Gastrointestinal Health and OTC sales in Italy

Looking at the OTC sales in Italy (Q1-2 2011) we can see that gastrointestinal health accounts for about 50%.
We can find a low dosed probiotic at 3° and 4° position, for about 4.9 million boxes and rectal glycerin formulations for constipation at position 9° and 10° for more than 3 million boxes.

Italians seems not much interested in quality looking at this data.
Infact they prefer to use a rectal formulation for the acute constipation instead of a prebiotic with adaptogen effects.
They ignore Ministero della Salute guidelines on the use of probiotics that recommend to use only live organisms and a dose of at least 10billion a day for the adults.

As usual, first 2 positions are strongly held by diclofenac and paracetamol brands that may have well known side effects on the gastrointestinal tract.

We find first antiacid at position 17° with 1 million boxes sold. Antiacids are generally safe but patients should not ignore possible interactions with frequently prescribed drugs like antibiotics tetracyclines and fluoroquinolones or bisphosfonates.

A recent study published on "Drug" described "Clinically significant drug interactions with antacids: an update"

The authors explain that antiacids-drug interactions are more frequent now that antiacids are sold without prescription and suggestions from health care professionals.

Antiacid-drug interactions can be more important if the antiacid is coupled with a proton pump inhibitor and the mechanisms can be a gastric pH-dependent by H2RAs and a cation-mediated chelation by antacids.

Adiposity in children and its correlation with BP

The effect of adiposity on blood pressure in children is minimal until the body mass index reaches the 85th percentile, at which point it intensifies, according to a study published online Oct. 3 in Hypertension.

Wanzhu Tu, Ph.D. followed 1,111 children for 4.5 years. Blood tests and BP were measured.

"There is a marked intensification of the influence of adiposity on BP when children reach the categories of overweight and obese. Among the possible pathways, leptin may be a potentially important mediator acting through the sympathetic nervous system (reflected in heart rate)," the authors write.



BMI was used in this study to meaure adiposity but a new index can give furter information about the real fat percentage.




This new index is called Body Adiposity Index (BAI) and it is calculated using Hip circumference and Height.





Try to calculate your BAI and compare it with your BMI.

Here you can calculate your BMI



Are the 2 indexes telling you the same story?

Iron deficiency in obese people linked to inflammation

It is difficult to think at obesity as a condition linked to nutritional carencies because we normally think that it is caused by excess of nutrients.

Obesity is not caused by excess of nutrients
It is caused by excess of empty calories and bad fats.

The paradox is that you can also witness nutritional carencies like hypoferremia (iron deficiency) in obese people.


A clinical trial with 172 healthy non-obese (BMI <30 kg/m2), and 234 obese (BMI ≥30 kg/m2) has been conducted to understand mechanisms involved in the hypoferremia of obesity. Results are published here.

Researchers found in obese patients:
- inadequate bioavailable iron relative to body weight
- diminished intestinal absorption
- decreased iron bioavailability induced by inflammatory adipokines

This study confiirms that obesity is a condition where inflammatory pathways are over-activated and nutritional carencies can be present despite the excess of food intake.

Falsely normal ferritin concentrations are commonly found and are likely increased by chronic inflammation. So this marker if measured alone can be misleading in obese people.

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Probiotics and Longevity: New Theory

Very interesting theory tries to link probiotics use and longevity.
The article is published on the current issue of Medical Hypotheses
(Volume 77, Issue 4 , Pages 469-472, October 2011).

Authors think that Probiotics-induced increase of large intestinal luminal polyamine concentration may promote longevity
We read from the abstract that: "Many mechanisms contribute to senescence, such as telomere shortening in replicative cells, cumulative damage to DNA leading to genomic instability, and oxidative damage to molecules by reactive oxygen species (ROS). These include chronic low-grade inflammation (inflammageing), a major risk factor for ageing and age-related diseases, such as Alzheimer’s disease and type II diabetes"

The authors discuss in this article the rationale and recent evidence for probiotic-induced upregulation of intestinal luminal polyamine (PA) production in the extension of lifespan by preventing inflammageing.

