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Marinheiro R, Parreira L, Amador P, Mesquita D, Farinha J, Fonseca M, Esteves A, Pinheiro A, Sousa S, Silva M, Lopes C, Fernandes A, Guerreiro A, Chambel D, Caria R. P3563The influence of circadian patterand obstructive sleep apnean of blood pressure in nocturnal arrhythmias in hypertensive patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
There is growing evidence suggesting hypertension is related to the occurrence of arrhythmias. When occurring predominantly during the night, two potential entities commonly present in hypertensive patients could be related with increased arrhythmogenesis: (1) the lack of normal nocturnal dipping of blood pressure (BP) (non-dipping pattern of hypertension) or (2) obstructive sleep apnea (OSA). Thus, nocturnal arrhythmias (NAs) can identify hypertensive patients with OSA and/or non-dipping pattern, both related with adverse outcomes.
Aims
To determine if NAs are related with non-dipping hypertension, OSA or both.
Methods
We studied hypertensive patients who performed ambulatory blood pressure monitoring (ABPM) and also polysomnography and 24-hour Holter monitoring. Non-dipping pattern was considered when nocturnal BP reduction was inferior to 10%. Based on Holter monitoring, NAs were present when atrial fibrillation, frequent premature atrial contractions (PACs) (>30 PACs/hour), runs of >4 consecutive PACs, frequent premature ventricular contractions (PVCs) (>30PVCs/hour) or runs of >4 consecutive PVCs were present predominantly during sleeping hours. During polyssonography, apnoea/hypopnoea index (AHI) and oxygen saturation (SaO2) were analysed. Moderate to severe OSA was considered when AHI >15.
Results
We studied 104 patients [median age 62 (54–70) years, 65% male): 42 (40%) had moderate to severe OSA (median AHI=11 (6–26), mean SaO2=94% (92–95)] and 64 (61%) were non-dippers. NAs occurred in 18 patients (17%) and they were independently associated with AHI (Odds Ratio (OR) for a one unit increase 1.04, 95% confidence interval (CI) 1.01–1.07, p=0.03) but not with SaO2 (OR 0.96, CI 0.78–1.19, p=0.73) nor non-dipping pattern (OR 1.23, CI 0.38–3.98, p=0.72). No interaction was found between OSA and non-dipping hypertension (p=0.35). In patients with dipping pattern (n=40), AHI was higher in NAs patients comparing with no NAs patients (median AHI 29 versus 10, p=0.04), while in those with non-dipping pattern (n=64), AHI was not statistically different between patients with and without NAs (21 versus 11, p=0.12) (figure).
Figure 1
Conclusion
In this population of hypertensive patients, the presence of NAs was associated with OSA severity (i.e AHI), but not with the non-dipping pattern of hypertension. The importance of obstructive events in arrhythmogenesis seemed to be more pronounced in dipping patients, suggesting the abnormal high blood pressure during the night may also have some impact on NAs in non-dipping patients. Overall, our results suggest that OSA screening should be considered when nocturnal arrhythmias are detected in hypertensive patients, but ABPM should not be forgotten since multiple mechanisms can be involved in nocturnal arrhythmogenesis.
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Marinheiro R, Parreira L, Amador P, Mesquita D, Farinha J, Fonseca M, Esteves A, Pinheiro A, Sousa S, Silva M, Lopes C, Chambel D, Santos B, Carradas C, Caria R. P3795Should we also screen for obstructive sleep apnea in patients presenting with excessive supraventricular ectopic activity? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
It is recommended to consider obstructive sleep apnoea (OSA) screening in atrial fibrillation (AF) patients with risk factors, due to the strong evidence of an association between these two entities. Excessive supraventricular ectopic activity (ESVEA) has been proposed to be a risk factor for AF. However, strong evidence between ESVEA and OSA has not been established.
Objective
We aimed to determine if ESVEA is associated with moderate to severe OSA since its treatment may prevent AF.
