This page has only limited features, please log in for full access.
High sodium and low potassium intakes are associated with increased levels of blood pressure and risk of cardiovascular diseases. Assessment of habitual dietary habits are helpful to evaluate their intake and adherence to healthy dietary recommendations. In this study, we determined sodium and potassium food-specific content and intake in a Northern Italy community, focusing on the role and contribution of adherence to Mediterranean diet patterns. We collected a total of 908 food samples and measured sodium and potassium content using inductively coupled plasma mass spectrometry. Using a validated semi-quantitative food frequency questionnaire, we assessed habitual dietary intake of 719 adult individuals of the Emilia-Romagna region. We then estimated sodium and potassium daily intake for each food based on their relative contribution to the overall diet, and their link to Mediterranean diet patterns. The estimated mean sodium intake was 2.15 g/day, while potassium mean intake was 3.37 g/day. The foods contributing most to sodium intake were cereals (33.2%), meat products (24.5%, especially processed meat), and dairy products (13.6%), and for potassium they were meat (17.1%, especially red and white meat), fresh fruits (15.7%), and vegetables (15.1%). Adherence to a Mediterranean diet had little influence on sodium intake, whereas potassium intake was greatly increased in subjects with higher scores, resulting in a lower sodium/potassium ratio. Although we may have underestimated dietary sodium intake by not including discretionary salt use and there may be some degree of exposure misclassification as a result of changes in food sodium content and dietary habits over time, our study provides an overview of the contribution of a wide range of foods to the sodium and potassium intake in a Northern Italy community and of the impact of a Mediterranean diet on intake. The mean sodium intake was above the dietary recommendations for adults of 1.5–2 g/day, whilst potassium intake was only slightly lower than the recommended 3.5 g/day. Our findings suggest that higher adherence to Mediterranean diet patterns has limited effect on restricting sodium intake, but may facilitate a higher potassium intake, thereby aiding the achievement of healthy dietary recommendations.
Marcella Malavolti; Androniki Naska; Susan Fairweather-Tait; Carlotta Malagoli; Luciano Vescovi; Cristina Marchesi; Marco Vinceti; Tommaso Filippini. Sodium and Potassium Content of Foods Consumed in an Italian Population and the Impact of Adherence to a Mediterranean Diet on Their Intake. Nutrients 2021, 13, 2681 .
AMA StyleMarcella Malavolti, Androniki Naska, Susan Fairweather-Tait, Carlotta Malagoli, Luciano Vescovi, Cristina Marchesi, Marco Vinceti, Tommaso Filippini. Sodium and Potassium Content of Foods Consumed in an Italian Population and the Impact of Adherence to a Mediterranean Diet on Their Intake. Nutrients. 2021; 13 (8):2681.
Chicago/Turabian StyleMarcella Malavolti; Androniki Naska; Susan Fairweather-Tait; Carlotta Malagoli; Luciano Vescovi; Cristina Marchesi; Marco Vinceti; Tommaso Filippini. 2021. "Sodium and Potassium Content of Foods Consumed in an Italian Population and the Impact of Adherence to a Mediterranean Diet on Their Intake." Nutrients 13, no. 8: 2681.
The results of a voluntary screening campaign for the presence of anti-SARS-CoV-2 serum antibodies are presented, performed on workers in the highly industrialized province of Modena in northern Italy in the period 18 May–5 October 2020. The employment activities of the subjects that tested positive for anti-SARS-CoV-2 IgM and/or IgG antibodies were determined and classified using the International Standard Industrial Classification of All Economic Activities (ISIC). The distribution across different sectors was compared to the proportion of workers employed in the same sectors in the province of Modena as a whole. Workers with anti-SARS-CoV-2 serum antibodies were mainly employed in manufacturing (60%), trade (12%), transportation (9%), scientific and technical activities (5%), and arts, entertainment and recreation activities (4.5%). Within the manufacturing sector, a cluster of workers with positive serological tests was observed in the meat processing sector, confirming recent data showing a possible increased risk of SARS-CoV-2 infection in these workers.
Alberto Modenese; Tommaso Mazzoli; Nausicaa Berselli; Davide Ferrari; Annalisa Bargellini; Paola Borella; Tommaso Filippini; Isabella Marchesi; Stefania Paduano; Marco Vinceti; Fabriziomaria Gobba. Frequency of Anti-SARS-CoV-2 Antibodies in Various Occupational Sectors in an Industrialized Area of Northern Italy from May to October 2020. International Journal of Environmental Research and Public Health 2021, 18, 7948 .
AMA StyleAlberto Modenese, Tommaso Mazzoli, Nausicaa Berselli, Davide Ferrari, Annalisa Bargellini, Paola Borella, Tommaso Filippini, Isabella Marchesi, Stefania Paduano, Marco Vinceti, Fabriziomaria Gobba. Frequency of Anti-SARS-CoV-2 Antibodies in Various Occupational Sectors in an Industrialized Area of Northern Italy from May to October 2020. International Journal of Environmental Research and Public Health. 2021; 18 (15):7948.
Chicago/Turabian StyleAlberto Modenese; Tommaso Mazzoli; Nausicaa Berselli; Davide Ferrari; Annalisa Bargellini; Paola Borella; Tommaso Filippini; Isabella Marchesi; Stefania Paduano; Marco Vinceti; Fabriziomaria Gobba. 2021. "Frequency of Anti-SARS-CoV-2 Antibodies in Various Occupational Sectors in an Industrialized Area of Northern Italy from May to October 2020." International Journal of Environmental Research and Public Health 18, no. 15: 7948.
Selenium is both an essential nutrient and a highly toxic element, depending on its dose and chemical forms. We aimed to quantify urinary selenium excretion and dietary selenium intake in 137 healthy non-smoking blood donors living in the northern Italian province of Reggio Emilia. We assessed selenium status by determining urinary selenium levels (mean 26.77 µg/L), and by estimating dietary selenium intake (mean 84.09 µg/day) using a validated semi-quantitative food frequency questionnaire. Fasting blood levels of glucose, lipids and thyroid-stimulating hormone were measured using automatized laboratory procedures. Dietary and urinary selenium were correlated (beta coefficient (β) = 0.19). Despite this, the association of the two indicators with health endpoints tended to diverge. Using linear regression analysis adjusted for age, sex, body mass index, cotinine levels and alcohol intake, we observed a positive association between urinary selenium and blood triglyceride (β = 0.14), LDL-cholesterol (β = 0.07) and glucose levels (β = 0.08), and an inverse one with HDL-cholesterol (β = −0.12). Concerning dietary selenium, a slightly positive association could be found with glycemic levels only (β = 0.02), while a negative one emerged for other endpoints. The two selenium indicators showed conflicting and statistically highly imprecise associations with circulating TSH levels. Our findings suggest that higher selenium exposure is adversely associated with blood glucose levels and lipid profile. This is the case even at selenium exposures not exceeding tolerable upper intake levels according to current guidelines.
