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Biomedical subjects

S Salvini

Publications and source records attributed to S Salvini.

At least 19 recordsLinked to original sources

Physical activity of subjects aged 50-64 years involved in the European Prospective Investigation into Cancer and Nutrition (EPIC).

OBJECTIVE: To describe physical activity of participants in the European Prospective Investigation into Cancer and Nutrition (EPIC). DESIGN: A cross-sectional analysis of baseline data of a European prospective cohort study. SUBJECTS: This analysis was restricted to participants in the age group 50-64 years, which was represented in all EPIC centres. It involved 236 386 participants from 25 centres in nine countries. In each EPIC centre, physical activity was assessed by standardised and validated questions. Frequency distribution of type of professional activity and participation in non-professional activities, and age-adjusted means, medians and percentiles of time dedicated to non-professional activities are presented for men and women from each centre. RESULTS: Professional activity was most frequently classified as sedentary or standing in all centres. There was a wide variation regarding participation in different types of non-professional activities and time dedicated to these activities across EPIC centres. Over 80% of all EPIC participants engaged in walking, while less than 50% of the subjects participated in sport. Total time dedicated to recreational activities was highest among the Dutch participants and lowest among men from Malmö (Sweden) and women from Naples (Italy). In all centres, total time dedicated to recreational activity in the summer was higher than in the winter. Women from southern Europe spent the most time on housekeeping. CONCLUSIONS: There is a considerable variation of physical activity across EPIC centres. This variation was especially evident for recreational activities in both men and women.

Cross-Sectional Studies↗

Dietary and familial determinants of 10-year survival among patients with gastric carcinoma.

BACKGROUND: Although the role of diet in gastric carcinoma (GC) causation has been investigated extensively, its association with long term survival has never been explored in detail. METHODS: The authors assessed the vital status on December 31, 1997 of a series of 382 patients with GC who were interviewed in 1985-1987 in the framework of a population-based case-control study in a high risk area for GC in Italy. Follow-up information at 10 years was available for all but three patients. The risk of dying was evaluated by Cox proportional hazard models, including patient age, gender, social status, disease stage at diagnosis, and lymph node involvement as confounding variables. RESULTS: The overall survival probability was 0.26 at 5 years and 0.18 at 10 years after interview. The most important predictors were disease stage, lymph node involvement, and histopathologic grading (TNM classification). Overall, a high intake of alcohol was associated with an increased risk of dying (P = 0.02). In contrast, survival was increased in patients with a high intake of alpha-tocopherol (P = 0.04). A positive first-degree family history of GC was reported by 84 patients and tended to be associated with a reduced risk of death. A significant protective trend was found with increasing intake of vegetable fat and starch among these familial cases, with a 50% risk reduction. In contrast, this subgroup showed a two-fold increased risk of dying with a high intake of animal protein, animal fat, and preformed N-nitrosodimethylamine. CONCLUSIONS: The current results provide evidence that premorbid diet may influence the prognosis of patients with GC, and they suggest that specific pathways for disease progression may exist among familial cases.

Aged↗

Erectile dysfunction in men with obstructive sleep apnea: an early sign of nerve involvement.

Erectile dysfunction (ED) is common in men with obstructive sleep apnea (OSAS) but no completely convincing hypotheses about the underlying pathogenic mechanisms have been published in the literature. The aims of the present study were to assess the presence of ED in a group of OSAS patients without daytime respiratory failure and to determine whether this dysfunction was related to peripheral nerve involvement. Evaluation of the bulbocavernosus reflex (BCR) and the somato-sensory evoked potentials of pudendal nerve (PSEPs), the most widely established method of documenting pudendal neuropathies as being the cause of impotence, was performed in 25 patients. Data on BCR were compared with those of 25 healthy males volunteers matched for age. BCR was altered in 17 patients: in 6 it was elicited while in 11 it had a prolonged latency and reduced amplitude. Patients with altered BCR presented an higher AHI, an higher percentage of sleep time spent with SaO2 <90% (TST90) and a lower daytime PaO2. Six patient had clinically silent neurophysiological signs of mild polyneuropathy. The degree of OSAS and gas exchange alteration was more severe in patients with polyneuropathy than in those with isolated BCR alteration. ED is a common finding in OSAS patients and this alteration seems to be related to a nerve dysfunction. The development of nerve dysfunction is associated with a more severe degree of OSAS and nocturnal hypoxia.

Arousal↗

Plasma levels of antioxidant vitamins and cholesterol in a large population sample in central-northern Italy.