Methods
We studied patients who performed polysomnography and 24-hour Holter monitoring. Patients with atrial fibrillation were excluded. ESVEA was defined as more than 30 PACs per hour (frequent PACs) or runs of >4 consecutive PACs. The circadian pattern of PACs was also evaluated. Sleeping hours were used to define “nocturnal”. Moderate to severe OSA was defined when polyssonography demonstrated a apnoea/hypopnoea index (AHI) >15. We examined the association between ESVEA and moderate to severe OSA during wakefulness and sleep.
Results
We studied 290 patients [median age 65 (55–72) years, 62% males, body mass index (BMI) 30 (27–34)]. 112 (38%) had moderate to severe OSA. Median AHI was 11 (5–24) and mean oxygen saturation was 94% (92–95). Median PACs was 35 (9–117) and 29 patients (10%) had frequent PACs. Runs of >4PACs occurred in 114 patients (39%). Forty-three patients (15%) had predominant nocturnal PACs and 42 (14%) had nocturnal runs of PACs. Multivariate logistic regression analysis demonstrated only nocturnal PACs were associated with moderate to severe OSA (p=0.027) (table 1).
Multivariate logistic regression Odds Ratio 95% Confidence Interval p-value Male gender 4.49 2.48–8.17 <0.001 Body mass index (kg/m2) 1.09 1.03–1.15 0.002 Nocturnal PACs 4.12 1.17–14.46 0.027 Variables not included in the model: age, number of PACs/h, frequent PACs (>30 PAcs/hour), runs of PACs (>4 consecutive PACs), nocturnal frequent PACs and nocturnal runs of PACs.
Conclusion
OSA screening in patients presenting with nocturnal PACs should be routinely considered, especially in male and obese. Treating moderate to severe OSA patients with CPAP has a potential benefit in preventing ESVEA and consequently AF.
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Mendes F, Paciência I, Lopes C, Santos A, Barros H, Moreira A, Moreira P. OR56: Pregnancy Exposure to Maternal Smoking and High Caffeine Intake is Associated with Increased Childhood Asthma Risk: Evidence from a Birth Cohort. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32528-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Assunção R, Alvito P, Brazão R, Carmona P, Fernandes P, Jakobsen LS, Lopes C, Martins C, Membré JM, Monteiro S, Nabais P, Thomsen ST, Torres D, Viegas S, Pires SM, Boué G. Building capacity in risk-benefit assessment of foods: Lessons learned from the RB4EU project. Trends Food Sci Technol 2019. [DOI: 10.1016/j.tifs.2019.07.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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80
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Martins C, Vidal A, De Boevre M, De Saeger S, Nunes C, Torres D, Goios A, Lopes C, Assunção R, Alvito P. Exposure assessment of Portuguese population to multiple mycotoxins: The human biomonitoring approach. Int J Hyg Environ Health 2019; 222:913-925. [DOI: 10.1016/j.ijheh.2019.06.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/18/2019] [Accepted: 06/24/2019] [Indexed: 12/11/2022]
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81
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Martins T, Vaz A, Asseiceira I, Mexia S, Pereira L, Lopes C, Azevedo P, Barreto C, Sampaio D. P317 Nutritional status and body composition in a cystic fibrosis population: comparison with a healthy population. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30610-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pinto A, Santos AC, Lopes C, Oliveira A. Dietary patterns at 7 year-old and their association with cardiometabolic health at 10 year-old. Clin Nutr 2019; 39:1195-1202. [PMID: 31133488 DOI: 10.1016/j.clnu.2019.05.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/02/2019] [Accepted: 05/05/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS Diet is usually represented as single foods or dietary patterns not related with a specific outcome, and its cardiometabolic effects at early ages are not clearly understood. This study aims to assess whether dietary patterns derived at 7 years of age have an effect on cardiometabolic health at 10 year-old. METHODS This study uses data from the Generation XXI birth cohort (northern Portugal, 2005-2006). Dietary data were collected by a validated food frequency questionnaire at 7 year-old and dietary patterns were previously derived through partial least squares (PLS), principal component analysis and latent class analysis. At 10 year-old, systolic (SBP) and diastolic (DBP) blood pressure were measured, and blood samples were drawn to analyze cardiometabolic parameters. Linear regression coefficients and 99% confidence intervals [βˆ (99% CI)] were computed (covariates: birth weight, gestational age, physical activity, maternal age and education) (n = 3350). RESULTS A dietary pattern that explains the BMI z-score at 10 year-old (PLS-1, characterized by the intake of processed meat, energy-dense foods and low in vegetables) was significantly associated with SBP (βˆ = 0.052, 99% CI:0.022; 0.082), DBP (βˆ = 0.043, 99% CI: 0.022; 0.065), triglycerides (βˆ = 0.065, 99% CI: 0.026; 0.104), HDL-cholesterol (βˆ = -0.059, 99% CI: -0.099; -0.019), LDL-cholesterol (βˆ = 0.040, 99% CI: 0.001; 0.080) and HOMA-IR (βˆ = 0.110, 99% CI: 0.071; 0.149). After further adjustment for BMI at 10 year-old, the magnitude of the associations was weakened. No associations were observed between the other derived dietary patterns and cardiometabolic health. CONCLUSIONS Adherence at 7 years of age to a dietary pattern rich in energy-dense foods, processed meat and low in vegetables, may increase several cardiometabolic parameters at 10 years of age. BMI at 10 year-old explained part of these effects.
