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Teixeira B, Afonso C, Severo M, Carvalho C, Torres D, Lopes C, Oliveira A. Exploring dietary patterns and their association with environmental sustainability and body mass index in children and adolescents: Insights from the National Food, Nutrition and Physical Activity Survey 2015-2016. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 945:174051. [PMID: 38885700 DOI: 10.1016/j.scitotenv.2024.174051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 06/14/2024] [Accepted: 06/14/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVE To adapt four dietary patterns for children and adolescents, and study their associations with sustainability (greenhouse-gas emissions-GHGE and land use-LU), and health (body mass index-BMI) indicators. RESEARCH METHODS & PROCEDURES Dietary intake of children (3-9y) and adolescents (10-17y) from the National Food, Nutrition and Physical Activity Survey 2015-2016, Portugal (n = 1153) was assessed through two non-consecutive interviews: one-day food diaries (children), and 24-h recalls (adolescents), using an automated multiple-pass method, including a picture book for portion sizes estimation. Adherence to the Eat-Lancet and World Health Organization (WHO) recommendations, Mediterranean and Atlantic diets were evaluated using adapted versions for pediatrics of the World Index for Sustainability and Health (WISH), Diet Quality Index (DQI), Mediterranean Diet Score (MDS) and Southern-European Atlantic Diet (SEAD), respectively. Diet-related GHGE and LU were estimated using the SHARP-Indicators database. BMI (measured) z-scores were classified according to WHO criteria. A standardized weighted health-sustainability composite index was created (BMI + 0.5*GHGE+0.5*LU). Adjusted linear regression models were computed. RESULTS WISH, DQI, MDS, and SEAD had weighted mean scores (range) of 50 (0-130), 24 (9-36), 20 (8-32), and 17 (8-32), respectively. All dietary patterns were associated with lower environmental impact, particularly in children, but not with BMI. Only MDS explained both health and sustainability indicators in childhood (composite index: sd.β = -0·223,95%CI:-0·347,-0·072,R2 = 25.1 %), and adolescence (composite index: sd.β = -0·159,95%CI:-0·315,-0·003,R2 = 31.3 %). CONCLUSION The Mediterranean diet was the most related to (higher) environmental sustainability and (lower) BMI. However, in children (not adolescents), the WISH, DQI, and SEAD showed then same associations.
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Affiliation(s)
- Beatriz Teixeira
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto [Faculty of Nutrition and Food Sciences, University of Porto], Rua do Campo Alegre, 823, 4150-180 Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto [Laboratory for Integrative and Translational Research in Population Health (ITR)], Rua das Taipas 135, 4050-600 Porto, Portugal.
| | - Cláudia Afonso
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto [Faculty of Nutrition and Food Sciences, University of Porto], Rua do Campo Alegre, 823, 4150-180 Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto [Laboratory for Integrative and Translational Research in Population Health (ITR)], Rua das Taipas 135, 4050-600 Porto, Portugal.
| | - Milton Severo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto [Laboratory for Integrative and Translational Research in Population Health (ITR)], Rua das Taipas 135, 4050-600 Porto, Portugal.
| | - Catarina Carvalho
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto [Faculty of Nutrition and Food Sciences, University of Porto], Rua do Campo Alegre, 823, 4150-180 Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto [Laboratory for Integrative and Translational Research in Population Health (ITR)], Rua das Taipas 135, 4050-600 Porto, Portugal.
| | - Duarte Torres
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto [Faculty of Nutrition and Food Sciences, University of Porto], Rua do Campo Alegre, 823, 4150-180 Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto [Laboratory for Integrative and Translational Research in Population Health (ITR)], Rua das Taipas 135, 4050-600 Porto, Portugal.
