Marisa Porrini

Purpose: Well-balanced plant-based diets can promote health and reduce environmental impact. However, evidence from interventional studies remains limited. This pilot intervention study aimed to provide exploratory insights into potential challenges associated with the EAT-IT dietary pattern, an adaptation of the EAT-Lancet Healthy Reference Diet. Methods: Nine subjects (mean age 26 ± 2 years, 5 females) participated in a 6-week randomized controlled cross-over trial. Participants followed two isocaloric interventions: the EAT-IT dietary pattern and a control diet based on the Italian Food-Based Dietary Guidelines. Dietary intake was recorded using 7-day food records. Anthropometric measurements and metabolic parameters were collected according to standardized and validated protocols. Gut microbiota was analyzed through 16 S rRNA gene sequencing and taxonomic profiling. Acceptability was evaluated via a validated questionnaire. Results: Nutritional analysis showed that the EAT-IT pattern significantly increased fiber intake from 11.3 ± 5.2 to 15.1 ± 4.2 g/1000 kcal and ω-6 fatty acid intake from 5.7 ± 2.2 to 6.6 ± 1.9 g/day ( p < 0.05 for interaction). Regarding metabolic markers, a significant within-group reduction ( p < 0.05) was observed for fasting insulin (8.4 ± 2.2 to 6.5 ± 2.2 µU/mL) and HOMA1-IR (2.0 ± 0.6 to 1.5 ± 0.5). Changes in gut microbiota were also observed, specifically an increase in Bacteroides and a decrease in Coriobacteriaceae. While generally well-accepted, participants reported a higher perceived effort for EAT-IT, particularly regarding legume preparation. Conclusion: Despite the small sample size, this pilot study offers relevant insights into key aspects of sustainable plant-based diets, underscoring the necessity for further investigation.

Background and aims: Reward-based eating reflects hedonic drivers of intake, including loss of control, diminished satiety, and preoccupation with food. We translated, adapted and studied the psychometric properties of the 13- and 5-item Reward-Based Eating Drive Scale (RED), for Portugal, Poland and Italy. Methods: A cross-cultural study was conducted with higher education students and general population samples (n = 1999). After translation and cultural adaptation, the RED was administered with food craving items, and collection of sociodemographic and anthropometric data. Factorial structure and measurement invariance were tested using confirmatory factor analysis (CFA), internal consistency with Cronbach’s alpha, and convergent validity via correlations with BMI and cravings. Results: CFA supported the expected structures of the RED-13 (three factors) and RED-X5 (unifactorial), with configural and metric invariance across countries and groups. Only partial scalar invariance was achieved for both versions. The RED-13 showed good to excellent internal consistency for total scores (0.868 ≤ α ≤ 0.906), with acceptable to good reliability for Loss of control (0.769 ≤ α ≤ 0.821), lower values for Lack of satiety (0.655 ≤ α ≤ 0.723), and good to excellent consistency for Preoccupation with food (0.881 ≤ α ≤ 0.918). The RED-X5 showed acceptable internal consistency (0.737 ≤ α ≤ 0.811) and correlated strongly with RED-13 (r = 0.949, p < 0.001). Both correlated positively with BMI and food cravings. Age, sex, and country had small to medium multivariate effects on RED scores. Conclusions: The RED-13 and RED-X5 showed good psychometric properties in Portugal, Poland, and Italy, with the RED-13 providing a multifactorial assessment and the RED-X5 offering a brief alternative.

The study aims to evaluate the effect of an acute meal and long-term intake of Mediterranean Diet (MD) on different parameters such as strength, physical performance, body composition and blood markers in a group of non-professional athletes who practice a strength activity. Thirteen volunteers completed two 8-week dietary interventions in a randomised, cross-over design. Also an acute study was performed. Subjects received a MD High in carbohydrates, characterised by at least five portions of pasta/week and an average 55-60% of daily energy derived from carbohydrates, versus an MD reduced in carbohydrates, with less than two portions of pasta/week and an average of 40-45% of daily energy provided by carbohydrates. Mainly, data did not show significant differences for the parameters analysed, except for Elbow Flexor maximum voluntary contraction (p = .039). Results enlighten that increasing total carbohydrates intake, as typically in the MD, does not negatively affect physical performance, body composition and strength.

