In Italy in 2023, about 3,000,000 people suffer from Eating Disorders.
We are talking about 5% of the Italian population, and unfortunately 30% of adolescents after COVID, of which 6% are under 12 years old (1).
Such an incidence is comparable to that of Diabetes (5.9%, 3,500,000 people) (1) and is higher than that of cancer in Italy (about 4% of the entire population) (2).
This figure is also alarming because it is growing and growing especially in the adolescent population, which is our future.
In DCA, pain makes its way into the body image, which is the first aspect evident on the outside of each of us, because one’s body becomes an impenetrable peel (in obesity), or transparent (in anorexia), and food becomes a cure (in bulimia) to the pain itself, and suffering , frustration vent in compensatory behaviors (the purging mechanisms), and obsession with the body,with food catalyze attention on a daily basis. Sunsets, the sea, the rays of the sun, the laughter of friends, the caresses of loved ones become pale and faint glimmers in daily life characterized only by a profound distortion of one’s body.
Early diagnosis allows the establishment of a course of treatment and care not only for the patient but also for the familiar surroundings. Therapy should focus on identifying vital risk factors, nutritional framing with cognitive-behavioral techniques, and individual psychotherapy (sometimes combined with group psychotherapy) and helping the family environment. Therapists all need to work together and for the patient by supporting the family and educating them, and must be able to have emergency referral points available to stabilize the patient where necessary (3).
1) Istat data 2023
2) Epicenter.iss.it; cancer registry in Italy
3) clinical Practice Guideline for Eating disorders. Ministry of Healthcare and Consumer affairs.
In recent decades, the prevalence of obesity and overweight has increased worldwide, in both men and women. According to the latest evaluation carried out by the Cancer Research Association of the University of Verona in 2017, overweight and obesity are proven risk factors for 13 tumor sites, with risk estimates that vary widely depending on the tumor site . Obesity is also related to a worse prognosis for some cancers, particularly breast and colon cancers. Childhood and adolescent obesity, also on the rise in many countries, has been associated with an increased risk of cancer in adulthood. One of the main causes of obesity is the imbalance in energy balance favored by a diet rich in processed foods, red meat, trans and saturated fatty acids, sugary foods and drinks and low in fruit and vegetables, legumes and whole grains. The main national and international recommendations to reduce the prevalence of obesity include a balanced diet and regular physical activity.
The change in eating habits and lifestyle (we are therefore talking about a sedentary lifestyle and an increase in simple sugars and unsaturated fats in the diet) is now a global phenomenon. Even in rural populations in Southern Africa* there has been an increase in the risk of cancer.
Therefore, nutrition is no longer just a risk factor for cerebral and cardiovascular diseases, being among the leading causes of hospitalization in industrialized countries. It becomes one of the most important and most avoidable risks of cancer which is the health emergency of these decades.
Learning to eat, learning to live to live better and also to prevent Cancer.
The report, which was very technical and difficult to use for dissemination purposes, focused on the complex interaction in the diagnostic and follow-up (post medical or surgical therapy) phases.
The endocrine pathologies that involve the neuroradiologist (a highly specialized figure on brain diagnostics, which should not be entrusted to the general radiologist, precisely because it is very specific) are predominantly pituitary-secreting ones. In non-secreting forms, the endocrinologist is usually contacted AFTER surgery or for diagnostic completeness, by another specialist, and the neuroradiologist has certainly already intervened.
The most frequent pituitary pathology is Hyperprolactinemia (pituitary adenoma, a pathology ALWAYS benign, accounts for 44% of pituitary tumors) with a prevalence around 60-100/million and an incidence of 6-10/million per year. As if to say that in a city like Rome, about 36-60 people a year get pituitary adenoma. the role of the neuroradiologist is crucial to distinguish a stress hyperprolactinemia or adenoma, and to evaluate the effectiveness of therapy (usually medical).
