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Teixeira B, Afonso C, Severo M, Carvalho C, Torres D, Lopes C, Oliveira A. Exploring dietary patterns and their association with environmental sustainability and body mass index in children and adolescents: Insights from the National Food, Nutrition and Physical Activity Survey 2015-2016. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 945:174051. [PMID: 38885700 DOI: 10.1016/j.scitotenv.2024.174051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 06/14/2024] [Accepted: 06/14/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVE To adapt four dietary patterns for children and adolescents, and study their associations with sustainability (greenhouse-gas emissions-GHGE and land use-LU), and health (body mass index-BMI) indicators. RESEARCH METHODS & PROCEDURES Dietary intake of children (3-9y) and adolescents (10-17y) from the National Food, Nutrition and Physical Activity Survey 2015-2016, Portugal (n = 1153) was assessed through two non-consecutive interviews: one-day food diaries (children), and 24-h recalls (adolescents), using an automated multiple-pass method, including a picture book for portion sizes estimation. Adherence to the Eat-Lancet and World Health Organization (WHO) recommendations, Mediterranean and Atlantic diets were evaluated using adapted versions for pediatrics of the World Index for Sustainability and Health (WISH), Diet Quality Index (DQI), Mediterranean Diet Score (MDS) and Southern-European Atlantic Diet (SEAD), respectively. Diet-related GHGE and LU were estimated using the SHARP-Indicators database. BMI (measured) z-scores were classified according to WHO criteria. A standardized weighted health-sustainability composite index was created (BMI + 0.5*GHGE+0.5*LU). Adjusted linear regression models were computed. RESULTS WISH, DQI, MDS, and SEAD had weighted mean scores (range) of 50 (0-130), 24 (9-36), 20 (8-32), and 17 (8-32), respectively. All dietary patterns were associated with lower environmental impact, particularly in children, but not with BMI. Only MDS explained both health and sustainability indicators in childhood (composite index: sd.β = -0·223,95%CI:-0·347,-0·072,R2 = 25.1 %), and adolescence (composite index: sd.β = -0·159,95%CI:-0·315,-0·003,R2 = 31.3 %). CONCLUSION The Mediterranean diet was the most related to (higher) environmental sustainability and (lower) BMI. However, in children (not adolescents), the WISH, DQI, and SEAD showed then same associations.
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Affiliation(s)
- Beatriz Teixeira
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto [Faculty of Nutrition and Food Sciences, University of Porto], Rua do Campo Alegre, 823, 4150-180 Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto [Laboratory for Integrative and Translational Research in Population Health (ITR)], Rua das Taipas 135, 4050-600 Porto, Portugal.
| | - Cláudia Afonso
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto [Faculty of Nutrition and Food Sciences, University of Porto], Rua do Campo Alegre, 823, 4150-180 Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto [Laboratory for Integrative and Translational Research in Population Health (ITR)], Rua das Taipas 135, 4050-600 Porto, Portugal.
| | - Milton Severo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto [Laboratory for Integrative and Translational Research in Population Health (ITR)], Rua das Taipas 135, 4050-600 Porto, Portugal.
| | - Catarina Carvalho
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto [Faculty of Nutrition and Food Sciences, University of Porto], Rua do Campo Alegre, 823, 4150-180 Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto [Laboratory for Integrative and Translational Research in Population Health (ITR)], Rua das Taipas 135, 4050-600 Porto, Portugal.
| | - Duarte Torres
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto [Faculty of Nutrition and Food Sciences, University of Porto], Rua do Campo Alegre, 823, 4150-180 Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto [Laboratory for Integrative and Translational Research in Population Health (ITR)], Rua das Taipas 135, 4050-600 Porto, Portugal.