Teresa Urbano; Tommaso Filippini; Daniela Lasagni; Tiziana De Luca; Sabrina Sucato; Elisa Polledri; Francesco Bruzziches; Marcella Malavolti; Claudia Baraldi; Annalisa Santachiara; Thelma A. Pertinhez; Roberto Baricchi; Silvia Fustinoni; Marco Vinceti. Associations between Urinary and Dietary Selenium and Blood Metabolic Parameters in a Healthy Northern Italy Population. Antioxidants 2021, 10, 1193 .
AMA StyleTeresa Urbano, Tommaso Filippini, Daniela Lasagni, Tiziana De Luca, Sabrina Sucato, Elisa Polledri, Francesco Bruzziches, Marcella Malavolti, Claudia Baraldi, Annalisa Santachiara, Thelma A. Pertinhez, Roberto Baricchi, Silvia Fustinoni, Marco Vinceti. Associations between Urinary and Dietary Selenium and Blood Metabolic Parameters in a Healthy Northern Italy Population. Antioxidants. 2021; 10 (8):1193.
Chicago/Turabian StyleTeresa Urbano; Tommaso Filippini; Daniela Lasagni; Tiziana De Luca; Sabrina Sucato; Elisa Polledri; Francesco Bruzziches; Marcella Malavolti; Claudia Baraldi; Annalisa Santachiara; Thelma A. Pertinhez; Roberto Baricchi; Silvia Fustinoni; Marco Vinceti. 2021. "Associations between Urinary and Dietary Selenium and Blood Metabolic Parameters in a Healthy Northern Italy Population." Antioxidants 10, no. 8: 1193.
Accumulating evidence from both experimental and nonexperimental human studies in the last 15 years indicates that exposure to high levels of the trace element selenium increases the risk of type 2 diabetes. However, the relation of dose to effect is not well understood because randomized controlled trials used only one dose (200 μg/day) of selenium supplementation. While no new trial on this topic has been published since 2018, several nonexperimental studies have appeared. We therefore updated a previous meta-analysis to include recently published observational studies, and incorporated the recently developed one-stage random-effects model to display the dose-response relation between selenium and type 2 diabetes. We retrieved 34 potentially eligible nonexperimental studies on selenium and diabetes risk up to April 15, 2021. The bulk of the evidence indicates a direct relation between blood, dietary and urinary levels of selenium and risk of diabetes, but not with nail selenium, which may be considered a less reliable biomarker. The association was nonlinear, with risk increasing above 80 μg/day of dietary selenium. Whole blood/plasma/serum selenium concentrations of 160 μg/L corresponded to a risk ratio of 1.96 (95% CI 1.27–3.03) compared with a concentration of 90 μg/L (approximately 60 μg of daily selenium intake). The cohort studies, which are less susceptible to reverse causation bias, indicated increased risk for both blood and urine selenium levels and dietary selenium intake, whereas no such pattern emerged from studies relying on nail selenium content. Overall, the nonexperimental studies agree with findings from randomized controlled trials, indicating that moderate to high levels of selenium exposure are associated with increased risk for type 2 diabetes.
Marco Vinceti; Tommaso Filippini; Lauren A. Wise; Kenneth J. Rothman. A systematic review and dose-response meta-analysis of exposure to environmental selenium and the risk of type 2 diabetes in nonexperimental studies. Environmental Research 2021, 197, 111210 .
AMA StyleMarco Vinceti, Tommaso Filippini, Lauren A. Wise, Kenneth J. Rothman. A systematic review and dose-response meta-analysis of exposure to environmental selenium and the risk of type 2 diabetes in nonexperimental studies. Environmental Research. 2021; 197 ():111210.
Chicago/Turabian StyleMarco Vinceti; Tommaso Filippini; Lauren A. Wise; Kenneth J. Rothman. 2021. "A systematic review and dose-response meta-analysis of exposure to environmental selenium and the risk of type 2 diabetes in nonexperimental studies." Environmental Research 197, no. : 111210.
Background: The relationship between dietary sodium intake and blood pressure (BP) has been tested in clinical trials and nonexperimental human studies, indicating a direct association. The exact shape of the dose–response relationship has been difficult to assess in clinical trials because of the lack of random-effects dose–response statistical models that can include 2-arm comparisons. Methods: After performing a comprehensive literature search for experimental studies that investigated the BP effects of changes in dietary sodium intake, we conducted a dose–response meta-analysis using the new 1-stage cubic spline mixed-effects model. We included trials with at least 4 weeks of follow-up; 24-hour urinary sodium excretion measurements; sodium manipulation through dietary change or supplementation, or both; and measurements of systolic and diastolic BP at the beginning and end of treatment. Results: We identified 85 eligible trials with sodium intake ranging from 0.4 to 7.6 g/d and follow-up from 4 weeks to 36 months. The trials were conducted in participants with hypertension (n=65), without hypertension (n=11), or a combination (n=9). Overall, the pooled data were compatible with an approximately linear relationship between achieved sodium intake and mean systolic as well as diastolic BP, with no indication of a flattening of the curve at either the lowest or highest levels of sodium exposure. Results were similar for participants with or without hypertension, but the former group showed a steeper decrease in BP after sodium reduction. Intervention duration (≥12 weeks versus 4 to 11 weeks), type of study design (parallel or crossover), use of antihypertensive medication, and participants’ sex had little influence on the BP effects of sodium reduction. Additional analyses based on the BP effect of difference in sodium exposure between study arms at the end of the trial confirmed the results on the basis of achieved sodium intake. Conclusions: In this dose–response analysis of sodium reduction in clinical trials, we identified an approximately linear relationship between sodium intake and reduction in both systolic and diastolic BP across the entire range of dietary sodium exposure. Although this occurred independently of baseline BP, the effect of sodium reduction on level of BP was more pronounced in participants with a higher BP level.
Tommaso Filippini; Marcella Malavolti; Paul K. Whelton; Androniki Naska; Nicola Orsini; Marco Vinceti. Blood Pressure Effects of Sodium Reduction. Circulation 2021, 143, 1542 -1567.
AMA StyleTommaso Filippini, Marcella Malavolti, Paul K. Whelton, Androniki Naska, Nicola Orsini, Marco Vinceti. Blood Pressure Effects of Sodium Reduction. Circulation. 2021; 143 (16):1542-1567.
Chicago/Turabian StyleTommaso Filippini; Marcella Malavolti; Paul K. Whelton; Androniki Naska; Nicola Orsini; Marco Vinceti. 2021. "Blood Pressure Effects of Sodium Reduction." Circulation 143, no. 16: 1542-1567.
