COLTIVAZIONE
DELL’OLIVO
• Origini: 5000 a.C. (Medio
Oriente)
• 4500 a.c. Codice di
Hammurabi
• In Italia: 500 a.c.
• 800 milioni di piante nel
mondo
• 700 milioni di piante nel
Mediterraneo
Mediterranean
Diet
Dietary patterns found
in olive growing regions
of the Mediterranean
Countries
Basso rischio cardiovascolare
Basso rischio di cancro
“Vantaggio” Mediterraneo
RUOLO DELL’OLIO D’OLIVA
IMPORTANZA BIOLOGICA
DELL’OLIO D’OLIVA
• MUFA
- Fluidità di membrana
cellulare
• ANTIOSSIDANTI
- Anti radicali liberi
- Anti perossidazione
• MALATTIE CARDIOSVACOLARI
-  LDL - colesterolo
-  Ipertrigliceridemia
IMPORTANZA BIOLOGICA
DELL’OLIO D’OLIVA
• APPARATO DIGERENTE
-  attività della colecisti
-  secrezione pancreatica
• CANCRO
- > apoptosi
-  oncogene ras,
- < addotti al DNA
WITH MEDITERRANEAN DIET:
< 10% PROSTATE,
PANCREAS,
ENDOMETRIUM
< 25% COLON
< 15% BREAST
(Trichopoulou et al., 2000)
CANCER RISK FACTORS
FATS
The issue of fats, and of
specific types of fats, on the
risk of colorectal and breast
cancers, as well as of
several other neoplasms,
remains a major open
question.
RRs and 95% CI of selected cancers according to
RED MEAT consumption. Italy, 1983-1997
CARNE & CANCRO DEL
COLON
Meta-analisi, IARC, Lione 2002
Carni
lavorate
1.8
1.6
1.2
Pesce
1
0.8




 

Tutte le carni

Carni
bianche
1.4
Carni
rosse


0.6
 Cohort studies
 Case-control studies
 All studies
GENETICA E DIETA
Nei Giapponesi emigrati negli Stati Uniti:
Marcato aumento del cancro del colon in soggetti
con genotipo rapid NAT2:
Ma solo in chi consumava carni rosse molto cotte
J Natl Cancer Inst Monogr 1999;(26):101-5
COMBINED INFLUENCE OF GENETIC AND DIETARY FACTORS ON COLORECTAL CANCER
INCIDENCE IN JAPANESE AMERICANS.
Marchand LL. (Honolulu, USA)
Cancer Epidemiol Biomarkers Prev 2002 Jun;11(6):541-8
DIET ACTIVITY, AND LIFESTYLE ASSOCIATIONS WITH P53 MUTATIONS
IN COLON TUMORS.
Slattery ML, Curtin K et al. (Salt Lake City, USA)
P53: tumor suppressor gene
Casi con mutazione del gene P53 più frequentemente:
consumano una dieta “occidentale”
presentano indice glicemico alto
seguono una dieta ricca in carni rosse e fast food
GRASSI N-6 E N-3
IN RAPPORTO TRA
ACIDI VARIE
POPOLAZIONI
POPOLAZIONI
n-6:n-3
Periodo paleolitico
0,79
Grecia prima del 1960
1,00 / 2,00
Stati Uniti 2000
16,74
Regno Unito e Nord Europa
15
Giappone
4
Italia
13
RRs and 95% CI of selected cancers according to
FISH consumption. Italy, 1983-1997.
