Simona Esposito

Bio: Simona Esposito is an academic researcher. The author has contributed to research in topics: Medicine & Mediterranean diet. The author has an hindex of 3, co-authored 10 publications receiving 18 citations.

Edible Mushrooms and Beta-Glucans: Impact on Human Health.

Abstract: Mushroom cell walls are rich in β-glucans, long or short-chain polymers of glucose subunits with β-1,3 and β-1,6 linkages, that are responsible for the linear and branching structures, respectively. β-glucans from cereals, at variance, have no 1,6 linkages nor branching structures. Both immunomodulatory and anti-inflammatory effects of mushrooms have been described using purified β-glucans or fungi extracts on cellular and experimental models; their potential clinical use has been tested in different conditions, such as recurrent infections of the respiratory tract or complications of major surgery. Another promising application of β-glucans is on cancer, as adjuvant of conventional chemotherapy. β-glucans may protect the cardiovascular system, ameliorating glucose, lipid metabolism, and blood pressure: these activities, observed for oat and barley β-glucans, require confirmation in human studies with mushroom β-glucans. On the other hand, mushrooms may also protect the cardiovascular system via a number of other components, such as bioactive phenolic compounds, vitamins, and mineral elements. The growing knowledge on the mechanism(s) and health benefits of mushrooms is encouraging the development of a potential clinical use of β-glucans, and also to further document their role in preserving health and prevent disease in the context of healthy lifestyles.

Changes in ultra-processed food consumption during the first Italian lockdown following the COVID-19 pandemic and major correlates: results from two population-based cohorts.

Abstract: OBJECTIVE: To evaluate changes in ultra-processed food (UPF) intake and its major correlates during the first Italian lockdown (March 9 -May 3 2020). DESIGN: Retrospective observational study. SETTING: Italy. PARTICIPANTS: We analysed 2,992 subjects (mean age 57.9±15.3 y, 40.4% men). Individual participant data were pooled from 2 retrospective cohorts: 1) The Moli-LOCK cohort consists of 1,501 adults, a portion of the larger Moli-sani Study (n=24,325; 2005-2010) who were administered a phone-based questionnaire to assess lifestyles and psychological factors during confinement; 2) the ALT RISCOVID-19 is a web-based survey of 1,491 individuals distributed throughout Italy who self-responded to the same questionnaire by using Google forms.UPF was defined according to NOVA classification based on degree of food processing. An UPF score was created by assigning 1 point to increased consumption, -1 to decreased and 0 point for unchanged intakes of 19 food items, with higher values indicating an increase in UPF during confinement. RESULTS: Overall, 37.5% of the population reported some increase in UPF (UPF score ≥1). Adults were more likely to decrease UPF (multivariable regression coefficient s=-1.94; 95%CI: -2.72,-1.17 for individuals aged >75 y as compared to 18-39 y) as did individuals from southern Italian regions as compared to Northern inhabitants (s=-1.32; -1.80,-0.84), while UPF lowering associated with increased exercise (s=-0.90; -1.46,-0.35) and weight loss (s=-1.05; -1.51, -0.59) during confinement. CONCLUSIONS: During the first Italian lockdown, about 40% of our population switched to unfavourable eating as reflected by increased UPF intake and this may have long-term effects for health.

Changes in the consumption of foods characterising the Mediterranean dietary pattern and major correlates during the COVID-19 confinement in Italy: results from two cohort studies.

Abstract: We investigated the effect of confinement during the COVID-19 pandemic on the consumption of foods characterising the Mediterranean dietary pattern (MDP) and its major correlates in two Italian pop

Reproducibility and validity of a food-frequency questionnaire (NFFQ) to assess food consumption based on the NOVA classification in adults.

Abstract: NOVA is a classification that divides foods into four groups according to processing. Since no questionnaires have been validated to assess the consumption of foods with different levels of process...

Ultra-processed food consumption and its correlates among Italian children, adolescents and adults from the Italian Nutrition & Health Survey (INHES) cohort study.

Abstract: OBJECTIVE To assess ultra-processed food (UPF) consumption and its socio-demographic, psychosocial and behavioural correlates in a general population of Italian children, adolescents and adults. DESIGN Cross-sectional telephone-based survey. SETTING Italy, 2010-2013. PARTICIPANTS In total, 9078 participants (5-97 years) from the Italian Nutrition & Health Survey. Dietary intakes were collected by a 1-d 24-h dietary recall. UPF was defined by the NOVA classification and expressed as percentage of total energies. RESULTS Average energy intake from UPF (95 % CI) was 17·3 % (17·1 %, 17·6 %) among adults and 25·9 % (24·8 %, 27·0 %) in children/adolescents. Top sources of UPF were processed meats (32·5 %) and bread substitutes (16·7 %). Among adults, age (β = -3·10; 95 % CI (-4·40, -1·80) for >65 years v. 20-40 years; βs are dimensionless) and residing in Southern Italy (β = -0·73; 95 % CI (-1·32, -0·14) v. Northern) inversely associated with UPF. Screen view during meals was directly linked to UPF, as well as poor self-rated health (β = 5·32; 95 % CI (2·66, 7·99)), adverse life events (β = 2·33; 95 % CI (1·48, 3·18)) and low sleep quality (β = 2·34; 95 % CI (1·45, 3·23)). Boys consumed two-point percent more UPF of the total energy than girls (β = 2·01; 95 % CI (0·20, 3·82)). For all ages, a Mediterranean diet was inversely associated with UPF (β = -4·86; 95 % CI (-5·53, -4·20) for good v. poor adherence in adults and (β = -5·08; 95 % CI (-8·38, -1·77) for kids). CONCLUSIONS UPF contributes a modest proportion of energy to the diets of Italian adults while being one-quarter of the total energies in children/adolescents. UPF was associated with several psychosocial factors and eating behaviours. Increased adherence to Mediterranean diet would possibly result in lower UPF consumption.