We assessed the relation between COVID-19 waves in Italy, which was severely affected during the pandemic. We evaluated the hypothesis that a larger impact from the first wave (February–May 2020) predicts a smaller peak during the second wave (September–October 2020), in the absence of local changes in public health interventions and area-specific differences in time trends of environmental parameters. Based on publicly available data on province-specific SARS-CoV-2 infections and both crude and multivariable cubic spline regression models, we found that for provinces with the lowest incidence rates in the first wave, the incidence in the second wave increased roughly in proportion with the incidence in the first wave until an incidence of about 500–600 cases/100,000 in the first wave. Above that value, provinces with higher incidences in the first wave experienced lower incidences in the second wave. It appears that a comparatively high cumulative incidence of infection, even if far below theoretical thresholds required for herd immunity, may provide noticeable protection during the second wave. We speculate that, if real, the mechanism for this pattern could be depletion of most susceptible individuals and of superspreaders in the first wave. A population learning effect regarding cautious behavior could have also contributed. Since no area-specific variation of the national policy against the SARS-CoV-2 outbreak was allowed until early November 2020, neither individual behaviors nor established or purported environmental risk factors of COVID-19, such as air pollution and meteorological factors, are likely to have confounded the inverse trends we observed in infection incidence over time.
Marco Vinceti; Tommaso Filippini; Kenneth J. Rothman; Silvia Di Federico; Nicola Orsini. SARS-CoV-2 infection incidence during the first and second COVID-19 waves in Italy. Environmental Research 2021, 197, 111097 -111097.
AMA StyleMarco Vinceti, Tommaso Filippini, Kenneth J. Rothman, Silvia Di Federico, Nicola Orsini. SARS-CoV-2 infection incidence during the first and second COVID-19 waves in Italy. Environmental Research. 2021; 197 ():111097-111097.
Chicago/Turabian StyleMarco Vinceti; Tommaso Filippini; Kenneth J. Rothman; Silvia Di Federico; Nicola Orsini. 2021. "SARS-CoV-2 infection incidence during the first and second COVID-19 waves in Italy." Environmental Research 197, no. : 111097-111097.
The awareness of citizens concerning the health risks caused by environmental pollution is growing, but studies on determinants of pro-environmental behaviors have rarely examined health-related aspects. In this study, we investigated these determinants using data from a large survey among Italian university students (15 Universities: 4778 filled questionnaires). Besides the health-related aspects, represented by environmental health risk perception and functional health literacy, we considered social and demographic characteristics (gender, area of residence, sources of information, trust in institutional and non-institutional subjects, and students’ capacity of positive actions, indicated as internal locus of control). The attitudes towards pro-environmental behaviors were positive for more than 70% of students and positively related with health risk perception, internal locus of control, and health literacy. The correspondence between the positive attitudes towards pro-environmental behaviors and the real adoption of such behaviors was approximately 20% for most behaviors, except for the separate collection of waste (60%). Such a discrepancy can be attributable to external obstacles (i.e., lack of time, costs, lack of support). The health-related aspects were linked to the pro-environmental attitudes, but to a lesser extent to pro-environmental behaviors, owing to the complexity of their determinants. However, they should be taken in account in planning education interventions.
Annalaura Carducci; Maria Fiore; Antonio Azara; Guglielmo Bonaccorsi; Martina Bortoletto; Giuseppina Caggiano; Andrea Calamusa; Antonella De Donno; Osvalda De Giglio; Marco Dettori; Pamela Di Giovanni; Angela Di Pietro; Alessio Facciolà; Ileana Federigi; Iolanda Grappasonni; Alberto Izzotti; Giovanni Libralato; Chiara Lorini; Maria Montagna; Liberata Nicolosi; Grazia Paladino; Giacomo Palomba; Fabio Petrelli; Tiziana Schilirò; Stefania Scuri; Francesca Serio; Marina Tesauro; Marco Verani; Marco Vinceti; Federica Violi; Margherita Ferrante. Pro-Environmental Behaviors: Determinants and Obstacles among Italian University Students. International Journal of Environmental Research and Public Health 2021, 18, 3306 .
AMA StyleAnnalaura Carducci, Maria Fiore, Antonio Azara, Guglielmo Bonaccorsi, Martina Bortoletto, Giuseppina Caggiano, Andrea Calamusa, Antonella De Donno, Osvalda De Giglio, Marco Dettori, Pamela Di Giovanni, Angela Di Pietro, Alessio Facciolà, Ileana Federigi, Iolanda Grappasonni, Alberto Izzotti, Giovanni Libralato, Chiara Lorini, Maria Montagna, Liberata Nicolosi, Grazia Paladino, Giacomo Palomba, Fabio Petrelli, Tiziana Schilirò, Stefania Scuri, Francesca Serio, Marina Tesauro, Marco Verani, Marco Vinceti, Federica Violi, Margherita Ferrante. Pro-Environmental Behaviors: Determinants and Obstacles among Italian University Students. International Journal of Environmental Research and Public Health. 2021; 18 (6):3306.
Chicago/Turabian StyleAnnalaura Carducci; Maria Fiore; Antonio Azara; Guglielmo Bonaccorsi; Martina Bortoletto; Giuseppina Caggiano; Andrea Calamusa; Antonella De Donno; Osvalda De Giglio; Marco Dettori; Pamela Di Giovanni; Angela Di Pietro; Alessio Facciolà; Ileana Federigi; Iolanda Grappasonni; Alberto Izzotti; Giovanni Libralato; Chiara Lorini; Maria Montagna; Liberata Nicolosi; Grazia Paladino; Giacomo Palomba; Fabio Petrelli; Tiziana Schilirò; Stefania Scuri; Francesca Serio; Marina Tesauro; Marco Verani; Marco Vinceti; Federica Violi; Margherita Ferrante. 2021. "Pro-Environmental Behaviors: Determinants and Obstacles among Italian University Students." International Journal of Environmental Research and Public Health 18, no. 6: 3306.
Background and Aims Experimental and non-experimental human studies have consistently shown a positive association between exposure to the trace element selenium, which occurs primarily through diet, and risk of type 2 diabetes mellitus. Plausible biological mechanisms include adverse effects of selenium and selenium-containing proteins on glucose metabolism. However, the levels of exposure above which risk increases are uncertain. Methods and Results We examined the association between selenium intake and first hospitalization for type 2 diabetes during a median follow-up period of 8.2 years among 21,335 diabetes-free participants in the Moli-sani cohort, Italy. Selenium intake was ascertained at baseline using a food frequency questionnaire, showing a median value of 59 μg/day. During follow-up, we identified 135 incident cases of hospitalization for diabetes, based on population-based hospital discharge data. We used a Cox proportional hazards model to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for hospitalization for diabetes, adjusting for potential confounders. HRs (95% CIs) were 1.01 (0.60-1.70), 1.13 (0.66-1.96) and 1.75 (0.99-3.10) comparing the second, third, and fourth sex-specific quartiles with the first quartile, respectively. Risk was 64% greater in the fourth quartile as compared with the previous three. Spline regression analysis also indicated a steeper increase in risk occurring among men compared with women. Conclusions In a large population of Italian adults free of type 2 diabetes at cohort entry, high dietary selenium intake was associated with increased risk of hospitalization for diabetes.
