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Mediterranean drinking pattern

is defined as moderate intake of alcoholic beverages, with wine preference (≥80% of alcohol consumed as wine) and drinking only with meals.

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Mendelian Randomization

the basic idea of the Mendelian randomization is to use genetic variables as instrumental variables, i.e., genes associated with an exposure (in this study, alcohol consumption or alcohol metabolism) but not directly related to outcome (in this study, HDL-cholesterol and other lipid parameters).  Since the genetic pattern is determined before birth, it should not (at least, in theory) be confounded by later lifestyle exposures or outcome variables.  Thus, it allows the investigators to make causal inference.

Mendelian randomization provides an approach to addressing questions of causality without many of the typical biases that impact the validity of traditional epidemiologic approaches. While Mendelian randomization studies can provide important suggestive evidence for causal relations between risk factor (consumption of alcoholic beverages in this case) and disease outcome (blood lipid levels), they are not true experiments and are dependent on several assumptions. Evidence from randomized controlled trials, when possible, should continue to guide clinical decisions.

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is a method of summarizing the results of the same research purpose and comprehensively evaluating its combined effect. It can be an objective, systematic, comprehensive, qualitative and quantitative statistical analysis. It has functions that improve estimates of effect, construct a general review method for omitting inadequate study conclusions, and reinforce the effectiveness of statistical results to yield more comprehensive and reliable study results that are more representative of the general population.

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Metabolic Equivalent Task

refers to energy expenditure from sports and walking during the week.

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Metabolic syndrome

a cluster of abnormalities including increased abdominal fat, poor ability to use the hormone insulin, high blood pressure and high blood levels of triglycerides.

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Moli Sani

The Moli-sani study ( is a cohort study aiming at evaluating the risk factors (environmental, genetics, bio-molecular) linked to chronic-degenerative disease with particular regard to cancer, cardiovascular, cerebrovascular and neurodegenerative disease.


More information about the Moli Sani study on our databse: 

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Nitric oxide

is a signaling molecule produced by the body that helps the body cells to communicate. It signals the body to release more blood to the organs when needed. One of the common ways to increase the concentration of NO in the body is through exercise. While working out, body muscles need more oxygen, which is supplied with blood. The heart pumps with high pressure to supply sufficient blood to the muscles; the lining of the arteries releases NO into the blood in order to relax and widen the vessel wall and thus, more blood can pass through. However, with age, blood vessels and NO-systems become inefficient due to free radicals, poor diet, etc., causing veins and arteries to deteriorate. It helps in supplying the sufficient amount of blood flow to the tissues and therefore, allows smooth muscles to relax.

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Non-Alcoholic Steatohepatitis

Is a common, often “silent” liver disease. It resembles alcoholic liver disease, but occurs in people who drink little or no alcohol. The major feature in NASH is fat in the liver, along with inflammation and damage. Most individuals with NASH feel well and are not aware that they have a liver problem. Nevertheless, NASH can be severe and can lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to work properly.

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is defined as the presence of fat in the liver ( with > 5,5% of liver cells being fatty, hepatic steatosis) after the excluding secondary causes of fat accumulation in the liver (e.g. significant alcohol consumption, certain medications, and other medical conditions). NAFLD occurs when the liver has problems breaking down lipids, causing fat to build up in the liver tissue. NAFLD is now the most common chronic liver disease in high-income countries, and it is estimated to affect at least 25%–40% of the general population. It can progress from simple steatosis to non-alcoholic steatohepatitis (NASH) and hepatic fibrosis to liver cancer.

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Observational studies

Like intervention studies, observational studies attempt to understand cause-and-effect relationships. However, unlike interventions, the researcher is not able to control how subjects are assigned to groups and/or which treatments each group receives. Researchers record variables’ values as they naturally occur (can be retrospective or prospective) during a certain follow up period (see Intervention studies).

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Over-the-counter drugs

Over-the-counter (OTC) drugs are medicines sold directly to a consumer without a prescription from a healthcare professional, as opposed to prescription drugs, which may be sold only to consumers possessing a valid prescription.


