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Costa SA, Severo M, Lopes C, Torres D. Association between bisphenol A exposure and cardiometabolic outcomes: A longitudinal approach. JOURNAL OF HAZARDOUS MATERIALS 2024; 476:135000. [PMID: 38909471 DOI: 10.1016/j.jhazmat.2024.135000] [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: 05/01/2024] [Revised: 06/17/2024] [Accepted: 06/20/2024] [Indexed: 06/25/2024]
Abstract
Increased cardiometabolic risk is associated with abnormalities in blood biomarkers profile and adiposity measurements. Some substances found in the food matrix and the environment, called endocrine-disrupting chemicals, may impair cardiometabolic health in the early and later stages of life. Bisphenol A (BPA) is a food contaminant that migrates from food contact materials and may act as an endocrine disruptor, negatively affecting human health. The present work aims to longitudinally assess the association between BPA exposure and cardiometabolic outcomes, considering data from Portuguese population-based birth cohort Generation XXI. Blood insulin (0.06stdβ; 95 %CI:0.03,0.09) and insulin resistance (0.05stdβ; 95 %CI:0.02,0.08) presented a significant longitudinal association with BPA daily exposure after adjustment for important variables and energy. The same findings were observed for fat mass (0.03stdβ; 95 %CI 0.01,0.06) and waist circumference (0.06stdβ; 95 %CI:0.04,0.08). For z-BMI, a significant cross-sectional (0.03stdβ; 95 %CI:0.01,0.04) and longitudinal (0.02stdβ; 95 %CI:0.00,0.04) association was found. This was the first study assessing the association between BPA exposure and health outcomes from childhood to adolescence. We found an association between BPA exposure and increased blood insulin level, insulin resistance, fat mass percentage, waist circumference and z-BMI. Our results point to the need to reduce exposure to BPA in the early stages of life.
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Affiliation(s)
- Sofia Almeida Costa
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, Porto 4050-600, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, Porto 4050-600, Portugal.
| | - Milton Severo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, Porto 4050-600, Portugal; Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua Jorge de Viterbo Ferreira 228, Porto 4050-313, Portugal
| | - Carla Lopes
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, Porto 4050-600, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, Porto 4050-600, Portugal; Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro Porto, Porto 4200-319, Portugal
| | - Duarte Torres
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, Porto 4050-600, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, Porto 4050-600, Portugal; Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Rua Dr. Roberto Frias, Porto 4200-465, Portugal
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Papadopoulou A, Karayiannis D, Dimitra G, Pafili Z. The Accuracy of Height Prediction Equations in Greek Patients: A Cross-Sectional Study. Nutrients 2024; 16:2062. [PMID: 38999810 PMCID: PMC11243520 DOI: 10.3390/nu16132062] [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: 06/05/2024] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 07/14/2024] Open
Abstract
In clinical settings, standing height measurement is often difficult to perform due to patients' inability to stand upright. Height prediction equations derived from measurements of the length of other body segments have been published; however, they are not readily applicable to all populations since ethnic differences affect the relationship between standing height and body segment length. This cross-sectional study aimed to examine the accuracy of height prediction using the Malnutrition Universal Screening Tool (MUST) height predictive equations among Greek patients and to develop new, nationally representative equations. The study population consisted of 1198 Greek adult outpatients able to stand upright without assistance and without medical conditions that affected their height. Standing height, ulna length, knee height and demi-span measurements were obtained from 599 males and 599 females. Patients were stratified into age groups of <55 and ≥55 years, <60 and ≥60 years and <65 and ≥65 years according to the categories indicated by the MUST for height prediction from alternative measurements. There were positive correlations between standing height and ulna length and knee height and demi-span length (p < 0.001) in both sexes and all age categories. A strong correlation was observed between the measured and predicted standing height using ulna length (rho = 0.870, p < 0.001), knee height (rho = 0.923, p < 0.001) and demi-span length (rho = 0.906, p < 0.001). The average difference between the MUST indicative equations' height predictions from alternative measurements and actual height was -3.04 (-3.32, -2.76), -1.21 (-1.43, -0.988) and 2.16 (1.92, 2.41), respectively. New height prediction equations for Greek patients were identified, with the predicted values closer to the measured standing heights than those predicted with the MUST indicative equations for height prediction from alternative measurements.
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Affiliation(s)
| | | | | | - Zoe Pafili
- Department of Clinical Nutrition, Evangelismos General Hospital, 10676 Athens, Greece; (A.P.); (D.K.); (G.D.)
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Costa SA, Severo M, Correia D, Carvalho C, Magalhães V, Vilela S, Cunha S, Casal S, Lopes C, Torres D. Methodological approaches for the assessment of bisphenol A exposure. Food Res Int 2023; 173:113251. [PMID: 37803563 DOI: 10.1016/j.foodres.2023.113251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 10/08/2023]
Abstract
Bisphenol A (BPA) is an endocrine disruptor used in food contact materials, by the application of polycarbonate plastics and epoxy resins. The main objective of this study is to compare the estimate of daily BPA exposure at 13 years of age and in the adult Portuguese population, using different methodological approaches, and assess the associations between this exposure and sociodemographic characteristics. METHODOLOGY Cross-sectional data of 13-years follow-up from a population-based birth cohort Generation XXI (GXXI) (n = 2804) and from the National Food, Nutrition and Physical Activity Survey (IAN-AF 2015-2016) (n = 3845, ≥18 years old) was used. Dietary information was collected through three food diaries for adolescents and two non-consecutive 24-hour-recalls for adults. To estimate the daily exposure to BPA, three methodological approaches were used. "Food groups attribution" merged the food consumption data with the concentration of BPA in food groups. "Regression tree model" and "random forest" combined food consumption information with urinary BPA, measured in a subsample of 24-hour urine (in adolescents n = 216, and in adults n = 82), both used to predict BPA exposure in the remaining sample. The fit-index of the methodologies was assessed through the root mean square error (RMSE), mean absolute error (MAE) and Spearman correlation coefficient (ρ). Associations between BPA exposure and sociodemographic variables were tested by linear regression models, adjusted for sex, age groups (in adults) and educational level. Tolerable Daily Intake (TDI) of 0.2 ng/kg body weight (bw), recently proposed by the European Food Safety Authority (EFSA), was used for the risk characterization of BPA exposure. RESULTS The "random forest" was found as the best methodology to estimate the daily BPA exposure (adolescents: RMSE = 0.989, MAE = 0.727, ρ = 0.168; adults: RMSE = 0.193, MAE = 0.147, ρ = 0.250). The median dietary BPA exposure, calculated by "food groups attribution", was 79.1 and 46.1 ng/kg bw/day for adolescents and adults, respectively, while "random forest" estimated a BPA exposure of 26.7 and 38.0 ng/kg bw/day. 99.9% of the Portuguese population presented a daily exposure above TDI. Male adolescents, females and higher educated adults, were those more exposed to BPA. CONCLUSIONS The estimated daily BPA exposure strongly depends on the methodological approach. Food groups attribution may overestimate the exposure while the random forest appears to be a better methodological approach to estimate BPA exposure. Nevertheless, for all methods, the Portuguese population presented an unsafe BPA exposure by largely exceeding the safe levels proposed by EFSA.
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Affiliation(s)
- Sofia Almeida Costa
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
| | - Milton Severo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal
| | - Daniela Correia
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro Porto, 4200-319 Porto, Portugal
| | - Catarina Carvalho
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
| | - Vânia Magalhães
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
| | - Sofia Vilela
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
| | - Sara Cunha
- LAQV-REQUIMTE, Laboratório de Bromatologia e Hidrologia, Faculdade de Farmácia, Universidade do Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal
| | - Susana Casal
- LAQV-REQUIMTE, Laboratório de Bromatologia e Hidrologia, Faculdade de Farmácia, Universidade do Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal
| | - Carla Lopes
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro Porto, 4200-319 Porto, Portugal
| | - Duarte Torres
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.
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Ma CC, Mo PC, Hsu HY, Su FC. A novel sensor-embedded holding device for monitoring upper extremity functions. Front Bioeng Biotechnol 2022; 10:976242. [PMID: 36406219 PMCID: PMC9670142 DOI: 10.3389/fbioe.2022.976242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
Abstract
There are several causes that can lead to functional weakness in the hands or upper extremities (UE), such as stroke, trauma, or aging. Therefore, evaluation and monitoring of UE rehabilitation have become essential. However, most traditional evaluation tools (TETs) and assessments require clinicians to assist or are limited to specific clinical settings. Several novel assessments might apply to wearable devices, yet those devices will still need clinicians or caretakers to help with further tests. Thus, a novel UE assessment device that is user-friendly and requires minimal assistance would be needed. The cylindrical grasp is one of the common UE movements performed in daily life. Therefore, a cylindrical sensor-embedded holding device (SEHD) for training and monitoring was developed for a usability test within this research. The SEHD has 14 force sensors with an array designed to fit holding positions and a six-axis inertial measurement unit (IMU) to monitor grip strength, hand dexterity, acceleration, and angular velocity. Six young adults, six healthy elderly participants, and three stroke survivors had participated in this study to see if the SEHD could be used as a reference to TETs. During result analyses, where the correlation coefficient analyses were applied, forearm rotation smoothness and the Purdue Pegboard Test (PPT) showed a moderate negative correlation [r (16) = −0.724, p < 0.01], and the finger independence showed a moderate negative correlation with the PPT [r (10) = −0.615, p < 0.05]. There was also a highly positive correlation between the maximum pressing task and Jamar dynamometer in maximum grip strength [r (16) = 0.821, p < 0.01]. These outcomes suggest that the SEHD with simple movements could be applied as a reference for users to monitor their UE ability.
