The prevalence of overweight, obesity, and their related complications is increasing worldwide. The purpose of this umbrella review was to summarize and critically evaluate the effects of different diets on anthropometric parameters and cardiometabolic risk factors. Medline, Embase, Scopus, Cochrane Database of Systematic Reviews, and Web of Science, from inception to April 2019, were used as data sources to select meta-analyses of randomized controlled trials that examined the effects of different diets on anthropometric parameters and cardiometabolic risk factors. Strength and validity of the evidence were assessed through a set of predefined criteria. Eighty articles reporting 495 unique meta-analyses were examined, covering a wide range of popular diets: low-carbohydrate (n = 21 articles), high-protein (n = 8), low-fat (n = 9), paleolithic (n = 2), low-glycemic-index/load (n = 12), intermittent energy restriction (n = 6), Mediterranean (n = 11), Nordic (n = 2), vegetarian (n = 9), Dietary Approaches to Stop Hypertension (DASH) (n = 6), and portfolio dietary pattern (n = 1). Great variability in terms of definition of the intervention and control diets was observed. The methodological quality of most articles (n = 65; 81%), evaluated using the “A MeaSurement Tool to Assess systematic Reviews-2” questionnaire, was low or critically low. The strength of evidence was generally weak. The most consistent evidence was reported for the Mediterranean diet, with suggestive evidence of an improvement in weight, BMI, total cholesterol, glucose, and blood pressure. Suggestive evidence of an improvement in weight and blood pressure was also reported for the DASH diet. Low-carbohydrate, high-protein, low-fat, and low-glycemic-index/load diets showed suggestive and/or weak evidence of a reduction in weight and BMI, but contrasting evidence for lipid, glycemic, and blood pressure parameters, suggesting potential risks of unfavorable effects. Evidence for paleolithic, intermittent energy restriction, Nordic, vegetarian, and portfolio dietary patterns was graded as weak. Among all the diets evaluated, the Mediterranean diet had the strongest and most consistent evidence of a beneficial effect on both anthropometric parameters and cardiometabolic risk factors. This review protocol was registered at www.crd.york.ac.uk/PROSPERO/ as CRD42019126103.

Background Although there is substantial interest in intermittent fasting as a dietary approach in active individuals, information regarding its effects in elite endurance athletes is currently unavailable. The present parallel randomized trial investigated the effects of a particular intermittent fasting approach, called time-restricted eating (TRE), during 4 weeks of high-level endurance training. Methods Sixteen elite under-23 cyclists were randomly assigned either to a TRE group or a control group (ND). The TRE group consumed 100% of its estimated daily energy needs in an 8-h time window (from 10:00 a.m. to 6:00 p.m.) whilst energy intake in the ND group was distributed in 3 meals consumed between 7:00 a.m. and 9:00 p.m. Fat and fat-free mass were estimated by bioelectrical impedance analysis and VO2max and basal metabolism by indirect gas analyzer. In addition, blood counts, anabolic hormones (i.e. free testosterone, IGF-1) and inflammatory markers (i.e. IL-6, TNF-α) were assessed. Results TRE reduced body weight (− 2%; p = 0.04) and fat mass percentage (− 1.1%; p = 0.01) with no change in fat-free mass. Performance tests showed no significant differences between groups, however the peak power output/body weight ratio (PPO/BW) improved in TRE group due to weight loss (p = 0.02). Free testosterone and IGF-1 decreased significantly (p = 0.01 and p = 0.03 respectively) in TRE group. Leucocyte count decreased in ND group (p = 0.02) whilst the neutrophils-to-lymphocytes ratio (NLR) decreased significantly (p = 0.03) in TRE group. Conclusions Our results suggest that a TRE program with an 8-h feeding window elicits weight loss, improves body composition and increases PPO/BW in elite cyclists. TRE could also be beneficial for reducing inflammation and may have a protective effect on some components of the immune system. Overall, TRE could be considered as a component of a periodized nutrition plan in endurance athletes. Trial registration This trial was retrospectively registered at clinicaltrials.gov as NCT04320784 on 25 March 2020.

Data on the impact of the ketogenic diet (KD) on children’s growth remain controversial. Here, we retrospectively investigated the occurrence of linear growth retardation in 34 children (47% males; age range: 2−17 years) diagnosed with drug-resistant epilepsy (DRE; n = 14) or glucose transporter type 1 deficiency syndrome (GLUT1-DS; n = 20) who had been treated with the KD for 12 months. The general characteristics of children with and without growth retardation were also compared. All participants received a full-calorie, traditional KD supplemented with vitamins, minerals, and citrate. Most children (80%; 11/14 in the DRE subgroup and 16/20 in the GLUT1-DS subgroup) treated with the KD did not show growth retardation at 12 months. Although participants with and without delay of growth did not differ in terms of baseline clinical characteristics, dietary prescriptions, or supplementation patterns, marked ketosis at 12 months tended to occur more frequently in the latter group. Altogether, our results indicate that growth retardation may occur in a minority of children treated with the KD. However, further research is required to identify children at risk and to clarify how increased ketones levels may affect endocrine pathways regulating growth during KD administration.