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Prada M, Godinho C, Rodrigues DL, Lopes C, Garrido MV. The impact of a gluten-free claim on the perceived healthfulness, calories, level of processing and expected taste of food products. Food Qual Prefer 2019. [DOI: 10.1016/j.foodqual.2018.10.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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84
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Falcão F, Lopes C, Viegas E, Perez R, Aldir I, Farinha H, Carvalho A, Mirco A, Marques S, Bana E Costa T, Miranda AC, Lebre L, Peixe P, Chagas C, Mansinho K, Correia JM. Experience of a Portuguese Center: Effectiveness of Direct-Acting Antiviral Therapy for Hepatitis C. ACTA MEDICA PORT 2019; 32:189-194. [PMID: 30946789 DOI: 10.20344/amp.10655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/11/2018] [Indexed: 11/20/2022]
Abstract
INTRODUCTION In late 2014, Portugal implemented a national program for the treatment of patients with chronic hepatitis C with directacting antiviral agents. This program has made Portugal one of the first European countries to implement a structured measure of treatment to eliminate this serious public health problem. The aim of this study was to assess the effectiveness of direct-acting antiviral therapy in the treatment of patients with chronic hepatitis C virus infection. MATERIAL AND METHODS A retrospective observational study was conducted at Centro Hospitalar de Lisboa Ocidental on the national online platform from December 2014 until February 2017 and included patients with hepatitis C virus infection who underwent treatment. The primary endpoint was sustained virologic response at least 12 weeks post treatment. Data was analyzed with the SPSS 17.0 program. RESULTS During the study period, 820 patients completed therapy and achieved sufficient follow-up time to assess sustained virologic response with an overall response rate of 97.2% (n = 797) and a response rate of 98.0%, 99.5%, 90.9%, 95.1% and 94.2% for genotypes 1a, 1b, 2, 3 and 4, respectively. Data suggested that advanced fibrosis (F3/F4), human immunodeficiency virus co-infection and treatment failure with interferon and ribavirin were not negatively related with sustained virologic response in our population. Most patients (80.1%) completed treatment with ledipasvir/sofosbuvir ± ribavirin. The most common adverse events were fatigue and insomnia followed by headache and weight loss. DISCUSSION Patients predominantly had genotype 1 infection which correlates with HCV distribution in Europe, but we found a major proportion in genotype 4 which can be explained by immigration from African countries. Our patients' ages ranging from 22 to 90 years, reflected a new approach with no upper age limit. Direct-acting antivirals regimens resulted in remarkably high SVR rates compared to interferon-based regimens, which were consistent with clinical trials data. CONCLUSION Our data showed that direct-acting antiviral-based regimens are safe and have a high success rate in the treatment of patients with hepatitis C virus infection in a real-world setting.