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Affiliation(s)
- Charlie Chen Ma
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Pu-Chun Mo
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Hsiu-Yun Hsu
- Department of Physical Medicine Rehabilitation, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Fong-Chin Su
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
- Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan
- *Correspondence: Fong-Chin Su,
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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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Valerio T, de Monsabert BG, Faudot B, De Villeneuve Bargemon JB, Jaloux C, Milan JL, Vigouroux L. The effect of index finger distal interphalangeal joint arthrodesis on muscle forces and adjacent joint contact pressures. Med Biol Eng Comput 2022; 60:2537-2547. [DOI: 10.1007/s11517-022-02624-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 06/07/2022] [Indexed: 12/01/2022]
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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: 5] [Impact Index Per Article: 2.5] [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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Urinary Sodium Excretion and Adherence to the Mediterranean Diet in Older Adults. Nutrients 2021; 14:nu14010061. [PMID: 35010935 PMCID: PMC8747036 DOI: 10.3390/nu14010061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/18/2021] [Accepted: 12/22/2021] [Indexed: 11/25/2022] Open
Abstract
Despite the well-known benefits of the Mediterranean Diet (MedDiet), data on the sodium intake is scarce. This study aimed to quantify the association between sodium excretion and the adherence to the MedDiet in the elderly. A representative sample of 1500 Portuguese adults (≥65 years) was assessed (1321 were eligible for the present analysis). A 24 h urine sample was collected and analysed for creatinine and sodium. Excessive sodium intake was defined as above 2000 mg/day. The adherence to the MedDiet was assessed by the PREDIMED. A binary logistic regression model was conducted to evaluate the association between urinary sodium excretion and the adherence to the MedDiet. Odds Ratios (OR) and respective 95% Confidence Intervals (95% CI) were calculated. Excessive sodium excretion was observed in 80.0% of men and 91.5% of women whereas a high adherence to the MedDiet was reported by 42.2% of women and 46.4% of men. After adjusting for confounders, excessive sodium excretion was associated with a high adherence to the MedDiet in men (OR = 1.94; 95% CI: 1.03–3.65) but not in women. These results show that the MedDiet can be an important source of sodium and highlight the need for implementing strategies to reduce sodium intake when following a MedDiet.
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Is a Handful an Effective Way to Guide Nut Recommendations? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157812. [PMID: 34360105 PMCID: PMC8345392 DOI: 10.3390/ijerph18157812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 07/16/2021] [Accepted: 07/17/2021] [Indexed: 12/24/2022]
Abstract
Dietary guidelines recommend consuming 30 g of nuts per day to reduce the risk of chronic disease. A 'handful' is commonly used to guide consumers. Research is lacking on how this translates into actual gram amounts. This study quantified the grams of nuts represented by different portion size measures, including a 'handful' and '30 g serving' among 120 participants. Each participant was randomised to a sequence where they received three of six different nut types (from almonds, cashews, hazelnuts, macadamias, peanuts, and walnuts) and were instructed to take a: 'usual serving', 'handful', 'small handful', 'large handful', and '30 g serving' of each. Combining all nut types, the median 'handful' was 36.3 g, compared to 28.7 g for the estimated '30 g serving' and 24.8 for the 'usual serving'. The 'large handful' was approximately double the 'handful' (61.3 g), whereas the 'small handful' was about half (16.7 g). Eighty-three percent of portions chosen were at least 80% of the recommended 30 g intake when participants were asked to take a 'handful', compared to 63% for the '30 g serving'. It appears a 'handful' can be used as a practical tool to guide recommended nut intakes, and increases the amount selected compared to instructions to take a '30 g serving'.
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Ordonez Diaz T, Nichols JA. Anthropometric scaling of musculoskeletal models of the hand captures age-dependent differences in lateral pinch force. J Biomech 2021; 123:110498. [PMID: 34062348 PMCID: PMC8225253 DOI: 10.1016/j.jbiomech.2021.110498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 04/28/2021] [Accepted: 05/02/2021] [Indexed: 11/23/2022]
Abstract
Musculoskeletal models and computer simulations enable non-invasive study of muscle function and contact forces. Hand models are useful for understanding the complexities of hand strength, precision movement, and the dexterity required during daily activities. Yet, generic models fail to accurately represent the entire scope of the population, while subject-specific models are labor-intensive to create. The objective of this study was to assess the efficacy of scaled generic models to represent the broad spectrum of strength profiles across the lifespan. We examined one hundred lateral pinch simulations using a generic model of the wrist and thumb anthropometrically scaled to represent the full range of heights reported for four ages across childhood, puberty, older adolescence, and adulthood. We evaluated maximum lateral pinch force produced, muscle control strategies, and the effect of linearly scaling the maximum isometric force. Our simulations demonstrated three main concepts. First, anthropometric scaling could capture age-dependent differences in pinch strength. Second, a generic muscle control strategy is not representative of all populations. Lastly, simulations do not employ optimal fiber length to complete a lateral pinch task. These results demonstrate the potential of anthropometrically-scaled models to study hand strength across the lifespan, while also highlighting that muscle control strategies may adapt as we age. The results also provide insight to the force-length relationship of thumb muscles during lateral pinch. We conclude that anthropometric scaling can accurately represent age characteristics of the population, but subject-specific models are still necessary to represent individuals.
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Affiliation(s)
- Tamara Ordonez Diaz
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Jennifer A Nichols
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA.
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Dottor A, Sansone LG, Battista S, Mori L, Testa M. Flexion-extension strength of the index-thumb system in Italian population. A cross-sectional study to gather normative data. J Hand Ther 2021; 36:85-96. [PMID: 34253400 DOI: 10.1016/j.jht.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/03/2021] [Accepted: 05/06/2021] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Cross-sectional study. INTRODUCTION Flexion (Palmar Pinch, PP-MVC and Tip Pinch, TP-MVC) and extension (E-MVC) maximal voluntary contraction (MVC) of the index-thumb system offers a quick way to estimate the level of hands' impairment in several musculoskeletal and neurologic conditions. PURPOSE OF THE STUDY This study established normative data of PP-MVC, TP-MVC, E-MVC in the Italian population and evaluated their correlation with hand dominance, anthropometric factors, dexterity and workload level. METHODS In our study, 303 healthy people (150F, 153M) were recruited. Participants performed PP-MVC, TP-MVC and E-MVC tests per hand, conducted by using a pinch-gauge. T-test was used to analyze MVC means between sexes and between hands. One-way ANOVA was conducted to compare MVC means in male and female samples stratified by age (18-29, 30-44, 45-59, 60-74, +75). Spearman's correlation analysis was performed to determine anthropometric variables, dexterity and workload level effects on MVCs. RESULTS Medium-to-large effect sizes of age were shown in the majority of tasks. The 30 to 44 years and then +75 years age groups showed the highest and the lowest values, respectively, for both sex and both hands. Men were meanly 50% stronger, and the dominant hand showed higher values (6-10%). MVC-tests correlated moderately with weight and height weakly with dexterity and workload level. CONCLUSIONS After 30 to 44 years, hand strength declines in line with the normal process of aging that also entails muscle fibers and the reduction of daily activities in older adults. In relative terms, E-MVC showed the highest strength loss in the over 75 seconds. The difference between sexes was higher in E-MVC than in flexion MVCs. E-MVC seems to depend more on musculoskeletal architecture that differs from women to men, according to the highest correlation between E-MVC and anthropometric variables. Only high workload levels impacted hand strength. In heaviest occupations, no PP-MVCs differences were observed between hands.
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Affiliation(s)
- Alberto Dottor
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Lucia Grazia Sansone
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Simone Battista
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Laura Mori
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Marco Testa
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy.
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Guerra RS, Sousa-Santos AR, Sousa AS, Valdiviesso R, Afonso C, Moreira P, Padrão P, Borges N, Santos A, Ferro G, Martins C, Amaral TF. Prediction equations for estimating body weight in older adults. J Hum Nutr Diet 2021; 34:841-848. [PMID: 33966329 DOI: 10.1111/jhn.12879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Assessing body weight in older adults may be challenging. Hence, the present study aimed to develop and cross-validate updated and reproducible equations to estimate body weight in a large sample of older adults, namely among the older-old. METHODS In total, 1456 individuals aged ≥ 65 years, from the Nutrition UP 65 study, were included in the present analysis. The participants were randomly assigned to one of two sub-samples: development (n = 991) and validation samples (n = 465). Prediction equations using height, mid-upper arm circumference (MUAC), waist circumference (WC), calf circumference (CC) and triceps skinfold thickness (TST) were generated for the development sample using multiple regression analysis and then validated using the validation sample. RESULTS The model with five predictor variables generated the following equations: females 65-79 years: -114.682 + 0.522 × height (cm) + 0.620 × MUAC (cm) + 0.517 × WC (cm) + 0.893 × CC (cm) + 0.111 × TST (mm) (adjusted r2 = 0.883, standard error of the estimate (SEE) = 4.4); females ≥ 80 years: -110.806 + 0.494 × height (cm) + 0.637 × MUAC (cm) + 0.500 × WC (cm) + 0.986 × CC (cm) + 0.021 × TST (mm) (adjusted r2 = 0.890, SEE = 3.9); males 65-79 years: -114.875 + 0.558 × height (cm) + 0.073 × MUAC (cm) + 0.671 × WC (cm) + 0.717 × CC (cm) + 0.182 × TST(mm) (adjusted r2 = 0.820, SEE=5.0); and males ≥ 80 years: -128.789 + 0.546 × height (cm) + 0.202 × MUAC (cm) + 0.612 × WC (cm) + 1.236 × CC (cm) + 0.093 × TST (mm) (adjusted r2 = 0.906, SEE = 3.5). CONCLUSIONS Body weight can be estimated with good accuracy in older adults using these sex- and age-specific equations generated from regression models using three to five anthropometric predictor variables.