As frequency it follows Cushing’s disease (incidence 5-25/million/year), which consists of increased cortisol levels due to ACTH-secreting pituitary adenoma. The endocrinologist usually has the laboratory and clinical diagnostic tools to detect increased cortisol levels, but the role of the neuroradiologist is critical to localize the pathology and to define whether cortisol secretion is autonomous or dependent on pituitary adenoma, and to decide whether to refer to the neurosurgeon or proceed with medical therapy.
The neuroradiologist can participate directly with interventional procedures such as petrous sinus catheterization, which measures ACTH levels directly in the pituitary circulation, and correlates with peripheral circulating ACTH levels.
Acromegaly and gigantism are an additional cause for referral to the neuroradiologist by the endocrinologist. These are rare disorders with an incidence of 3/million, but known to the general public because patients have distinctive physiognomic features, and some patients with acromegaly have been well known in the past (such as Primo Carnera, the great boxer of the twentieth century).
Rare but existing, TSH-oma, a cause of hyperthyroidism of pituitary origin (accounts for less than 1% of functioning pituitary tumors and is the cause of 0.1% of cases of hyperthyroidism).
The extra-hypophyseal pathology that involves the neuroradiologist is definitely Basedowian ophthalmopathy, which is the typical ocular involvement of Basedow’s disease hyperthyroidism, that from the presence of TSH receptor antibody. Evaluation of the level of involvement of the retrobulbar fat or the extrinsic muscles of the eye allows early decisions on the most appropriate therapeutic choice.
Desserts at Christmas have always been part of the tradition of any Western country. Christmas parties without lights and sweets are not holidays, for everyone, whether they are diabetics, people with weight problems or people who have no disorders whatsoever. The important thing, however, is that this joy does not then turn into pain.
Therefore, a number of behavioral strategies should be adopted to properly manage this particular period but to enjoy it to the fullest.
Food has always represented a compensatory element of emotions and a gratification; the infant to calm himself down attaches to the mother’s breast and in this way often becomes pacified.
It is important, however, that the affective value of food does not conflict with our health, and indeed food helps us to live better.
Therefore, behavioral psychologists together with endocrinologists have compiled a series of tips to better manage social events and desserts.
1.) We enjoy the sight of sweets, enjoy window displays in which they are arranged, beautiful, colorful and gratifying even just to be seen. At most we buy a small portion to be eaten later in the day at the end of the meal.
2.) Instead, let us limit “the purchase of sweets” that will be used during the recurrence days 24, 25, 31, New Year’s Day and the Epiphany.
3.) Whenever we wish to eat a dessert always do so at the end of a meal : never eat it as a substitute for a meal, but always at the end of the meal itself by reducing the carbohydrates of that meal or eliminating them completely in the case of diabetic and obese patients, increasing protein and including at least three side dishes.
4.) Use a small dessert plate or even a bread plate in the case of the most important occasions by putting all the desserts you want to eat but all together without taking a second course.
These strategies will allow us to fully enjoy what we are experiencing but keep in check what is harmful to our health.
Merry Christmas to all of you and your loved ones!
Vacations are over. Heat is over. Work is coming full circle again. First colds are back, and Italian health care is preparing to support the new flu wave, and with it the new Sars-19 spike that is likely to be in winter, like all flu spikes.
Recent studies by Italian groups have shown a relationship between low vitamin D levels and COVID onset, especially in populations in northern Italy. Could this be a possible contributing cause (along with particulate pollution that acted as a vehicle for the virus) of why Northern Italy was so plagued by COVID in the first and second waves? In fact, the last 30 years in Italy have seen a real global decline in vitamin D levels. The cause of this phenomenon is, as always, multifactorial.
1)The change in the tilt of the Earth’s axis is related to the change in the rotation of the two poles (instead of north to south currently to the east) which is in turn influenced by the ongoing climate change (the Earth’s axis is responsible for the seasons) and which is responsible for the reduced ability of the sun in our latitudes to fix Vitamin D.