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is a group of cholesterol compounds that contain extra oxygen atoms were found to be highly toxic and highly effective in producing arteriosclerosis. The highly damaging oxycholesterols are found in foods in which cholesterol is subjected to heating and exposure to the oxygen of the air during food processing, cooking or preservation.

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is an inflammatory disease of the pancreas associated with inappropriate release of digestive enzymes into the small intestine to aid the digestion of carbohydrates, proteins, and fat as well as the release of the hormones glucagon and insulin into the blood stream. These hormones are involved in the blood glucose metabolism.

Acute pancreatitis occurs suddenly and most often resolves within several days. Most cases of acute pancreatitis are linked to gallstones. Cigarette smoking and heavy alcohol use have been associated with risk of pancreatitis.

Chronic pancreatitis occurs most commonly after an episode of acute pancreatitis and is the result of ongoing inflammation of the pancreas. Damage to the pancreas from excessive alcohol use may not cause symptoms for many years, but then the person may suddenly develop severe pancreatitis symptoms, including severe pain and loss of pancreatic function, resulting in digestion and blood sugar abnormalities.

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are mainly phytochemicals found abundantly in natural plant food sources. The most important food sources are fruit and vegetables, green tea, black tea, red wine, coffee, chocolate, olives, and extra virgin olive oil. Herbs and spices, nuts and algae also supply certain polyphenols. Some polyphenols are specific to particular food (ie. flavanones in citrus fruit, isoflavones in soya, phloridzin in apples). Others, such as quercetin, are found in all plant products such as fruit, vegetables, cereals, leguminous plants, tea, and wine.

In general, red wine will be richer in phenols abundant in the skin and seeds, such as anthocyanin, proanthocyanidins and flavonols, whereas the phenols in white wine will essentially originate from the pulp, and these will be the phenolic acids together with lower amounts of catechins and stilbenes. Average total polyphenol content measured by the Folin method is 216 mg/100 ml for red wine and 32 mg/100 ml for white wine. The content of phenols in rosé wine (82 mg/100 ml) is intermediate between that in red and white wines (see flavonoids).

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Wine contains phenolic compounds (polyphenols) which give wine its characteristic colour and flavour and are produced by plants in response to fungal infection, and various chemical and physical stressors, especially during ripening. They are extracted from the seeds and skins of grapes during fermentation of winemaking, when the juice is in contact with the grape skins and seeds. The amount of polyphenols in red wine is generally greater than in white wine because the red juice has longer contact with the grape skins during fermentation enabling more phenolic substances to be extracted into the red juice.

There is evidence that certain wine-derived phenolic compounds, such as resveratrol, and flavonoids such as anthocyanins, catechins and flavanols can provide health benefits. Researchers have shown that wine-derived phenolic compounds act as antioxidants and stimulate antioxidant defense systems (Forman et al 2014).  Thereby, these antioxidants are believed to reduce the damage caused by the body's free radicals (toxic waste products) which contribute to causing degenerative diseases in the body such as cancer, Alzheimer's disease, Parkinson's disease and general ageing.

Many polyphenols are metabolised by gut bacteria. Recently, it has been shown that rather than the polyphenols themselves, their metabolites might be the key compounds in cardiovascular and cancer protection (Yang et al 2020).


Resveratrol is a naturally occurring phenolic compound in red wine that provides a number of anti-aging health benefits. As a natural food ingredient, numerous animal and laboratory studies have demonstrated that resveratrol shows a high antioxidant activity. Resveratrol also exhibits antitumor activity and is considered a potential candidate for prevention and treatment of several types of cancer. Other observed bioactivity includes anti-inflammatory, anti-carcinogenic, cardio-protective, vasorelaxant and neuroprotective effects. Although resveratrol can inhibit the growth of cancer cells in experimental and animal models, it is not known whether resveratrol can prevent and/or help treat cancer in humans (Carter et al 2014, Ramirez-Garza et al 2018, Salehi et al 2018).


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