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Affiliation(s)
- Rita S Guerra
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,LAETA-INEGI - Universidade do Porto, Porto, Portugal
| | - Ana R Sousa-Santos
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Ana S Sousa
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Rui Valdiviesso
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Cláudia Afonso
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Pedro Moreira
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,CIAFEL - Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - Patrícia Padrão
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Nuno Borges
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | - Alejandro Santos
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,I3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Graça Ferro
- Alto Minho Local Health Unit, EPE, Estrada de Santa Luzia, Viana do Castelo, Portugal
| | - Cátia Martins
- Obesity Research Group, Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Teresa F Amaral
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,LAETA-INEGI - Universidade do Porto, Porto, Portugal
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13
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Gamba M, Moreira P, Borges N, Santos A, Afonso C, Amaral TF, Padrão P. Are older adults with excessive sodium intake at increased risk of hypohydration? J Hum Nutr Diet 2021; 34:834-840. [PMID: 33513297 DOI: 10.1111/jhn.12859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sodium intake is expected to affect water needs, although compensation mechanisms may not work efficiently particularly in older adults. The aim of this cross-sectional study was to quantify the association between sodium excretion and hydration status in a representative sample of Portuguese older adults. METHODS A cluster sampling approach was used, representing Portuguese older adults (≥65 years) according to sex, education level and region. From a sample size of 1500 participants, 1318 were eligible for the present analysis. A 24-h urine sample was collected, and volume, osmolality, creatinine and sodium were quantified. Free water reserve (FWR) was used to assess hydration status. Excessive sodium intake was defined as above 2000 mg day-1 as recommended by the World Health Organization. A multivariable binary logistic regression model was used to estimate the association between FWR and sodium excretion. Odds ratios (OR) and respective 95% confidence intervals (95% CI) were calculated. RESULTS Excessive sodium excretion was observed in 80.0% of women and 91.5% of men, whereas hypohydration affected 10.9% of women and 23.6% of men. After adjusting for confounders, excessive sodium excretion was associated with an increased risk of hypohydration among men (OR = 2.75; 95% CI = 1.06-7.15). CONCLUSIONS These results stress the positive association between excessive sodium intake and hypohydration in men and highlight the need for implementing strategies regarding the reduction of salt consumption and the promotion of water intake.
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Affiliation(s)
- Marta Gamba
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Pedro Moreira
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Centro de Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - Nuno Borges
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | - Alejandro Santos
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,I3S-Instituto de Investigação e Inovação em Saúde, Porto, Portugal
| | - Cláudia Afonso
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Teresa F Amaral
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,UISPA-IDMEC, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| | - Patrícia Padrão
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
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Santos Júnior GM, Geraldes AAR, Oliveira DWLD, Pereira PMG, Albuquerque RBD. Validation of anthropometric equations for predicting body mass and height in older women. REVISTA BRASILEIRA DE CINEANTROPOMETRIA E DESEMPENHO HUMANO 2021. [DOI: 10.1590/1980-0037.2021v23e77985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract To investigate the cross-validity of two equations widely used in national research to predict body mass and height in older Brazilians. Additionally, the importance of possible differences between observed and predicted BMI will be investigated with the help of equations. BM and HEI were measured using mechanical scales and portable stadiometers in a sample of 200 older women (66.6 ± 5.43 years) living in Maceió / AL - Brazil. To verify the validity of equations, the following variables were used: Student's t-test, constant error (CE), total error (TE) and standard error of estimation (SEE). To verify agreement between actual and predicted values, the Bland-Altman test was used. The comparison between BM and HEI values obtained through equations and those verified in measurements showed statistically significant differences (p <0.05). CE between predicted and measured values, TE of tested equations, as well as SEE for the prediction of variables: BM (1.66; 0.11 and 6.33), HEI (-0.02; 0.02 and 0.10) and BMI (1.47; 0.10 and 3.24) allowed determining relative values very close to actual ones (2.6%, 1.31% and 5.3% for BM, HEI and BMI respectively); however, values were not statistically significant. The equations analyzed should not be used in a general way for the population of older Brazilian women with characteristics similar to those analyzed in this study. Therefore, further studies should be carried out with the objective of constructing specific equations for the population of older women and hospitalized patients, especially the most fragile ones.
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15
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Wen J, Wang J, Xu Q, Wei Y, Zhang L, Ou J, Hong Q, Ji C, Chi X, Tong M. Hand anthropometry and its relation to grip/pinch strength in children aged 5 to 13 years. J Int Med Res 2020; 48:300060520970768. [PMID: 33275482 PMCID: PMC7720326 DOI: 10.1177/0300060520970768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To evaluate the development level of children’s physiological hand shape indicators and their relationship with grip/pinch strength. Methods Hand shape and grip/pinch strength in 1255 Chinese children aged 5 to 13 years were prospectively measured. Development curves of physiological hand shape indicators and grip/pinch strength were constructed. Results The physiological hand shape indicators (full length, middle finger length, width, and wrist thickness) and grip/pinch strength of boys and girls increased with age and showed statistically significant differences at different ages. In most age groups, hand shape indicators and grip/pinch strength were larger in boys than in girls of the same age. After puberty, the physiological hand shape indicators and grip/pinch strength increased more rapidly in girls than in boys of the same age, and the differences gradually decreased thereafter. Moreover, a significant difference in pinch strength between the right and left hands was observed in most age groups. Pearson correlation analysis showed that the physiological hand shape indicators were significantly positively correlated with grip/pinch strength, height, weight, and body mass index. Conclusions This study revealed the relationship between physiological hand shape indicators and grip/pinch strength and provided reference ranges of physiological hand shape indicators and grip/pinch strength for children.
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Affiliation(s)
- Juan Wen
- Department of Children Health Care, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.,Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Jing Wang
- Department of Children Health Care, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Qu Xu
- Department of Children Health Care, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Yan Wei
- Department of Child Health Care, The Affiliated Wuxi Children's Hospital of Nanjing Medical University, Wuxi, China
| | - Lei Zhang
- Department of Children Health Care, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Jiaxin Ou
- Department of Children Health Care, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Qin Hong
- Department of Children Health Care, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Chenbo Ji
- Department of Children Health Care, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.,Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Xia Chi
- Department of Children Health Care, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.,Institute of Pediatrics, Nanjing Medical University, Nanjing, China
| | - Meiling Tong
- Department of Children Health Care, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.,Institute of Pediatrics, Nanjing Medical University, Nanjing, China
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16
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Afonso C, Sousa-Santos AR, Santos A, Borges N, Padrão P, Moreira P, Amaral TF. Frailty status is related to general and abdominal obesity in older adults. Nutr Res 2020; 85:21-30. [PMID: 33422742 DOI: 10.1016/j.nutres.2020.10.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 08/28/2020] [Accepted: 10/23/2020] [Indexed: 02/04/2023]
Abstract
The association between frailty and obesity may differ according to the heterogeneity of body mass index (BMI) and waist circumference (WC) phenotypes in older adults. We hypothesized that the use of simple indicators of general and abdominal obesity combined, may more accurately represent obesity and allow to further elucidate on how frailty status and its criteria are related to obesity. A sample of 1444 older adults, aged ≥65 years (Nutrition UP 65 study) was included in a cross-sectional analysis. General and abdominal obesity were defined according to World Health Organization BMI and WC cut-offs, and frailty by Fried et al. phenotype. A cluster analysis defined groups according to BMI and WC levels. Overweight (BMI between 25.0 and 29.9 kg/m2; 44.6%), general obesity (BMI ≥30.0 kg/m2; 39.0%), and abdominal obesity (WC >102 cm for men and >88 cm for women) were highly frequent (66.5%). Prefrailty (odds ratio [OR]: 2.33; 95% confidence interval [CI]: 1.52-3.57) and frailty (OR: 2.87; 95% CI: 1.58-5.22) were directly associated with the "general and abdominal obesity" cluster. Regarding frailty criteria, low handgrip strength (OR: 2.29; 95% CI: 1.55-3.38) and weight loss (OR: 0.27; 95% CI: 0.14-0.52) were also associated with this cluster. In this sample of older adults presenting a high frequency of overweight and obesity, prefrailty and frailty are linked to higher levels of adiposity, but only when both general and abdominal obesity are present. Present results emphasize the importance of the evaluation of both BMI and WC in the geriatric clinical practice and suggest that older adults presenting both general and abdominal obesity should be routinely screened for frailty.
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Affiliation(s)
- Cláudia Afonso
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Ana Rita Sousa-Santos
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.
| | - Alejandro Santos
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal; I3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Nuno Borges
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal; CINTESIS - Centro de Investigação em Tecnologia e Serviços de Saúde, Porto, Portugal
| | - Patrícia Padrão
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Pedro Moreira
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; CIAFEL - Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - Teresa F Amaral
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal; UISPA, LAETA-INEGI - Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
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Association Between Anthropometric Indicators of Nutrition Status and Length of Hospital Stay in Hospitalized Patients. JPEN J Parenter Enteral Nutr 2020; 45:381-393. [DOI: 10.1002/jpen.1844] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 03/30/2020] [Indexed: 11/07/2022]
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18
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Sousa-Santos AR, Afonso C, Borges N, Santos A, Padrão P, Moreira P, F Amaral T. Sarcopenia, physical frailty, undernutrition and obesity cooccurrence among Portuguese community-dwelling older adults: results from Nutrition UP 65 cross-sectional study. BMJ Open 2020; 10:e033661. [PMID: 32546486 PMCID: PMC7305469 DOI: 10.1136/bmjopen-2019-033661] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES To investigate the coexistence of sarcopenia, frailty, undernutrition and obesity and to identify the factors associated with the cooccurrence of these conditions in an older population. DESIGN Cross-sectional. SETTING Portugal. PARTICIPANTS 1454 older adults with 65 years or older, from Nutrition UP 65 study. PRIMARY AND SECONDARY OUTCOME MEASURES Sarcopenia was identified using the European Working Group on Sarcopenia in Older People 2 guidelines and physical frailty using Fried phenotype. Mini-Nutritional Assessment-Short Form was used to ascertain undernutrition, and obesity was evaluated by body mass index. RESULTS 57.3% presented at least one condition, 38.0% were identified with one and 19.3% were identified with two or more conditions. When all preconditions were considered, 95.7% of the older adults presented at least one of these preconditions or conditions. Multinomial logistic regression multivariate analysis revealed that being male (OR 0.61; 95% CI 0.43 to 0.88), being married or in a common-law marriage (OR 0.58; 95% CI 0.40 to 0.84) and having a higher educational level (OR 0.23; 95% CI 0.07 to 0.73) were inversely associated with having two or more conditions, while age >75 years (OR 1.60; 95% CI 1.14 to 2.24), a poor self-perception of health status (OR 5.61; 95% CI 3.50 to 9.01), ≥5 medications (OR 3.11; 95% CI 1.77 to 5.46) and cognitive impairment (OR 1.84; 95% CI 1.37 to 2.48) were directly associated. CONCLUSIONS Almost three out of five older adults presented at least one of the conditions related to nutritional status, and about one in five had two or more of these occurrences. However, the low coexistence observed between all of these reinforces the need to assess them all individually during the geriatric assessment.