| | - Carla Lopes
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto [Laboratory for Integrative and Translational Research in Population Health (ITR)], Rua das Taipas 135, 4050-600 Porto, Portugal; Faculdade de Medicina da Universidade do Porto [Faculty of Medicine, University of Porto], Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
| | - Andreia Oliveira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto [Laboratory for Integrative and Translational Research in Population Health (ITR)], Rua das Taipas 135, 4050-600 Porto, Portugal; Faculdade de Medicina da Universidade do Porto [Faculty of Medicine, University of Porto], Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
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Silva S, Severo M, Lopes C. Association between calcium intake from different food sources during childhood and cardiometabolic risk on adolescence: The Generation XXI birth cohort. Pediatr Obes 2024:e13158. [PMID: 39155440 DOI: 10.1111/ijpo.13158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 07/15/2024] [Accepted: 07/22/2024] [Indexed: 08/20/2024]
Abstract
BACKGROUND Calcium intake has been associated with lower adiposity, but few studies explored the longitudinal relation of calcium from different sources and cardiometabolic markers in young population. OBJECTIVE Prospectively estimate the association between dairy and non-dairy calcium intake at 4, 7, and 10 years (y) of age and cardiometabolic risk at 13 y. METHODS The sample included 4017 participants from the Generation XXI birth cohort. Dietary data were collected from a 3-day food diary. Cardiometabolic clusters at 13 y were estimated by a probabilistic Gaussian mixture model (z-score of waist circumference [WC], HOMA-IR; HDL cholesterol, triglycerides, and systolic blood pressure [BP]). Multivariable linear and logistic regression models were used to estimate associations. RESULTS Calcium intake (/100 mg), after adjustment for confounders, was negatively and significantly associated with body mass index (BMI) (β = -0.02, 95% CI: -0.04; -0.01), WC (cm) (β = -0.23, 95% CI: -0.36; -0.11), and diastolic BP (mmHg) (β = -0.14, 95% CI: -0.26; -0.03). After additional adjustment for total energy intake, associations lose statistical significance. Calcium intake from milk at 7 y was inversely associated with WC (β = -0.25, 95% CI: -0.48; -0.03) and from yogurt at 10 y was associated with higher BMI (β = 0.08, 95% CI: 0.03; 0.13) and WC (β = 0.54, 95% CI: 0.12; 0.96). Calcium from vegetables at 4, 7, 10 y reduces later cardiometabolic risk (OR = 0.71; OR = 0.84; OR = 0.98, respectively). CONCLUSIONS This study supports a protective effect of calcium on adolescents' cardiometabolic health, especially from vegetables.
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Affiliation(s)
- Sara Silva
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Milton Severo
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto, Porto, Portugal
| | - Carla Lopes
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal
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Sampaio J, Pinto J, Pizarro A, Oliveira B, Moreira A, Padrão P, Moreira P, Guedes de Pinho P, Carvalho J, Barros R. Combined mediterranean diet-based sustainable healthy diet and multicomponent training intervention impact on plasma biomarkers and metabolome in older adults. Clin Nutr 2024; 43:2125-2135. [PMID: 39116619 DOI: 10.1016/j.clnu.2024.07.025] [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: 02/05/2024] [Revised: 07/22/2024] [Accepted: 07/22/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND AND AIMS Healthy dietary patterns and exercise practices have been associated with improved metabolic and inflammatory profiles. However, studies regarding the combined effect of these interventions on plasma biomarkers and metabolome in older adults are sparser. The primary aim of this study was to investigate the impact of a combined Mediterranean Diet-based Sustainable Healthy Diet (SHD) and Multicomponent Training (MT) intervention on the plasma biomarkers and metabolome and how dietary intake and exercise could modulate these effects. METHODS SHD intervention included a weekly supply of Mediterranean Diet-based SHD food and four nutrition sessions involving a Mediterranean-Diet culinary workshop, and the exercise program included 50-min MT group sessions, held three times a week, lasting both 12 weeks. Plasma biomarkers were obtained through standard biochemical analysis. A proton (1H) nuclear magnetic resonance (NMR) spectroscopy-based metabolomics approach was used to study the metabolome in blood plasma. Repeated measures ANOVA were performed and adjusted for confounders. RESULTS SHD + MT intervention significantly decreased HDL-C and calcium. SHD + MT showed some changes in common with the SHD and MT group, namely a significant decrease in citrate levels (p = 0.009 for SHD + MT; p = 0.037 for SHDT) and an increase in pyruvate (p < 0.001 for MT and SHD + MT). The SHD + MT group also revealed specific changes in the levels of some amino acids (decrease in alanine, glutamine and lysine: p = 0.026; p < 0.001; p = 0.038, respectively). Increases in formate (p = 0.025) and unsaturated lipids (p = 0.011) are consistent with changes in energy and lipoprotein metabolism. CONCLUSION Our data show that a combined lifestyle intervention program, including a Mediterranean Diet-based SHD and MT, could modulate biomarker and metabolome and there seems to be a metabolic path associated to these interventions in older adults. Due to its wide-ranging relevance, it is pertinent to assess to what extent combined SHD and MT can contribute to better clinical profiles.
