bjelakovi G et al. JAMA 2007

ANTIOXIDANT SUPPLEMENTS Cochrane Database Systematic Review 2012 AUTHORS CONCLUSIONS We found no evidence to support antioxidant supplements for primary or secondary prevention. Beta-carotene and vitamin E seem to increase mortality, and so may higher doses of vitamin A.

There is not currently sufficient conclusive evidence to justify making any public health recommendation in relation to antioxidants ANTIOXIDANTS

ZUCCHERI AGGIUNTI: RACCOMANDAZIONI

BEVANDE DOLCI: RACCOMANDAZIONI

BEVANDE DOLCI E RISCHIO CARDIOMETABOLICO Consumption of sugar-sweetened beverages has been associated to: non-alcoholic fatty liver disease hypertricerydemia increased visceral fat obesity metabolic syndrome cardiovascular disease Richelsen B et al. Sugar-sweetened beverages and cardio-metabolic disease risk Curr Opin Clin Nutr Matab Care 2013 (in press)

Nutrition 2010; 26:

World Action on Salt & Health (WASH)

SALE: RACCOMANDAZIONI

Intermediate target < 5 g/die SALT Long-term GOAL < 4 g/die

Greater adherence to a Mediterranean diet confers a significant protection for overall mortality, as well as cardiovascular disease mortality and incidence of cancer and degenerative diseases. MODELLO ALIMENTARE MEDITERRANEO BMJ 2008; 337:a1344

Am J Clin Nutr 2010; 92:

Kastorini CM, J Am Coll Cardiol 2011; 57: studi soggetti Efficace in prevenzione primaria S. metabolica DIETA MEDITERRANEA

Kastorini CM, J Am Coll Cardiol 2011; 57: Migliora i parametri metabolici S. metabolica DIETA MEDITERRANEA

DIETE MEDITERRANEE: CARATTERISTICHE

ALIMENTAZIONE E PREVENZIONE CARDIOVASCOLARE Quando inizia?