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Affiliation(s)
- Ana Rita Sousa-Santos
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Cláudia Afonso
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Nuno Borges
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- CINTESIS - Centro de Investigação em Tecnologia e Serviços de Saúde, Porto, Portugal
| | - Alejandro Santos
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- I3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Patrícia Padrão
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Pedro Moreira
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- CIAFEL - Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - Teresa F Amaral
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- UISPA, LAETA-INEGI - Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
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Association between living setting and malnutrition among older adults: The PEN-3S study. Nutrition 2020; 73:110660. [PMID: 32179404 DOI: 10.1016/j.nut.2019.110660] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 10/18/2019] [Accepted: 11/18/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Malnutrition is frequent among older adults, especially those living in nursing homes, but the association between residential setting and nutritional status is controversial. The aim of this study was to examine the association between living setting (nursing home versus community) and malnutrition while adjusting for demographic, socioeconomic, health-related, and psychosocial factors. METHODS This cross-sectional study included a randomly selected representative sample of Portuguese adults ≥65 y of age. Interviewers collected data regarding demographic and socioeconomic characteristics, nutritional status, physical activity, energy intake, cognitive function, self-reported general health, functional status, symptoms of depression, and loneliness. Logistic regression models were used to estimate the association between residential setting and malnutrition. RESULTS Participants were 1186 nursing home residents (72.8% women, 49.2% ≥85 y of age) and 1120 community dwellers (49% women, 21.3% ≥85 y of age). Following Mini Nutritional Assessment (MNA®) criteria, 29.6% of nursing home residents and 14.1% of community dwellers were at risk of malnutrition, whereas 2.3% and 0.3%, respectively, were malnourished. The living setting was not significantly associated with malnutrition after adjusting for functional status, symptoms of depression, and feelings of loneliness (odds ratio, 1.03; 95% confidence interval, 0.67-1.58). CONCLUSIONS Risk of malnutrition and malnutrition are more prevalent among nursing home residents than community dwellers. Physical (functional status) and mental health (symptoms of depression and loneliness) seems more relevant to nutritional status than residential setting by itself. These findings should be taken into account when designing public health policies to tackle malnutrition among older adults.
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Mendes J, Afonso C, Borges N, Santos A, Moreira P, Padrão P, Negrão R, Amaral TF. Adherence to a Mediterranean Dietary Pattern and Functional Parameters: A Cross-Sectional Study in an Older Population. J Nutr Health Aging 2020; 24:138-146. [PMID: 32003402 DOI: 10.1007/s12603-019-1300-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES In older adults, diet and physical activity are among the most important behaviours that influence health. The Mediterranean Dietary Pattern has been related to longevity and can benefit physical function in older adults. The present study aims to quantify the association of adherence to a Mediterranean Dietary Pattern with physical functioning through by handgrip strength, as well as, with sedentary behaviour based on sitting time, in a sample of older adults. METHODS A cross-sectional study was conducted in 1,491 older adults ≥ 65 years old. The adherence or non-adherence to a Mediterranean Dietary Pattern was assessed using the previously validated and translated 14 item questionnaire, the PREDIMED (Prevención com Dieta Mediterránea). Handgrip strength was measured with a Jamar Dynamometer. Sitting time per day was used as an indicator of sedentary behaviour. Multinomial logistic regressions were performed to quantify the association of adherence to a Mediterranean Dietary Pattern with handgrip strength and sitting time. RESULTS Compared to participants who adhered to a Mediterranean Dietary Pattern, those who did not adhere to this diet have a significantly higher adjusted odds ratio for low handgrip strength [adjusted odds ratio: 1.50; 95% confidence interval: 1.09-2.05], as well as for longer sitting time [adjusted odds ratio: 1.43; 95% confidence interval: 1.04-1.96]. CONCLUSION In older adults, the non-adherence to a Mediterranean Dietary Pattern was associated with both lower values of handgrip strength and longer sitting time.
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Affiliation(s)
- J Mendes
- Joana Mendes, Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal, Address: Rua Dr. Roberto Frias, 4200-465 Porto, Portugal, Telephone: +351 225 074 320/ Fax: +351 225 074 329, E-mail:
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21
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König LM, Ziesemer K, Renner B. Quantifying Actual and Perceived Inaccuracy When Estimating the Sugar, Energy Content and Portion Size of Foods. Nutrients 2019; 11:nu11102425. [PMID: 31614559 PMCID: PMC6835963 DOI: 10.3390/nu11102425] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/06/2019] [Accepted: 10/09/2019] [Indexed: 12/23/2022] Open
Abstract
In order to adhere to dietary guidelines and manage health risks, consumers need to be able to estimate with some accuracy the sugar and energy content of foods. The present study compared how well participants could estimate the sugar and energy content of foods, the weight of foods, and approximate portion size (using a hand measure estimation aid). The study had three aims. First, it aimed to investigate differences in accuracy across the four measures. Second, it aimed to examine whether these differences in accuracy between estimation measures were accurately perceived by the participants. Third, it aimed to test if estimation accuracy was related to food journaling experience, body-mass index or gender. One hundred and ninety-seven participants took part in an estimation task and filled in a questionnaire. While the participants were inaccurate when using all four estimation measures, inaccuracy was most pronounced for sugar content (ds ≥ 0.39), which was consistently overestimated by between 62.1% and 98.5% of the sample. None of the other measures showed a consistent pattern of under- or overestimation. Participants’ perceived accuracy did not match their actual accuracy (rs ≤ |0.20|, ps ≥ 0.005). Actual accuracy showed only marginal covariation with food journaling experience (ts ≤ 2.01, ps ≥ 0.049, ds ≤ 0.14), body-mass index (rs ≤ |0.15|, ps ≥ 0.041) or gender (ts ≤ 3.17, ps ≥ 0.002, ds ≤ 0.46). It is particularly challenging for consumers to estimate the sugar content of food, which might have negative consequences for health and well-being. Thus, more education about sugar content and misperceptions is needed to support consumers so that they can make healthy food choices.
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Affiliation(s)
- Laura M König
- Department of Psychology, University of Konstanz, P.O. box 47, 78457 Konstanz, Germany.
| | - Katrin Ziesemer
- Department of Psychology, University of Konstanz, P.O. box 47, 78457 Konstanz, Germany.
| | - Britta Renner
- Department of Psychology, University of Konstanz, P.O. box 47, 78457 Konstanz, Germany.
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22
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Sousa AS, Mendes J, Guerra RS, Padrão P, Moreira P, Santos A, Borges N, Afonso C, Martins C, Ferro G, Amaral TF. Sitting time and associated factors among Portuguese older adults: results from Nutrition UP 65. Eur J Ageing 2019; 17:321-330. [PMID: 32904787 DOI: 10.1007/s10433-019-00532-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Older adults are particularly susceptible to sedentary behaviours. Sitting time has been increasingly referred to as a potentially modifiable risk factor in the prevention of chronic diseases. Identifying factors associated with sitting time, particularly those that are modifiable, will allow for more effective public health strategies. This study aimed to describe sitting time among Portuguese older adults and to evaluate associated factors. A cross-sectional study including 1423 older adults ≥ 65 years old was conducted. Sitting time was assessed with the International Physical Activity Questionnaire. Socio-demographic, health, anthropometric and functional variables were collected. Bivariate and multivariate linear regression models were conducted to study the association between these variables and sitting time. The median of sitting time was 300 min/day (interquartile range = 240 min/day), which is equal to 5 h/day. The following factors were directly associated with longer sitting time: being male, age ≥ 80 years, living in Central or Southern Portugal, being retired from work, as well as presenting low physical activity, obesity or longer time to walk 4.6 metres. On the other hand, being married, having higher education and higher household income were inversely associated with longer sitting time. It can be concluded that Portuguese older adults spend a considerable amount of time sitting per day. Potentially modifiable risk factors associated with longer sitting time in this population were related to nutritional status and functional ability.
