coltivazione dellolivo origini: 5000 a.c. (medio oriente) 4500 a.c. codice di hammurabi in italia:...
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COLTIVAZIONE COLTIVAZIONE DELL’OLIVODELL’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 Mediterranean DietDiet
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 IMPORTANZA BIOLOGICA DELL’OLIO D’OLIVADELL’OLIO D’OLIVA
• MUFA- Fluidità di membrana
cellulare
• ANTIOSSIDANTI- Anti radicali liberi- Anti perossidazione
• MALATTIE CARDIOSVACOLARI- LDL - colesterolo- Ipertrigliceridemia
IMPORTANZA BIOLOGICA IMPORTANZA BIOLOGICA DELL’OLIO D’OLIVADELL’OLIO D’OLIVA
• APPARATO DIGERENTE- attività della colecisti- secrezione pancreatica
• CANCRO- > apoptosi - oncogene ras,- < addotti al DNA
< 10% PROSTATE,
PANCREAS, ENDOMETRIUM
< 25% COLON
< 15% BREAST
WITH MEDITERRANEAN DIET:
(Trichopoulou et al., 2000)
CANCER RISK FACTORSCANCER RISK FACTORSCANCER RISK FACTORSCANCER RISK FACTORS
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.
FATSFATS
RRs and 95% CI of selected cancers according to RRs and 95% CI of selected cancers according to RED MEATRED MEAT consumption. Italy, 1983-1997 consumption. Italy, 1983-1997
Pesce
1
1.2
1.4
1.6
1.8
0.8
0.6
Carni bianche
Carni lavorate Carni
rosse
Tutte le carni
Cohort studies
Case-control studies All studies
CARNE & CANCRO DEL COLON
Meta-analisi, IARC, Lione 2002
CARNE & CANCRO DEL COLON
Meta-analisi, IARC, Lione 2002
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):101-5COMBINED 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):541-8DIET 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 GRASSI N-6 E N-3 IN RAPPORTO TRA IN RAPPORTO TRA
ACIDI VARIE ACIDI VARIE POPOLAZIONIPOPOLAZIONI
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 RRs and 95% CI of selected cancers according to FISHFISH consumption. Italy, 1983-1997. consumption. Italy, 1983-1997.
N-3 Polyunsaturated fatty acidsN-3 Polyunsaturated fatty acidsQUINTILE OF INTAKE
CANCER SITE 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)
OMEGA-3 & CANCROOMEGA-3 & CANCRO
(olio di pesce)(olio di pesce)
DHADHA
Riduce l’espressione di Riduce l’espressione di COX-2 COX-2 Induce Induce apoptosiapoptosi
(Da Caterina,01)(Da Caterina,01)
Olive oil & Olive oil & Colorectal cancerColorectal 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)
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
FATSFATS
FATSFATS
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)
FATSFATS
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 Olive oil Oral and pharyngeal Oral and pharyngeal cancercancer
UPPER LIMIT - (g per day) INTAKE QUINTILE
1 3 5
Olive oil 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)
Butter 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)
Substituting Substituting olive oil olive oil for other seasoning for other seasoning fatsfats has favourable has favourable
effects on the risk of effects on the risk of oral, laringeal and oral, laringeal and
pharyngeal (OR= 0.7),pharyngeal (OR= 0.7), and and oesophageal oesophageal (OR= 0.4)(OR= 0.4) cancers cancers
FATS
Mediterranean diet Mediterranean diet score and cancers score and cancers
of the upper of the upper digestive tractdigestive 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)
Cancer Mediterranean diet score<3 4 6
Oral/pharyngeal
Cases/controls 214/241 120/376 41/201
OR (95% CI) 1 0.41 (0.30-0.57) 0.40 (0.26-0.62)
Oesophageal
Cases/controls 102/147 66/174 14/83
OR (95% CI) 1 0.63 (0.41-0.95) 0.26 (0.13-0.51)
Laryngeal
Cases/controls 183/225 98/279 19/124
OR (95% CI) 1 0.47 (0.33-0.66) 0.23 (0.13-0.40)
Mediterranean diet score and cancers of the
upper digestive tract (Bosetti, ‘03)
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 riskPizza and cancer risk
CANCER
OR (95% CI)
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):609-15MEN 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 TOTAL AND INDIVIDUAL PHENOLIC COMPOUNDS IN OLIVE OILCOMPOUNDS IN OLIVE OIL
PHENOLIC COMPOUND mg/kg
OLIVE OIL
ALL VOQ RVO P value
Total 196 19 232 15 62 12 < 0.0000
1
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
POLYPHENOLSPOLYPHENOLS
0
50
100
150
200
250
300
350
Extra-verginRefined Seed oil
LIGNANSLIGNANS
0
10
20
30
40
50
60
70
80
90
Extra-vergin Refined Seed oil
Eur J Cancer Prev 2002 Aug;11(4):351-8Cancer 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 Scavenging of ROS generated in the faecal matrix by tyrosol isolated from olive oil.by tyrosol isolated from olive oil.
100
20 0.01 0.1 1 10 100 1000
10000
Dihydroxy benzoic acids (%)
Tyrosol (µ M)
J Agric Food Chem 2002 Oct 9;50(21):5962-7Influence 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
SQUALENESQUALENE
0
50
100
150
200
250
300
350
400
Extra-verginRefinedSeed oil
SQ
UA
LEN
E M
G/1
00
G
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):444-51Diet, 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 Cancer Preventive role of
olive oilolive oil Study projectStudy project
CASES CONTROLS Italy 12000 10000
Greece 1500 1500
Spain ? ?