BACKGROUND: In a population-based multicenter case-control study of diet, life-style, and gastric cancer a large series of adults, aged 30-75 years (mean 58.9 years), were randomly sampled from the general population in 3 areas of Central-Northern Italy. AIM OF THE STUDY: To evaluate the relationship between plasma levels of antioxidant vitamins and cholesterol, and sociodemographic characteristics, life-style factors, and dietary intake of selected nutrients in a sample of the Italian population. METHODS: A fasting blood sample was available for 945 subjects (553 men, 392 women). The plasma concentrations of ascorbic acid, carotene, retinol, alpha-tocopherol, and cholesterol were determined by a centralized laboratory. All participants answered to a detailed questionnaire collecting information on sociodemographic and anthropometric characteristics, smoking, alcohol drinking, and dietary habits. Covariance analysis models, with post hoc Dunnett tests, including terms for age, sex, study center, and period of blood drawing, were used for selected multiple-way comparisons of mean values of plasma nutrients. RESULTS: Mean plasma values of retinol were higher among men while women had higher levels of plasma carotene, ascorbic acid, alpha-tocopherol, and cholesterol. Plasma carotene levels showed an inverse association with body mass index, alcohol consumption, and smoking and a positive association with social class. Carotene concentrations were higher in plasma samples obtained in spring/summer, while ascorbic acid levels were higher in autumn/winter. Partial correlation co-efficients between plasma vitamin levels showed a strong correlation between carotene and ascorbic acid (0.69 in men; 0.74 in women), between carotene and alpha-tocopherol (0.44; 0.37), and between alpha-tocopherol and ascorbic acid (0.45; 0.41). Plasma alpha-tocopherol and retinol correlated with plasma cholesterol. On the other hand, plasma carotene and ascorbic acid were correlated with their estimated dietary intakes, while the intakes of other nutrients, as expected, correlated rather poorly with the respective plasma concentrations. CONCLUSIONS: Socio-economic factors, life-style, and specific nutrient intake, in addition to gender, are related to nutrient plasma levels in Italian adults and may provide specific suggestions for the prevention of chronic diseases.

Adult↗

Sources of macro- and micronutrients in Italian women: results from a food frequency questionnaire for cancer studies.

The knowledge of major sources of macro- and micronutrients is essential in order to interpret differences in the diet-cancer link in various geographical areas and to provide better nutritional guidelines. For this purpose we took advantage of the control group of a case-control study on breast cancer carried out in six Italian areas. The dietary habits of 2,588 cancer-free women aged 20-74 years (median age 56) were elicited between 1991 and 1994 by means of an interviewer-administered food frequency questionnaire (FFQ) that included 78 foods or food groups, in addition to several questions on general dietary pattern (e.g., fat in seasoning). Bread was the first contributor for total energy (12%), protein (8%) and starch (32%) intake, whereas, for saturated fatty acid, the first sources were different types of cheese (28%); for monounsaturated fatty acids the dressing oils of salad and tomatoes (12%); and, for sugars, apples and pears (19%). Raw vegetables and fresh fruit represented the most important source of most vitamins. The first contributors of vitamin C and beta-carotene were citrus fruits (29%) and raw carrots (17%), respectively. Thus, between 40 and 80% of specific macronutrient intake and up to 90% intake of several micronutrients were derived from the first ten foods or food groups. Often, the major contributors to the intake of a specific component were foods with a relatively low content, but eaten in large quantities. This work further highlights the specificity of nutrient sources in southern European populations.

Adult↗

Intake of macronutrients and risk of breast cancer.

BACKGROUND: The association between risk of breast cancer and dietary fat and intakes of other energy sources remains controversial. The Italian population offers special opportunities to assess the influence of high intakes of unsaturated fat and starch and, because the population has low awareness of diet and cancer issues, there is less scope for recall bias. We have assessed the relations of various macronutrient intakes with risk of breast cancer. METHODS: In this case-control study, 2569 women with incident breast cancer (median age 55 years) and 2588 control women (median age 56 years) in hospital with acute, non-neoplastic diseases, were interviewed in six different areas of Italy between 1991 and 1994. A validated food-frequency questionnaire was used. It included questions on 78 foods and recipes grouped into six sections, as well as specific questions on individual fat intake pattern. FINDINGS: The risk of breast cancer decreased with increasing total fat intake (trend p 0.01) whereas the risk increased with increasing intake of available carbohydrates (trend p = 0.002). The odds ratios for women in the highest compared with the lowest quintile of energy-adjusted intake were 0.81 for total fat and 1.30 for available carbohydrates. Starch was the chief contributor to the positive association with available carbohydrates. High intakes of polyunsaturated and unsaturated fatty acids (i.e., polyunsaturated fatty acids plus oleic acid) were associated with a decreased risk of breast cancer (odds ratios for highest vs lowest quintile 0.70 and 0.74, respectively). Conversely, the intakes of saturated fatty acids, protein, and fibre were not significantly associated with breast-cancer risk. INTERPRETATION: This case-controls study shows that unsaturated fatty acids protect against breast cancer, possibly because intake of these nutrients is closely correlated with a high intake of raw vegetables. The findings also suggest a possible risk in southern European populations, of reliance on a diet largely based on starch.