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Vilela S, Oliveira A, Severo M, Lopes C. Chrono-Nutrition: The Relationship between Time-of-Day Energy and Macronutrient Intake and Children’s Body Weight Status. J Biol Rhythms 2019; 34:332-342. [DOI: 10.1177/0748730419838908] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The time of eating has been considered to have an important role in weight regulation. However, it is unknown if there are specific daily patterns of energy and macronutrient distribution that could be more beneficial for metabolic outcomes, especially obesity. This study aimed to assess the effect of time-of-day energy and macronutrient intake at 4 y of age on the weight status at 7 y of age. The study sample included 1961 children from the population-based birth cohort Generation XXI, with data on 3-day food diaries at 4 y and body mass index (BMI) z-scores at 7 y. Dietary patterns based on the collected data were obtained for the distribution of energy and macronutrients across eating occasions. Having a relatively higher energy intake at lunch and supper (OR = 1.19, 95% CI = 1.05 to 1.34) or at mid-afternoon (OR = 1.18, 95% CI = 1.05 to 1.34) at 4 y was associated with higher odds of becoming overweight/obese at 7 y. A relatively higher intake of fat at lunch was positively associated with later children’s odds for being overweight or obese (OR = 1.17, 95% CI = 1.03 to 1.32). These associations were independent of the effect on children’s eating behaviors related to appetite. Our results also show a detrimental relation between skipping breakfast and eating late in the day and children’s body weight. Considering all daily eating occasions, a higher proportion of energy and macronutrient intake at the main meals and a lower proportion during the afternoon and evening seems to be more beneficial for children’s weight. These results emphasize the important role of daily food intake rhythm on excessive weight gain in childhood.
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Barros L, Lopes C, Oliveira A. Child and family characteristics are associated with a dietary variety index in 4-year-old children from the Generation XXI cohort. Nutr Res 2019; 63:76-85. [DOI: 10.1016/j.nutres.2018.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 10/18/2018] [Accepted: 12/03/2018] [Indexed: 11/16/2022]
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Vilela S, Severo M, Moreira T, Oliveira A, Hetherington MM, Lopes C. Association between eating frequency and eating behaviours related to appetite from 4 to 7 years of age: Findings from the population-based birth cohort generation XXI. Appetite 2019; 132:82-90. [PMID: 30296505 DOI: 10.1016/j.appet.2018.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 10/03/2018] [Accepted: 10/04/2018] [Indexed: 11/15/2022]
Abstract
The examination of specific characteristics of eating habits in childhood and its influence on eating behaviours is needed to better understand the establishment of appetite-related eating behaviours. This study aimed to assess the association between eating frequency (EF) (main meals vs. snacks) at 4 and 7y and problematic eating behaviours and appetite-related eating behaviours at 7y. The analysis included 1359 children from the birth cohort Generation XXI who provided 3-day food diaries, at both ages, and complete information on the Child Eating Behaviour Questionnaire, at 7y. Problematic eating behaviours were assessed using parental perception of child's poor eating (including not eating enough, eating too slow or overeating) at both ages. A time-of-day approach was used to distinguish main meals from snacks. A cross-lagged analysis was performed to check the direction of the association between EF and parental concerns regarding problematic eating behaviours. Associations between EF and appetite-related eating behaviours were evaluated through linear regression models. Between 4 and 7y a moderate tracking of EF was described as well as a strong tracking of parental concerns. We found a bidirectional relationship between EF and parental concerns. Prospectively, a higher frequency of snacks at 4y was independently associated with higher scores in 'Desire to Drink' at 7y (β = 0.051, 95%CI:0.009; 0.093). At 7y, a higher EF had a positive association with 'Satiety Responsiveness' but an inverse association with 'Enjoyment of Food'. A higher number of main meals had a positive association with 'Enjoyment of Food' and 'Food Responsiveness'. In conclusion, children who had more eating occasions seem to have more food-avoidance behaviours, traits that might protect these children from gaining excessive weight.