N-3 Polyunsaturated fatty acids
QUINTILE OF INTAKE
CASES/CONTROLS
(N)
3RD
5TH (HIGHEST)
Oral
cavity/pharynx
736/1772
0.7 (0.5-0.9)
0.5 (0.3-0.7)
Oesophagus
395/1066
0.7 (0.5-1.1)
0.5 (0.3-0.7)
Large bowel
2280/4765
1.0 (0.9-1.2)
0.7 (0.6-0.9)
Colon
1394/4765
0.9 (0.8-1.1)
0.7 (0.5-0.8)
Rectum
886/4765
1.1 (0.9-1.4)
0.8 (0.6-1.0)
Breast
2900/3122
1.0 (0.8-1.1)
0.8 (0.7-1.0)
Ovary
1031/2411
0.8 (0.6-1.0)
0.6 (0.4-0.7)
CANCER SITE
OMEGA-3 & CANCRO
(olio di pesce)
DHA
Riduce l’espressione di COX-2
Induce apoptosi
(Da Caterina,01)
Olive oil &
Colorectal cancer
Tertile of intake
2
3 (high)
Colorectal
0.78 (0.62-0.99)
0.77 (0.59-0.99)
Colon
0.79 (0.59-1.04)
0.82 (0.60-1.12)
Rectum
0.79 (0.57-1.11)
0.69 (0.46-1.02)
FATS
In a large study from Italy, isocaloric
substitution of 5% of total calories as
saturated fats by unsaturated ones was
associated with reductions in breast (OR=
0.67) and colorectal (OR= 0.78) cancer risk
FATS
DIETARY CHANGE
BREAST
(OR 95% CI)
COLON
RECTUM
(OR 95% CI)
Replacement of saturated fat by
complex carbohydrate
(10% of cal.)
0.95
(0.73-1.25)
0.96
(0.74-1.24)
Replacement of saturated fat by
polyunsaturated fat
(5% of cal.)
0.67
(0.54-0.83)
0.78
(0.65-0.95)
Replacement of complex
carbohydrate by polyunsaturated
fat
(5% of cal.)
0.69
(0.58-0.81)
0.80
(0.69-0.93)
FATS
DIETARY CHANGE
BREAST
(OR 95% CI)
COLON
RECTUM
(OR 95% CI)
Replacement of saturated fat by
monounsaturated fat
(5% of cal.)
0.91
(0.73-1.12)
0.89
(0.73-1.09)
Replacement of complex
carbohydrate by
monounsaturated fat
(5% of cal.)
0.93
(0.83-1.04)
0.91
(0.82-1.00)
Olive oil
Oral and pharyngeal cancer
UPPER LIMIT - (g per day)
INTAKE QUINTILE
1
3
5
3.2
29.5
-
OR (95% CI)
1
0.7 (0.5-1.1)
0.4 (0.3-0.7)
Vegetable-adjusted OR (95% CI)
1
0.8 (0.5-1.2)
0.6 (0.4-0.9)
Mixed seed oils
0.3
2.3
-
OR (95% CI)
1
1.0 (0.7-1.4)
1.1 (0.7-1.7)
Vegetable-adjusted OR (95% CI)
1
0.9 (0.6-1.4)
1.1 (0.7-1.7)
0.4
1.9
-
OR (95% CI)
1
1.3 (0.8-1.9)
2.3 (1.6-3.5)
Vegetable-adjusted OR (95% CI)
1
1.3 (0.9-2.0)
2.4 (1.6-3.5)
Olive oil
Butter
FATS
Substituting olive oil
for other seasoning
fats has favourable
effects on the risk of
oral, laringeal and
pharyngeal (OR= 0.7),
and oesophageal
(OR= 0.4) cancers
Mediterranean diet
score and cancers
of the upper
digestive tract
An a priori defined score, summarising eight
of the major characteristics of the
Mediterranean diet, was applied to data of
case-control studies of oral (n=599),
oesophageal (n=304) and laryngeal (n=460)
cancers
Diet
and cancers of the
upper digestive tract
CANCER, OR (95% CI)
ORAL/PHARYNGEAL
OESOPHAGEAL