| | - Carla Lopes
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto [Laboratory for Integrative and Translational Research in Population Health (ITR)], Rua das Taipas 135, 4050-600 Porto, Portugal; Faculdade de Medicina da Universidade do Porto [Faculty of Medicine, University of Porto], Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
| | - Andreia Oliveira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto [Laboratory for Integrative and Translational Research in Population Health (ITR)], Rua das Taipas 135, 4050-600 Porto, Portugal; Faculdade de Medicina da Universidade do Porto [Faculty of Medicine, University of Porto], Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
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Silva M, Rodrigues SSP, Correia DM, Rei MCC, Severo M, Costa AIA, Torres DPM, Lopes CMM. Eating out of home in Portugal: characterisation and effects on dietary intake. Br J Nutr 2024:1-13. [PMID: 38772907 DOI: 10.1017/s0007114524000990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2024]
Abstract
This cross-sectional study aims to describe and compare energy, nutrient intake and food consumption according to eating location and by age groups using data from the National Food, Nutrition and Physical Activity Survey (IAN-AF 2015/2016). Dietary intake was estimated by two non-consecutive days of food diaries (children)/24-h recalls (other age groups), and four eating location categories were defined according to the proportion of meals consumed at out-of-home locations: Home (at least 80 % of meals at home), Other Homes, School or Work and Restaurants and Other Places. The majority of meals (69·1 %) were consumed at home. Meals were also often taken at school by children and adolescents and in restaurants and similar outlets by adults and elderly. Children and adolescents in the School or Work category ate more fruit, vegetables and pulses and cereals and starchy tubers, whereas adults in this category ate more red and processed meats, sugar-sweetened beverages and sweets. Compared with Home category, Restaurants and Other Places was associated with worse diet adequacies among children (β = -1·0; 95 % CI = -2·0, -0·04), adolescents: (β = -2·4; 95 % CI = -3·2, -1·5) and adults (β = -1·3; 95 % CI = -1·6, -1·0) reflecting higher intakes of energy, fat, trans-fatty acids and SFA, and Na. The elderly consumed more free sugars and fat when eating out of home in general. Overall, findings reflect important variation in nutrient profiles by eating location, with meals taken at school or work contributing to higher consumption of nutrient-dense foods and those taken in restaurants and other similar settings implying higher consumption of energy-dense foods.
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Affiliation(s)
- Mariana Silva
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Sara Simões Pereira Rodrigues
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Daniela Macedo Correia
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Mariana Correia Castro Rei
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Milton Severo
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
| | - Ana Isabel Almeida Costa
- CATÓLICA-LISBON School of Business and Economics, Portuguese Catholic University, Lisbon, Portugal
| | - Duarte Paulo Martins Torres
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Carla Maria Moura Lopes
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
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Cardoso S, Correia D, Vilela S. Associations between chronotype, diet quality and timing of energy intake in Portuguese children and adolescents: The potential role of summer holidays. Chronobiol Int 2024; 41:647-657. [PMID: 38606916 DOI: 10.1080/07420528.2024.2339970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
Later chronotypes may be associated with lower diet quality and later timing of energy intake in paediatric age. Period of data collection of these variables may affect these parameters and inter-relationship. We aimed to assess the cross-sectional association of chronotype with a diet quality score (HEI) and caloric midpoint (time of achieving 50% of total daily energy intake), considering summer holidays, using data from the National Food, Nutrition and Physical Activity Survey 2015-2016 for 578 participants (6-14 years of age). Chronotype was estimated by the midpoint of sleep and categorized as Early, Intermediate and Late, using physical activity diaries, while outcomes using two food diaries/24 h recalls. Associations of chronotype with outcomes were assessed by linear regressions adjusted for sex, age, parental education (model 1), BMI, sports practice (model 2), and summer holidays (no/yes) (model 3). In model 2, a Late vs. Early chronotype was negatively associated with HEI (β ˆ = -0.74; 95% CI: -1.47, -0.07) and positively with caloric midpoint (β ˆ = 0.35; 95% CI: 0.02, 0.69). However, associations lost significance in model 3. The association between chronotype and dietary habits may be benefit from being studied considering school terms and summer holidays. Future larger prospective studies are needed to clarify the role of summer holidays on this inter-relationship.