Marco Vinceti; Marialaura Bonaccio; Tommaso Filippini; Simona Costanzo; Lauren A. Wise; Augusto Di Castelnuovo; Emilia Ruggiero; Mariarosaria Persichillo; Chiara Cerletti; Maria Benedetta Donati; Giovanni de Gaetano; Licia Iacoviello. Dietary selenium intake and risk of hospitalization for type 2 diabetes in the Moli-sani study cohort. Nutrition, Metabolism and Cardiovascular Diseases 2021, 31, 1738 -1746.
AMA StyleMarco Vinceti, Marialaura Bonaccio, Tommaso Filippini, Simona Costanzo, Lauren A. Wise, Augusto Di Castelnuovo, Emilia Ruggiero, Mariarosaria Persichillo, Chiara Cerletti, Maria Benedetta Donati, Giovanni de Gaetano, Licia Iacoviello. Dietary selenium intake and risk of hospitalization for type 2 diabetes in the Moli-sani study cohort. Nutrition, Metabolism and Cardiovascular Diseases. 2021; 31 (6):1738-1746.
Chicago/Turabian StyleMarco Vinceti; Marialaura Bonaccio; Tommaso Filippini; Simona Costanzo; Lauren A. Wise; Augusto Di Castelnuovo; Emilia Ruggiero; Mariarosaria Persichillo; Chiara Cerletti; Maria Benedetta Donati; Giovanni de Gaetano; Licia Iacoviello. 2021. "Dietary selenium intake and risk of hospitalization for type 2 diabetes in the Moli-sani study cohort." Nutrition, Metabolism and Cardiovascular Diseases 31, no. 6: 1738-1746.
(1) Background: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease with still unknown etiology. Some occupational and environmental risk factors have been suggested, including long-term air pollutant exposure. We carried out a pilot case-control study in order to evaluate ALS risk due to particulate matter with a diameter of ≤10 µm (PM10) as a proxy of vehicular traffic exposure. (2) Methods: We recruited ALS patients and controls referred to the Modena Neurology ALS Care Center between 1994 and 2015. Using a geographical information system, we modeled PM10 concentrations due to traffic emissions at the geocoded residence address at the date of case diagnosis. We computed the odds ratio (OR) and 95% confidence interval (CI) of ALS according to increasing PM10 exposure, using an unconditional logistic regression model adjusted for age and sex. (3) Results: For the 132 study participants (52 cases and 80 controls), the average of annual median and maximum PM10 concentrations were 5.2 and 38.6 µg/m3, respectively. Using fixed cutpoints at 5, 10, and 20 of the annual median PM10 levels, and compared with exposure 3, we found no excess ALS risk at 5–10 µg/m3 (OR 0.87, 95% CI 0.39–1.96), 10–20 µg/m3 (0.94, 95% CI 0.24–3.70), and ≥20 µg/m3 (0.87, 95% CI 0.05–15.01). Based on maximum PM10 concentrations, we found a statistically unstable excess ALS risk for subjects exposed at 10–20 µg/m3 (OR 4.27, 95% CI 0.69–26.51) compared with those exposed 3. However, risk decreased at 20–50 µg/m3 (OR 1.49, 95% CI 0.39–5.75) and ≥50 µg/m3 (1.16, 95% CI 0.28–4.82). ALS risk in increasing tertiles of exposure showed a similar null association, while comparison between the highest and the three lowest quartiles lumped together showed little evidence for an excess risk at PM10 concentrations (OR 1.13, 95% CI 0.50–2.55). After restricting the analysis to subjects with stable residence, we found substantially similar results. (4) Conclusions: In this pilot study, we found limited evidence of an increased ALS risk due to long-term exposure at high PM10 concentration, though the high statistical imprecision of the risk estimates, due to the small sample size, particularly in some exposure categories, limited our capacity to detect small increases in risk, and further larger studies are needed to assess this relation.
Tommaso Filippini; Jessica Mandrioli; Carlotta Malagoli; Sofia Costanzini; Andrea Cherubini; Giuseppe Maffeis; Marco Vinceti. Risk of Amyotrophic Lateral Sclerosis and Exposure to Particulate Matter from Vehicular Traffic: A Case-Control Study. International Journal of Environmental Research and Public Health 2021, 18, 973 .
AMA StyleTommaso Filippini, Jessica Mandrioli, Carlotta Malagoli, Sofia Costanzini, Andrea Cherubini, Giuseppe Maffeis, Marco Vinceti. Risk of Amyotrophic Lateral Sclerosis and Exposure to Particulate Matter from Vehicular Traffic: A Case-Control Study. International Journal of Environmental Research and Public Health. 2021; 18 (3):973.
Chicago/Turabian StyleTommaso Filippini; Jessica Mandrioli; Carlotta Malagoli; Sofia Costanzini; Andrea Cherubini; Giuseppe Maffeis; Marco Vinceti. 2021. "Risk of Amyotrophic Lateral Sclerosis and Exposure to Particulate Matter from Vehicular Traffic: A Case-Control Study." International Journal of Environmental Research and Public Health 18, no. 3: 973.
Risk of early-onset dementia (EOD) might be modified by environmental factors and lifestyles, including diet. The aim of this study is to evaluate the association between dietary habits and EOD risk. We recruited 54 newly-diagnosed EOD patients in Modena (Northern Italy) and 54 caregivers as controls. We investigated dietary habits through a food frequency questionnaire, assessing both food intake and adherence to dietary patterns, namely the Greek-Mediterranean, the Dietary Approaches to Stop Hypertension (DASH), and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets. We modeled the relation between dietary factors and risk using the restricted cubic spline regression analysis. Cereal intake showed a U-shaped relation with EOD, with risk increasing above 350 g/day. A high intake (>400 g/day) of dairy products was also associated with excess risk. Although overall fish and seafood consumption showed no association with EOD risk, we found a U-shaped relation with preserved/tinned fish, and an inverse relation with other fish. Similarly, vegetables (especially leafy) showed a strong inverse association above 100 g/day, as did citrus and dry fruits. Overall, sweet consumption was not associated with EOD risk, while dry cake and ice-cream showed a positive relation and chocolate products an inverse one. For beverages, we found no relation with EOD risk apart from a U-shaped relation for coffee consumption. Concerning dietary patterns, EOD risk linearly decreased with the increasing adherence to the MIND pattern. On the other hand, an inverse association for the Greek-Mediterranean and DASH diets emerged only at very high adherence levels. To the best of our knowledge, this is the first study that explores the association between dietary factors and EOD risk, and suggests that adherence to the MIND dietary pattern may decrease such risk.
Tommaso Filippini; Giorgia Adani; Marcella Malavolti; Caterina Garuti; Silvia Cilloni; Giulia Vinceti; Giovanna Zamboni; Manuela Tondelli; Chiara Galli; Manuela Costa; Annalisa Chiari; Marco Vinceti. Dietary Habits and Risk of Early-Onset Dementia in an Italian Case-Control Study. Nutrients 2020, 12, 3682 .