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Cruz F, Ramos E, Lopes C, Araújo J. Tracking of food and nutrient intake from adolescence into early adulthood. Nutrition 2018; 55-56:84-90. [DOI: 10.1016/j.nut.2018.02.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 12/02/2017] [Accepted: 02/07/2018] [Indexed: 10/17/2022]
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89
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Martins C, De Boevre M, De Saeger S, Assunção R, Nunes C, Torres D, Goios A, Lopes C, Alvito P, Vidal A. Exposure of Portuguese population to mycotoxins: the contribution of human biomonitoring studies. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky214.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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90
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Madeira T, Peixoto-Plácido C, Sousa-Santos N, Santos O, Alarcão V, Goulão B, Mendonça N, Nicola PJ, Yngve A, Bye A, Bergland A, Amaral TF, Lopes C, Gorjão Clara J. Malnutrition among older adults living in Portuguese nursing homes: the PEN-3S study. Public Health Nutr 2018; 22:1-12. [PMID: 30319081 PMCID: PMC10260583 DOI: 10.1017/s1368980018002318] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 06/30/2018] [Accepted: 08/07/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To characterise the nutritional status and to identify malnutrition-associated variables of older adults living in Portuguese nursing homes. DESIGN Cross-sectional study. Data on demographic and socio-economic characteristics, self-reported morbidity, eating-related problems, nutritional status, cognitive function, depression symptoms, loneliness feelings and functional status were collected by trained nutritionists through a computer-assisted face-to-face structured interview followed by standardised anthropometric measurements. Logistic regression was used to identify factors associated with being at risk of malnutrition/malnourished. SETTING Portuguese nursing homes. SUBJECTS Nationally representative sample of the Portuguese population aged 65 years or over living in nursing homes. RESULTS A total of 1186 individuals (mean age 83·4 years; 72·8 % women) accepted to participate. According to the Mini Nutritional Assessment, 4·8 (95 % CI 3·2, 7·3) % were identified as malnourished and 38·7 (95 % CI 33·5, 44·2) % were at risk of malnutrition. These percentages increased with age and were significantly higher for women. Logistic regression showed (OR; 95 % CI) that older adults reporting no or little appetite (6·5; 2·7, 15·3), those revealing symptoms of depression (2·6; 1·6, 4·2) and those who were more dependent in their daily living activities (4·7; 2·0, 11·1) were also at higher odds of being malnourished or at risk of malnutrition. CONCLUSIONS Malnutrition and risk of malnutrition are prevalent among nursing home residents in Portugal. It is crucial to routinely screen for nutritional disorders, as well as risk factors such as symptoms of depression and lower functional status, to prevent and treat malnutrition.
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Cabral M, Araújo J, Lopes C, Ramos E. Food intake and high-sensitivity C-reactive protein levels in adolescents. Nutr Metab Cardiovasc Dis 2018; 28:1067-1074. [PMID: 30031673 DOI: 10.1016/j.numecd.2018.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 06/04/2018] [Accepted: 06/05/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS Diet comprises factors with anti and pro-inflammatory potential that can contribute to modulate obesity-induced inflammation. We aimed to assess the association between food intake and high-sensitivity C-reactive protein (hsCRP) levels in adolescents. METHODS AND RESULTS A cross-sectional analysis of 991 adolescents aged 13 years old was conducted as part of the EPITeen cohort, Porto, Portugal. Food intake was assessed by a food frequency questionnaire and thirteen food groups were defined. Anthropometric assessment was performed and serum hsCRP was measured in a fasting blood sample. hsCRP concentrations above the 75th percentile were considered high. Logistic regression was fitted to estimate the association between the intake frequency of the food groups and hsCRP, stratified by BMI and adjusted for sex, parental education and total energy intake. Median (25-75th percentiles) hsCRP concentrations increased with increasing values of BMI [normal weight: 0.20 (0.10-0.50); overweight: 0.40 (0.20-0.80); obese: 1.10 (0.40-2.15) mg/l, p < 0.001]. After adjustment for sex, parental education and total energy intake, no statistically significant associations were found amongst normal weight and overweight participants. However, among obese individuals, having as reference the first frequency category (<1 per day), a higher frequency of vegetables/legumes intake showed a decreased odds of high hsCRP levels (OR: 0.10, 95%CI 0.03-0.38, 1-3 per day; and OR: 0.14, 95%CI 0.04-0.52, >3 per day). CONCLUSION Among participants with obesity-induced higher hsCRP levels, a higher frequency of vegetable/legume intake was inversely related to hsCRP.
