CHOKO-AGE
Combining vitamin E-functionalized CHOcolate with physical exercise to reduce the risK Of protein-energy malnutrition in pre-dementia AGEd people
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Abstract
The CHOKO-AGE project starts from the assumption that nutrition and physical exercise can support each other to prevent protein-energy malnutrition (PEM) and muscle wasting in the elderly at risk of frailty and disability. Age-dependent PEM is associated with specific alterations of endocrine factors, such as cortisol and insulin, and with a reduced competence of tissues, including the muscle, to utilize dietary nutrients to prevent and eventually repair the lesions deriving from the exposure to cellular stressors, such as reactive metabolites of molecular oxygen produced during metabolic processes, mechanical stresses, etc. The control of cortisol levels and the protection of mitochondrial function and membrane integrity in muscle cells, are key targets in PEM.
Our experimental hypothesis is that physical activity and chocolate polyphenols can combine their cortisol lowering effect with the antioxidant and cytoprotection function of vitamin E, to prevent the age-dependent decline of mitochondrial function and nutrient metabolism in skeletal muscle. Positive effects are also expected on immune cells and in the homeostatic control of inflammatory pathways and tissue repair mechanisms.
To test this hypothesis, a vitamin E-functionalized dark chocolate rich in polyphenols will be developed in collaboration with Perugina, Nestlè company, and its effects will be investigated combined with a high-intensity interval physical training in a 6-month randomized case-control trial in elderly dementia patients. This is a well-defined population of subjects at risk of PEM and frailty. Muscle mass will be the primary endpoint in this intervention study, whereas metabolomics and proteomics data on muscle metabolism, together with cortisol levels and clinical and laboratory indices of neurological and immuno-inflammatory functions, will represent secondary end-points. The latter will be important to interpret molecular and mechanistic aspects standing behind the response to nutrition and physical activity treatment.
To summarize, the fundamental aim of this project is to develop a nutritionally-enhanced and palatable food to support physical activity in preventing PEM in the elderly.
The CHOKO-AGE project involves a consortium of 5 university partners located in Italy, Norway, United Kingdom, and Spain, and of two external collaborators: “Perugina, NestlèItaliana, Spa” and “Molecular Horizon Srl”.
Consortium
| Partner Organization | Partner Country |
|---|---|
| University of Perugia, Department of Pharmaceutical Sciences | Italy |
| University of Verona, Department of Neurological and Movement Sciences | Italy |
| Norwegian University of Science and Technology, Department of Circulation and Medical Imaging | Norway |
| University of Liverpool Department of Musculoskeletal Biology II, Institute of Ageing and Chronic Disease | United Kingdom |
| Aging and Physical Exercise Research Group. INCLIVA Biomedical Research Institute | Spain |
| Nestlé Italiana SpA | Italy |
| Molecular Horizon Srl | Italy |
Highlights
- the CHOKO-AGE project will develop a new vitamin E-functionalized dark chocolate food product
- content and type of the functional agents present in the innovative food product will be verified and their biological activity will be investigated in cell models,
- a high-intensity interval physical training program tailored to elderly subjects at risk of malnutrition and frailty will be designed,
- the effects of the innovative food product and physical activity on indices of protein-energy malnutrition will be verified in a randomized clinical trial,
- molecular and functional data of muscle tissue metabolism and immuno-inflammatory pathways will be gathered and evaluated for interpretation with state-of-the-art bioinformatics tools,
- study outcomes will be utilized to develop models of personalized nutrition and physical activity in the aged at risk of malnutrition and frailty,
- results will be available for the scientific community, national and local health systems, and the general public.
Products
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Magazine: BMJ Open
Link: https://pubmed.ncbi.nlm.nih.gov/38135320/
Author: Pedrinolla A, Isanejad M, Antognelli C, Bartolini D, Borras C, Cavedon V, Di Sante G, Migni A, Mas-Bargues C, Milanese C, Baschirotto C, Modena R, Pistilli A, Rende M, Schena F, Stabile AM, Telesa NV, Tortorella S, Hemmings K, Vina J, Wang E, McArdle A, Jackson MJ, Venturelli M, Galli F.
Magazine: BMJ Open
Link: https://pubmed.ncbi.nlm.nih.gov/38135320/
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Magazine: Archives of Biochemistry and Biophysics
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Magazine: Molecular Neurobiology
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Magazine: Redox Biology
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Magazine: The Journals of Gerontology: Series A
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Magazine: The Journals of Gerontology: Series A
Start- and endpage: 1931-1938
Link: https://doi.org/10.1093/gerona/glac119
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Title: Genistein, a tool for geroscience.