AMA StyleTommaso Filippini, Giorgia Adani, Marcella Malavolti, Caterina Garuti, Silvia Cilloni, Giulia Vinceti, Giovanna Zamboni, Manuela Tondelli, Chiara Galli, Manuela Costa, Annalisa Chiari, Marco Vinceti. Dietary Habits and Risk of Early-Onset Dementia in an Italian Case-Control Study. Nutrients. 2020; 12 (12):3682.
Chicago/Turabian StyleTommaso Filippini; Giorgia Adani; Marcella Malavolti; Caterina Garuti; Silvia Cilloni; Giulia Vinceti; Giovanna Zamboni; Manuela Tondelli; Chiara Galli; Manuela Costa; Annalisa Chiari; Marco Vinceti. 2020. "Dietary Habits and Risk of Early-Onset Dementia in an Italian Case-Control Study." Nutrients 12, no. 12: 3682.
After the appearance of COVID-19 in China last December 2019, Italy was the first European country to be severely affected by the outbreak. The first diagnosis in Italy was on February 20, 2020, followed by the establishment of a light and a tight lockdown on February 23 and on March 8, 2020, respectively. The virus spread rapidly, particularly in the North of the country in the ‘Padan Plain’ area, known as one of the most polluted regions in Europe. Air pollution has been recently hypothesized to enhance the clinical severity of SARS-CoV-2 infection, acting through adverse effects on immunity, induction of respiratory and other chronic disease, upregulation of viral receptor ACE-2, and possible pathogen transportation as a virus carrier. We investigated the association between air pollution and subsequent COVID-19 mortality rates within two Italian regions (Veneto and Emilia-Romagna). We estimated ground-level nitrogen dioxide through its tropospheric levels using data available from the Sentinel-5P satellites of the European Space Agency Copernicus Earth Observation Programme before the lockdown. We then examined COVID-19 mortality rates in relation to the nitrogen dioxide levels at three 14-day lag points after the lockdown, namely March 8, 22 and April 5, 2020. Using a multivariable negative binomial regression model, we found an association between nitrogen dioxide and COVID-19 mortality. Although ecological data provide only weak evidence, these findings indicate an association between air pollution levels and COVID-19 severity.
Tommaso Filippini; Kenneth J. Rothman; Silvia Cocchio; Elena Narne; Domenico Mantoan; Mario Saia; Alessia Goffi; Fabrizio Ferrari; Giuseppe Maffeis; Nicola Orsini; Vincenzo Baldo; Marco Vinceti. Associations between mortality from COVID-19 in two Italian regions and outdoor air pollution as assessed through tropospheric nitrogen dioxide. Science of The Total Environment 2020, 760, 143355 -143355.
AMA StyleTommaso Filippini, Kenneth J. Rothman, Silvia Cocchio, Elena Narne, Domenico Mantoan, Mario Saia, Alessia Goffi, Fabrizio Ferrari, Giuseppe Maffeis, Nicola Orsini, Vincenzo Baldo, Marco Vinceti. Associations between mortality from COVID-19 in two Italian regions and outdoor air pollution as assessed through tropospheric nitrogen dioxide. Science of The Total Environment. 2020; 760 ():143355-143355.
Chicago/Turabian StyleTommaso Filippini; Kenneth J. Rothman; Silvia Cocchio; Elena Narne; Domenico Mantoan; Mario Saia; Alessia Goffi; Fabrizio Ferrari; Giuseppe Maffeis; Nicola Orsini; Vincenzo Baldo; Marco Vinceti. 2020. "Associations between mortality from COVID-19 in two Italian regions and outdoor air pollution as assessed through tropospheric nitrogen dioxide." Science of The Total Environment 760, no. : 143355-143355.
Background: Early-onset dementia (EOD) is defined as dementia with symptom onset before 65 years. The role of environmental risk factors in the etiology of EOD is still undefined. We aimed at assessing the role of environmental risk factors in EOD etiology, taking into account its different clinical types. Methods: Using a case-control study, we recruited all EOD cases referred to Modena hospitals from 2016 to 2019, while the referent population was drawn from cases’ caregivers. We investigated residential history, occupational and environmental exposures to chemicals and lifestyle behaviors through a self-administered questionnaire. We computed the odds ratios of EOD risk (overall and restricting to the Alzheimer’s dementia (AD) or frontotemporal dementia (FTD) diagnoses) and the corresponding 95% confidence intervals using an unconditional logistic regression model. Results: Fifty-eight EOD patients (19 FTD and 32 AD) and 54 controls agreed to participate. Most of the investigated exposures, such as occupational exposure to aluminum, pesticides, dyes, paints or thinners, were associated with an increased odds ratio (OR) for FTD but not for AD. Long-term use of selenium-containing dietary supplements was associated with increased OR for EOD and, particularly, for FTD. For both EOD forms, smoking and playing football showed an increased odds ratio, while cycling was associated with increased risk only in FTD. Overall sports practice appeared to be a protective factor for both types. Conclusions: Our results suggest a role of environmental and behavioral risk factors such as some chemical exposures and professional sports in EOD etiology, in particular with reference to FTD. Overall sports practice may be associated with a reduced EOD risk.
Giorgia Adani; Tommaso Filippini; Caterina Garuti; Marcella Malavolti; Giulia Vinceti; Giovanna Zamboni; Manuela Tondelli; Chiara Galli; Manuela Costa; Marco Vinceti; Annalisa Chiari. Environmental Risk Factors for Early-Onset Alzheimer’s Dementia and Frontotemporal Dementia: A Case-Control Study in Northern Italy. International Journal of Environmental Research and Public Health 2020, 17, 7941 .
AMA StyleGiorgia Adani, Tommaso Filippini, Caterina Garuti, Marcella Malavolti, Giulia Vinceti, Giovanna Zamboni, Manuela Tondelli, Chiara Galli, Manuela Costa, Marco Vinceti, Annalisa Chiari. Environmental Risk Factors for Early-Onset Alzheimer’s Dementia and Frontotemporal Dementia: A Case-Control Study in Northern Italy. International Journal of Environmental Research and Public Health. 2020; 17 (21):7941.
Chicago/Turabian StyleGiorgia Adani; Tommaso Filippini; Caterina Garuti; Marcella Malavolti; Giulia Vinceti; Giovanna Zamboni; Manuela Tondelli; Chiara Galli; Manuela Costa; Marco Vinceti; Annalisa Chiari. 2020. "Environmental Risk Factors for Early-Onset Alzheimer’s Dementia and Frontotemporal Dementia: A Case-Control Study in Northern Italy." International Journal of Environmental Research and Public Health 17, no. 21: 7941.
We much appreciate the positive comments and interest concerning our study on the environmental and occupational risk factors of amyotrophic lateral sclerosis (ALS)
Tommaso Filippini; Marina Tesauro; Maria Fiore; Carlotta Malagoli; Michela Consonni; Federica Violi; Laura Iacuzio; Elisa Arcolin; Gea Oliveri Conti; Antonio Cristaldi; Pietro Zuccarello; Elisabetta Zucchi; Letizia Mazzini; Fabrizio Pisano; Ileana Gagliardi; Francesco Patti; Jessica Mandrioli; Margherita Ferrante; Marco Vinceti. Reply to Comment on “Environmental and Occupational Risk Factors of Amyotrophic Lateral Sclerosis: A Population-Based Case-Control Study”. International Journal of Environmental Research and Public Health 2020, 17, 6492 .