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Affiliation(s)
- Ana Sofia Sousa
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,Faculty of Health Sciences (Nutrition Sciences), Fernando Pessoa University, Praça de 9 de Abril 349, 4249-004 Porto, Portugal.,ciTechCare - Center for Innovative Care and Health Technology, IP Leiria, Rua General Norton de Matos, Apartado 4133, 2411-901 Leiria, Portugal
| | - Joana Mendes
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,Department of Biomedicine, Biochemistry Unit, Faculty of Medicine, University of Porto, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal.,I3S - Institute for Research and Innovation in Health, University of Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal
| | - Rita S Guerra
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,Faculty of Health Sciences (Nutrition Sciences), Fernando Pessoa University, Praça de 9 de Abril 349, 4249-004 Porto, Portugal.,UISPA-IDMEC, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - Patrícia Padrão
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
| | - Pedro Moreira
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal.,The Research Centre in Physical Activity, Health and Leisure, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal
| | - Alejandro Santos
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,I3S - Institute for Research and Innovation in Health, University of Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal
| | - Nuno Borges
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal
| | - Cláudia Afonso
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
| | - Cátia Martins
- Obesity Research Group, Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Graça Ferro
- Alto Minho Local Health Unit, EPE, Estrada de Santa Luzia, 4904-858 Viana do Castelo, Portugal
| | - Teresa F Amaral
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,UISPA-IDMEC, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
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23
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Madden AM, Mashanova A, Amirabdollahian F, Ghuman S, Makda M, Collinson A, Dean F, Hirsz M, Lennie S, Maynard MJ, Power B. Improved prediction equations for estimating height in adults from ethnically diverse backgrounds. Clin Nutr 2019; 39:1454-1463. [PMID: 31285079 DOI: 10.1016/j.clnu.2019.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/26/2019] [Accepted: 06/06/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND & AIMS When body height cannot be measured, it can be predicted from ulna length (UL). However, commonly used published prediction equations may not provide useful estimates in adults from all ethnicities. This study aimed to evaluate the relationship between UL and height in adults from diverse ethnic groups and to consider whether this can be used to provide useful prediction equations for height in practice. METHODS Standing height and UL were measured in 542 adults at seven UK locations. Ethnicity was self-defined using UK Census 2011 categories. Data were modelled to give two groups of height prediction equations based on UL, sex and ethnicity and these were tested against an independent dataset (n = 180). RESULTS UL and height were significantly associated overall and in all groups except one with few participants (P = 0.059). The new equations yielded predicted height (Hp) that was closer to measured height in the Asian and Black subgroups of the independent population than the Malnutrition Universal Screening Tool (MUST) equations. For Asian men, (Hp (cm) = 3.26 UL (cm) + 83.58), mean difference from measured (95% confidence intervals) was -0.6 (-2.4, +1.2); Asian women, (Hp = 3.26 UL + 77.62), mean difference +0.5 (-1.4, 2.4) cm. For Black men, Hp = 3.14 UL + 85.80, -0.4 (-2.4, 1.7); Black women, Hp = 3.14 UL + 79.55, -0.8 (-2.8, 1.2). These differences were not statistically significant while predictions from MUST equations were significantly different from measured height. CONCLUSIONS The new prediction equations provide an alternative for estimating height in adults from Asian and Black groups and give mean predicted values that are closer to measured height than MUST equations.
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Affiliation(s)
- Angela M Madden
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, AL10 9AB, UK.
| | - Alla Mashanova
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, AL10 9AB, UK
| | | | - Sandeep Ghuman
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, AL10 9AB, UK
| | - Munibah Makda
- School of Health Sciences, Liverpool Hope University, Liverpool, L16 9JD, UK
| | - Avril Collinson
- School of Health Professions, University of Plymouth, Plymouth, PL6 8BH, UK
| | - Frances Dean
- School of Health Professions, University of Plymouth, Plymouth, PL6 8BH, UK
| | - Malgorzata Hirsz
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, LS1 3HE, UK
| | - Susan Lennie
- School of Health Sciences, Robert Gordon University, Aberdeen, AB10 7QG, UK
| | - Maria J Maynard
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, LS1 3HE, UK
| | - Brian Power
- Institute for Liver and Digestive Health, University College London, London, NW3 2PF, UK
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Teixeira B, Afonso C, Sousa AS, Guerra RS, Santos A, Borges N, Moreira P, Padrão P, Amaral TF. Adherence to a Mediterranean Dietary Pattern status and associated factors among Portuguese older adults: Results from the Nutrition UP 65 cross-sectional study. Nutrition 2019; 65:91-96. [PMID: 31079018 DOI: 10.1016/j.nut.2019.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 02/06/2019] [Accepted: 03/20/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate adherence to the Mediterranean dietary pattern (MDP) and its associated factors in older Portuguese adults. METHODS A cross-sectional observational study was designed. In the context of the Nutrition UP 65 study, a national cluster sample of 1407 Portuguese individuals ≥65 y of age was analyzed. Adherence to the MDP was evaluated with the Portuguese version of the Prevention with Mediterranean Diet tool. The association between an individual's characteristics and adherence to the MDP was analyzed through hierarchical logistic regression analysis. RESULTS In this study, 43% of participants adhered to the MDP (n = 609). Higher educational level (odds ratio [OR], 2.38; 95% confidence interval [CI], 1.54-3.69), living in the center (OR, 1.35; 95% CI, 1.01-1.79), being married or living in a common-law marriage (OR, 1.54; 95% CI, 1.20-1.97), and body mass index (ORpreobese, 1.52; 95% CI, 1.02-2.25) were related with increased odds of adherence to the MDP. Otherwise, lower adherence to the MDP was found for participants who were ≥80 y of age (OR, 0.70; 95% CI, 0.52-0.94), who lived in Madeira (OR, 0.35; 95% CI, 0.14-0.89) and Azores (OR, 0.28; 95% CI, 0.08-0.99), who rated their health as moderate (OR, 0.65; 95% CI, 0.50-0.84) or as bad or very bad (OR, 0.63; 95% CI, 0.45-0.90), and those who reported six or more comorbidities (OR, 0.62; 95% CI, 0.39-0.97). CONCLUSIONS Of the sample, 57% did not adhere to the Mediterranean diet. Potentially modifiable factors associated with lower adherence to the MDP were lower educational and health status.
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Affiliation(s)
- Beatriz Teixeira
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal.
| | - Cláudia Afonso
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Ana S Sousa
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
| | - Rita S Guerra
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal; Unidade de Integração de Sistemas e Processos Automatizados (UISPA) - Instituto de Engenharia Mecânica (IDMEC), Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| | - Alejandro Santos
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal; I3S - Instituto de Investigação e Inovação em Saúde, Porto, Portugal
| | - Nuno Borges
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal; CINTESIS - Centro de Investigação em Tecnologia e Serviços de Saúde, Porto, Portugal
| | - Pedro Moreira
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Centro de Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - Patrícia Padrão
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Teresa F Amaral
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal; Unidade de Integração de Sistemas e Processos Automatizados (UISPA) - Instituto de Engenharia Mecânica (IDMEC), Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
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25
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Intarak N, Theerapanon T, Thaweesapphithak S, Suphapeetiporn K, Porntaveetus T, Shotelersuk V. Genotype-phenotype correlation and expansion of orodental anomalies in LTBP3-related disorders. Mol Genet Genomics 2019; 294:773-787. [PMID: 30887145 DOI: 10.1007/s00438-019-01547-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 03/08/2019] [Indexed: 01/30/2023]
Abstract
The latent transforming growth factor-beta-binding protein 3 (LTBP3), encoding extracellular matrix proteins, plays a role in skeletal formation. Mutations in LTBP3 have been associated with various types of skeletal dysplasia. We aimed to characterize clinical and molecular features of more patients with mutations in the gene, which may help suggest genotype-phenotype correlation. The first two East Asian patients with short stature, heart defects, and orodental anomalies having LTBP3 mutations were identified. Whole exome and Sanger sequencing revealed that the one with a novel heterozygous missense (c.2017G>T, p.Gly673Cys) mutation in LTBP3 had clinical features consistent with acromicric dysplasia (ACMICD). The variant was located in the highly conserved EGF-like calcium-binding domain adjacent to the single reported LTBP3 variant associated with ACMICD. This finding supports that LTBP3 is a disease gene for ACMICD. Another patient with a novel homozygous splice site acceptor (c.1721-2A>G) mutation in LTBP3 was affected with dental anomalies and short stature (DASS). Previously undescribed orodental features included multiple unerupted teeth, high-arched palate, and microstomia found in our patient with ACMICD, and extensive dental infection, condensing osteitis, and deviated alveolar bone formation in our patient with DASS. Our results and comprehensive reviews suggest a genotype-phenotype correlation: biallelic loss-of-function mutations cause DASS, monoallelic missense gain-of-function mutations in the EGF-like domain cause ACMICD, and monoallelic missense gain-of-function mutations with more drastic effects on the protein functions cause geleophysic dysplasia (GPHYSD3). In summary, we expand the phenotypic and genotypic spectra of LTBP3-related disorders, support that LTBP3 is a disease gene for ACMICD, and propose the genotype-phenotype correlation of LTBP3 mutations.
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Affiliation(s)
- Narin Intarak
- Genomics and Precision Dentistry Research Unit, Department of Physiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Thanakorn Theerapanon
- Genomics and Precision Dentistry Research Unit, Department of Physiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Sermporn Thaweesapphithak
- Center of Excellence for Regenerative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Kanya Suphapeetiporn
- Center of Excellence for Medical Genomics, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
- Excellence Center for Medical Genetics, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, 10330, Thailand
| | - Thantrira Porntaveetus
- Genomics and Precision Dentistry Research Unit, Department of Physiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand.
| | - Vorasuk Shotelersuk
- Center of Excellence for Medical Genomics, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
- Excellence Center for Medical Genetics, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, 10330, Thailand
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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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Affiliation(s)
- Teresa Madeira
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028Lisboa, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Catarina Peixoto-Plácido
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028Lisboa, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Nuno Sousa-Santos
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028Lisboa, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Osvaldo Santos
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028Lisboa, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Violeta Alarcão
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028Lisboa, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Beatriz Goulão
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Nuno Mendonça
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028Lisboa, Portugal
- Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK
| | - Paulo Jorge Nicola
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028Lisboa, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Agneta Yngve
- Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Asta Bye
- OsloMet – Oslo Metropolitan University, Oslo, Norway
- Regional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | | | - Teresa F Amaral
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Carla Lopes
- EPIUnit – Institute of Public Health, University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - João Gorjão Clara
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028Lisboa, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
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Baker M, Cornelson K. Gender-Based Occupational Segregation and Sex Differences in Sensory, Motor, and Spatial Aptitudes. Demography 2018; 55:1749-1775. [PMID: 30218274 DOI: 10.1007/s13524-018-0706-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Research on sex differences in humans documents gender differences in sensory, motor, and spatial aptitudes. These aptitudes, as captured by Dictionary of Occupational Titles (DOT) codes, predict the occupational choices of men and women in the directions indicated by this research. We simulate that eliminating selection on these skills reduces the Duncan index of gender-based occupational segregation by 20 % to 23 % in 1970 and 2012, respectively. Eliminating selection on DOT variables capturing other accounts of this segregation has a smaller impact.