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Affiliation(s)
- Sofia Cardoso
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Daniela Correia
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Sofia Vilela
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
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Magalhães V, Severo M, Costa SA, Correia D, Carvalho C, Torres D, Casal S, Cunha S, Lopes C. Bisphenol A and cardiometabolic risk in adolescents: Data from the Generation XXI cohort. Nutr Metab Cardiovasc Dis 2024; 34:1088-1096. [PMID: 38403484 DOI: 10.1016/j.numecd.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 12/12/2023] [Accepted: 01/08/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND AND AIMS Bisphenol A (BPA), an endocrine disruptor widely used in food contact materials, has been linked to a worse health profile. This study intends to estimate the association between BPA exposure and cardiometabolic patterns at adolescence. METHODS AND RESULTS Data from the Portuguese population-based birth cohort Generation XXI at the age of 13 were used (n = 2386 providing 3-day food diaries and fasting blood samples). BPA exposure was measured in 24-h urine from a subsample (n = 206) and then predicted in all participants using a random forest method and considering dietary intake from diaries. Three cardiometabolic patterns were identified (normal, modified lipid profile and higher cardiometabolic risk) using a probabilistic Gaussian mixture model. Multinomial regression models were applied to associate BPA exposure (lower, medium, higher) and cardiometabolic patterns, adjusting for confounders. The median BPA exposure was 1532 ng/d, corresponding to 29.4 ng/kg/d. Adolescents higher exposed to BPA (compared to medium and lower levels) had higher BMI z-score (kg/m2) (0.68 vs. 0.39 and 0.52, respectively; p = 0.008), higher levels of body fat (kg) (16.3 vs. 13.8 and 14.6, respectively; p = 0.002), waist circumference (76.2 vs. 73.7 and 74.9, respectively; p = 0.026), insulinemia (ug/mL) (14.1 vs. 12.7 and 13.1, respectively; p = 0.039) and triglyceridemia (mg/dL) (72.7 vs. 66.1 and 66.5, respectively; p = 0.030). After adjustment, a significant association between higher BPA and a higher cardiometabolic risk pattern was observed (OR: 2.55; 95%CI: 1.41, 4.63). CONCLUSION Higher BPA exposure was associated with a higher cardiometabolic risk pattern in adolescents, evidencing the role of food contaminants in health.
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Affiliation(s)
- Vânia Magalhães
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
| | - Milton Severo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Sofia Almeida Costa
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Daniela Correia
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Catarina Carvalho
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal; Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
| | - Duarte Torres
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal; Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
| | - Susana Casal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal; LAQV-REQUIMTE - Laboratório de Bromatologia e Hidrologia, Faculdade de Farmácia da Universidade do Porto, Porto, Portugal
| | - Sara Cunha
- LAQV-REQUIMTE - Laboratório de Bromatologia e Hidrologia, Faculdade de Farmácia da Universidade do Porto, Porto, Portugal
| | - Carla Lopes
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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Carvalho C, Severo M, Correia D, Lopes C, Torres D. Meat or meatless meals at lunch and dinner – exploring the associated factors and transition between meals. Int J Food Sci Nutr 2023:1-12. [PMID: 36971097 DOI: 10.1080/09637486.2023.2190504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
This study aimed to explore the factors associated with the consumption of meat vs. meatless meals and to assess the applicability of a multi-state model to describe transitions between lunch and dinner. Fifteen thousand four hundred and eight main meals (lunch and dinner) from a sample of adults (18-84 years, n = 3852) from the Portuguese Food, Nutrition and Physical Activity Survey (IAN-AF 2015-2016) were categorised as meat, fish, ovolactovegetarian or snack. Adjusted generalised-mixed-effects models were used to explore the associations and a time-homogeneous Markov-multi-state model was applied to study the transitions. Women, older and higher educated individuals presented higher odds of consuming meatless meals and lower hazard of transitioning to meat in the following main meal. Strategies for replacing meat with more sustainable foods should be specific towards different population groups. Studying transitions across main meals, using multi-state models, can support the development of feasible, realistic and group-specific strategies to replace meat and promote dietary variety.
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Quantitative risk-benefit assessment of Portuguese fish and other seafood species consumption scenarios. Br J Nutr 2022; 128:1997-2010. [PMID: 34872627 DOI: 10.1017/s0007114521004773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Portugal has high fish/seafood consumption, which may have both risks and benefits. This study aims to quantify the net health impact of hypothetical scenarios of fish/seafood consumption in the Portuguese population using a risk-benefit assessment methodology. Consumption data from the National Food, Nutrition and Physical Activity Survey 2015-2016 (n 5811) were used to estimate the mean exposure to methylmercury and EPA + DHA in the current and the alternative scenarios considered. Alternative scenarios (alt) were modelled using probabilistic approaches to reflect substitutions from the current consumption in the type of fish/seafood (alt1: excluding predatory fishes; alt2: including only methylmercury low-level fishes) or in the frequency of weekly fish/seafood consumption (alt3 to alt6: 1, 3, 5 or 7 times a week, replacing fish/seafood meals with meat or others). The overall health impact of these scenarios was quantified using disability-adjusted life years (DALY). In the Portuguese population, about 11 450 DALY could be prevented each year if the fish/seafood consumption increased to a daily basis. However, such a scenario would result in 1398 extra DALY considering the consumption by pregnant women and the respective risk on fetal neurodevelopment. Our findings support a recommendation to increase fish/seafood consumption up to 7 times/week. However, for pregnant women and children, special considerations must be proposed to avoid potential risks on fetal neurodevelopment due to methylmercury exposure.