Adult↗

Validation of a food-frequency questionnaire to assess dietary intakes in cancer studies in Italy. Results for specific nutrients.

The validity of a 77-item food-frequency questionnaire (FFQ) developed for a multicenter case-control study on diet and cancer in Italy was assessed. Trained interviewers administered the same FFQ to 452 volunteers from three Italian provinces (Pordenone, Genoa, and Forli) completed in two different seasons, at an interval of 3 to 10 months. For 395 (130 males, 265 females; median age = 52 years; range = 35 to 69 years) volunteers, two 7-day dietary (7-DD) records were available. Average intake obtained by means of the FFQ was overestimated by approximately 18% in comparison with the corresponding values based on the two 7-DD records (reference method). Pearson partial correlation coefficients, adjusted for total energy intake between the nutrient intakes assessed by the FFQ and reference method, ranged from 0.19 for vegetable fat to 0.64 for sugar (median value r = 0.46). The unadjusted deattenuated coefficients, which took into account the interindividual variability of consumption, estimated by means of the two 7-DD records, ranged from 0.29 for vegetable fat to 0.72 for starch (median value r = 0.54). The proportion of subjects correctly classified within the lowest two quintiles ranged between 59% for vegetable fat and vitamin E, and 96% for alcohol, and those correctly classified within the highest two quintiles ranged between 44% for vegetable fat and 94% for alcohol. The average proportion of subjects correctly classified within one quintile was 73%. These data indicate that this FFQ provides valid estimates of intakes for major nutrients, comparable to those reported from other studies in North America and other European countries.

Adult↗

Validity and reproducibility of alcohol consumption in Italy.

BACKGROUND: The reproducibility and validity of alcohol consumption has not been adequately studied, particularly in mediterranean countries, where alcohol drinking is a widespread habit, especially during meals. METHODS: We compared alcohol consumption measured by two interviewer-administered food frequency questionnaires (FFQ) with average intake derived from two 7-day dietary (7-DD) records (the reference method) on 395 volunteers. Different types of alcoholic beverages were considered separately in order to verify the ability of the questionnaire to assess detailed patterns of alcohol intake. RESULTS: A satisfactory level of reproducibility and validity of the pattern of alcohol consumption across different levels and types of alcoholic beverage intake was observed. The reproducibility of wine and total alcohol intake showed correlation coefficients > 0.75 in both sexes. The validity was somewhat higher for wine (around 0.70) than for other alcoholic beverages and total alcohol intake. This is probably accounted for by the more regular pattern of wine consumption during the year as compared to other alcoholic beverages (beer, grappa, etc) which are more strongly influenced by seasonal and daily variations. However, about 30% of abstainers according to FFQ were drinkers by the reference method. The opposite was observed in only 4% of subjects. CONCLUSION: The FFQ is a reliable and valid instrument for collecting alcohol intake in regular drinkers. Lower validity in irregular drinkers may be due to seasonal variation and/or inadequacy of the FFQ to capture irregular patterns of consumption and/or inadequacy of the average of two 7-DD as a reference method. Furthermore, a considerable degree of misclassification was observed between non-drinkers and moderate drinkers.

Adult↗

Plasma levels of the antioxidant selenium and risk of myocardial infarction among U.S. physicians.

The well-known antioxidant properties of selenium have been linked to a lower incidence of cardiovascular disease in humans, but the findings remain controversial. To explore whether the plasma selenium level predicts risk of myocardial infarction (MI), we analyzed prospectively collected plasma samples in a nested case-control study among participants in the Physicians' Health Study, a randomized trial of aspirin and beta-carotene. Blood specimens were collected between August 1982 and December 1984 and stored at -80 degrees C. All infarcts were documented by medical records. This study is based on 251 subjects who had infarctions and an equal number of healthy controls, matched by age, smoking status, and time from randomization. The mean +/- SD levels of plasma selenium were 114.4 +/- 15.1 ng/g in the cases with MI, and 113.2 +/- 15.7 ng/g in controls (paired t = 0.94, p = 0.35). Conditional logistic regression analysis by quintile of plasma selenium levels showed no suggestion of any protective effect of selenium; subjects in the highest quintile had a relative risk of 1.27 (95% confidence interval 0.71 to 2.29) when compared with the bottom quintile, and 1.53 (95% confidence interval 0.61 to 3.84) after adjustment for other cardiovascular risk factors. These data provide no evidence for an association between increased plasma selenium and reduced risk of MI at the current levels of selenium intake within the U.S.