Dieta Mediterranea e prevenzione dei tumori e
delle malattie cardiovascolari
MICRONUTRIENTI & SOSTANZE MICRONUTRIENTI & SOSTANZE BIOATTIVEBIOATTIVE
VIT. C, E, ACIDO FOLICO, SE FRUTTA & VERDURA
LUTEINA VEGETALI GIALLI E VERDI
LICOPENE POMODORO
FLAVONOIDI FRUTTA & VERDURA, THE, VINO
CUMARINE AGRUMI
DITIOLTIONI
CRUCIFEREISOTIOCIANATI
INDOLO-3- CARBINOLO
DIALLIL SOLFIDE
AGLIOALLIL METIL TRISOLFIDE
FLAVONOIDI
* Responsabili dei colori di molti vegetali
* Presenti in semi, agrumi, the, vino rosso
* Azione antiossidante e antiproliferativa
CAROTENOIDI E CANCROCAROTENOIDI E CANCRO• Luteina < incidenza Ca mammella
(premenopausa)
> apoptosi• Zeaxantina < Ca mammella (in storia
familiare positiva!)
Vegetali gialli (arance, carote,
pomodori)Spinaci, broccoli,
sedano
ANTIOSSIDANTI E ANTIOSSIDANTI E FRUTTAFRUTTA
(Unità ORAC)(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
ANTIOSSIDANANTIOSSIDANTI E FRUTTATI E FRUTTA
(Unità ORAC)(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 IL TUMORE DELLO STOMACO STOMACO
QUANTA FRUTTA E QUANTA FRUTTA E VERDURA ?VERDURA ?
QUANTA FRUTTA E QUANTA FRUTTA E VERDURA ?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 CALORIE ,PESO e SALUTE (?!?)e SALUTE (?!?)CALORIE ,PESO CALORIE ,PESO e SALUTE (?!?)e SALUTE (?!?)
•
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)
COLON-RETTO
(Franceschi ,Giacosa et al, 97)
CALORIE & CANCRO DEL COLON
Studio Italiano
ATTIVITA’ FISICA ATTIVITA’ FISICA E CANCRO DEL COLONE CANCRO DEL COLON
ATTIVITA’ FISICA ATTIVITA’ FISICA E CANCRO DEL COLONE CANCRO DEL COLON
0 1 2 3 4 5
Livello di attività fisica
Ris
chio
re
lati
vo
0.6
1
2
Slattery et al, 97
CARBOIDRATI &CARBOIDRATI &
CANCRO DEL COLON CANCRO DEL COLON Studio ItalianoStudio Italiano
CARBOIDRATI &CARBOIDRATI &
CANCRO DEL COLON CANCRO DEL COLON Studio ItalianoStudio Italiano
Alimenti ORs in highest (95% CI)vs lowest quintile
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)
COLON-RETTO
(Franceschi ,Giacosa et al, 97)
CHO & CANCRO DELLA CHO & CANCRO DELLA MAMMELLAMAMMELLA
Quintile di consumo
1 (basso) 2 3 4 5 (alto)
Carboidrati disponibili
OR 1 1.05 1.13 1.16 1.29
Amidi
OR 1 1.05 1.28 1.24 1.39
Lancet, 96
IPOTESI INSULINICAIPOTESI INSULINICAIPOTESI INSULINICAIPOTESI 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’
BODY MASS INDEX (kg/m2)
20 25 30 35 40
2.5
2
1.5
1
-------------------------------------------------------------------------
COMPLICANZE DELL’OBESITA’
METABOLICHE
• DIABETE • DISLIPIDEMIA• GOTTA
CARDIOVASCOLARI
• IPERTENSIONE• EVENTI CEREBROVASC.• CORONOPATIA• SCOMPENSO CARDIACO• INSUFFICIENZA VENOSA
ALTRE
• COLELITIASI • CALCOLOSI RENALE • APNEE NOTTURNE • ARTROSI ERNIA IATALE
L’ERNIA IATALEL’ERNIA IATALE
• IL REFLUSSO
• IL DOLORE
• IL BRUCIORE
• MAL DI CUORE ?
• ASMA?
• TOSSE?
Ernia iataleErnia iataleEsofagiteEsofagite
Esofago di BarrettEsofago di Barrett
•
L’ERNIA IATALEL’ERNIA IATALE
Calcolosi della colecistiCalcolosi della colecisti
Calcolosi della colecistiCalcolosi della colecisti
DIETA E PREVENZIONE DIETA E PREVENZIONE DEI TUMORIDEI TUMORI
DIETA E PREVENZIONE DIETA E PREVENZIONE DEI TUMORIDEI TUMORI
Evita il soprappeso e l’obesità e tieni costantemente
sott’occhio il peso corporeo, stando attento a ciò che mangi
ed evitando la sedentarietà.
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.
Assumi spesso alimenti ricchi
in fibre e prodotti integrali.
Cerca di assumere almeno
cinque porzioni al giorno tra frutta e
verdura.
Cerca di limitare il
consumo di zucchero,
dolci e prodotti con
farina bianca.
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, bevial 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.
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
Mediterranean diet score and cancers of the upper digestive tract