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Nutritional intake and malnutrition in institutionalised and non-institutionalised older adults. Br J Nutr 2022; 128:921-931. [PMID: 34583786 DOI: 10.1017/s0007114521003925] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Malnutrition (synonym: undernutrition) is prevalent among older adults, which may be partly related to changes in dietary intake, but evidence on the link between malnutrition and diet is scarce. The aims of this study were to estimate the association between energy/nutrients intake and malnutrition, and to characterise nutritional inadequacy in institutionalised and non-institutionalised older adults. A national survey was conducted including a Portuguese representative sample of nursing home (NH) residents (n 563) and community-dwellers (n 837) aged ≥ 65 years. Data included socio-demographic characteristics, self-reported health, loneliness feelings, nutritional status (Mini Nutritional Assessment®) and dietary intake (two non-consecutive 24-h recalls). A higher energy intake was associated with lower odds of malnutrition risk (being 'at risk of malnutrition' or 'malnourished') in both settings, but only significant among NH residents after adjusting for confounders (NH: OR = 0·66, 95 % CI 0·50, 0·86; community: OR = 0·64, 95 % CI 0·37, 1·10). The intake of carbohydrates, fat, fibre, vitamin C, Na, K and Mg was inversely associated with malnutrition risk in NH residents, and protein, fat, vitamin B6, folates, Na, K, Ca and Mg intake in community-dwellers. After additional adjustment for total energy, only Na and Mg intake of community-dwellers remained significantly associated. The prevalence of inadequate nutrient intake was generally higher for the malnutrition risk group, which was particularly evident among community-dwellers. The effect of dietary intake on nutritional status seems more dependent on total energy and carbohydrates intake in institutionalised elders, whereas among community-dwellers protein and some micronutrients appear to have a greater impact.
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Interaction effects of socio-economic position in the association between eating location and diet quality in Portuguese children and adolescents: results from the National Food, Nutrition and Physical Activity Survey 2015-2016. Br J Nutr 2022; 128:940-947. [PMID: 34743770 DOI: 10.1017/s0007114521004049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study aims to evaluate the interaction effect of socio-economic environment (SEE) in the relationship between the eating location (EL) and diet quality, in children and adolescents. Data included Portuguese children and adolescents (3-17 years) from a National Dietary Survey Sample (IAN-AF 2015/2016, n 987). Dietary intake was obtained by 2-d food diaries (children) or 2-24-h-recall (adolescents). Participants were classified into four groups of EL: 'Home', 'Other homes', 'School' and 'Restaurants'. Diet quality was measured as a higher adherence to a healthy eating pattern. A previous developed socio-economic classification was used, and participants were grouped as belonging to a low socio-economic environment (LSE) or middle-high socio-economic environment (MHSE). Linear regression models were used to evaluate the association between EL and diet quality, stratified by the SEE. A statistically significant interaction effect was found (P < 0·01) for the SEE in the association between EL and diet quality. After adjustment for potential confounders, in LSE, participants belonging to 'Other homes' (β = -2·07; 95 % CI:-3·70, -0·44) and 'Restaurants' (β = -3·31; 95 % CI: -5·08, -1·54) had lower scores in the diet quality score, comparing to 'Home'. In MHSE, comparing with 'Home', 'Restaurants' showed lower diet quality (β = -1·56; 95 % CI:-2·65, -0·48), while the 'School' had better diet quality (β = 0·90; 95 % CI: 0·16, 1·64). The SEE influences the association between EL and diet quality and, belonging to more disadvantaged SEE, might represent a higher risk of unhealthy eating habits when eating out-of-home.
