On 9-10 of March, ESR 7 and ESR 11 attended a national congress on Nutrition, Obesity and Cancer in Bari, Italy. It was two days filled with interesting lectures presenting the state-of-the-art in the field. Since it would be impossible to transcribe the meeting here, we are sharing what each of us considered to be the highlights of the congress.
The congress of Nutrition, Obesity and Cancer served as an extremely valuable opportunity for us, first year researchers in southern Italy, to understand more about the therapeutic approaches of local gastronomy in two of the most worrisome worldwide epidemiologies.
This said, there were many important messages addressed to different levels of our society, from children to elderly and aimed to both governmental institutions and pharmacological companies.
Of special interest, were the topics related to adipose tissue classifications in the body and sarcopenia related to obesity. While white adipocytes are the storage of lipids and released as free fatty acids, brown adipocytes keep the thermal homeostasis by burning glucose and lipids. Temperature plays a significant role in keeping the percentage of fat in the body, such as refrigeration, turning white adipocytes into brown ones. Similarly, a high fat diet would cause brown adipose tissue to increase its thermogenic capacity, as a response to the excessive caloric intake, and maintaining body weight.
Sarcopenia, on the other hand, refers to the loss of muscle mass as a result of aging, among others. Sarcopenia is linked to obesity since both share many metabolic abnormalities, including impaired mitochondria oxidation, insulin resistance and hormonal dysregulations. Resistance training can help improving muscle strength as measured by maximal force production and increasing fiber size of the skeletal muscle, serving as an useful tool in order to prevent sarcopenia.
Furthermore, the role of nutrition in gene transcription was mentioned several times during the event, as it is fundamental in changes seen in the DNA structure. Indeed, as a final remark, it was stressed all aging, bioavailability of local products, dietary habits, mood, physical activity routine as well as sleeping patterns, to help or worsen the pathophysiological mechanisms leading to cancer and obesity.
Educating people towards achieving a high-quality lifestyle from a very young age could drastically change both the local bioavailability and overall health status of our society.
- Cinti, S. (2018). The Obese Adipose Organ. Obesity, Type 2 Diabetes and the Adipose Organ: A Pictorial Atlas from Research to Clinical Applications. Cham, Springer International Publishing: 265-305.
- Cruz-Jentoft, A. J., J. P. Baeyens, J. M. Bauer, Y. Boirie, T. Cederholm, F. Landi, F. C. Martin, J. P. Michel, Y. Rolland, S. M. Schneider, E. Topinkova, M. Vandewoude, M. Zamboni and P. European Working Group on Sarcopenia in Older (2010). “Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People.” Age Ageing 39(4): 412-423.
- Giordano, A., A. Smorlesi, A. Frontini, G. Barbatelli and S. Cinti (2014). “MECHANISMS IN ENDOCRINOLOGY: White, brown and pink adipocytes: the extraordinary plasticity of the adipose organ.” European Journal of Endocrinology 170(5): R159-R171.
- Rosenberg, I. H. (1997). “Sarcopenia: origins and clinical relevance.” J Nutr 127(5 Suppl): 990S-991S.
Obesity is a worldwide epidemic with several consequences to general health, including higher risk of developing some types of cancer. Several different pathophysiological mechanisms were approached during this Congress, and relevant topics such as the role of microbiota and GLP-1 agonists treatment in obesity were discussed.
Of special interest to me were the presentations on recommended diets to curb obesity and decrease risk of cancer. Here are some of the scientific findings shared:
- A low-fat diet compared to a Mediterranean low-carbohydrate diet promoted the same weight loss in over 200 participants, however, following a Mediterranean diet preferentially decreased atherogenic and diabetogenic fat depots, such as visceral fat. 
- A very large epidemiological study (PURE: Prospective Urban Rural Epidemiology) conducted in 18 countries showed that a high carbohydrate diet (over 60% of total daily calories) accompanied by a low-fat intake results in a higher risk of total mortality, non-cardiovascular disease mortality, and stroke. These findings are consistent with studies favouring a Mediterranean diet, which is considered a high-fat diet – but higher in unsaturated over saturated fat. 
- A study with healthy individuals analysing timing of meals and metabolic rate came to the conclusion that the same meal given at 08 AM or 08 PM had different metabolic effects in the body. The evening meal resulted in lower resting metabolic rate, and increased glycemic/insulinemic responses, “suggesting circadian variations in the energy expenditure and metabolic pattern of healthy individuals”. 
- A large epidemiological study (NutriNet-Santé) found that a higher intake of ultra-processed food (generally high in saturated fat, sugar and salt) was associated with a higher overall risk of cancer, but also a particularly higher risk of breast cancer. 
Overall, it was reinforced the prominent role a healthy diet plays in managing obesity and decreasing the risk of associated cancers. What constitutes a healthy and adequate diet is still under study, but results are promising for the Mediterranean diet!
- Gepner, Yftach, et al. “Effect of Distinct Lifestyle Interventions on Mobilization of Fat Storage Pools: The CENTRAL MRI Randomized Controlled Trial.” Circulation (2017): CIRCULATIONAHA-117.
- Dehghan, Mahshid, et al. “Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study.” The Lancet 390.10107 (2017): 2050-2062.
- Bo, S., et al. “Is the timing of caloric intake associated with variation in diet-induced thermogenesis and in the metabolic pattern? A randomized cross-over study.” International Journal of Obesity 39.12 (2015): 1689.
- Fiolet, Thibault, et al. “Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort.” bmj 360 (2018): k322.
ESR7 Emilio Molina from Spain, and ESR11 Raquel Baccetto from Brazil, are currently working under the supervision of Prof. Piero Portincasa at the University of Bari ‘Aldo Moro’, Italy.