US Trends on Health and Nutrition from HHS

The U.S. Department of Health and Human Services (HHS) released findings from its Final Review for Healthy People 2010 on October 6, 2011.
Download the Healthy People 2010 Final Review

In this interesting report we can find interesting statistical data regarding health of U.S. population, what's happened in the last 10 years and how much health target have been achieved or not.

Of course these data can not be extended to European population but can be used as indicators of trends in western populations.


I recommend the section regarding nutrition where we can find (for example) data on
calcium intake and iron deficiency in population.

For example we see that iron deficiency is about 9% in general population up to 36% in low income pregnant women.

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Siamo uomini o batteri?

Se analizziamo la composizione del nostro corpo dal punto di vista ecologico ci accorgiamo che in realtà l'essere umano è paragonabile ad una giungla o ad un lago dove vivono migliaia di specie diverse.
Se vogliamo progredire nel campo della medicina, della biologia molecolare e della genetica dobbiamo accettare che l'uomo come individuo biologico è un concetto completamente superato.
L'uomo è invece un Microbioma e come tale deve essere trattato, operando quindi sulle componenti classiche degli ecosistemi: componente organica, inorganica, flussi di energia etc.
Questo approccio soltanto è in grado di fornirci la giusta chiave di lettura per affrontare le patologie nfiammatorie croniche intestinali (Mici) e numerose forme di neoplasie.

Una visione rivoluzionaria quella che ci propone il Dott. Carl Zimmer in questa fantastica presentazione.
Non finirò mai di ringraziarlo per averla voluta condividere.

The Human Jungle: Exploring the Microbiome

View more presentations from cwzimmer

Ma quanto stiamo bene!!! Osservasalute 2010

Nuova fotografia dello stato di salute in Italia grazie all'Osservatorio Nazionale sullo Stato della Salute delle Regioni Italiane.

Il rapporto completo 2010 è disponibile gratuitamente sul sito dell'Osservatorio dopo registrazione.

Ecco alcune pillole di informazione

selezionate per voi......

"Nel Nord Italia si muore di più di cancro ma al sud hanno poco da festeggiare perchè muoiono di più per cause cardiovascolari"

"Le donne sopravvivono mediamente più degli uomini (84 contro 78); il divario tende a ridursi (anche se le donne hanno parecchi giri di vantaggio)"

"Le donne si dimostrano più furbe degli uomini nei riguardi del consumo eccessivo di alcol, il rapporto della popolazione a rischio è di 5 uomini per ogni donna (però le donne si ubriacano con quantità d'alcol minori)."

"Aumentano obesi e sovrappeso. Il 40% della popolazione è completamente sedentaria e non pratica alcuna attività fisica (se si escludono sport come lo zapping, lo shopping e la visione di partite di calcio)"

"600 incidenti stradali al giorno con feriti, la città con più alta frequenza di infortuni è Foggia (se abitate a Foggia siete autorizzati a toccarvi i marroni)"

"Diminuiscono sifilide e gonorrea mentre ritornano tubercolosi e legionella (tranne in Molise dove non è stato riportato alcun caso)"

"Aumenta drasticamente l'uso di antidepressivi ma la gente continua imperterrita a renderci la vita impossibile (prova a parcheggiare in centro per avere una conferma)"

"Aumenta la spesa sanitaria in tutto il paese con picchi in Campania; la Lombardia spende di meno per fornire servizi migliori (io penso di sapere il motivo... ma è solo un'ipotesi)"

"La spesa sanitaria pubblica procapite varia dai 1671 della Sicilia ai 2171 della Provincia Autonoma di Bolzano."

"Per i farmaci non rimborsabili spendiamo il 35-40% di quello che lo stato spende per noi".

"Aumenta la fertilità delle donne in Italia, ma solo delle immigrate (gli Italiani non hanno tanta voglia di mettere al mondo nuovi disoccupati)"

Insomma dopo tutto siamo ancora un paese dove si vive bene e se ti investe un autobus ti soccorrono anche se non hai la carta di credito. Ovviamente si potrebbe stare meglio se le cose fossero diverse da come sono. Ma questa è un'altra storia......