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Affiliation(s)
- Michael Baker
- Department of Economics, University of Toronto, 150 St. George Street, Toronto, Ontario, M5S 3G7, Canada. .,National Bureau of Economic Research, Cambridge, MA, USA.
| | - Kirsten Cornelson
- Department of Economics, University of Notre Dame, 3051 Jenkins Nanovic Hall, Notre Dame, IN, 46556, USA
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Assistive Handlebar Based on Tactile Sensors: Control Inputs and Human Factors. SENSORS 2018; 18:s18082471. [PMID: 30061541 PMCID: PMC6111261 DOI: 10.3390/s18082471] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 07/17/2018] [Accepted: 07/26/2018] [Indexed: 11/17/2022]
Abstract
Tactile sensors can be used to build human-machine interfaces, for instance in isometric joysticks or handlebars. When used as input sensor device for control, questions arise related to the contact with the human, which involve ergonomic aspects. This paper focuses on the example application of driving a powered wheelchair as attendant. Since other proposals use force and torque sensors as control input variables, this paper explores the relationship between these variables and others obtained from the tactile sensor. For this purpose, a handlebar is instrumented with tactile sensors and a 6-axis force torque sensor. Several experiments are carried out with this handlebar mounted on a wheelchair and also fixed to a table. It is seen that it is possible to obtain variables well correlated with those provided by force and torque sensors. However, it is necessary to contemplate the influence of issues such as the gripping force of the human hand on the sensor or the different kinds of grasps due to different physical constitutions of humans and to the inherent random nature of the grasp. Moreover, it is seen that a first step is necessary where the contact with the hands has to stabilize, and its characteristics and settle time are obtained.
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Nachvak SM, Hedayati S, Hejazi N, Motamedi-Motlagh A, Abdollahzad H. Nutritional care and balance of energy in patients hospitalized in Iranian intensive care units. NUTR CLIN METAB 2018. [DOI: 10.1016/j.nupar.2018.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Moreira P, Sousa AS, Guerra RS, Santos A, Borges N, Afonso C, Amaral TF, Padrão P. Sodium and potassium urinary excretion and their ratio in the elderly: results from the Nutrition UP 65 study. Food Nutr Res 2018; 62:1288. [PMID: 29545733 PMCID: PMC5846206 DOI: 10.29219/fnr.v62.1288] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 01/18/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND We aimed to describe urinary sodium and potassium excretion and their ratio in a representative sample of Portuguese elderly population, according to sociodemographic characteristics and weight status. METHODS A cluster sampling approach was used, representing older Portuguese adults (≥65 years) according to age, sex, education level, and regional area within the Nutrition UP 65 study. This cross-sectional evaluation was conducted in 2015 and 2016. From a sample size of 1,500 participants, 1,318 were eligible for the present analysis, 57.3% were women, and 23.5% were aged ≥80 years. Sodium and potassium consumption was evaluated through one 24 h urinary excretion. Inadequate sodium intake was defined as ≥2,000 mg/day, inadequate potassium intake was considered as <3,510 mg/day, and inadequate sodium-to-potassium ratio was defined as >1, according to the World Health Organization cutoffs. RESULTS The proportion of the participants with an inadequate intake was 80.0% in women and 91.5% in men (sodium), 96.2% of women and 79.4% of men (potassium), and 98.4% of women and 99.1% of men (sodium-to-potassium ratio). Higher sodium adequacy was observed among the older elderly, unmarried, with lower household income, and underweight/normal weight. Higher potassium adequacy was observed in the younger elderly, married, and with higher income. CONCLUSION The majority of the Portuguese elderly population was classified as having inadequate sodium, potassium, and sodium-to-potassium ratio urinary excretion. Therefore, strategies for reducing sodium and increasing potassium intake are priorities in the Portuguese elderly population.
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Affiliation(s)
- Pedro Moreira
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Centro de Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - Ana S. Sousa
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- Escola Superior de Saúde, Instituto Politécnico de Leiria, Leiria, Portugal
| | - Rita S. Guerra
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Alejandro Santos
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- I3S-Instituto de Investigação e Inovação em Saúde, Porto, Portugal
| | - Nuno Borges
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- CINTESIS–Centre for Health Technology and Services Research, Porto, Portugal
| | - Cláudia Afonso
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Teresa F. Amaral
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- UISPA-IDMEC, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| | - Patrícia Padrão
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
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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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Affiliation(s)
- Carla Lopes
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal.,Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Duarte Torres
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Andreia Oliveira
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal.,Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Milton Severo
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal.,Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Sofia Guiomar
- National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Violeta Alarcão
- Institute of Preventive Medicine and Public Health, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Elisabete Ramos
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal.,Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Sara Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Sofia Vilela
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Luísa Oliveira
- National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sports, University of Porto, Porto, Portugal
| | - Pedro J Teixeira
- Centro Interdisciplinar de Estudo da Performance Humana, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Paulo J Nicola
- Institute of Preventive Medicine and Public Health, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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- University of Porto, Porto, Portugal
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Lopes C, Torres D, Oliveira A, Severo M, Guiomar S, Alarcão V, Vilela S, Ramos E, Rodrigues S, Oliveira L, Nicola P, Mota J, Teixeira P, Soares S. National Food, Nutrition and Physical Activity Survey of the Portuguese general population. ACTA ACUST UNITED AC 2017. [DOI: 10.2903/sp.efsa.2017.en-1341] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Carla Lopes
- University of Porto Portugal
- EPIUnit Institute of Public Health University of Porto Portugal
| | - Duarte Torres
- University of Porto Portugal
- EPIUnit Institute of Public Health University of Porto Portugal
| | - Andreia Oliveira
- University of Porto Portugal
- EPIUnit Institute of Public Health University of Porto Portugal
| | - Milton Severo
- University of Porto Portugal
- EPIUnit Institute of Public Health University of Porto Portugal
| | - Sofia Guiomar
- National Health Institute Doutor Ricardo Jorge Portugal
- University of Lisbon Portugal
| | | | - Sofia Vilela
- EPIUnit Institute of Public Health University of Porto Portugal
| | - Elisabete Ramos
- University of Porto Portugal
- EPIUnit Institute of Public Health University of Porto Portugal
| | - Sara Rodrigues
- University of Porto Portugal
- EPIUnit Institute of Public Health University of Porto Portugal
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Padrão P, Sousa AS, Guerra RS, Álvares L, Santos A, Borges N, Afonso C, Amaral TF, Moreira P. A Cross-Sectional Study on the Association between 24-h Urine Osmolality and Weight Status in Older Adults. Nutrients 2017; 9:nu9111272. [PMID: 29165353 PMCID: PMC5707744 DOI: 10.3390/nu9111272] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 11/18/2017] [Accepted: 11/20/2017] [Indexed: 01/17/2023] Open
Abstract
Data on the association between hydration and body weight in the elderly are scarce. The objective of this work was to quantify the association between 24-h urine osmolality and weight status in the elderly. A cross-sectional study was conducted within the Nutrition UP 65 study. A quota sampling was implemented to achieve a nationally representative sample of Portuguese older adults (≥65 years) according to age, sex, education and region. From a sample size of 1500 participants, 1315 were eligible for the present analysis, 57.3% were women and 23.5% were aged ≥80 years. Participants were grouped using tertiles of 24-h urine osmolality by sex. World Health Organization cutoffs were used to classify participants according to weight status. Multinomial multivariable logistic regression models were conducted to evaluate the association of tertiles of osmolality with weight status, adjusting for confounders. Odds Ratios (OR) and respective 95% Confidence Intervals (95% CI) were calculated. Being in the 3rd urine osmolality tertile (highest) was associated with a higher risk of being obese in men, OR = 1.97, 95% CI = 1.06, 3.66. No such association was found in women. These results highlight the need for implementing studies in order to clarify the association between hydration and weight status in the elderly.
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Affiliation(s)
- Patrícia Padrão
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, 4200-465 Porto, Portugal.
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal.
- Escola Superior de Saúde de Leiria, Instituto Politécnico de Leiria, 2411-901 Leiria, Portugal.
| | - Ana S Sousa
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, 4200-465 Porto, Portugal.
| | - Rita S Guerra
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, 4200-465 Porto, Portugal.
| | - Luísa Álvares
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, 4200-465 Porto, Portugal.
| | - Alejandro Santos
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, 4200-465 Porto, Portugal.
- I3S-Instituto de Investigação e Inovação em Saúde, 4200-135 Porto, Portugal.
| | - Nuno Borges
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, 4200-465 Porto, Portugal.
- CINTESIS-Centre for Health Technology and Services Research, 4200-450 Porto, Portugal.
| | - Cláudia Afonso
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, 4200-465 Porto, Portugal.
| | - Teresa F Amaral
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, 4200-465 Porto, Portugal.
- System Integration and Process Automation Unit (UISPA)-Institute of Mechanical Engineering (IDMEC), Faculdade de Engenharia, Universidade do Porto, 4200-465 Porto, Portugal.
| | - Pedro Moreira
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, 4200-465 Porto, Portugal.
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal.
- Centro de Atividade Física, Saúde e Lazer, Universidade do Porto, 4200-450 Porto, Portugal.