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Magazine: Mechanisms of Ageing and Development
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Magazine: Mechanisms of Ageing and Development
Link: https://doi.org/10.1016/j.mad.2022.111665
Title: The multimodal action of genistein in Alzheimer's and other age-related diseases.
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Magazine: Free Radical Biol. and Med.
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Title: Serum Levels of Clusterin, PKR, and RAGE Correlate with Amyloid Burden in Alzheimer's Disease
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Title: Wheat germ oil vitamin E cytoprotective effect and its nutrigenomics signature in human hepatocyte lipotoxicity.
Author: Bartolini D*,Marinelli R, StabileAM*, Frammartino T, Guerrini A, Garetto S, Lucci J,Migni A, Zatini L, Marcantonini G,Rende M*, Galli F.
Magazine: Heliyon
Link: https://www.sciencedirect.com/science/article/pii/S2405844022020369
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Title: Exercise and nutritional interventions on sarcopenia and frailty in heart failure: a narrative review of systematic reviews and meta- analyses.
Author: Prokopidis K,Isanejad M*,Akpan A, Stefil M,Tajik B, Giannos P, Venturelli M*,Sankaranarayanan R.
Link: https://onlinelibrary.wiley.com/doi/full/10.1002/ehf2.14052
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Title: Melatonin Repairs the Lipidome of Human Hepatocytes Exposed to Cd and Free Fatty Acid-Induced Lipotoxicity.
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Magazine: J Pineal Res.
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Title: Choko-age project: in vitro bioactivity evaluation of a new Vitamin E-funzionalized chocolate product.
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Magazine: Italian Journal of Anatomy and Embryology
Author: Varfaj I., Migni A., Stabile A.M., Pedrinolla A., Pistilli A., Tognoloni A., Di Sante G., Venturelli M., Galli F., Rende M., Bartolini D.
Magazine: Italian Journal of Anatomy and Embryology
Title: Role of altered cortisol production in the development of sarcopenia.
Author: Anne McArdle, Samuel Pringle, Jekaterina Kumiscia, Kay Hemmings, Desiree Bartolini, Anna Migni, Massimo Venturelli, Jose Vina, Francesco Galli, Malcolm Jackson
Magazine: American Physiological Society
Link: https://journals.physiology.org/doi/abs/10.1152/physiol.2023.38.S1.5735268
Author: Anne McArdle, Samuel Pringle, Jekaterina Kumiscia, Kay Hemmings, Desiree Bartolini, Anna Migni, Massimo Venturelli, Jose Vina, Francesco Galli, Malcolm Jackson
Magazine: American Physiological Society
Link: https://journals.physiology.org/doi/abs/10.1152/physiol.2023.38.S1.5735268
Title: The Choko-Age project: development and analytical characterization of a new chocolate product functionalized with vitamin E to combine with physical exercise in preventing malnutrion in pre-dementia eldery subjects.
Author: Anna Migni, Francesco Galli, Cinzia Antognelli, Desirée Bartolini, Consuelo Borrás, Gabriele Cruciani, Gabriele Di Sante, Kay Hemmings, Malcom Jackson, Anne McArdle, Giada Marcantonini, Cristina Mas-Bargues, Anna Pedrinolla, Roberto Modena, Marta Piroddi, Alessandra Pistilli, Mario Rende, Federico Schena, Bartolomeo Sebastiani, Anna Maria Stabile, Vincenzo Nicola Talesa, Sara Tortorella, Massimo Venturelli, José Viña, Eivind Wang, Linda Zatini
Magazine: Free Radical Biology and Medicine
Start- and endpage: 27
Author: Anna Migni, Francesco Galli, Cinzia Antognelli, Desirée Bartolini, Consuelo Borrás, Gabriele Cruciani, Gabriele Di Sante, Kay Hemmings, Malcom Jackson, Anne McArdle, Giada Marcantonini, Cristina Mas-Bargues, Anna Pedrinolla, Roberto Modena, Marta Piroddi, Alessandra Pistilli, Mario Rende, Federico Schena, Bartolomeo Sebastiani, Anna Maria Stabile, Vincenzo Nicola Talesa, Sara Tortorella, Massimo Venturelli, José Viña, Eivind Wang, Linda Zatini
Magazine: Free Radical Biology and Medicine
Start- and endpage: 27
Title: The Choko-AGE study: Combining vitamin E-functionalized CHOcolate with physical exercise to reduce the risK Of protein energy malnutrition in predementia AGEd people.