Ultra-Processed Foods and Nutritional Dietary Profile: A Meta-Analysis of Nationally Representative Samples.

Abstract: Excessive consumption of ultra-processed foods (UPFs), as described by the NOVA classification system, represents a potential threat to human health. The nutritional composition of UPFs may explain their observed adverse effects. The present study aimed to provide a quantitative meta-analysis of nationally representative surveys on the consumption of UPFs and the dietary/nutrient composition of respondents’ diets. A systematic search for relevant studies published prior to July 2021 was conducted via electronic databases. The studies that provided the dietary/nutrient composition of foods categorized according to the NOVA classification system were selected. The association between UPFs and other dietary variables was modelled using ordinary least squares linear regression based on aggregated data extracted from the selected articles. Consumption of UPFs represented up to 80% of total caloric intake in the US and Canada, with confectionery and sugar-sweetened beverages being the most consumed items. When considered in relation to other food groups, an inverse linear relation between UPFs and less-processed foods was evident. Increased UPF intake correlated with an increase in free sugars, total fats, and saturated fats, as well as a decrease in fiber, protein, potassium, zinc, and magnesium, and vitamins A, C, D, E, B12, and niacin. In conclusion, the data indicate that increased UPF consumption negatively affects the nutritional quality of diets.

A Systematic Review of Worldwide Consumption of Ultra-Processed Foods: Findings and Criticisms.

Abstract: A debate is ongoing on the significance and appropriateness of the NOVA classification as a tool for categorizing foods based on their degree of processing. As such, the role of ultra-processed food (UPF) on human health is still not completely understood. With this review, we aimed to investigate the actual level of consumption of UPF across countries and target populations to determine the impact in real contexts. Suitable articles published up to March 2021 were sourced through the PubMed and SCOPUS databases. Overall, 99 studies providing data on the level of UPF consumption expressed as the percentage of total energy intake were identified, for a total of 1,378,454 participants. Most of them were published in Brazil (n = 38) and the United States (n = 15), and the 24 h recall was the most-used tool (n = 63). Analysis of the results revealed that the United States and the United Kingdom were the countries with the highest percent energy intake from UPF (generally >50%), whereas Italy had the lowest levels (about 10%); the latter was inversely associated with adherence to the Mediterranean diet. High variability was also observed based on sex, age, and body mass index, with men, young people, and overweight/obese subjects generally having higher levels of consumption compared to older subjects. Overall, our findings underline the large differences in UPF intake. Since most of the observations derived from studies conducted with food questionnaires are not specifically validated for UPF, further efforts are essential to confirm the results previously obtained and to investigate further the association between UPF consumption and health status, also considering the actual contribution within different dietary patterns, which has been less investigated to date.

Association of vitamin D deficiency with COVID-19 infection severity: Systematic review and meta-analysis.

Abstract: BACKGROUND: We sought to evaluate the association between vitamin D deficiency and the severity of coronavirus disease 2019 (COVID-19) infection. METHODS: Multiple databases from 1 January 2019 to 3 December 2020 were searched for observational studies evaluating the association between vitamin D deficiency and severity of COVID-19 infection. Independent reviewers selected studies and extracted data for the review. The main outcomes of interest were mortality, hospital admission, length of hospital stay and intensive care unit admission. RESULTS: Seventeen observational studies with 2756 patients were included in the analyses. Vitamin D deficiency was associated with significantly higher mortality (odds ratio [OR]: 2.47, 95% confidence interval [CI]: 1.50-4.05; 12 studies; hazard ratio [HR]: 4.11, 95% CI: 2.40-7.04; 3 studies), higher rates of hospital admissions (OR: 2.18, 95% CI: 1.48-3.21; 3 studies) and longer hospital stays (0.52 days; 95% CI: 0.25-0.80; 2 studies) as compared to nonvitamin D deficient status. Subgroup analyses based on different cut-offs for defining vitamin D deficiency, study geographic locations and latitude also showed similar trends. CONCLUSIONS: Vitamin D deficiency is associated with greater severity of COVID-19 infection. Further studies are warranted to determine if vitamin D supplementation can decrease the severity of COVID-19.

Eating Habits during the COVID-19 Lockdown in Italy: The Nutritional and Lifestyle Side Effects of the Pandemic.

Abstract: To limit the spread of coronavirus SARS-CoV-2, a nationwide lockdown started in Italy in March 2020. In this unpredictable situation, a cross-sectional study using an online questionnaire was carried out by the Observatory on Food Surplus, Recovery and Waste of CREA Food and Nutrition Centre. The aim of this work was to evaluate how Italian habits changed during this period, the determinants of changes, and the effect on food waste prevention. In a sample of 2678 respondents, 62% showed low Adherence to the Mediterranean Diet (AMD). During lockdown many of participants improved the quality of their diet, increasing their consumption of fruit (24.4%), vegetables (28.5%), legumes (22.1%), nuts (12%), and fish or shellfish (14%). Unfavorable changes were observed with the excessive consumption of sweets or pastries (36.9%) and comfort foods (22.7%), and a lack of physical activity (37.2%). The main novelty of this study was the examination of dietary changes identified by a cluster analysis. Respondents with generally high AMD improved their eating habits, while the habits of the respondents with generally low AMD remained unchanged. In addition, nearly 80% of respondents were sensitive to food waste. The study provides a useful contribution to the debate on nutritional recommendations in case of further lockdown.