LARYNGEAL
Monounsaturated/
saturated fat ratio
0.72 (0.56-0.93)
0.73 (0.51-1.01)
0.97 (0.73-1.28)
Alcohol
4.26 (3.11-5.83)
6.04 (3.79-9.62)
2.77 (2.01-3.83)
Legumes
1.09 (0.87-1.38)
1.03 (0.74-1.42)
0.75 (0.58-0.98)
Cereals
0.77 (0.59-1.00)
0.96 (0.67-1.38)
0.92 (0.68-1.24)
Fruit
1.06 (0.83-1.35)
0.95 (0.68-1.31)
0.82 (0.62-1.07)
Vegetables
0.79 (0.62-1.01)
0.72 (0.51-1.01)
0.51 (0.39-0.67)
Meat and meat products
1.42 (1.11-1.81)
1.50 (1.06-2.13)
1.53 (1.15-2.04)
Milk and dairy products
1.09 (0.86-1.40)
1.24 (0.87-1.75)
1.07 (0.81-1.42)
Mediterranean diet score
and cancers of the
upper digestive tract
(Bosetti, ‘03)
Cancer
Mediterranean diet score
<3
6
4
Oral/pharyngeal
Cases/controls
OR (95% CI)
214/241
120/376
41/201
1
0.41 (0.30-0.57)
0.40 (0.26-0.62)
102/147
66/174
14/83
1
0.63 (0.41-0.95)
0.26 (0.13-0.51)
183/225
98/279
19/124
1
0.47 (0.33-0.66)
0.23 (0.13-0.40)
Oesophageal
Cases/controls
OR (95% CI)
Laryngeal
Cases/controls
OR (95% CI)
Pizza and cancer risk
Pizza is one of the best
known and most
widespread Italian foods,
and it is the most
common generic
commercial sign
worldwide. Investigating
the role of pizza on
cancer risk may have
interesting implications
in respect to dietary
advice not only in Italy
Pizza and cancer risk
OR (95% CI)
CANCER
OCCASIONAL
REGULAR
ALL EATERS
Oral cavity
and pharynx
0.76 (0.60-0.95)
0.66 (0.47-0.93)
0.73 (0.59-0.91)
Oesophagus
0.57 (0.42-0.78)
0.41 (0.25-0.69)
0.53 (0.39-0.72)
Larynx
0.86 (0.66-1.11)
0.82 (0.56-1.19)
0.85 (0.66-1.08)
Colon
0.84 (0.72-0.97)
0.74 (0.61-0.89)
0.81 (0.70-0.93)
Rectum
0.85 (0.71-1.02)
0.93 (0.75-1.17)
0.88 (0.74-1.04)
Cancer Causes Control 2000 Aug;11(7):609-15
MEN WHO CONSUME VEGETABLE OILS RICH IN
MONOUNSATURATED FAT: THEIR DIETARY PATTERNS AND
RISK OF PROSTATE CANCER (NEW ZEALAND).
Norrish AE, Jackson RT et al. (Auckland, New Zealand)
317 prostate cancer cases vs 480 controls.
Increasing levels of MUFA-rich vegetable oil intake were associated
with a progressive reduction in prostate cancer risk
- multivariate relative risk = 0.5 (> 5.5 ml per day vs. nonconsumption
- P trend = 0.005)
Prostate cancer risk was not associated with intake of total MUFA or
the major animal food sources of MUFA
CONCLUSION: 1) protective effect of an associated dietary pattern
high in antioxidants and fish oils.
2) Independent protective effect of MUFA-rich
vegetable oils unrelated to the MUFA component
PHENOLIC AND LIPID COMPONENTS
OF OLIVE OILS-2: THE
CONCENTRATION AND ANTIOXIDANT
ACTIVITY OF TOTAL PHENOLS,
SIMPLE PHENOLS, SECOIRIDOIDS,
LIGNANS AND SQUALENE.