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Pascoal P, Rosa P, Lopes C. 112 The impact of expression of feelings on sexual satisfaction: testing the mediating role of sexual self-disclosure in a sample of cisgendered heterosexual adults in a monogamous relationship. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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93
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Martins T, Vaz A, Asseiceira I, Mexia S, Pereira L, Lopes C, Almeida Nunes P, Azevedo P, Barreto C, Sampaio D. P199 Nutritional status and eating behaviour in a CF population. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30494-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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94
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Goiana-da-Silva F, Cruz-E-Silva D, Allen L, Gregório MJ, Severo M, Nogueira PJ, Nunes AM, Graça P, Lopes C, Miraldo M, Breda J, Wickramasinghe K, Darzi A, Araújo F, Mikkelsen B. Modelling impacts of food industry co-regulation on noncommunicable disease mortality, Portugal. Bull World Health Organ 2018; 97:450-459. [PMID: 31258214 PMCID: PMC6593340 DOI: 10.2471/blt.18.220566] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 04/04/2019] [Accepted: 04/04/2019] [Indexed: 11/27/2022] Open
Abstract
Objective To model the reduction in premature deaths attributed to noncommunicable diseases if targets for reformulation of processed food agreed between the Portuguese health ministry and the food industry were met. Methods The 2015 co-regulation agreement sets voluntary targets for reducing sugar, salt and trans-fatty acids in a range of products by 2021. We obtained government data on dietary intake in 2015–2016 and on population structure and deaths from four major noncommunicable diseases over 1990–2016. We used the Preventable Risk Integrated ModEl tool to estimate the deaths averted if reformulation targets were met in full. We projected future trends in noncommunicable disease deaths using regression modelling and assessed whether Portugal was on track to reduce baseline premature deaths from noncommunicable diseases in the year 2010 by 25% by 2025, and by 30% before 2030. Findings If reformulation targets were met, we projected reductions in intake in 2015–2016 for salt from 7.6 g/day to 7.1 g/day; in total energy from 1911 kcal/day to 1897 kcal/day due to reduced sugar intake; and in total fat (% total energy) from 30.4% to 30.3% due to reduced trans-fat intake. This consumption profile would result in 248 fewer premature noncommunicable disease deaths (95% CI: 178 to 318) in 2016. We projected that full implementation of the industry agreement would reduce the risk of premature death from 11.0% in 2016 to 10.7% by 2021. Conclusion The co-regulation agreement could save lives and reduce the risk of premature death in Portugal. Nevertheless, the projected impact on mortality was insufficient to meet international targets.
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Oliveira A, Araújo J, Severo M, Correia D, Ramos E, Torres D, Lopes C. Prevalence of general and abdominal obesity in Portugal: comprehensive results from the National Food, nutrition and physical activity survey 2015-2016. BMC Public Health 2018; 18:614. [PMID: 29747603 PMCID: PMC5946450 DOI: 10.1186/s12889-018-5480-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 04/19/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND This study includes, for the first time, estimates of general and abdominal obesity prevalence for all ages of the Portuguese population, using common standardized methodologies. Results are compared by sex, age groups, educational level and geographical regions. METHODS Participants were a representative sample of the Portuguese population aged between 3 months and 84 years of age (n = 6553), enrolled in the National Food, Nutrition and Physical Activity Survey, 2015-2016. Objective anthropometric measurements included length/height, weight and body circumferences, performed according to standard procedures. Body mass index (BMI) was classified according to the World Health Organization (WHO) growth charts for children and adolescents, and WHO criteria for adults. Abdominal obesity was defined in adults as waist-hip ratio ≥ 0.85 in women or ≥ 0.90 in men. Prevalence estimates and 95% confidence intervals (95%CI) were weighted according to a complex sampling design, considering stratification by seven geographical regions and cluster effect for the selected Primary Health Care Unit. RESULTS The national prevalence of obesity is 22.3% (95%CI: 20.5-24.0), significantly higher in women. Obesity prevalence is much higher in the elderly (39.2%, 95%CI. 34.2-44.2), while children and adolescents have the lowest prevalence around 8-9%. In a regression model, three knot points denoting an inflection of obesity prevalence across the life span were observed around 5, 15 and 75 years. The prevalence of pre-obesity at national level is 34.8% (95%CI: 32.9-36.7), higher in men, and almost 18% of children and 24% of adolescents have pre-obesity. The sex- and age-standardized prevalence of obesity ranged from 38.3% (95%CI: 34.6-42.1) to 13.1% (95%CI: 10.3-15.9) for the less and the most educated individuals, respectively. Although some geographical region disparities, obesity prevalence did not significantly differed across regions (p = 0.094). The national prevalence of abdominal obesity in adults is 50.5% (95%CI: 47.9-53.1), particularly high in the elderly (80.2%). CONCLUSION Almost 60% of the general Portuguese population is obese or pre-obese. Women, elderly and less educated individuals present the highest obesity prevalence. Abdominal obesity, in particular, seems to be a relevant public health problem among the elderly men.