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Carvalho C, Correia D, Severo M, Magalhães V, Casal S, Ramos E, Lopes C, Torres D. Dietary exposure to artificial sweeteners and associated factors in the Portuguese population. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2022; 39:1206-1221. [PMID: 35604339 DOI: 10.1080/19440049.2022.2075039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study aimed to evaluate the risk of the Portuguese population's exposure to six non-nutritive intense sweeteners (NNIS) and their main associated factors. A tiered approach was used to estimate the usual exposure to the NNIS obtained from two 1-day food diaries among children and two 24-hour recalls among adults in the Portuguese national dietary survey (IAN-AF 2015-2016; age: 3-84 y; n = 5005). The tiers considered were the following: Tier 2.1 represents the most conservative tier, in which all foods reported were matched with the respective maximum permitted levels (MPLs); in Tier 2.2, the MPLs were attributed only to the foods for which the brand's label information identified the presence of an added NNIS; finally, Tier 3 was identical to Tier 2.2, but analytical NNIS occurrence data were used, instead of MPLs. The usual exposure of the Portuguese population to each NNIS was very low in all tiers across all age groups, as was the estimated prevalence of exposure above the acceptable daily intake. Soft drinks were the main source of exposure for most sweeteners, and acesulfame K and aspartame were the most consumed NNIS. The odds of exposure to at least one NNIS were higher in more highly educated adults and elderly, obese elderly, women, and people with lower healthy diet scores. The estimated risk of exceeding the safety levels of NNIS intake was very low in all evaluated population groups, even when considering the most conservative approach.
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Affiliation(s)
- Catarina Carvalho
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Daniela Correia
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Milton Severo
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Vânia Magalhães
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Susana Casal
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Faculdade de Farmácia, LAQV/REQUIMTE, Laboratório de Bromatologia e Hidrologia, Universidade do Porto, Porto, Portugal
| | - Elisabete Ramos
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Carla Lopes
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Duarte Torres
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
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10
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Costa SA, Correia D, Carvalho C, Vilela S, Severo M, Lopes C, Torres D. Risk characterization of dietary acrylamide exposure and associated factors in the Portuguese population. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2022; 39:888-900. [PMID: 35286252 DOI: 10.1080/19440049.2022.2047540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Acrylamide exposure, mainly resulting from food cooking and processing, has been associated with a higher risk of health problems, due to genotoxic effects. This study aims to estimate acrylamide dietary exposure of the Portuguese population and its associated factors. Dietary data collected through 2 non-consecutive 24 hour recalls or food diaries from a representative sample of the Portuguese population from the National Food, Nutrition and Physical Activity Survey was used (n = 5811; 3-84 years). Occurrence data of acrylamide in food were obtained from EFSA. The margins of exposure (MOE) were calculated for peripheral neuropathy and neoplastic effects. The association between acrylamide and socio-demographic characteristics was estimated through linear regression models. For the total population, the estimated median daily dietary exposure per body weight to acrylamide was 0.38 µg/kg/day, ranging from 0.14 to 0.88 µg/kg/day for the 5th and 95th percentile, respectively. Children aged between 1-2 years had the highest acrylamide exposure (median 0.75 µg/kg/day, 95th percentile 1.41 µg/kg/day). For the peripheral neuropathy and neoplastic effects, the median MOE estimated was 1140 and 451, respectively. Men compared to women had a higher acrylamide dietary exposure, as well as smokers compared to non-smokers. Elderly and less educated individuals were inversely associated with acrylamide exposure. 'Bread and rusks' (24.2%) were the main source of acrylamide, followed by 'coffee' (21.3%). The current dietary exposure to acrylamide in the Portuguese population is of concern mainly regarding neoplastic effects. Our results point to the need to reduce exposure to acrylamide, especially in men, young children, higher educated individuals and smokers.