Robert W. Owen,1 Attilio Giacosa,2
Walter Mier, Bertold Spiegelhalder1
and Helmut Bartsch1
1German
Cancer Research Center, Heidelberg,
Germany
2National Institute of Cancer Research, Genoa,
Italy
TOTAL AND INDIVIDUAL PHENOLIC
COMPOUNDS IN OLIVE OIL
PHENOLIC
COMPOUND mg/kg
OLIVE OIL
ALL
VOQ
RVO
P value
Total
196  19
232  15
62  12
< 0.00001
Hydroxytyrosol
11.66  2.60
14.42  3.01
1.74  0.84
< 0.05
Tyrosol
22.13  3.82
27.45  4.05
2.98  1.33
< 0.01
Total simple phenols (TSP)
33.79  4.48
41.87  6.17
4.72  2.15
< 0.01
SID-1
7.97  2.57
9.62  3.18
2.00  0.87
ns
SID-2
15.75  3.54
18.09  4.31
7.30  3.01
ns
Total secoiridoids (SID)
23.71  5.61
27.72  6.84
9.30  3.81
ns
Lignans
34.09  4.42
41.53  3.93
7.29  2.56
< 0.001
TSP + SID + LIGNANS
91.59  10.57
111.12  9.99
21.31  8.03
< 0.001
POLYPHENOLS
350
300
250
200
150
100
50
0
Extra-vergin
Refined
Seed oil
LIGNANS
90
80
70
60
50
40
30
20
10
0
Extra-vergin
Refined
Seed oil
Eur J Cancer Prev 2002 Aug;11(4):351-8
Cancer chemoprevention by hydroxytyrosol isolated
from virgin olive oil through G1 cell cycle arrest and
apoptosis.
Fabiani R, De Bartolomeo A, Rosignoli P, Servili M, Montedoro
GF, Morozzi G. (Perugia, Italy)
Hydroxytyrosol inhibited proliferation of both human
promyelocytic leukaemia cells HL60 and colon adenocarcinoma
cells HT29
At concentrations ranging from 50 to 100 micromol/l,
hydroxytyrosol induced an appreciable apoptosis
Hydroxytyrosol (50-100 micromol/l) arrested the cells in the
G0/G1 phase with a concomitant decrease in the cell
percentage in the S and G2/M phases.
Scavenging of ROS generated in the faecal matrix
by tyrosol isolated from olive oil.
Dihydroxy benzoic acids (%)
100
Tyrosol (µ M)
20
0.01
0.1
1
10
100
1000
10000
J Agric Food Chem 2002 Oct 9;50(21):5962-7
Influence of thermal treatments simulating cooking
processes on the polyphenol content in virgin olive oil.
Brenes M, Garcia A, Dobarganes MC et al. (Sevilla, Spain)
• Thermal oxidation:
– rapid degradation of alpha-tochopherol
– 180°: < tyrosol and tydroxytyrosol
for 25 h.: lignans unchanged
• Microwave:
– for 10 min.: minor losses
• Pressure cooker:
– for 30 min: losses of polyphenols at ph <6
– alpha-tocopherol: not modified
• Lignans: the least affected polyphenols
SQUALENE
400
SQUALENE MG/100G
350
300
250
200
150
100
50
0
Extra-vergin
Refined
Seed oil
Squalene: potential chemopreventive agent.
Smith TJ. (University of South Carolina, USA), 2000
The average intake: 30 mg/day in the United States
200-400 mg/day in Mediterranean
countries (olive oil).
Experimental studies have shown that squalene can effectively
inhibit chemically-induced colon, lung and skin tumourigenesis
in rodents.
The mechanisms involved:
•inhibition of Ras farnesylation,
•modulation of carcinogen activation
•anti-oxidative activities.
Int J Cancer 2000 Aug 1;87(3):444-51
Diet, metabolic polymorphisms and dna adducts: the
EPIC-Italy cross-sectional study.
Palli D, Vineis P, Russo A, et al. (Florence, Italy)
DNA adducts in peripheral leukocytes: reliable indicator of internal
dose exposure to genotoxic agents and cancer risk.
EPIC-Italy (section of European prospective study):
47,749 men and women, aged 35-64 years, in 5 centres.
