Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Hyperandrogenism, hyperinsulinism and insulin resistance (IR) are the main drivers of clinical, metabolic and reproductive phenotypes of PCOS. In adolescence, the cornerstones of PCOS treatment are lifestyle and dietary interventions. In particular, the quality and quantity of carbohydrates introduced with the diet play a crucial role in the benefits of diet on PCOS. Recently, the ketogenic diet (KD) has attracted significant interest for the treatment of IR and for the control of carbohydrate metabolism, which has proven to be beneficial for several dysmetabolic conditions, including PCOS. The goal of the KD is to induce a fasting-like metabolism with production of chetonic bodies. Ketosis is a good regulator of calorie intake and mimics the starvation effect in the body, leading to body weight control and consequent metabolism. Additionally, during ketogenesis, insulin receptor sensitivity is also promoted. We proposed a broad overview of the available literature regarding KD indications and considered its metabolic benefits useful for improving PCOS management. The reported data support that a low-calorie ketogenic diet (LCKD) plays a positive role as a regulator of control weight, IR, glucose and lipid homeostasis and hormonal profile. Unfortunately, the evidence concerning the benefits of the very LCKD in adolescents with PCOS and excessive body weight is still numerically scarce. Further studies are necessary to understand whether these effects are due to weight loss or to the nutritional characteristics of this diet. Considering the long-term consequences of PCOS, it is crucial to detect the prospects of nutritional interventions to protect fertility, starting in adolescence.

Cancer prehabilitation is the process between the time of cancer diagnosis and the beginning of the active acute treatment; prehabilitation consists of various need-based interventions, e.g., physical activity, a nutritional program, and psychological support. It can be delivered as unimodal or multimodal interventions. Physical activity, including resistant exercise and aerobic activities, has to be tailored according to the patient’s characteristics; nutritional support is aimed at preventing malnutrition and sarcopenia; while psychological intervention intercepts the patient’s distress and supports specific intervention to address it. In addition, multimodal prehabilitation could have a potential impact on the immune system, globally reducing the inflammatory processes and, as a consequence, influencing cancer progression. However, many challenges are still to be addressed, foremost among them the feasibility of prehabilitation programs, the lack of adequate facilities for these programs’ implementation, and the fact that not all prehabilitation interventions are reimbursed by the national health system.

Background: Disease-related malnutrition, with or without inflammation, in older adults is currently emerging as a public health priority. The use of Foods for Special Medical Purposes, including Oral Nutritional Supplements, and supplements is crucial to support patients in achieving their nutritional needs. Therefore, this article aims to comprehensively provide an analysis of the adequacy of FSMPs in meeting the nutritional requirements of different age-related diseases and takes into account the emerging role of inflammation. Moreover, it provides an identikit of the ideal products, following the pathology-specific guidelines. Methods: Data on 132 products were gathered through face-to-face meetings with companies’ consultants. Specifically, information on energy, macronutrient, and micronutrient contents were collected, as well as on texture and flavors, osmolarity, cost, and packaging. Results: Most FSMPs met the daily recommendations for energy and protein intake. Nonetheless, few products contained β-hydroxy-β-methylbutyrate, optimal Branched-Chain Amino Acids ratios, arginine, glutamine, and omega-3 fatty acids. Furthermore, a marked predominance of FSMPs with a high osmolarity (85.7%), sweet taste (72%), and only animal protein content (79.5%) was observed. Cost analysis of FSMPs revealed a mean cost of EUR 5.35/portion. Products were mostly adequate for cancer, neurodegenerative diseases, diabetes, inflammatory bowel disease, end-stage kidney disease, dysphagiam and chronic obstructive pulmonary disease. However, gaps have been found for sarcopenia and abdominal surgery. Conclusion: In light of the current market landscape, there is a need for a comprehensive regulation that indicates the optimal composition of FSMPs and the production of such products to tackle disease-related malnutrition.

Iron plays a vital role in insulin signaling, regulating molecular mechanisms that influence cellular insulin responses. This review explores the link between iron metabolism and insulin resistance (IR) in children and adolescents with obesity. A connection between iron metabolism, iron deficiency (ID), and IR is well-documented, but further longitudinal studies are needed to better understand how iron metabolism influences insulin resistance during childhood and adolescence. This connection warrants attention due to its significant public health implications, as optimizing obesity management could help prevent both ID and metabolic complications in children. Current evidence does not suggest that dietary factors are primary contributors to ID in children. However, there is scientific evidence that weight reduction can restore iron homeostasis in people with obesity. Therefore, efforts should focus on improving dietary habits, increasing awareness of iron’s importance, and implementing strategies to address both ID and obesity.

This introductory chapter presents the book’s topics and illustrates its main objectives. We highlight the book’s key innovative aspects, which lie in the adoption of a multidisciplinary approach (health, economic, and organizational) and in considering multiple target groups in both the theoretical and empirical analyses. We introduce the addressed research questions, the collected data, and the theoretical and managerial contributions. The chapter closes with an illustration of the book’s structure.

Malnutrition, sarcopenia, and sarcopenic obesity may coexist with excess adiposity and cardiometabolic diseases in aging populations, but their combined burden and inflammatory profile remain insufficiently characterized. This study examined their prevalence and overlap in older adults with cardiometabolic diseases and explored associations with metabolic syndrome, multidimensional health-related factors and inflammation. In this cross-sectional study 303 Caucasian adults aged ≥ 65 years were recruited from a General Medicine ward and an Endocrinology and Metabolic Diseases outpatient clinic in Northern Italy. Malnutrition, sarcopenia, sarcopenic obesity, and metabolic syndrome were identified according to the GLIM, EWGSOP2, ESPEN/EASO, and IDF criteria, respectively. Sociodemographic, clinical, anthropometric, body composition, lifestyle, functional, psychological, and biochemical variables were collected using standardized procedures. CRP, WBC, platelet counts, prealbumin, uric acid, and circulating cytokines (IL-6, IL-10, TNF-α, and TGF-β) provided complementary information on inflammatory, nutritional, and metabolic status. The prevalence of malnutrition, sarcopenia, sarcopenic obesity, probable sarcopenia, and metabolic syndrome was 39.9%, 30.9%, 9.4%, 42.6%, and 60.1%, respectively, and was generally higher in inpatients. 13.2% of malnourished patients suffered from overweight or obesity, while malnutrition and sarcopenia overlapped in 29.2%. Older age, functional dependence, poorer physical health-related quality of life, and BMI class were associated with malnutrition or sarcopenia, whereas sarcopenic obesity was associated with age 75–84 years and low physical activity. Metabolic syndrome was significantly associated with malnutrition, sarcopenia, and sarcopenic obesity. Higher circulating IL-6 concentrations were observed in older participants and in those with sarcopenic obesity or metabolic syndrome. Malnutrition, sarcopenia, sarcopenic obesity, and metabolic syndrome are highly prevalent and overlapping conditions among older adults with cardiometabolic diseases, especially in hospitalized patients. Excess body weight does not exclude nutritional or muscle impairment, thus integrated assessment is needed to identify vulnerable older adults and guide targeted interventions.