2)The insufficient use of the foods available in the Italian territory of vitamin supplementation.
3) Fish from our seas, being very lean, have lower levels of vitamin D than those found in fish from the northern seas.
4) Vitamin D plays an important role in modulating the immune system, and so its deficiency may be associated with an improperly adapted immune system.
Vitamin D deficiency is also often found in young adolescents, students, complicit in the closing of recent years.
Therefore, a proper assessment of vitamin D level is definitely indicated not only in post-menopausal women, but in general also in a population poorly exposed to the sun and sedentary, in order to improve our body’s ability to respond to infections that we will have to live with for a long time.
Even the masks at least outdoors are removed. And we’ll be exposing ourselvesto the sun shortly.
It’s time to think about skin and the influence of food on skin. And yes, because studies show that Vitamin D levels, which are essential for the well-being of the skin, depend on sun exposure, but are influenced by baseline levels of Vitamin D. In other words: if we start with good levels of Vitamin D, sun exposure will strengthen and increase it.
Otherwise it will be almost useless.
Vitamin D, beta carotenoids and antioxidants are the natural allies of the skin and our health. In fact, foods rich in antioxidants and Omega 3 and 6 help reduce cardiovascular risk, reduce weight, maintain a high metabolism and have a very high content of Vitamin D, beta carotene and coenzymeQ.
Therefore, in order to keep the glycemic index under control, lose weight and take care of the skin, we start taking peppers, chard, tomatoes, watermelon, lettuce (rich in beta carotene), accompanying fish such as smoked salmon, tuna, mackerel, anchovies, octopus, (very rich in Vitamin D).
A tasty and quick idea? A nice salad nizzarda or Condiglione as they say in Liguria, prepared with lettuce, tomatoes and green beans (carotene, fiber and vitamin A) cucumber and onion (draining), tuna, anchovies, 1 hard-boiled egg and hard-boiled egg white in abundance crumbled (Vitamin D and omega 3 and 6). Two slices of wholemeal toast with seeds (wholemeal foods and seeds are
rich in Coenzyme Q), and lunch is complete and balanced.
But let’s get to the cheerier side of the argument! Samantha Mazzi, in addition to being the kind collaborator who often answers your calls, is an expert makeup artist at a professional level, having attended Stefania D’Alessandro course and working in high fashion as a makeup artist.
Donatella: Samantha, tell me about skin aging and the importance of facial
cleansing, especially during seasonal changes.
Samantha: First of all, skin aging is a completely normal, inevitable physiological process that affects all individuals, mainly linked to genetic factors and accentuated by the action of external environmental factors (UVB/ UVA rays, oxidative stress, pollution, diet etc). The sun rays specifically, going into the summer season, can have beneficial effects for the production of Vitamin D, as you rightly mentioned, but it is essential to take precautions for the skin. An incorrect or too prolonged exposure can have numerous harmful effects, both visible and invisible such as: erythema, sun spots, hyperkeratosis and photoaging (loss of elasticity and tone).
However, this process can be delayed or slowed down by working on prevention. We can counteract the factors that contribute to damaging our skin by adopting a healthy lifestyle and diet, including constant care of our skin and health.
How to best prepare your skin for the change of seasons?
Let me preface this by saying that our skin does not always have the same needs. These, in fact, change with the alternation of the seasons, because the skin becomes more delicate and sensitive according to external climatic variations. At the change of season it is therefore important to facilitate the process of cell renewal, to prolong, in this case, the tan and revive the dull complexion, caused mainly by pollution. Polluted air has an immediate effect on the skin of the face, which is dull and less toned, causing deeper consequences such as the production of free radicals (oxidation and premature aging of the skin) neutralizing in part the activity of antioxidant Vitamins E and C.