Several studies have highlighted the beneficial effects of consuming red raspberries on human health thanks to their high content of phytochemicals. However, the products used in these studies, both in the raw or freeze-dried form, were not fully characterized for nutrient and phytochemical composition. In this study, we aimed to determine the nutrient and non-nutrient compounds present in a freeze-dried red raspberry powder widely used by the food industry and consumers. The main sugars identified were fructose (12%), glucose (11%), and sucrose (11%). Twelve fatty acids were detected, with linoleic acid (46%), α-linolenic acid (20%), and oleic acid (15%) being the most abundant. Regarding micronutrients, vitamin C was the main hydro-soluble vitamin, while minerals, potassium, phosphorous, copper and magnesium were the most abundant, with concentrations ranging from 9 up to 96 mg/100 g, followed by manganese, iron and zinc, detected in the range 0.1–0.9 mg/100 g. Phytochemical analysis using UHPLC-DAD-HR-MS detection revealed the presence of Sanguiin H6 (0.4%), Lambertianin C (0.05%), and Sanguiin H-10 isomers (0.9%) as the main compounds. Among anthocyanins, the most representative compounds were cyanidin-3-sophoroside, cyanidin-3-glucoside and cyanidin-3-sambubioside. Our findings can serve as a reliable resource for the food industry, nutraceutical applications and for future investigations in the context of human health.

Anatomy education plays a critical role in medical practice, and the level of anatomical knowledge among students and physicians significantly impacts patient care. This article presents a pilot project conducted by the University of Milan aimed at exploring the effectiveness of the Area9's Rhapsode platform, an intelligent tutoring system that uses artificial intelligence to personalize learning and collect data on mastery acquisition. The study focused on liver anatomy and employed a flipped classroom approach, incorporating adaptive learning modules and an interactive in-class session. The project's execution, outcomes and preliminary pedagogical considerations are discussed. The results demonstrated improved learning quality, positive repurposing of study time, enhanced metacognitive awareness among students, with most of students demonstrating conscious mastery of the materials and a clear understanding of their level of competence. This approach, by providing valuable insights into the potential of artificial intelligence-based adaptive learning systems in anatomy education, could address the challenges posed by limited teaching hours, shortage of anatomist and the need for individualized instruction, with recommendations for future research and the expansion of adaptive learning modules to other anatomical districts.

Obesity is associated with an increased risk of chronic diseases and is responsible for millions of deaths worldwide. Diet is the most important lifestyle factor influencing body weight together with physical activity. In response to the growing need to address excess weight, a wide range of dietary strategies that promise rapid and easy weight loss have emerged attracting public attention and generating considerable debate. Besides them, only a few dietary models have been investigated for their potential role in body weight reduction and other health markers. In this chapter, different dietary approaches have been categorized according to their main characteristics: traditional patterns, diets based on macronutrient modifications, plant-based diets, time-restricted and intermittent fasting diets, and diets with therapeutical aims. In terms of body weight, the results showed very modest differences between the different dietary approaches. Taking into consideration their effect on overall health and their feasibility, traditional diets such as the Mediterranean diet and plant-based diets were found to be the most effective in the long-term course.

The consumption of plant-based drinks (PBDs) in substitution for cow’s milk (CM) is increasing due to concerns for human and planet health and animal welfare. The present review aims to analyze the main findings from intervention trials investigating the effect of PBDs in comparison with CM on markers of human health. Suitable articles published up to July 2022 were sourced from PubMed and Scopus databases. A total of 29 papers were collected, with 27 focusing on soy drinks (1 of which also evaluated the effects of an almond drink), while only 2 focused on rice drinks. Among studies focused on soy drinks, the most investigated factors were anthropometric parameters (n = 13), the lipid profile (n = 8), markers of inflammation and/or oxidative stress (n = 7), glucose and insulin responses (n = 6) and blood pressure (n = 4). Despite some evidence of a beneficial effect of PBDs, especially for the lipid profile, it was not possible to draw any overall conclusions due to some conflicting results. As well as the low number of studies, a wide heterogeneity was found in terms of the characteristics of subjects, duration and markers, which reduces the strength of the available results. In conclusion, further studies are needed to better elucidate the effects of substituting CM with PBDs, especially in the long term.