Author: Pedrinolla A., Venturelli M., Schena F., Pistilli A., Galli F., Bartolini D., Rende M., Di Sante G., Stabile A.M.
Magazine: Italian Journal of Anatomy and Embryology
Start- and endpage: 282-283
Link: https://www.proquest.com/openview/826cb4754e5a19298edba2a6e30dae70/1?cbl=756425&pq-origsite=gscholar
Author: Pedrinolla A., Venturelli M., Schena F., Pistilli A., Galli F., Bartolini D., Rende M., Di Sante G., Stabile A.M.
Magazine: Italian Journal of Anatomy and Embryology
Start- and endpage: 282-283
Link: https://www.proquest.com/openview/826cb4754e5a19298edba2a6e30dae70/1?cbl=756425&pq-origsite=gscholar
Title: The role of hypercortisolism, inflammation and modified redox on the functional loss of muscle with age: protective effects of vitamin E and cocoa polyphenols.
Author: Kay Hemmings, Konstantino Prokopidis, Anna Migni, Antognelli Cinzia, Desirée Bartolini, Consuelo Borrás, Gabriele Cruciani, Gabriele Di Sante, Marcantonini Giada, Cristina Mas Bargues, Roberto Modena, Anna Pedrinolla, Marta Piroddi, Alessandra Pistilli, Mario Rende, Federico Shena, Sebastiani Bartolomeo, Anna Maria Stabile, Nicola Talesa Vincenzo, Sara Tortorella, Massimo Venturelli, Jose Vina, Eivind Wang, Linda Zatini, Francesco Galli, Masoud Isanejad, Malcolm Jackson, Anne McArdle
Magazine: Free Radical Biology and Medicine
Start- and endpage: 26
Author: Kay Hemmings, Konstantino Prokopidis, Anna Migni, Antognelli Cinzia, Desirée Bartolini, Consuelo Borrás, Gabriele Cruciani, Gabriele Di Sante, Marcantonini Giada, Cristina Mas Bargues, Roberto Modena, Anna Pedrinolla, Marta Piroddi, Alessandra Pistilli, Mario Rende, Federico Shena, Sebastiani Bartolomeo, Anna Maria Stabile, Nicola Talesa Vincenzo, Sara Tortorella, Massimo Venturelli, Jose Vina, Eivind Wang, Linda Zatini, Francesco Galli, Masoud Isanejad, Malcolm Jackson, Anne McArdle
Magazine: Free Radical Biology and Medicine
Start- and endpage: 26
Title: PROGETTO DI RICERCA CHOKO-AGE
Author: Venturelli M. and Pedrinolla A.
Link: https://www.alzheimerverona.org/2022/progetto-di-ricerca-choko-age/
Author: Venturelli M. and Pedrinolla A.
Link: https://www.alzheimerverona.org/2022/progetto-di-ricerca-choko-age/
Title: Mid-Term Conference of Choko-Age Project
Author: Choko-agE Consortium
Link: https://dsf.unipg.it/home/avvisi-ed-eventi/archivio-avvisi-ed-eventi/1403-conference-of-choko-age-project-2-12-2022-cerism-rovereto
Author: Choko-agE Consortium
Link: https://dsf.unipg.it/home/avvisi-ed-eventi/archivio-avvisi-ed-eventi/1403-conference-of-choko-age-project-2-12-2022-cerism-rovereto
Title: Neuromuscular perspective of lack of muscle strength in dementia. a failure to communicate!
Author: Pedrinolla A., Modena R., Nave S., Baschirotto C., Montagni S., Barbi C., Venturelli M.
Magazine: Sport Sciences For Health
Start- and endpage: S1-S180
Link: https://doi.org/10.1007/s11332-024-01174-z
Author: Pedrinolla A., Modena R., Nave S., Baschirotto C., Montagni S., Barbi C., Venturelli M.
Magazine: Sport Sciences For Health
Start- and endpage: S1-S180
Link: https://doi.org/10.1007/s11332-024-01174-z
Title: Effects of high-intensity physical activity combined with nutritional supplementation on metabolic and functional components in subjects with dementia – preliminary data from the choko-age study
Author: Baschirotto C., Pedrinolla A., Modena R., Lucin C., Venturelli M.
