Francesco Landi is an Associate Professor of Internal Medicine (Catholic University of Rome, School of Medicine, Italy). He has the Ph.D. in Preventive Medicine. Main research interests are in geriatric assessment, nutritional problems, sarcopenia, health services for older and geriatric epidemiology. Landi serves on the Scientific Committee of Italian Geriatric Society, on the Editorial Board of international geriatric journals, and as a peer reviewer for medical journals. He has acted as the Principal Investigator in many multicenter national and international trials. Landi has over 250 peer-reviewed original papers, many of which are in the area of frailty and epidemiology.


Aim: Primary prevention is essential for reaching cardiovascular (CV) health. This is defined by seven ideal health metrics identified by the American Heart Association, with the cholesterol level as one of the major domains. The aims of the present study are to assess the prevalence of high cholesterol level and to evaluate how a healthy diet and physical activity correlates with cholesterol within a large unselected population.

Methods: All the 16.307 consecutive individuals (mean age 57.0±11.1 years; 48.4% women) who agreed to participate the Italian national campaign (Mese del Cuore, 2016) of CV prevention were included. The participants completed an online self-reported questionnaire created in the context of a CV health educational platform ( The following health metrics have been considered: never/former smoker, regular physical activity (at least two hours per week), body mass index lower than 25.0 Kg/m2, healthy diet (consumption of at least three portions of fruit and/or vegetables per day), cholesterol lower than 200mg/dl, diabetes absence and a blood pressure lower than 120/80mmHg.

Results: Participants presented, on average, 4.1±1.3 of the seven ideal CV health metrics (4.3±1.3 and 3.9±1.3 in women and men, respectively, p<0.001). Finally, in Figure 1 the synergistic effect of a healthy diet and physical activity on cholesterol levels is shown.

Conclusion: Prevalence of the seven CV health metrics was low in our population, in particular the uncontrolled cholesterol level. Social initiatives and awareness policies from health care agencies to improve the adherence to a healthy diet and physical activity programs are mandatory to promote CV health.