Here come into play two essential aspects to counteract this phenomenon. The health and beauty of our skin begins well below the surface, which is why it is important to include in our daily routine food supplements of natural origin. The “multi carotene” for example, is an antioxidant food supplement with carotenoids, which in addition to increase the protection of antioxidants in our
body and fight oxidative stress, protects our skin. Another more recent and innovative product, specific for our skin is a “nutricosmetic”. A holistic beauty system that combines supplements and drinks created in total harmony between nature and science, to go to enhance the outer beauty from the inside.
A food supplement that ensures a supply of nutrients to balance and protect cells from oxidative stress, for a radiant-looking skin with a natural glow.
The second aspect is a scrupulous cleaning of the face, the famous ” detersion “. By cleansing I am not simply referring to the removal of makeup with a makeup remover, but to the use of specific products (according to the type of skin: oily, dry, normal…) that helps to eliminate from the skin every trace of impurities, excess oil and makeup residues. In summary, if the face is not washed thoroughly, pores can become clogged leading to the onset of blemishes and rashes.
If we want to get the most out of a moisturizer, we need to minimize cell buildup, and that means using a good exfoliator. Twice a week I recommend a mechanical exfoliating scrub, which will stimulate the skin’s regeneration mechanisms and eliminate the superficial layer of dead cells that prevents the skin from looking smoother, firmer and more radiant. After this step, the skin will be more predisposed to receive the substances (active ingredients) present in the treatments that will be applied later. This will allow us, especially in the
summer season, to have a more even and lasting tan.
After cleaning, the next step, often underestimated, is the use of toner. Regular use of the toner helps to strengthen the natural defenses of the skin, restoring the physiological pH of the skin (which is altered with facial cleansing) and has the function of maintaining the level of moisture in the skin, which is essential to keep it hydrated. Finally, the toner makes the skin more “receptive” to the
following phases of the treatment, increasing its effectiveness and results.
It is important to finish our skincare with a serum and a cream.
In the skincare routine when we want to exploit the maximum concentration of active ingredients, a face “serum” is absolutely the best product. It complements and enhances the effectiveness of the cream, acting in synergy at various levels of the epidermis. It is, in fact, a treatment particularly suitable for the care of demanding skins. There are many different types of serums, each with a unique purpose and ingredients: some help brighten the skin or reduce blemishes; others focus on increasing hydration or fighting signs of
As a final step to rebalance the skin and provide it with the elements it needs to maintain its important barrier function; we apply our cream. I recommend the use of two different creams, in the morning a cream with sunscreen, to protect the skin from UVB/UVA rays and thus prevent the onset of spots and irritation.
In the evening a more emollient cream to keep our skin hydrated and elastic during the sleeping hours.
Donatella : Let’s move on to makeup now, what should be avoided when the
heat comes as makeup?
Samantha : The most important thing in summer is to let the skin breathe and to prefer heat and moisture resistant products. A light, breathable coverage with soothing or moisturizing properties and a reliable sun protection factor is the winning combination on summer days.
If we want to get a base with a natural effect and not too heavy, it does not mean that we have to avoid makeup, but simply replace our usual foundation with a foundation with a non-comedogenic formula, which allows our skin to
An excellent alternative can be a tinted cream or a bb cream. For the most obvious imperfections just a tip of concealer only on the area to be corrected, and a bit of powder to counteract the shiny effect. The advice is to use a few products so as to avoid sebum and sweat affecting our makeup. To emphasize even more the tan I recommend a nice blush and highlighter, preferably powder or with a cream to power formulation for a more velvety texture that blends with the skin very smoothly. For the eyes I would definitely avoid powders and focus
more on cream eyeshadows, bright, practical and more durable. As for the mascara, absolutely “waterproof” to avoid smudges and clumps throughout the day. Last step, lips, key word hydration. I always recommend having a moisturizing lip balm in our bags, preferably with sunscreen, to prevent the famous expression lines around the lip.
For makeup, I’d prefer a water-based lip tint to give a very natural complexion to the lips without drying them out. A very
versatile product that can also be applied to the cheeks as a blush, creating a natural blush effect. Otherwise, a nice plumping gloss is the way to go for your