AMA StyleTommaso Filippini, Marina Tesauro, Maria Fiore, Carlotta Malagoli, Michela Consonni, Federica Violi, Laura Iacuzio, Elisa Arcolin, Gea Oliveri Conti, Antonio Cristaldi, Pietro Zuccarello, Elisabetta Zucchi, Letizia Mazzini, Fabrizio Pisano, Ileana Gagliardi, Francesco Patti, Jessica Mandrioli, Margherita Ferrante, Marco Vinceti. Reply to Comment on “Environmental and Occupational Risk Factors of Amyotrophic Lateral Sclerosis: A Population-Based Case-Control Study”. International Journal of Environmental Research and Public Health. 2020; 17 (18):6492.
Chicago/Turabian StyleTommaso Filippini; Marina Tesauro; Maria Fiore; Carlotta Malagoli; Michela Consonni; Federica Violi; Laura Iacuzio; Elisa Arcolin; Gea Oliveri Conti; Antonio Cristaldi; Pietro Zuccarello; Elisabetta Zucchi; Letizia Mazzini; Fabrizio Pisano; Ileana Gagliardi; Francesco Patti; Jessica Mandrioli; Margherita Ferrante; Marco Vinceti. 2020. "Reply to Comment on “Environmental and Occupational Risk Factors of Amyotrophic Lateral Sclerosis: A Population-Based Case-Control Study”." International Journal of Environmental Research and Public Health 17, no. 18: 6492.
The COVID-19 pandemic has sparked an intense debate about the factors underlying the dynamics of the outbreak. Mitigating virus spread could benefit from reliable predictive models that inform effective social and healthcare strategies. Crucially, the predictive validity of these models depends upon incorporating behavioral and social responses to infection that underwrite ongoing social and healthcare strategies. Formally, the problem at hand is not unlike the one faced in neuroscience when modelling brain dynamics in terms of the activity of a neural network: the recent COVID-19 pandemic develops in epicenters (e.g. cities or regions) and diffuses through transmission channels (e.g., population fluxes). Indeed, the analytic framework known as “Dynamic Causal Modeling” (DCM) has recently been applied to the COVID-19 pandemic, shedding new light on the mechanisms and latent factors driving its evolution. The DCM approach rests on a time-series generative model that provides — through Bayesian model inversion and inference — estimates of the factors underlying the progression of the pandemic. We have applied DCM to data from northern Italian regions, which were the first areas in Europe to contend with the COVID-19 outbreak. We used official data on the number of daily confirmed cases, recovered cases, deaths and performed tests. The model — parameterized using data from the first months of the pandemic phase — was able to accurately predict its subsequent evolution (including social mobility, as assessed through GPS monitoring, and seroprevalence, as assessed through serologic testing) and revealed the potential factors underlying regional heterogeneity. Importantly, the model predicts that a second wave could arise due to a loss of effective immunity after about 7 months. This second wave was predicted to be substantially worse if outbreaks are not promptly isolated and contained. In short, dynamic causal modelling appears to be a reliable tool to shape and predict the spread of the COVID-19, and to identify the containment and control strategies that could efficiently counteract its second wave, until effective vaccines become available.
Daniela Gandolfi; Giuseppe Pagnoni; Tommaso Filippini; Alessia Goffi; Marco Vinceti; Egidio Ugo D'angelo; Jonathan Mapelli. Dynamic causal modeling of the COVID-19 pandemic in northern Italy predicts possible scenarios for the second wave. 2020, 1 .
AMA StyleDaniela Gandolfi, Giuseppe Pagnoni, Tommaso Filippini, Alessia Goffi, Marco Vinceti, Egidio Ugo D'angelo, Jonathan Mapelli. Dynamic causal modeling of the COVID-19 pandemic in northern Italy predicts possible scenarios for the second wave. . 2020; ():1.
Chicago/Turabian StyleDaniela Gandolfi; Giuseppe Pagnoni; Tommaso Filippini; Alessia Goffi; Marco Vinceti; Egidio Ugo D'angelo; Jonathan Mapelli. 2020. "Dynamic causal modeling of the COVID-19 pandemic in northern Italy predicts possible scenarios for the second wave." , no. : 1.
Background: Seafood is an important source of omega-3 fatty acids, which have been associated with improved oocyte quality and embryo morphology in some studies. However, seafood is also a source of persistent organic pollutants and heavy metals, which may adversely affect fecundity. Previous studies of seafood intake and fecundity have generated inconsistent results. Methods: In two prospective cohort studies of 7836 female pregnancy planners from Denmark (Snart Foraeldre, n = 2709) and North America (PRESTO, n = 5127), we evaluated the association of dietary intake of total seafood and marine-sourced long-chain omega-3 fatty acids (eicosapentaenoic acid, docosahexaenoic acid, and docosapentaenoic acid) with fecundability. Participants completed a baseline questionnaire on sociodemographics, behavioral factors, anthropometrics, and medical history, and a food frequency questionnaire. Pregnancy status was updated bimonthly for up to 12 months or until reported conception. We estimated fecundability ratios (FRs) and 95% confidence intervals (CIs) using proportional probabilities regression models, adjusted for energy intake and other potential confounders. We restricted analyses to women with ≤6 menstrual cycles of attempt time at enrollment. Results: Intake of total seafood or marine-sourced long-chain omega-3 fatty acids was not appreciably associated with fecundability in either cohort (≥200 vs. <50 g/week total seafood: FR = 0.94, 95% CI: 0.79–1.10 in Snart Foraeldre; FR = 1.00, 95% CI: 0.90–1.13 in PRESTO; marine fatty acids: ≥90th vs. <25th percentile: FR = 1.00, 95% CI: 0.85–1.18 in Snart Foraeldre; FR = 0.97, 95% CI: 0.86–1.09 in PRESTO). In PRESTO, where we collected additional data on seafood preparation, we observed an inverse association between fecundability and fried shellfish (≥10 g/week vs. none: FR = 0.77, 95% CI: 0.61–0.98), but not unfried shellfish (≥20 g/week vs. none: FR = 0.98, 95% CI: 0.89–1.07); in Snart Foraeldre, there was no association with total shellfish intake. Conclusions: We found little association between seafood intake and fecundability overall, but greater intake of fried shellfish was associated with reduced fecundability among North American participants.
Lauren A. Wise; Sydney K. Willis; Ellen M. Mikkelsen; Amelia K. Wesselink; Henrik Toft Sørensen; Kenneth J. Rothman; Katherine L. Tucker; Ellen Trolle; Marco Vinceti; Elizabeth E. Hatch. The Association between Seafood Intake and Fecundability: Analysis from Two Prospective Studies. Nutrients 2020, 12, 2276 .
