Increased plasma homocysteine is a risk factor for several pathological disorders. The present review focused on the role of homocysteine (Hcy) in different population groups, especially in risk conditions (pregnancy, infancy, old age), and on its relevance as a marker or etiological factor of the diseases in these age groups, focusing on the nutritional treatment of elevated Hcy levels. In pregnancy, Hcy levels were investigated in relation to the increased risk of adverse pregnancy outcomes such as small size for gestational age at birth, preeclampsia, recurrent abortions, low birth weight, or intrauterine growth restriction. In pediatric populations, Hcy levels are important not only for cardiovascular disease, obesity, and renal disease, but the most interesting evidence concerns study of elevated levels of Hcy in autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). Finally, a focus on the principal pathologies of the elderly (cardiovascular and neurodegenerative disease, osteoporosis and physical function) is presented. The metabolism of Hcy is influenced by B vitamins, and Hcy-lowering vitamin treatments have been proposed. However, clinical trials have not reached a consensus about the effectiveness of vitamin supplementation on the reduction of Hcy levels and improvement of pathological condition, especially in elderly patients with overt pathologies, suggesting that other dietary and non-dietary factors are involved in high Hcy levels. The importance of novel experimental designs focusing on intra-individual variability as a complement to the typical case–control experimental designs and the study of interactions between different factors it should be emphasized.

The novel coronavirus outbreak has caused substantial changes in societal norms as well as adjustments in health systems worldwide. To date the impact of these pandemic-related variations has yet to be fully understood also in the field of maternal health for which continuity of care is a proven life-saving preventive measure. Following the PRISMA guidelines for reviews, a literature search was carried out to assess different approaches that combine quality of maternal care with the imposed social-distancing rules. Nine studies were included in the scoping review. Reduction of in-person visits is the preferred overall solution. Yet, fewer consultations can still guarantee essential services and appropriate care through integration with telemedicine. Referral to epidemic-free community centres is an alternative option and new paths need to include the interdisciplinary contribution of medical consultants and IT experts, among others. In this context, delaying access for symptomatic expectant mothers is still debated since it carries the potential risk of untimely detection of pregnancy complications. Preliminary experiences provide an overview of the different attempts put in place to reshape health services to contain the pandemic hazards. These early prototypes may inspire future innovative health solutions compatible with local resources and specific population preferences and needs.

More healthy and sustainable food are nowadays desirable to improve human health and protect the planet’s resources. From this perspective, the aim of this study is to investigate artichoke (Cynara scolymus L.) by-products as a potential source of phenolic compounds and to use these compounds to design new fresh egg pasta formulation. Sustainable extraction was carried out using ultrasound-assisted extraction (UAE) and chemometric techniques, such as the Response Surface Methodology (RSM). UAE process parameters (temperature and time) and solvent composition (ethanol aqueous mixtures) were optimized using a three-level Box–Behnken design, in order to carry out the maximum yield in phenols. Under the optimal conditions (temperature: 60 °C; time: 60 min; solvent: 50% ethanol:water), the amount of phenolics (TPC) was 22.4 ± 0.2 mg GAE g⁻¹ d.w., characterized mainly by dicaffeoylquinic acid (32.8 ± 0.6 mg CAE g⁻¹ d.w.) and chlorogenic acid (14.1 ± 0.2 mg CAE g⁻¹ d.w.). Hence, the polyphenols extract was used as an ingredient to design a new formulation of functional fresh egg pasta. Four recipes with soft wheat and semolina (P₁ and P₂) and with soft wheat alone (P₃ and P₄) were prepared. Compared with control pastas (P₁ and P₃), the enriched ones (P₂ and P₄) showed a higher polyphenol content, especially for P₄ (1.86 ± 0.03 mg GAE g⁻¹ d.w. for P₁, 2.05 ± 0.02 mg GAE g⁻¹ d.w. for P₂, 1.92 ± 0.03 mg GAE g⁻¹ d.w. for P₃, 2.04 ± 0.02 mg GAE g⁻¹ d.w. for P₄). A high decrease in TPC was observed as a result of the cooking process, especially for the two control formulations (−71% for P₁ and −70% for P₃) in comparison with P₂ (−64%) and P₄ (−55%). At last, to assess the antimicrobial effect of artichoke by-products on fresh pasta and to monitor its spoilage, we used image analysis. Corresponding to a higher TPC content, P₂ and P₄ showed an extended shelf life of 16% and 33%, respectively, probably due to the antioxidant activity of artichoke. The new fresh egg pasta enriched with polyphenols extracted from artichoke by-products showed very good nutritional and technological characteristics, even after cooking, confirming the good potentiality of artichoke by-products in the design of new, healthy, and sustainable food products.

High adherence to a Mediterranean diet (MD) is favourable for its sustainability and beneficial effects on health. The available questionnaires, according to the MD dietary pattern, include the assessment of moderate alcohol consumption; but some groups, such as young adults and pre-conceptional and pregnant women, are not allowed to consume it. The aim of this study was to validate a new short questionnaire (MedQ-Sus) excluding alcohol consumption, to measure the adherence to the MD and to evaluate the nutritional adherence to a sustainable diet. The Harvard validated questionnaire was used for the validation study. A total of 316 subjects (20 to 70 YOA) completed both questionnaires. A high Spearman correlation coefficient (rho = 0.69; p < 0.01) was found between the MedQ-Sus and Harvard scores; a statistically significant positive correlation was found for all eight food groups. The MedQ-Sus had a significant discriminative capacity between adherence and non-adherence to the MD (optimal cut-off point = 9.5, sensitivity 0.86, specificity = 0.65). A very high nutritional adherence to a sustainable diet was found in the subjects for olive oil (97%), dairy food (90%), fresh vegetables (89%), fish and fish products (73), fresh fruit (56%), and cereals and cereals products (42%). A very low adherence was found for legumes (22%) and meat and meat products (9%). The results showed MedQ-Sus is a valid and quick assessment instrument for the evaluation of the adherence to the MD in all population groups, and could also be useful to evaluate the nutritional sustainability of the diet.

Montagnoli C, et al. World J Mens Health. 2021 Oct;39(4):626-644. https://doi.org/10.5534/wjmh.200147