Among 309 volunteers, 72.8% had detectable levels of DNA
adducts.
Strong negative associations emerged with the reported frequency
of consumption of fresh fruit and vegetables, olive oil, and the
intake of antioxidants.
DNA adducts were higher in subjects with GSTT1 null genotype (p
= 0.05).
Cancer Preventive role of
olive oil
Study project
Italy
Greece
Spain
CASES
CONTROLS
12000
10000
1500
1500
?
?
Dieta Mediterranea e
prevenzione dei tumori e
delle malattie cardiovascolari
MICRONUTRIENTI & SOSTANZE
BIOATTIVE
VIT. C, E, ACIDO FOLICO, SE
FRUTTA & VERDURA
LUTEINA
VEGETALI GIALLI E VERDI
LICOPENE
POMODORO
FLAVONOIDI
FRUTTA & VERDURA, THE, VINO
CUMARINE
AGRUMI
DITIOLTIONI
ISOTIOCIANATI
CRUCIFERE
INDOLO-3- CARBINOLO
DIALLIL SOLFIDE
ALLIL METIL TRISOLFIDE
AGLIO
FLAVONOIDI
* Responsabili dei colori di molti vegetali
* Presenti in semi, agrumi, the, vino rosso
* Azione antiossidante e antiproliferativa
CAROTENOIDI E CANCRO
• Luteina
• Zeaxantina
< incidenza Ca mammella
(premenopausa)
> apoptosi
< Ca mammella (in storia
familiare positiva!)
Vegetali gialli
(arance, carote,
pomodori)
Spinaci, broccoli,
sedano
ANTIOSSIDANTI E
FRUTTA
(Unità ORAC)
•
•
•
•
•
•
•
•
•
•
•
Arancia 1
Succo di arancia 1 bicchiere
Fragole una tazza
Prugne nere 3
Mirtilli 1 tazza
Melone 3 fette
Pesca 1
Mela 1
Spinaci cotti 1 tazza
Succo di uva nera un bicchiere
More 1 tazza
983 unità
1142 unità
1170 unità
1454 unità
3480 unità
197 unità
222 unità
301 unità
2042 unità
5216 unità
1466 unità
ANTIOSSIDAN
TI E FRUTTA
(Unità ORAC)
•
•
•
•
•
•
•
•
•
•
•
Arancia 1
983 unità
Succo di arancia 1 bicchiere
1142 unità
Fragole una tazza
1170 unità
Prugne nere 3
1454 unità
Mirtilli 1 tazza
3480 unità
Melone 3 fette
197 unità
Pesca 1
222 unità
Mela 1
301 unità
Spinaci cotti 1 tazza
2042 unità
Succo di uva nera un bicchiere
5216 unità
More 1 tazza
1466 unità
IL TUMORE DELLO
STOMACO
QUANTA FRUTTA E
VERDURA ?
•
•
•
•
•
500 – 600 g al giorno
Almeno 5 porzioni al giorno
Ogni porzione in più: < 10% rischio di CRC
La più ampia varietà possibile
Stagionalità, locoregionalità
CALORIE ,PESO
e SALUTE (?!?)