AMA StyleLauren A. Wise, Sydney K. Willis, Ellen M. Mikkelsen, Amelia K. Wesselink, Henrik Toft Sørensen, Kenneth J. Rothman, Katherine L. Tucker, Ellen Trolle, Marco Vinceti, Elizabeth E. Hatch. The Association between Seafood Intake and Fecundability: Analysis from Two Prospective Studies. Nutrients. 2020; 12 (8):2276.
Chicago/Turabian StyleLauren A. Wise; Sydney K. Willis; Ellen M. Mikkelsen; Amelia K. Wesselink; Henrik Toft Sørensen; Kenneth J. Rothman; Katherine L. Tucker; Ellen Trolle; Marco Vinceti; Elizabeth E. Hatch. 2020. "The Association between Seafood Intake and Fecundability: Analysis from Two Prospective Studies." Nutrients 12, no. 8: 2276.
Background Italy's severe COVID-19 outbreak was addressed by a lockdown that gradually increased in space, time and intensity. The effectiveness of the lockdown has not been precisely assessed with respect to the intensity of mobility restriction and the time until the outbreak receded. Methods We used processed mobile phone tracking data to measure mobility restriction, and related those data to the number of new SARS-CoV-2 positive cases detected on a daily base in the three most affected Italian regions, Lombardy, Veneto and Emilia-Romagna, from February 1 through April 6, 2020, when two subsequent lockdowns with increasing intensity were implemented by the Italian government. Findings During the study period, mobility restriction was inversely related to the daily number of newly diagnosed SARS-CoV-2 positive cases only after the second, more effective lockdown, with a peak in the curve of diagnosed cases of infection occurring 14 to 18 days from lockdown in the three regions and 9 to 25 days in the included provinces. An effective reduction in transmission must have occurred nearly immediately after the tighter lockdown, given the lag time of around 10 days from asymptomatic infection to diagnosis. The period from lockdown to peak was shorter in the areas with the highest prevalence of the infection. This effect was seen within slightly more than one week in the most severely affected areas. Interpretation It appears that the less rigid lockdown led to an insufficient decrease in mobility to reverse an outbreak such as COVID-19. With a tighter lockdown, mobility decreased enough to bring down transmission promptly below the level needed to sustain the epidemic. Funding No funding sources have been used for this work.
Marco Vinceti; Tommaso Filippini; Kenneth J. Rothman; Fabrizio Ferrari; Alessia Goffi; Giuseppe Maffeis; Nicola Orsini. Lockdown timing and efficacy in controlling COVID-19 using mobile phone tracking. EClinicalMedicine 2020, 25, 100457 -100457.
AMA StyleMarco Vinceti, Tommaso Filippini, Kenneth J. Rothman, Fabrizio Ferrari, Alessia Goffi, Giuseppe Maffeis, Nicola Orsini. Lockdown timing and efficacy in controlling COVID-19 using mobile phone tracking. EClinicalMedicine. 2020; 25 ():100457-100457.
Chicago/Turabian StyleMarco Vinceti; Tommaso Filippini; Kenneth J. Rothman; Fabrizio Ferrari; Alessia Goffi; Giuseppe Maffeis; Nicola Orsini. 2020. "Lockdown timing and efficacy in controlling COVID-19 using mobile phone tracking." EClinicalMedicine 25, no. : 100457-100457.
Cadmium is a toxic heavy metal that has been implicated in breast cancer etiology, albeit with inconsistent results. To investigate the shape of the relation between cadmium exposure and breast cancer incidence and mortality in cohort studies. Following a literature search through April 14, 2020, we carried out a systematic review and dose-response meta-analysis to investigate the shape of the relation between cadmium exposure (assessed either through diet or urine excretion) and disease incidence and mortality. For inclusion, a study had to report incidence or mortality for breast cancer according to baseline cadmium exposure category; be a prospective cohort, case-cohort or nested case-control study with a minimum one-year follow-up, and reporting effect estimates for all exposure categories. Studies were evaluated using the ROBINS-E risk of bias tool. The effects in humans were assessed quantitatively using one-stage dose-response meta-analysis in a random effects meta-analytical model. We identified 10 studies eligible for inclusion in the dose-response meta-analysis, six based on cadmium dietary intake, and four on urinary excretion levels. We found a marginal and imprecise positive relation between dietary cadmium intake and breast cancer, and no association when urinary cadmium excretion was used for exposure assessment. Compared to no exposure, at 20 µg/day of cadmium intake the summary risk ratio was 1.12 (95% confidence interval 0.80–1.56), while at 2 µg/g creatinine of cadmium excretion the summary risk ratio was 0.89 (95% confidence interval 0.38–2.14). Analysis restricted to post-menopausal women showed no association between either dietary or urinary cadmium and subsequent breast cancer incidence and mortality. Overall, we found scant evidence of a positive association between cadmium and breast cancer. Available data were too limited to carry out stratified analyses according to age, smoking and hormone receptor status. Therefore, possible associations between cadmium exposure and breast cancer in selected subgroups cannot be entirely ruled out.
Tommaso Filippini; Duarte Torres; Carla Lopes; Catarina Carvalho; Pedro Moreira; Androniki Naska; Maria-Iosifina Kasdagli; Marcella Malavolti; Nicola Orsini; Marco Vinceti. Cadmium exposure and risk of breast cancer: A dose-response meta-analysis of cohort studies. Environment International 2020, 142, 105879 .
AMA StyleTommaso Filippini, Duarte Torres, Carla Lopes, Catarina Carvalho, Pedro Moreira, Androniki Naska, Maria-Iosifina Kasdagli, Marcella Malavolti, Nicola Orsini, Marco Vinceti. Cadmium exposure and risk of breast cancer: A dose-response meta-analysis of cohort studies. Environment International. 2020; 142 ():105879.
Chicago/Turabian StyleTommaso Filippini; Duarte Torres; Carla Lopes; Catarina Carvalho; Pedro Moreira; Androniki Naska; Maria-Iosifina Kasdagli; Marcella Malavolti; Nicola Orsini; Marco Vinceti. 2020. "Cadmium exposure and risk of breast cancer: A dose-response meta-analysis of cohort studies." Environment International 142, no. : 105879.
Following the outbreak of Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) last December 2019 in China, Italy was the first European country to be severely affected, with the first local case diagnosed on 20 February 2020. The virus spread quickly, particularly in the North of Italy, with three regions (Lombardy, Veneto and Emilia-Romagna) being the most severely affected. These three regions accounted for >80% of SARS-CoV-2 positive cases when the tight lockdown was established (March 8). These regions include one of Europe's areas of heaviest air pollution, the Po valley. Air pollution has been recently proposed as a possible risk factor of SARS-CoV-2 infection, due to its adverse effect on immunity and to the possibility that polluted air may even carry the virus. We investigated the association between air pollution and subsequent spread of the SARS-CoV-2 infection within these regions. We collected NO2 tropospheric levels using satellite data available at the European Space Agency before the lockdown. Using a multivariable restricted cubic spline regression model, we compared NO2 levels with SARS-CoV-2 infection prevalence rate at different time points after the lockdown, namely March 8, 22 and April 5, in the 28 provinces of Lombardy, Veneto and Emilia-Romagna. We found little association of NO2 levels with SARS-CoV-2 prevalence up to about 130 μmol/m2, while a positive association was evident at higher levels at each time point. Notwithstanding the limitations of the use of aggregated data, these findings lend some support to the hypothesis that high levels of air pollution may favor the spread of the SARS-CoV-2 infection.