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Santos S, Severo M, Lopes C, Oliveira A. Anthropometric Indices Based on Waist Circumference as Measures of Adiposity in Children. Obesity (Silver Spring) 2018; 26:810-813. [PMID: 29577641 DOI: 10.1002/oby.22170] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 01/22/2018] [Accepted: 02/08/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The aim of this study was to compare the accuracy of body fat patterns and single measures in assessing body fat and to clarify the use of indices based on waist circumference as measures of adiposity in children. METHODS This study included 2,531 7-year-old children from the Generation XXI birth cohort (Porto, Portugal). Anthropometrics were obtained by trained personnel and whole-body dual-energy x-ray absorptiometry (DXA) scans were performed. RESULTS Principal component analysis identified two body fat patterns. Pattern 1 (BMI, fat mass index from tetra-polar bioelectric impedance, and waist-to-height ratio) showed strong correlations with DXA fat mass index (r = 0.85; P < 0.001), and pattern 2 (waist-to-hip, waist-to-thigh, and waist-to-weight ratios) showed moderate correlations with DXA central fat (r = 0.35; P < 0.001). Compared with single measures, body fat patterns showed similar correlations with DXA-derived measures. CONCLUSIONS Compared with single anthropometric indices, body fat patterns seem to add little value for estimating body fat in children. Waist-to-height ratio seems to be a proxy for total fat, while waist-to-hip, waist-to-thigh, and waist-to-weight ratios seem to be proxies for central fat. Further studies should address the predictive ability of waist-to-weight ratio to identify children at risk of developing cardiometabolic disease, as this was the first time describing its potential usefulness.
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Bacalhau M, Simões M, Rocha MC, Hardy SA, Vincent AE, Durães J, Macário MC, Santos MJ, Rebelo O, Lopes C, Pratas J, Mendes C, Zuzarte M, Rego AC, Girão H, Wong LJC, Taylor RW, Grazina M. Disclosing the functional changes of two genetic alterations in a patient with Chronic Progressive External Ophthalmoplegia: Report of the novel mtDNA m.7486G>A variant. Neuromuscul Disord 2018; 28:350-360. [PMID: 29398297 PMCID: PMC5952895 DOI: 10.1016/j.nmd.2017.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 11/14/2017] [Accepted: 11/15/2017] [Indexed: 01/06/2023]
Abstract
Chronic Progressive External Ophthalmoplegia (CPEO) is characterized by ptosis and ophthalmoplegia and is usually caused by mitochondrial DNA (mtDNA) deletions or mt-tRNA mutations. The aim of the present work was to clarify the genetic defect in a patient presenting with CPEO and elucidate the underlying pathogenic mechanism. This 62-year-old female first developed ptosis of the right eye at the age of 12 and subsequently the left eye at 45 years, and was found to have external ophthalmoplegia at the age of 55 years. Histopathological abnormalities were detected in the patient's muscle, including ragged-red fibres, a mosaic pattern of COX-deficient muscle fibres and combined deficiency of respiratory chain complexes I and IV. Genetic investigation revealed the "common deletion" in the patient's muscle and fibroblasts. Moreover, a novel, heteroplasmic mt-tRNASer(UCN) variant (m.7486G>A) in the anticodon loop was detected in muscle homogenate (50%), fibroblasts (11%) and blood (4%). Single-fibre analysis showed segregation with COX-deficient fibres for both genetic alterations. Assembly defects of mtDNA-encoded complexes were demonstrated in fibroblasts. Functional analyses showed significant bioenergetic dysfunction, reduction in respiration rate and ATP production and mitochondrial depolarization. Multilamellar bodies were detected by electron microscopy, suggesting disturbance in autophagy. In conclusion, we report a CPEO patient with two possible genetic origins, both segregating with biochemical and histochemical defect. The "common mtDNA deletion" is the most likely cause, yet the potential pathogenic effect of a novel mt-tRNASer(UCN) variant cannot be fully excluded.