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Sousa-Santos AR, Afonso C, Moreira P, Padrão P, Santos A, Borges N, Amaral TF. Weakness: The most frequent criterion among pre-frail and frail older Portuguese. Arch Gerontol Geriatr 2017; 74:162-168. [PMID: 29112877 DOI: 10.1016/j.archger.2017.10.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 09/25/2017] [Accepted: 10/23/2017] [Indexed: 01/29/2023]
Abstract
AIM In Portugal, the burden of pre-frailty and frailty in community-dwelling older adults is still unknown. The purpose of this study is to estimate the frequency of frailty in a Portuguese sample with ≥ 65years and to evaluate its associated factors. We also intend to identify which criterion has more impact on the diagnosis of frailty. METHODS 1457 older adults with ≥ 65years from the Nutrition UP 65 study were evaluated in a cross-sectional analysis. Frailty was identified according to Fried et al. by the presence of three or more of the following factors: unintentional weight loss, self-reported exhaustion, slowness, weakness and low physical activity. Pre-frailty was defined as the presence of one or two of these criteria. The association between individuals' characteristics and frailty status was analysed through logistic regression analysis. RESULTS The frequency of pre-frailty and frailty is 54.3% and 21.5%, respectively. In older adults classified as pre-frail or frail, 76.7% presented weakness and 48.6% exhaustion. In multivariate analyses, frailty was associated with age >75, lower education level, being single, divorced or widower, being professionally inactive, poor self-perception of health status, not drinking alcohol, being obese and undernourished or at undernutrition risk. CONCLUSION This condition is very prevalent in Portuguese older adults, one fifth are frail whereas half are pre-frail. Weakness identified by low handgrip strength is the most prevalent criterion in pre-frail and frail Portuguese older adults.
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Affiliation(s)
- A R Sousa-Santos
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.
| | - C Afonso
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - P Moreira
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; CIAFEL - Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal
| | - P Padrão
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal
| | - A Santos
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal; I3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal
| | - N Borges
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal; CINTESIS - Centro de Investigação em Tecnologia e Serviços de Saúde, Rua Dr. Plácido da Costa, s/n, 4200-450, Porto, Portugal
| | - T F Amaral
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal; UISPA, LAETA-INEGI - Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
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Guerra RS, Fonseca I, Sousa AS, Jesus A, Pichel F, Amaral TF. ESPEN diagnostic criteria for malnutrition – A validation study in hospitalized patients. Clin Nutr 2017; 36:1326-1332. [DOI: 10.1016/j.clnu.2016.08.022] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 01/25/2016] [Accepted: 08/24/2016] [Indexed: 01/10/2023]
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Santos A, Amaral TF, Guerra RS, Sousa AS, Álvares L, Moreira P, Padrão P, Afonso C, Borges N. Vitamin D status and associated factors among Portuguese older adults: results from the Nutrition UP 65 cross-sectional study. BMJ Open 2017; 7:e016123. [PMID: 28645977 PMCID: PMC5724139 DOI: 10.1136/bmjopen-2017-016123] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 04/06/2017] [Accepted: 04/26/2017] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To evaluate vitamin D status and its associated factors in Portuguese older adults from the Nutrition UP 65 study. DESIGN Cross-sectional observational study. PARTICIPANTS AND METHODS Nationwide cluster sample of 1500 Portuguese subjects ≥65 years old. Participants were classified, according to US Institute of Medicine cut-offs, as presenting normal 25-hydroxyvitamin D (25(OH)D) levels (≥50.0 nmol/L), at risk of inadequacy (30.0-49.9 nmol/L) or at risk of deficiency (<30 nmol/L). The association between individuals' characteristics and 25(OH)D levels was analysed through multinomial logistic regression analysis. RESULTS Median 25(OH)D serum value was 36.1 (interquartile range (IQR): 35.5) nmol/L. According to the used cut-offs, 39.6% of participants were at risk of 25(OH)D deficiency and 29.4% were at risk of 25(OH)D inadequacy. In the adjusted model, having higher skin pigmentation and waist circumference >88 cm for women and >102 cm for men were associated with higher odds of 25(OH)D deficiency. Otherwise, living in Lisbon Metropolitan Area and in Madeira, 1-12 years of schooling, being married or in a common-law marriage, monthly income ≥€1000, alcohol consumption, medication or supplements with vitamin D supplement use, and blood samples collected in spring or summer were associated with lower odds of being at risk of 25(OH)D deficiency. In this model, season of blood sample collection, medication or supplements use, and waist circumference were the factors more strongly associated with 25(OH)D levels. CONCLUSIONS Despite using the conservative Institute of Medicine cut-offs, over two-thirds of these study participants presented inadequate 25(OH)D levels, warranting the implementation of corrective measures. Potentially modifiable factors were strongly associated with 25(OH)D levels in this study. These findings may be particularly relevant to the development of public health policies in southern European countries.
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Affiliation(s)
- Alejandro Santos
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- i3S-Instituto de Investigação e Inovação em Saúde, Porto, Portugal
| | - Teresa F Amaral
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- UISPA, LAETA-INEGI, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| | - Rita S Guerra
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- UISPA, LAETA-INEGI, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| | - Ana S Sousa
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Luisa Álvares
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Pedro Moreira
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Centro de Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - Patrícia Padrão
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Cláudia Afonso
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Nuno Borges
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
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Ejection time: influence of hemodynamics and site of measurement in the arterial tree. Hypertens Res 2017; 40:811-818. [PMID: 28356575 DOI: 10.1038/hr.2017.43] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 02/24/2017] [Accepted: 02/26/2017] [Indexed: 12/31/2022]
Abstract
The left ventricular ejection time is routinely measured from a peripheral arterial waveform. However, the arterial waveform undergoes constant transformation as the pulse wave propagates along the arterial tree. Our goal was to determine if the left ventricular ejection time measured peripherally in the arterial tree accurately reflected the ejection time measured through the aortic valve. Moreover, we examined/accessed the modulating influence of hemodynamics on ejection time measurements. Continuous wave Doppler waveform images through the aortic valve and the simultaneously obtained radial artery pressure waveforms were analyzed to determine central and peripheral ejection times, respectively. The peripheral ejection time was significantly longer than the simultaneously measured central ejection time (174.5±25.2 ms vs. 120.7±14.4 ms; P<0.0001; 17.4±8.7% increase). Moreover, the ejection time prolongation was accentuated at lower blood pressures, lower heart rate and lower pulse wave velocity. The time difference between centrally and peripherally measured ejection times likely reflects intrinsic vascular characteristics. Moreover, given that the ejection time also depends on blood pressure, heart rate and pulse wave velocity, peripherally measured ejection times might need to be adjusted to account for changes in these variables.
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The Effects of Hemodynamic Changes on Pulse Wave Velocity in Cardiothoracic Surgical Patients. BIOMED RESEARCH INTERNATIONAL 2016; 2016:9640457. [PMID: 27900333 PMCID: PMC5120184 DOI: 10.1155/2016/9640457] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 09/01/2016] [Indexed: 02/07/2023]
Abstract
The effect of blood pressure on pulse wave velocity (PWV) is well established. However, PWV variability with acute hemodynamic changes has not been examined in the clinical setting. The aim of the present study is to investigate the effect of hemodynamic changes on PWV in patients who undergo cardiothoracic surgery. Using data from 25 patients, we determined blood pressure (BP), heart rate (HR), and the left ventricular outflow tract (LVOT) velocity-time integral. By superimposing the radial arterial waveform on the continuous wave Doppler waveform of the LVOT, obtained by transesophageal echo, we were able to determine pulse transit time and to calculate PWV, stroke volume (SV), cardiac output (CO), and systemic vascular resistance (SVR). Increases in BP, HR, and SVR were associated with higher values for PWV. In contrast increases in SV were associated with decreases in PWV. Changes in CO were not significantly associated with PWV.
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Amaral TF, Santos A, Guerra RS, Sousa AS, Álvares L, Valdiviesso R, Afonso C, Padrão P, Martins C, Ferro G, Moreira P, Borges N. Nutritional Strategies Facing an Older Demographic: The Nutrition UP 65 Study Protocol. JMIR Res Protoc 2016; 5:e184. [PMID: 27628097 PMCID: PMC5040866 DOI: 10.2196/resprot.6037] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 08/03/2016] [Accepted: 08/03/2016] [Indexed: 01/06/2023] Open
Abstract
Background The population of Portugal is aging. The lack of data on older adults’ nutritional status and the lack of nutrition knowledge amongst health professionals, caregivers, and older adults themselves, remains a challenge. Objective The Nutrition UP 65 study aims to reduce nutritional inequalities in the older Portuguese adult population and improve knowledge regarding older Portuguese adults’ nutritional status, specifically relating to undernutrition, obesity, sarcopenia, frailty, hydration, sodium, and vitamin D statuses. Methods A representative sample of older Portuguese adults was selected. Sociodemographic, lifestyle, anthropometric, functional, and clinical data were collected. Sodium excretion, hydration, and vitamin D statuses were assessed. Results Data collection (n=1500) took place between December, 2015 and June, 2016. Results will be disseminated in national and international scientific journals, and via Portuguese media. Conclusions Nutrition UP 65 results will provide evidence for the design and implementation of effective preventive public health strategies regarding the elderly. These insights may represent relevant health gains and costs savings.
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Affiliation(s)
- Teresa F Amaral
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal.
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Madeira T, Peixoto-Plácido C, Goulão B, Mendonça N, Alarcão V, Santos N, de Oliveira RM, Yngve A, Bye A, Bergland A, Lopes C, Nicola P, Santos O, Clara JG. National survey of the Portuguese elderly nutritional status: study protocol. BMC Geriatr 2016; 16:139. [PMID: 27423703 PMCID: PMC4947358 DOI: 10.1186/s12877-016-0299-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 06/03/2016] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Worldwide we are facing a serious demographic challenge due to the dramatic growth of the population over 60 years. It is expected that the proportion of this population will nearly double from 12 to 22 %, between 2015 and 2050. This demographic shift comes with major health and socio-economic concerns. Nutrition is a fundamental determinant of both health and disease and its role in extending a healthy lifespan is the object of considerable research. Notably, malnutrition is one of the main threats to health and quality of life among the elderly. Therefore, knowledge about nutritional status among the elderly is essential for the promotion and maintenance of healthy ageing and to support the development of health protection policies and equity in elderly health care. METHODS This is a nationwide nutrition survey of the Portuguese population over 65 years old, with data collection through face-to-face interviews. A representative and random sample of community dwelling elderly and nursing homes residents will be obtained by multistage sampling stratified per main Portuguese regions, sex and age groups. Minimum sample size was estimated to be 2077 elderly (979 in the community and 1098 in nursing homes). Data will be collected on food habits and eating patterns, nutritional status, food insecurity, lifestyle, self-rated general health status and self-reported diseases, functionality, loneliness, cognitive function, emotional status and demographic and socio-economic characterization. DISCUSSION This is the first national survey to evaluate the prevalence of nutritional risk and malnutrition of the Portuguese population above 65 years old, including those living in nursing homes. It will allow the identification of population subgroups of elderly with increased odds of malnutrition and nutritional risk. In addition, this survey will contribute to the identification of psychosocial and clinical predictors of malnutrition among elderly, which is an important risk factor for other devastating medical conditions.