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Affiliation(s)
- Sofia Almeida Costa
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Daniela Correia
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto Alameda Prof. Hernâni Monteiro Porto, Porto, Portugal
| | - Catarina Carvalho
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Sofia Vilela
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Milton Severo
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto Alameda Prof. Hernâni Monteiro Porto, Porto, Portugal
| | - Carla Lopes
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto Alameda Prof. Hernâni Monteiro Porto, Porto, Portugal
| | - Duarte Torres
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
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11
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Vellinga RE, Sam M, Verhagen H, Jakobsen LS, Ravn-Haren G, Sugimoto M, Torres D, Katagiri R, Thu BJ, Granby K, Hoekstra J, Temme EHM. Increasing Seaweed Consumption in the Netherlands and Portugal and the Consequences for the Intake of Iodine, Sodium, and Exposure to Chemical Contaminants: A Risk-Benefit Study. Front Nutr 2022; 8:792923. [PMID: 35071298 PMCID: PMC8770327 DOI: 10.3389/fnut.2021.792923] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/11/2021] [Indexed: 01/26/2023] Open
Abstract
Background: Seaweed has a high potential for nourishing the future planet. However, besides being beneficial, it also contains adverse components; this poses the question whether consumption of seaweed foods overall contributes beneficially or detrimentally to human health, and hence if their consumption should be promoted or restricted. Methods: This study evaluated the impact of substituting regular foods with seaweed foods in the diet, both in terms of nutritional quality (via iodine and sodium) and food safety (via arsenic, cadmium, lead, and mercury). Food consumption data from the Netherlands and Portugal (adults aged >18 years) were used, in which 10% of the amounts of pasta, bacon, and lettuce consumed were replaced by seaweed-derived products made from kelp (Saccharina latissima). Using Monte Carlo Risk Assessment software (MCRA), long-term nutrient intake and exposure to contaminants were assessed. The results obtained for the Netherlands and Portugal were compared with data from Japan, a country that has a high natural consumption of seaweed. Results: This low-tier risk-benefit study reveals that an increased seaweed consumption (as assessed by the 10% replacement with seaweed products) has no consequences in terms of intake of sodium and exposure to cadmium, lead, and mercury, and the associated (absence of) adverse health aspects. The alternative scenario almost doubled the mean iodine intake in the Netherlands (to 300 μg/day) and Portugal (to 208 μg/day) and increased the average exposure to arsenic levels in the Netherlands (to 1.02 μg/kg bw/day) and Portugal (to 1.67 μg/kg bw/day). Conclusion: The intake of iodine and exposure to arsenic in the Netherland and Portugal were certainly higher due to the modeled increase of seaweed foods. If seaweed consumption increases close to the 10% substitution, the public health consequences thereof may trigger further research.
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Affiliation(s)
- Reina Elisabeth Vellinga
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Matthijs Sam
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Hans Verhagen
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | | | - Gitte Ravn-Haren
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Minami Sugimoto
- Department of Social and Preventive Epidemiology, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Duarte Torres
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Ryoko Katagiri
- Division of Epidemiology, Center for Public Health Science, National Cancer Center, Tokyo, Japan
| | | | - Kit Granby
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Jeljer Hoekstra
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Elisabeth Helena Maria Temme
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
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12
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Magalhães V, Severo M, Torres D, Goios A, Ramos E, Lopes C. Energy intake misreport: how different methods affect its prevalence and nutrient intake estimates. Ann Hum Biol 2021; 48:557-566. [PMID: 34818956 DOI: 10.1080/03014460.2021.2010805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Although different methods for the evaluation of energy intake (EI) misreport have been described, it is unclear which one is the most appropriate. AIM To assess the performance of these methods in the prevalence of EI misreports and accuracy of nutrient intake estimates. METHODS Reports of 3,639 adults from the Portuguese National Food, Nutrition and Physical Activity Survey 2015-2016 were classified using univariate (Willett; interquartile range) and multivariate (Goldberg; predicted total energy expenditure [pTEE], testing different standard deviations [SD]) methods. Self-reported intakes were compared to their respective estimates by urinary excretion in a sub-sample of 80. The effect of the exclusion of misreporters on nutrient estimates was assessed by the differences in linear regression coefficients between plausible and total sample. RESULTS The highest prevalence of EI misreport was observed using pTEE 1SD (63.9%). Differences in the associations between nutrient self-reported intake and estimated intake using urinary biomarkers were verified with misreporters' exclusion by pTEE 1SD method (β-protein = 0.209; 95% CI = 0.074-0.529; β-potassium = 0.276; 95% CI = 0.060-0.560) and Goldberg 2SD (β-protein = 0.080; 95% CI = 0.025-0.235; β-potassium = 0.106; 95% CI = -0.048-0.246). CONCLUSIONS Multivariate methods lead to a higher prevalence of misreports and larger differences in nutrient estimates. The application of the pTEE 1SD and Goldberg 2SD methods resulted in more accurate nutrient estimates.