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Marinheiro AR, Parreira L, Amador P, Lopes C, Fernandes A, Duarte T, Farinha J, Sa C, Fonseca M, Caria R. P1198Clinical impact of oral anticoagulation in patients with atrial high rates episodes. Europace 2018. [DOI: 10.1093/europace/euy015.680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Marinheiro AR, Parreira L, Amador P, Farinha J, Duarte T, Sa C, Fonseca M, Lopes C, Fernandes A, Santos B, Chambel D, Caria R. P1123Long-term prognosis of excessive premature ventricular contractions is determined by the presence and etiology of structural heart disease. Europace 2018. [DOI: 10.1093/europace/euy015.609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lopes C, Torres D, Oliveira A, Severo M, Guiomar S, Alarcão V, Ramos E, Rodrigues S, Vilela S, Oliveira L, Mota J, Teixeira PJ, Nicola PJ, Soares S, Andersen LF. National Food, Nutrition, and Physical Activity Survey of the Portuguese General Population (2015-2016): Protocol for Design and Development. JMIR Res Protoc 2018; 7:e42. [PMID: 29449204 PMCID: PMC5832902 DOI: 10.2196/resprot.8990] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 11/28/2017] [Accepted: 11/28/2017] [Indexed: 11/13/2022] Open
Abstract
Background The assessment of food consumption data using harmonized methodologies at the European level is fundamental to support the development of public policies. Portugal is one of the countries with the most outdated information on individual food consumption. Objective The objective of this study was to describe the design and methodology of the National Food, Nutrition and Physical Activity Survey, 2015-2016, developed to collect national and regional data on dietary habits, physical activity (PA), and nutritional status, in a representative sample of the Portuguese general population (3 months-84 years). Methods Participants were selected by multistage sampling, using the National Heath Registry as the sampling frame. Data collection, during 12 months, was harmonized according to European guidelines (EU-MENU, European Food Safety Authority [EFSA]). Computer-assisted personal interviewing (CAPI) was performed on a specific electronic platform synchronized with nutritional composition data and considering the FoodEx2 classification system. Dietary assessment was performed using 24-hour recalls (two nonconsecutive, 8-15 days apart) or food diaries in the case of children aged <10 years, complemented with a food propensity questionnaire; PA data (International Physical Activity Questionnaire [IPAQ], the Activity Choice Index [ACI], and 4-days PA diaries); sociodemographic data, and other health-related data were also collected. Results A sample of 6553 individuals completed the first interview, and 5811 participants completed two dietary assessments. The participation rate among eligible individuals was 33.38% (6553/19,635), considering the first interview, and 29.60% (5811/19,635) for the participants with two completed interviews (about 40% in children and adolescents and 20% in elderly individuals). Results of the survey will be disseminated in national and international scientific journals during 2018-2019. Conclusions The survey will assist policy planning and management of national and European health programs on the improvement of nutritional status and risk assessment related to food hazards, and the enhancement of PA. The infrastructures and data driven from this Survey are a solid basis to the development of a future national surveillance system on diet, PA, and other health behaviors reproducible over time.
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