Tommaso Filippini; Kenneth J. Rothman; Alessia Goffi; Fabrizio Ferrari; Giuseppe Maffeis; Nicola Orsini; Marco Vinceti. Satellite-detected tropospheric nitrogen dioxide and spread of SARS-CoV-2 infection in Northern Italy. Science of The Total Environment 2020, 739, 140278 .
AMA StyleTommaso Filippini, Kenneth J. Rothman, Alessia Goffi, Fabrizio Ferrari, Giuseppe Maffeis, Nicola Orsini, Marco Vinceti. Satellite-detected tropospheric nitrogen dioxide and spread of SARS-CoV-2 infection in Northern Italy. Science of The Total Environment. 2020; 739 ():140278.
Chicago/Turabian StyleTommaso Filippini; Kenneth J. Rothman; Alessia Goffi; Fabrizio Ferrari; Giuseppe Maffeis; Nicola Orsini; Marco Vinceti. 2020. "Satellite-detected tropospheric nitrogen dioxide and spread of SARS-CoV-2 infection in Northern Italy." Science of The Total Environment 739, no. : 140278.
Background Epidemiologic studies, including trials, suggest an association between potassium intake and blood pressure ( BP ). However, the strength and shape of this relationship is uncertain. Methods and Results We performed a meta‐analysis to explore the dose‐response relationship between potassium supplementation and BP in randomized‐controlled trials with a duration ≥4 weeks using the recently developed 1‐stage cubic spline regression model. This model allows use of trials with at least 2 exposure categories. We identified 32 eligible trials. Most were conducted in adults with hypertension using a crossover design and potassium supplementation doses that ranged from 30 to 140 mmol/d. We observed a U‐shaped relationship between 24‐hour active and control arm differences in potassium excretion and BP levels, with weakening of the BP reduction effect above differences of 30 mmol/d and a BP increase above differences ≈80 mmol/d. Achieved potassium excretion analysis also identified a U‐shaped relationship. The BP ‐lowering effects of potassium supplementation were stronger in participants with hypertension and at higher levels of sodium intake. The BP increase with high potassium excretion was noted in participants with antihypertensive drug‐treated hypertension but not in their untreated counterparts. Conclusions We identified a nonlinear relationship between potassium intake and both systolic and diastolic BP , although estimates for BP effects of high potassium intakes should be interpreted with caution because of limited availability of trials. Our findings indicate an adequate intake of potassium is desirable to achieve a lower BP level but suggest excessive potassium supplementation should be avoided, particularly in specific subgroups.
Tommaso Filippini; Androniki Naska; Maria‐Iosifina Kasdagli; Duarte Torres; Carla Lopes; Catarina Carvalho; Pedro Moreira; Marcella Malavolti; Nicola Orsini; Paul K. Whelton; Marco Vinceti. Potassium Intake and Blood Pressure: A Dose‐Response Meta‐Analysis of Randomized Controlled Trials. Journal of the American Heart Association 2020, 9, e015719 .
AMA StyleTommaso Filippini, Androniki Naska, Maria‐Iosifina Kasdagli, Duarte Torres, Carla Lopes, Catarina Carvalho, Pedro Moreira, Marcella Malavolti, Nicola Orsini, Paul K. Whelton, Marco Vinceti. Potassium Intake and Blood Pressure: A Dose‐Response Meta‐Analysis of Randomized Controlled Trials. Journal of the American Heart Association. 2020; 9 (12):e015719.
Chicago/Turabian StyleTommaso Filippini; Androniki Naska; Maria‐Iosifina Kasdagli; Duarte Torres; Carla Lopes; Catarina Carvalho; Pedro Moreira; Marcella Malavolti; Nicola Orsini; Paul K. Whelton; Marco Vinceti. 2020. "Potassium Intake and Blood Pressure: A Dose‐Response Meta‐Analysis of Randomized Controlled Trials." Journal of the American Heart Association 9, no. 12: e015719.
Lead is a highly toxic heavy metal released into the environment after natural and anthropogenic activities. Excluding populations in occupations where there is possible lead contamination, food is the major source of human exposure. In this study, we determined lead contamination in food and beverages consumed in a Northern Italy community and performed a health risk assessment. We collected a total of 908 food samples and measured lead levels using inductively coupled plasma mass spectrometry. Using a validated food frequency questionnaire, we assessed the dietary habits and estimated daily lead dietary intakes in a sample of 719 adult individuals. We performed risk assessment using a benchmark dose and margin of exposure approach, based on exposure levels for both adverse effect of systolic blood pressure and chronic kidney disease. Foods with the highest lead levels include non-chocolate confectionery (48.7 µg/kg), leafy (39.0 µg/kg) and other vegetables (42.2 µg/kg), and crustaceans and molluscs (39.0 µg/kg). The estimated mean lead intake was 0.155 µg/kg bw-day in all subjects, with little lower intakes in men (0.151 µg/kg bw-day) compared to women (0.157 µg/kg bw-day). Top food contributors were vegetables, cereals, and beverages, particularly wine. In relation to risk assessment, the estimated dietary intake was lower than levels associated with cardiovascular risk and nephrotoxicity. Our study provides an updated assessment of lead food contamination and dietary exposure in a Northern Italian community. The margin of exposure risk assessment approach suggests that risk of detrimental effects due to dietary lead intake is low in the investigated population. Nonetheless, these exposure levels for adverse effects are not reference health standards, and no safety threshold value can be established for lead. As a consequence, other and more subtle adverse effects may still occur in vulnerable and occupationally exposed individuals, particularly in relation to the nervous system.
Marcella Malavolti; Susan J. Fairweather-Tait; Carlotta Malagoli; Luciano Vescovi; Marco Vinceti; Tommaso Filippini. Lead exposure in an Italian population: Food content, dietary intake and risk assessment. Food Research International 2020, 137, 109370 .
AMA StyleMarcella Malavolti, Susan J. Fairweather-Tait, Carlotta Malagoli, Luciano Vescovi, Marco Vinceti, Tommaso Filippini. Lead exposure in an Italian population: Food content, dietary intake and risk assessment. Food Research International. 2020; 137 ():109370.
Chicago/Turabian StyleMarcella Malavolti; Susan J. Fairweather-Tait; Carlotta Malagoli; Luciano Vescovi; Marco Vinceti; Tommaso Filippini. 2020. "Lead exposure in an Italian population: Food content, dietary intake and risk assessment." Food Research International 137, no. : 109370.