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Affiliation(s)
- Vânia Magalhães
- EP IUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal
| | - Milton Severo
- EP IUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto - Alameda Professor Hernâni Monteiro, Porto, Portugal
| | - Duarte Torres
- EP IUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal.,Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto - Rua Dr. Roberto Frias, Porto, Portugal
| | - Ana Goios
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto - Rua Dr. Roberto Frias, Porto, Portugal
| | - Elisabete Ramos
- EP IUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto - Alameda Professor Hernâni Monteiro, Porto, Portugal
| | - Carla Lopes
- EP IUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto - Alameda Professor Hernâni Monteiro, Porto, Portugal
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13
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Associated factors to the consumption of ultra-processed foods and its relation with dietary sources in Portugal. J Nutr Sci 2021; 10:e89. [PMID: 34733501 PMCID: PMC8532074 DOI: 10.1017/jns.2021.61] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/13/2021] [Accepted: 07/30/2021] [Indexed: 12/15/2022] Open
Abstract
Ultra-processed foods (UPFs) are common worldwide and associated with poorer health outcomes. This work aimed to explore the UPF consumption associated factors and its main dietary sources, by sex, in Portugal. Participants from the National Food, Nutrition and Physical Activity Survey (IAN-AF) 2015-2016, aged 3-84 years, were included (n 5005). Dietary intake was assessed through two 1-day food diaries/24 h recalls. UPFs were identified using the NOVA classification. Associations were evaluated through linear regression models. Median UPF consumption was 257 g/d (10⋅6 % of total quantity; 23⋅8 % of total energy). Adolescents were those with higher consumption (490 g/d). Compared to adults, younger ages were positively associated with UPF consumption (e.g. adolescents (-females: 192, 95 % confidence interval (CI): 135, 249; -males: 327, 95 % CI: 277, 377)). A lower educational level was associated with lower UPF consumption (-females: -63; 95 % CI: -91, -34; -males: -68; 95 % CI: -124, -12). Also, a lower UPF consumption was observed in married males/couples compared to singles (: -48, 95 % CI: -96, -1). Furthermore, female current/former smokers were associated with a higher UPF consumption v. never smokers (: 79, 95 % CI: 41, 118; : 42, 95 % CI: 8, 75, respectively). Main UPF sources were yoghurts, soft drinks and cold meats/sausages differing strongly by sex, age and education level. Yoghurts containing additives were the main contributors to the UPF consumption in children and adult females from all education (~20 %). Soft drinks were leaders in adolescents (females: 26⋅0 %; males: 31⋅6 %) and young male adults (24⋅4 %). Cold meats/sausages stood out among low-educated males (20⋅5 %). Males, younger age groups, higher education, children with less-educated parents, married/couple males and smoking females were positively associated with UPF consumption.
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14
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Oliveira A, Lopes C, Torres D, Ramos E, Severo M. Application of a Latent Transition Model to Estimate the Usual Prevalence of Dietary Patterns. Nutrients 2020; 13:nu13010133. [PMID: 33396483 PMCID: PMC7823363 DOI: 10.3390/nu13010133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 11/30/2022] Open
Abstract
Background: This study aims to derive habitual dietary patterns of the Portuguese adult population by applying two methodological approaches: a latent class model and a latent transition model. The novel application of the latent transition model allows us to determine the day-to-day variability of diet and to calculate the usual prevalence of dietary patterns. Methods: Participants are from the National Food, Nutrition and Physical Activity Survey of the Portuguese population, 2015–2016 (2029 women; 1820 men, aged ≥18 years). Diet was collected by two 24 h dietary recalls (8–15 days apart). Dietary patterns were derived by: (1) a latent class model using the arithmetic mean of food weigh intake, with concomitant variables (age and sex); (2) a latent transition model allowing the transition from one pattern to another, with the same concomitant variables. Results: Six dietary patterns were identified by a latent class model. By using a latent transition model, three dietary patterns were identified: “In-transition to Western” (higher red meat and alcohol intake; followed by middle-aged men), “Western” (higher meats/eggs and energy-dense foods intake; followed by younger men), and “Traditional-Healthier” (higher intake of fruit, vegetables and fish, characteristic of older women). Most individuals followed the same pattern on both days, but around 26% transited between “In-transition to Western” and “Western”. The prevalence of the dietary patterns using a single recall day (40%, 27%, 33%, respectively) is different from the usual prevalence obtained by the latent transition probabilities (48%, 36%, 16%). Conclusion: Three dietary patterns, largely dependent on age and sex, were identified for the Portuguese adult population: “In-transition to Western” (48%), “Western” (36%), and “Traditional-Healthier” (16%), but 26% were transient between patterns. Dietary patterns are, in general, deviating from traditional habits.