•
CALORIE & CANCRO DEL
COLON
Studio Italiano
COLON-RETTO
Quintili di Calorie
ORs
(95% CI)
1
1
2
1.10
(0.92-1.31)
3
1.18
(0.99-1.42)
4
1.16
(0.97-1.39)
5
1.50
(1.25-1.80)
Continuous (100 kcal/day)
1.02
(1.01-1.03)
(Franceschi ,Giacosa et al, 97)
ATTIVITA’ FISICA
E CANCRO DEL COLON
Rischio relativo
2
1




0.6
0
1
2
3
4
5
Livello di attività fisica
Slattery et al, 97
CARBOIDRATI &
CANCRO DEL COLON
Studio Italiano
COLON-RETTO
Alimenti
ORs in highest
vs lowest quintile
(95% CI)
Pane e farinacei
1.69
(1.36-2.10)
Dolci
1.13
(0.93-1.37)
Zucchero
1.43
(1.19-1.73)
Patate
1.20
(0.96-1.51)
(Franceschi ,Giacosa et al, 97)
CHO & CANCRO DELLA
MAMMELLA
Quintile di consumo
1 (basso)
2
3
4
5 (alto)
Carboidrati disponibili
OR
1
1.05
1.13 1.16
1.29
1
1.05
1.28 1.24
1.39
Amidi
OR
Lancet, 96
IPOTESI INSULINICA
• Le farine raffinate e gli zuccheri
possono indurre:
- sovraccarico glicemico
- resistenza insulinica
• Ciò può indurre promozione della
crescita cellulare
• Attraverso ormoni specifici e fattori di
crescita
RELAZIONE TRA BMI
E RISCHIO DI MORTALITA’
RISCHIO DI MORTALITA’
2.5
2
1.5
------------------------------------------------------------------------1
20
25
30
35
40
BODY MASS INDEX (kg/m2)
METABOLICHE
CARDIOVASCOLARI
• DIABETE
• DISLIPIDEMIA
• GOTTA
• IPERTENSIONE
• EVENTI
COMPLICANZE
DELL’OBESITA’
CEREBROVASC.
• CORONOPATIA
• SCOMPENSO
CARDIACO
• INSUFFICIENZA
VENOSA
ALTRE
• COLELITIASI • CALCOLOSI RENALE • APNEE NOTTURNE
• ARTROSI
ERNIA IATALE
L’ERNIA IATALE
• IL REFLUSSO
• IL DOLORE
• IL BRUCIORE
• MAL DI CUORE ?
• ASMA?
• TOSSE?
Ernia iatale
Esofagite
Esofago di Barrett
•
L’ERNIA IATALE
Calcolosi della colecisti
Calcolosi della colecisti
DIETA E PREVENZIONE
DEI TUMORI
Mantieni attivo il fisico
durante tutta la vita,
effettuando almeno
mezz’ora al giorno di
attività fisica intensa, ma
adeguando il tipo di
esercizio al variare dell’età.
Evita il soprappeso e l’obesità
e tieni costantemente
sott’occhio il peso corporeo,
stando attento a ciò che mangi
ed evitando la sedentarietà.
Assumi spesso
alimenti ricchi
in fibre
Cerca di
e prodotti
limitare il
integrali.
consumo di
zucchero,
dolci e
prodotti con
farina bianca.
Cerca di assumere
almeno
cinque porzioni al
giorno tra frutta e
verdura.
Modera l’apporto di grassi di origine animale
(ad esempio latticini e carni grasse) scegliendo
spesso latte e formaggi magri e togliendo il
grasso visibile dalla carne e la pelle dal pollo.
Per la cottura e per i condimenti, scegli
preferibilmente olio extra-vergine d’oliva.
Ricordati che
il pesce e i legumi sono
splendide alternative alla
carne.
Inoltre, l’olio presente nel
pesce è utile per prevenire
vari tumori (soprattutto il
tumore della mammella) e le
malattie cardiovascolari.
Bevi acqua in
abbondanza
e, se assumi alcolici, bevi
al massimo due bicchieri
al giorno di vino o birra
se sei di sesso maschile,
uno se sei di sesso
femminile.
La scelta e lo stoccaggio degli
alimenti sono molto importanti.
Controlla sempre l’etichetta e,
per i vegetali, cerca di preferire
prodotti locali, stagionali
e freschi o surgelati.
Per cucinare in modo salutare,
fai uso di piccole quantità di
grasso e olio,
utilizza basse temperature e
riduci il più possibile i tempi di
cottura.
Mediterranean diet score and cancers
of the upper digestive tract
This study provides
evidence that an a
priori defined
nutritional pattern,
which includes
several aspects of the
Mediterranean diet,
favourably affects the
risk of cancers of the
upper aerodigestive
tract