Magazine: Sport Sciences For Health (2024)
Start- and endpage: S1-S180
Link: https://doi.org/10.1007/s11332-024-01174-z
Author: Baschirotto C., Pedrinolla A., Modena R., Lucin C., Venturelli M.
Magazine: Sport Sciences For Health (2024)
Start- and endpage: S1-S180
Link: https://doi.org/10.1007/s11332-024-01174-z
Title: Effect of High-Intensity Exercise and Chocolate with Vitamin-E Supplementation on Body Composition and Strength in Elderly People with Dementia: Preliminary Data from The Chokoage Study
Author: Modena R., Pedrinolla A., Baschirotto C., Nave S., Montagni S., Cavedon V., Barbi C., Giuriato G., Venturelli M., Wang E.
Magazine: Sport Sciences For Health (2024)
Start- and endpage: S1-S180
Link: https://doi.org/10.1007/s11332-024-01174-z
Author: Modena R., Pedrinolla A., Baschirotto C., Nave S., Montagni S., Cavedon V., Barbi C., Giuriato G., Venturelli M., Wang E.
Magazine: Sport Sciences For Health (2024)
Start- and endpage: S1-S180
Link: https://doi.org/10.1007/s11332-024-01174-z
Title: Neuromuscular point of view in Alzheimerʼs disease: the impact of the disease appears heterogenous between upper and lower limbs.
Author: Pedrinolla A., Modena R., Barbi C., Venturelli M.
Magazine: XV SISMES National Congress, Chieti, Italy.
Author: Pedrinolla A., Modena R., Barbi C., Venturelli M.
Magazine: XV SISMES National Congress, Chieti, Italy.
Title: High-intensity training, dark chocolate and vitamin-E against muscle mass and strength loss in elderly people with dementia
Author: Modena R., Pedrinolla A., Barbi C., Baschirotto C., Cavedon V., Giuriato G., Venturelli M.
Magazine: XV SISMES National Congress, Chieti, Italy
Author: Modena R., Pedrinolla A., Barbi C., Baschirotto C., Cavedon V., Giuriato G., Venturelli M.
Magazine: XV SISMES National Congress, Chieti, Italy
Title: Effects of high-intensity exercise training on vascular function in individuals with Alzheimer disease
Author: Baschirotto C., Pedrinolla A., Modena R., Venturelli M.
Magazine: XV SISMES National Congress, Chieti, Italy
Author: Baschirotto C., Pedrinolla A., Modena R., Venturelli M.
Magazine: XV SISMES National Congress, Chieti, Italy
Title: "ll cioccolato per combattere la malnutrizione e la fragilità negli anziani" - 03.08.22
Author: assimo Venturelli, Anna Pedrinolla, Roberto Modena, Valentina Cavedon, Chiara Milanese, Nicola Smania, Federico Schena, Cristina Fonte e Valentina Varalta.
Link: https://www.univr.it/it/comunicati-stampa/-/asset_publisher/kA9JVb3XLtHs/content/ll-cioccolato-per-combattere-la-malnutrizione-e-la-fragilita-negli-anziani-03-08-22
Author: assimo Venturelli, Anna Pedrinolla, Roberto Modena, Valentina Cavedon, Chiara Milanese, Nicola Smania, Federico Schena, Cristina Fonte e Valentina Varalta.
Link: https://www.univr.it/it/comunicati-stampa/-/asset_publisher/kA9JVb3XLtHs/content/ll-cioccolato-per-combattere-la-malnutrizione-e-la-fragilita-negli-anziani-03-08-22
Title: "Progetto Choko Age, il cioccolato come alleato contro la demenza senile"
Author: Venturelli M.
Magazine: Univrmagazine
Link: https://www.univrmagazine.it/2021/07/05/progetto-choko-age-il-cioccolato-come-alleato-contro-la-demenza-senile/
Author: Venturelli M.
Magazine: Univrmagazine
Link: https://www.univrmagazine.it/2021/07/05/progetto-choko-age-il-cioccolato-come-alleato-contro-la-demenza-senile/
Title: "Choko-Age, cioccolato e attività fisica contro il declino cognitivo"
Author: Pedrinolla A.
Magazine: Spazio50
Link: https://www.spazio50.org/choko-age-cioccolato-e-attivita-fisica-contro-il-declino-cognitivo/
Author: Pedrinolla A.
Magazine: Spazio50
Link: https://www.spazio50.org/choko-age-cioccolato-e-attivita-fisica-contro-il-declino-cognitivo/
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