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Affiliation(s)
- Teresa Madeira
- Instituto de Medicina Preventiva e Saúde Pública da Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
- Instituto de Saúde Ambiental da Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
| | - Catarina Peixoto-Plácido
- Instituto de Medicina Preventiva e Saúde Pública da Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
- Instituto de Saúde Ambiental da Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
| | - Beatriz Goulão
- Instituto de Medicina Preventiva e Saúde Pública da Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
- Health Services Research Unit, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Nuno Mendonça
- Instituto de Medicina Preventiva e Saúde Pública da Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
- Institute for Ageing, Newcastle University, Newcastle-upon-tyne, NE1 7RU, UK
| | - Violeta Alarcão
- Instituto de Medicina Preventiva e Saúde Pública da Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
- Instituto de Saúde Ambiental da Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
| | - Nuno Santos
- Instituto de Medicina Preventiva e Saúde Pública da Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
- Instituto de Saúde Ambiental da Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
| | - Rita Machado de Oliveira
- Instituto de Medicina Preventiva e Saúde Pública da Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
- Instituto de Saúde Ambiental da Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
| | - Agneta Yngve
- Department of Food, Nutrition and Dietetics, Uppsala University, P.O. Box 256, SE 75 105, Uppsala, Sweden
| | - Asta Bye
- Oslo and Akershus University College of Applied Sciences, Pilestredet 46, 0167, Oslo, Norway
- Regional Advisory Unit for Palliative Care, Oslo University Hospital, Box 4965, Nydalen, 0424, Oslo, Norway
| | - Astrid Bergland
- Oslo and Akershus University College of Applied Sciences, Pilestredet 46, 0167, Oslo, Norway
| | - Carla Lopes
- EPIUnit-Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600, Porto, Portugal
- Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Paulo Nicola
- Instituto de Medicina Preventiva e Saúde Pública da Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
- Instituto de Saúde Ambiental da Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
| | - Osvaldo Santos
- Instituto de Medicina Preventiva e Saúde Pública da Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal.
- Instituto de Saúde Ambiental da Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal.
- Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal.
| | - João Gorjão Clara
- Instituto de Medicina Preventiva e Saúde Pública da Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
- Instituto de Saúde Ambiental da Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisboa, Portugal
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Estimation of stature from handprint dimensions in Egyptian population. J Forensic Leg Med 2015; 34:55-61. [PMID: 26165660 DOI: 10.1016/j.jflm.2015.05.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 05/01/2015] [Accepted: 05/20/2015] [Indexed: 11/21/2022]
Abstract
Handprint in the scene of the crime is one of the most valuable clues in identification of the assailant. There are numerous studies on estimation of stature from direct measures of hand dimensions, but using a handprint instead, there is little research on it. So this study tried to focus on handprint as a tool used in estimation of stature. One hundred right male hands and 91 right female hands were scanned, processed via Photoshop program and handprint measurements were taken using a software program. Our results showed that stature could be estimated from handprint measurements by simple and multiple regression equations with standard error of estimate was the lowest in handprint length ±4.54 cm in male and ±5.38 cm in female. It was concluded that handprint from the scene of the crime could be used for the prediction of the stature of the assailant.
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Guerra RS, Sousa AS, Fonseca I, Pichel F, Restivo MT, Ferreira S, Amaral TF. Comparative analysis of undernutrition screening and diagnostic tools as predictors of hospitalisation costs. J Hum Nutr Diet 2014; 29:165-73. [DOI: 10.1111/jhn.12288] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- R. S. Guerra
- Departamento de Bioquímica; Faculdade de Medicina da Universidade do Porto; Porto Portugal
- UISPA-IDMEC; Faculdade de Engenharia da Universidade do Porto; Porto Portugal
- Unidade de Nutrição; Centro Hospitalar do Porto; Porto Portugal
| | - A. S. Sousa
- Unidade de Nutrição; Centro Hospitalar do Porto; Porto Portugal
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto; Porto Portugal
| | - I. Fonseca
- Unidade de Nutrição; Centro Hospitalar do Porto; Porto Portugal
| | - F. Pichel
- Unidade de Nutrição; Centro Hospitalar do Porto; Porto Portugal
| | - M. T. Restivo
- UISPA-IDMEC; Faculdade de Engenharia da Universidade do Porto; Porto Portugal
| | - S. Ferreira
- Serviço de Informação de Gestão; Centro Hospitalar do Porto; Porto Portugal
| | - T. F. Amaral
- UISPA-IDMEC; Faculdade de Engenharia da Universidade do Porto; Porto Portugal
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto; Porto Portugal
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Madden AM, Smith S. Body composition and morphological assessment of nutritional status in adults: a review of anthropometric variables. J Hum Nutr Diet 2014; 29:7-25. [PMID: 25420774 DOI: 10.1111/jhn.12278] [Citation(s) in RCA: 144] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Evaluation of body composition is an important part of assessing nutritional status and provides prognostically useful data and an opportunity to monitor the effects of nutrition-related disease progression and nutritional intervention. The aim of this narrative review is to critically evaluate body composition methodology in adults, focusing on anthropometric variables. The variables considered include height, weight, body mass index and alternative indices, trunk measurements (waist and hip circumferences and sagittal abdominal diameter) and limb measurements (mid-upper arm and calf circumferences) and skinfold thickness. The importance of adhering to a defined measurement protocol, checking measurement error and the need to interpret measurements using appropriate population-specific cut-off values to identify health risks were highlighted. Selecting the optimum method for assessing body composition using anthropometry depends on the purpose (i.e. evaluating obesity or undernutrition) and requires practitioners to have a good understanding of both practical and theoretical limitations and to be able to interpret the results wisely.
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Affiliation(s)
- A M Madden
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - S Smith
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
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Guerra RS, Amaral TF, Sousa AS, Pichel F, Restivo MT, Ferreira S, Fonseca I. Handgrip strength measurement as a predictor of hospitalization costs. Eur J Clin Nutr 2014; 69:187-92. [PMID: 25369830 DOI: 10.1038/ejcn.2014.242] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 09/16/2014] [Accepted: 09/27/2014] [Indexed: 01/10/2023]
Abstract
BACKGROUND Undernutrition status at hospital admission is related to increased hospital costs. Handgrip strength (HGS) is an indicator of undernutrition, but the ability of HGS to predict hospitalization costs has yet to be studied. OBJECTIVE To explore whether HGS measurement at hospital admission can predict patient's hospitalization costs. SUBJECTS/METHODS A prospective study was conducted in a university hospital. Inpatient's (n=637) HGS and undernutrition status by Patient-Generated Subjective Global Assessment were ascertained. Multivariable linear regression analysis, computing HGS quartiles by sex (reference: fourth quartile, highest), was conducted in order to identify the independent predictors of hospitalization costs. Costs were evaluated through percentage deviation from the mean cost, after adjustment for patients' characteristics, disease severity and undernutrition status. RESULTS Being in the first or second HGS quartiles at hospital admission increased patient's hospitalization costs, respectively, by 17.5% (95% confidence interval: 2.7-32.3) and 21.4% (7.5-35.3), which translated into an increase from €375 (58-692) to €458 (161-756). After the additional adjustment for undernutrition status, being in the first or second HGS quartiles had, respectively, an economic impact of 16.6% (1.9-31.2) and 20.0% (6.2-33.8), corresponding to an increase in hospitalization expenditure from €356 (41-668) to €428 (133-724). CONCLUSIONS Low HGS at hospital admission is associated with increased hospitalization costs of between 16.6 and 20.0% after controlling for possible confounders, including undernutrition status. HGS is an inexpensive, noninvasive and easy-to-use method that has clinical potential to predict hospitalization costs.
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Affiliation(s)
- R S Guerra
- 1] Departamento de Bioquímica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal [2] UISPA-IDMEC, Faculdade de Engenharia da Universidade do Porto, Porto, Portugal [3] Unidade de Nutrição, Centro Hospitalar do Porto, Porto, Portugal
| | - T F Amaral
- 1] UISPA-IDMEC, Faculdade de Engenharia da Universidade do Porto, Porto, Portugal [2] Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
| | - A S Sousa
- 1] Unidade de Nutrição, Centro Hospitalar do Porto, Porto, Portugal [2] Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
| | - F Pichel
- Unidade de Nutrição, Centro Hospitalar do Porto, Porto, Portugal
| | - M T Restivo
- UISPA-IDMEC, Faculdade de Engenharia da Universidade do Porto, Porto, Portugal
| | - S Ferreira
- Serviço de Informação de Gestão, Centro Hospitalar do Porto, Porto, Portugal
| | - I Fonseca
- Unidade de Nutrição, Centro Hospitalar do Porto, Porto, Portugal
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Guerra RS, Fonseca I, Pichel F, Restivo MT, Amaral TF. Handgrip strength cutoff values for undernutrition screening at hospital admission. Eur J Clin Nutr 2014; 68:1315-21. [DOI: 10.1038/ejcn.2014.226] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 09/01/2014] [Accepted: 09/16/2014] [Indexed: 01/04/2023]
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