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Affiliation(s)
- Andreia Oliveira
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (C.L.); (D.T.); (E.R.); (M.S.)
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal
- Correspondence:
| | - Carla Lopes
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (C.L.); (D.T.); (E.R.); (M.S.)
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal
| | - Duarte Torres
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (C.L.); (D.T.); (E.R.); (M.S.)
- Faculty of Nutrition and Food Sciences, University of Porto, Rua do Campo Alegre 823, 4150-180 Porto, Portugal
| | - Elisabete Ramos
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (C.L.); (D.T.); (E.R.); (M.S.)
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal
| | - Milton Severo
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (C.L.); (D.T.); (E.R.); (M.S.)
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal
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15
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Beckmann M, Wilson T, Lloyd AJ, Torres D, Goios A, Willis ND, Lyons L, Phillips H, Mathers JC, Draper J. Challenges Associated With the Design and Deployment of Food Intake Urine Biomarker Technology for Assessment of Habitual Diet in Free-Living Individuals and Populations-A Perspective. Front Nutr 2020; 7:602515. [PMID: 33344495 PMCID: PMC7745244 DOI: 10.3389/fnut.2020.602515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/29/2020] [Indexed: 12/27/2022] Open
Abstract
Improvement of diet at the population level is a cornerstone of national and international strategies for reducing chronic disease burden. A critical challenge in generating robust data on habitual dietary intake is accurate exposure assessment. Self-reporting instruments (e.g., food frequency questionnaires, dietary recall) are subject to reporting bias and serving size perceptions, while weighed dietary assessments are unfeasible in large-scale studies. However, secondary metabolites derived from individual foods/food groups and present in urine provide an opportunity to develop potential biomarkers of food intake (BFIs). Habitual dietary intake assessment in population surveys using biomarkers presents several challenges, including the need to develop affordable biofluid collection methods, acceptable to participants that allow collection of informative samples. Monitoring diet comprehensively using biomarkers requires analytical methods to quantify the structurally diverse mixture of target biomarkers, at a range of concentrations within urine. The present article provides a perspective on the challenges associated with the development of urine biomarker technology for monitoring diet exposure in free-living individuals with a view to its future deployment in "real world" situations. An observational study (n = 95), as part of a national survey on eating habits, provided an opportunity to explore biomarker measurement in a free-living population. In a second food intervention study (n = 15), individuals consumed a wide range of foods as a series of menus designed specifically to achieve exposure reflecting a diversity of foods commonly consumed in the UK, emulating normal eating patterns. First Morning Void urines were shown to be suitable samples for biomarker measurement. Triple quadrupole mass spectrometry, coupled with liquid chromatography, was used to assess simultaneously the behavior of a panel of 54 potential BFIs. This panel of chemically diverse biomarkers, reporting intake of a wide range of commonly-consumed foods, can be extended successfully as new biomarker leads are discovered. Towards validation, we demonstrate excellent discrimination of eating patterns and quantitative relationships between biomarker concentrations in urine and the intake of several foods. In conclusion, we believe that the integration of information from BFI technology and dietary self-reporting tools will expedite research on the complex interactions between dietary choices and health.
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Affiliation(s)
- Manfred Beckmann
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
| | - Thomas Wilson
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
| | - Amanda J. Lloyd
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
| | - Duarte Torres
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- Epidemiology Research Unit (EPIUnit), Institute of Public Health, University of Porto, Porto, Portugal
| | - Ana Goios
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- Epidemiology Research Unit (EPIUnit), Institute of Public Health, University of Porto, Porto, Portugal
| | - Naomi D. Willis
- Human Nutrition Research Centre, Population Health Sciences Institute, William Leech Building, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - Laura Lyons
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
| | - Helen Phillips
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
| | - John C. Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, William Leech Building, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - John Draper
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
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