Metabolic Syndrome (MetS) is characterized by a group of dysmetabolic conditions, including abdominal obesity, dyslipidemia, glucose intolerance and/or insulin resistance, and hypertension. Generally, MetS is accompanied by an exacerbation of oxidative stress, inflammation, and vascular dysfunction. Increasing evidence suggests that berries and berry bioactives could play a potential role in the prevention and mitigation of the risk factors associated with MetS. The present systematic review summarizes the more recently available evidence deriving from human intervention studies investigating the effect of berries in subjects with at least three out of five MetS parameters. The PubMed, Scopus, and Embase databases were systematically searched from January 2010 until December 2022. A total of 17 human intervention trials met the inclusion criteria. Most of them were focused on blueberry (n = 6), cranberry (n = 3), and chokeberry (n = 3), while very few or none were available for the other berries. If considering MetS features, the main positive effects were related to lipid profile (low and high-density lipoproteins, cholesterol, and triglycerides) following blueberries and chokeberries, while conflicting results were documented for anthropometric parameters, blood pressure, and fasting blood glucose levels. Other markers analyzed within the studies included vascular function, oxidative stress, and inflammation. Here, the main positive effects were related to inflammation with a reduction in interleukin 6 and tumor necrosis factor-alpha following the intake of different berries. In conclusion, although limited, the evidence seems to support a potential role for berries in the modulation of lipid profile and inflammation in subjects with MetS. Furthermore, high-quality intervention trials are mandatory to demonstrate the role of berries in reducing risk factors for MetS and related conditions. In the future, such a demonstration could bring the adoption of berries as a potential dietary strategy to prevent/counteract MetS and related risk factors.

Aging is associated with an increased risk of developing cardiovascular disease which is often accompanied by a decline in vascular health and function. Current evidence suggests that berries may have a potential role in the modulation of vascular function, but dietary interventions are still needed to confirm findings, especially in older subjects. In the context of the MIND FoodS HUB project, this study aims to investigate the effect of a single serving of blueberry (250 g of blueberry versus a control product) in a group of older subjects (≥ 60y) through a randomized, controlled, cross-over dietary intervention trial. Specifically, the study evaluates the absorption kinetics of bioactives following the blueberries intake and the effects on markers related to oxidative stress, inflammation, and vascular function analyzed at different time points. By considering a drop-out rate estimate of 25%, at least 20 subjects will be recruited in the study. The study will provide evidence to support the potential beneficial effects of blueberry and its bioactive compounds on vascular function in a group of population more susceptible to vascular dysfunction and to the development of cardiovascular diseases. Moreover, the study will contribute the analysis of several metabolic and functional markers that can support the biological plausibility of the results obtained. Finally, the trial will provide data on the absorption and metabolism of blueberry bioactives which will be used to study their association with the different markers under study. Trail registration: The trial is registered at ISRCTN (http://isrctn.com/ISRCTN18262533); May 7, 2021.

The definition of a healthy and sustainable diet is nowadays considered pivotal, but data related to environmental outcomes are still debated. In this study, we compared the carbon (CF) and water footprints (WF) of an Italian-Mediterranean (EAT-IT) dietary pattern designed on the “Planetary diet”, with a pattern based on the Italian Dietary Guidelines (IDG). The influence of different food categories and food choices on environmental impact was assessed. To this aim, weekly dietary patterns were developed, considering food categories and related portions and frequencies of consumption. Results show that the EAT-IT dietary pattern, compared to the IDG, had a significantly lower CF (2.82 ± 1.07 and 3.74 ± 0.92 kg CO₂/day, respectively) but not WF. Protein-rich foods were the main contributors to CF and WF in both dietary patterns. The increased substitution of frozen instead of fresh foods, imported instead of local fruits, greenhouse-grown instead of seasonal vegetables, and processed legume-based foods instead of unprocessed legumes caused an increasing worsening of the CF in both patterns, but with different magnitudes. Our analysis indicated that the EAT-IT dietary pattern can be considered sustainable for CF, but individual choices are likely to largely affect the final environmental outcomes.