No abstract

Le chiediamo pochi minuti del suo tempo per compilare questo questionario che ci servirà a comprendere il consumo di alimenti ultra-processati nella popolazione italiana.Compilando il questionario, le chiediamo di considerare le sue abitudini alimentari nell'arco dell'ultimo anno e, per ogni alimento, di considerare sia la frequenza di consumo che le quantità medie consumate ogni qualvolta ha mangiato quell'alimento. Qui sotto le mettiamo un esempio del questionario e delle possibili risposte:☞ Nel caso di consumo inferiore ad una volta al mese, contrassegni solo la prima casella senza indicare la quantità; ☞ Nel caso di consumo superiore ad una volta al mese, contrassegni anche la casella relativa alla quantità consumata in termini di porzione media in ogni occasione di consumo; ☞ Nel caso di consumo giornaliero, indichi con un numero anche le volte al giorno che lo ha consumato.Se utilizza gli alimenti per preparare ricette specifiche (che non trova nell'elenco) può considerare i singoli alimenti nelle relative sezioni ed indicarne la frequenza di consumo e le quantità consumate. Nel caso in cui non dovesse trovare nella lista alcuni alimenti che consuma o utilizza abitualmente, nell'ultima pagina troverà una sezione nella quale poterli inserire.Se ha modificato la sua dieta per motivi di salute o personali per brevi periodi di tempo, le ricordiamo di compilare il questionario riferendosi alla sua abituale alimentazione.

To the best of our knowledge, no specific questionnaires on sports nutrition knowledge (NK) have been validated so far in Italian early adolescents. The aim of the present study was to validate a short (26-item) general and sports NK questionnaire in a group of Italian early adolescents. To this aim, the questionnaire was administered to 264 subjects for analysis of internal consistency, and in a subgroup (n = 39) for evaluating the reliability over time. The questionnaire revealed good overall internal consistency and reliability (Cronbach’s α = 0.684) and a highly significant correlation over time (r = 0.977, p < 0.001). Comparison with other validated questionnaires is tricky, because the previous questionnaires were validated in different populations, such as middle or late adolescents or adults, with a higher number of items compared to our questionnaire. Furthermore, data on adolescent NK in Italy are very limited. This study provides a brief, feasible, and validated questionnaire that can be used for investigating sports NK in young subjects. It could be used for evaluating the efficacy of education on general and sports nutrition in both the general population and athletes, and for investigating the relationship between NK and different sports in early adolescence.

The classic ketogenic diet (cKD) requires constant nutritional monitoring over time both to ensure its effectiveness and to reduce the likelihood of short- and long-term adverse effects. We retrospectively described the use of remote monitoring by e-mail during the first year of follow-up on cKD in 34 children (47% males; age range: 2−17 years) diagnosed with drug-resistant epilepsy (DRE; n = 14) or glucose transporter type 1 deficiency syndrome (GLUT1-DS; n = 20). All the e-mails were evaluated analyzing their frequency and content at 3, 6 and 12 months. Three families never sent e-mails. A median of 36.0 (IQR 23.0–64.0) e-mails per family were sent during the 12 follow-up months by the 31 patients. GLUT1-DS patients sent a greater number of e-mails than the DRE group (median 39.0 (IQR 25.5–56.5) vs. median 26.0 (IQR 19.0–65.0)). At the end of the follow-up period, a greater number of e-mails had been exchanged between the nutritional team and the families belonging to the group that increased its linear growth (median 83.5; IQR 48.0–102.0), compared to the other ones. Constant remote monitoring by e-mail could be a feasible and effective way for a better cKD management.

Orthorexia nervosa (ON) is defined as the excessive attention on healthy eating, and studies especially focused on food quality ON prevalence in university students can be extremely variable. The objective of this study is to investigate whether there was a difference in ON risk between health-scientific, economic-humanistic, sport sciences and dietetics and nutrition students, and to evaluate if lifestyle-related ON risk factors (dieting, physical activity, drugs and supplements use) could have an impact in different ways in determining ON risk among students attending these four programs. Participants were recruited at the University of Pavia and received a two-section questionnaire including demographic and lifestyle information and the ORTO-15 questionnaire. A total of 671 students (54% F e 46% M) completed the questionnaire (median age 21.00 (IQR 20.00–23.00), median BMI 21.77 kg/m2 (IQR 20.06–23.66 kg/m2)). The 31.2% had ORTO-15 test scores < 35, and were considered at risk of having ON. No differences were found in ON risk among the students attending the four university courses. Dieting was confirmed as the major ON risk factor for health-scientific, economic-humanistic and sport sciences students. The type of sport practiced was an important determinant of ON risk only for the economic-humanistic course, while supplements use was statistically different between sport sciences students with or without ON. Our findings may suggest that lifestyle-related risk factors of orthorexia can differ among the students of distinct university courses, but these results need to be supported by further longitudinal and prospective studies.