Adult↗

Influence of food groups and food diversity on breast cancer risk in Italy.

Although debate on breast cancer and diet has been concentrated on nutrients, assessment of the role of specific foods and food groups and variety of food intake retains a considerable importance. To further elucidate the role of dietary habits, 2,569 women with incident breast cancer (median age 55 years) and 2,588 control women (median age 56 years), hospitalised with acute non-neoplastic diseases, were interviewed between 1991 and 1994 in 6 different Italian areas. The validated food frequency questionnaire included 79 food items and recipes, which were grouped into 18 food groups (5 for "diversity" analyses purpose). After allowance for non-dietary confounding factors and total energy intake, significant trends of increasing breast cancer risk with increasing intake emerged for the following food groups: bread and cereal dishes, pork and processed meats, and sugar and candies. Conversely, high intake of milk, poultry, fish, raw vegetables, potatoes and coffee and tea seemed to exert a protection against the development of breast cancer. Intake of soups, eggs, other meats, cheese, cooked vegetables, citrus fruits, other fruits and cake and desserts were not significantly related to breast cancer risk. The variety of vegetable types consumed weekly seemed to have a beneficial effect beyond the advantage of high vegetable intake per se.

Breast Neoplasms↗

Reproducibility of an Italian food frequency questionnaire for cancer studies. Results for specific nutrients.

The reproducibility of measures of the intake of total energy and 27 selected nutrients from a quantitative food frequency questionnaire (FFQ) used in a case-control study on cancer of the breast, ovary, and digestive tract was evaluated. The results of two FFQ administrations at an interval of 3 to 10 months (median = 5.4 months) to 452 volunteers (144 males and 308 females; median age = 50 years) from three Italian provinces (Pordenone, Genoa, and Forì) were compared. Pearson correlation coefficients (r) between crude nutrient intake (unadjusted for energy) ranged from 0.50 for vegetable fat to 0.80 for alcohol, with most values falling between 0.60 and 0.70 (median r = 0.67). Adjustment of nutrient intakes for total energy slightly decreased most coefficients (median r = 0.60). The agreement between the two measurements did not differ substantially by sex, age, education, and interval between interviews. The contribution of specific FFQ components (i.e., frequency-only questions, open questions, portion size, and fat intake pattern) was also assessed separately with respect to the performance and reproducibility of nutrient measures, yielding, in general, very similar results. The seven questions concerning individual fat intake pattern, which were used to modulate the composition of various recipes, led, however, to a significant increase in mean daily intake of vegetable fat, oleic acid, and vitamin E, but a reduction of estimated daily intake of linoleic acid and polyunsaturated fatty acids.(ABSTRACT TRUNCATED AT 250 WORDS)

Case-Control Studies↗

Influence of some covariates on the reproducibility of an Italian semi-quantitative food frequency questionnaire.

We studied the influence of age, sex, education and time between interviews on the reproducibility of a semi-quantitative food frequency questionnaire (FFQ) developed in Italy for a case-control study on cancers of the breast and digestive tract. The questionnaire had been administered twice to 452 Italian men and women and included the weekly consumption of 77 food items or groups of foods, seven summary questions and three questions on some general dietary habits. Spearman correlation coefficients for the 77 dietary items plus the seven summary questions did not differ between males (median 0.61) and females (median 0.58), volunteers younger than 50 years (median 0.58) and aged 50 or more (median 0.59), volunteers with fewer than 10 years of education (median 0.58) and with 10 or more (median 0.59). A slightly higher Spearman correlation coefficient was found when the two interviews were conducted 5-6 months apart (median 0.60) or more than 6 (median 0.59) than when less than 5 (median 0.55). Similarly, Pearson correlation coefficients for the intake of 27 nutrients or micronutrients, plus caloric intake, computed from the FFQ showed no differences between males (median 0.65) and females (median 0.64), two age groups (median 0.67 for subjects aged < 50 years and 0.65 for those aged > or = 50), and two educational levels (median 0.68 for < 10 years and 0.65 for > or = 10 years). The median Pearson correlation coefficient for nutrients was slightly higher for those subjects who were interviewed with the planned interval (5-6 months, median 0.71) than when the interval was shorter (median 0.57) or longer (median 0.64).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