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Affiliation(s)
- Joana Sampaio
- Faculty of Sport (FADEUP), University of Porto, Porto, Portugal; Research Centre in Physical Activity, Health, and Leisure (CIAFEL), University of Porto, Porto, Portugal; Epidemiology Unit (EPIUnit), Public Health Institute (ISPUP), University of Porto, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.
| | - Joana Pinto
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, University of Porto, Porto, Portugal; UCIBIO - Applied Molecular Biosciences Unit, Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Andreia Pizarro
- Faculty of Sport (FADEUP), University of Porto, Porto, Portugal; Research Centre in Physical Activity, Health, and Leisure (CIAFEL), University of Porto, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Bruno Oliveira
- Faculty of Nutrition and Food Sciences (FCNAUP), University of Porto, Porto, Portugal
| | - André Moreira
- Epidemiology Unit (EPIUnit), Public Health Institute (ISPUP), University of Porto, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal; Faculty of Medicine (FMUP), University of Porto, Porto, Portugal
| | - Patrícia Padrão
- Epidemiology Unit (EPIUnit), Public Health Institute (ISPUP), University of Porto, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal; Faculty of Nutrition and Food Sciences (FCNAUP), University of Porto, Porto, Portugal
| | - Pedro Moreira
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), University of Porto, Porto, Portugal; Epidemiology Unit (EPIUnit), Public Health Institute (ISPUP), University of Porto, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal; Faculty of Nutrition and Food Sciences (FCNAUP), University of Porto, Porto, Portugal
| | - Paula Guedes de Pinho
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, University of Porto, Porto, Portugal; UCIBIO - Applied Molecular Biosciences Unit, Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Joana Carvalho
- Faculty of Sport (FADEUP), University of Porto, Porto, Portugal; Research Centre in Physical Activity, Health, and Leisure (CIAFEL), University of Porto, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.
| | - Renata Barros
- Epidemiology Unit (EPIUnit), Public Health Institute (ISPUP), University of Porto, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal; Faculty of Nutrition and Food Sciences (FCNAUP), University of Porto, Porto, Portugal.
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Antoniazzi L, Miranda RC, Rauber F, Afonso C, Santos C, Lopes C, Rodrigues S, Levy RB. Inadequate intakes of fatty acids attributed to the ultra-processed foods consumed by Portuguese population: The upper project. Nutr Metab Cardiovasc Dis 2024:S0939-4753(24)00265-5. [PMID: 39174431 DOI: 10.1016/j.numecd.2024.07.003] [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: 11/10/2023] [Revised: 07/02/2024] [Accepted: 07/09/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND AND AIMS Population-based studies suggest an inverse relationship between the dietary share of ultra-processed foods (UPF), as defined by NOVA classification, and the overall dietary nutritional quality. However, few studies have evaluated the impact of ultra-processed foods on the fatty acid profile of the diet. The aim of this study was to assess the association between consumption of UPF and the fatty acids profile of the diet in Portugal. METHODS AND RESULTS Cross-sectional data from IAN-AF 2015-2016 were used for this study. Food consumption data were collected through two 24-h food recalls, and food items were classified according to the NOVA system. For both adults and elderly, the contents of total fatty acids (TFA), saturated fatty acids (SFA) and trans fatty (TRFA) were higher in the fraction of UPF, compared to the other three NOVA groups, while [monounsaturated fatty acids (MUFA)+, polyunsaturated fatty acids (PUFA)/SFA] ratio was lower. The UPF population attributable fraction (PAF) demonstrated that if the dietary contribution of UPF was reduced to levels observed in the first quintile, statistically significant reductions in the prevalence of inadequate intakes of fatty acids would be observed for adults [TRFA (PAF 98.37%, 95% CI 87.27-99.79) and SFA (PAF 37.26%, 95% CI 25.46-47.19)] and for elderly [TRFA (PAF 94.61%, 95% CI 77.59-98.71) and PUFA (PAF 98.28, 95% CI 48.22-99.94)]. CONCLUSIONS In this study the consumption of UPF was associated with a worse fatty acids profile in the Portuguese diet, adding evidence regarding the negative impact of UPF on diet quality.
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Affiliation(s)
- Luiza Antoniazzi
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil; Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil.
| | - Renata C Miranda
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil; Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil; Department of Nutrition, Institute of Health Sciences, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Fernanda Rauber
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil; Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil; Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Cláudia Afonso
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal; Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, Porto, Portugal
| | - Cristina Santos
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), Associate Laboratory RISE-Health Research Network, University of Porto, Porto, Portugal
| | - Carla Lopes
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal
| | - Sara Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal; Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, Porto, Portugal
| | - Renata B Levy
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil; Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
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Fernandes AC, Morais C, Franchini B, Pereira B, Pinho O, Cunha LM. Clean-label products: Factors affecting liking and acceptability by Portuguese older adults. Appetite 2024; 197:107307. [PMID: 38518867 DOI: 10.1016/j.appet.2024.107307] [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: 12/04/2023] [Revised: 03/04/2024] [Accepted: 03/12/2024] [Indexed: 03/24/2024]
Abstract
Consumers are preferring more "natural" foods, made of "healthier" and "familiar" components - the "clean-label" trend. As the population ages, understanding the older adult consumer segment becomes increasingly important. This study aims to identify the factors influencing the acceptability and liking of clean-label products in older adults living in the community. A convenience sample of 100 older adults was used for this cross-sectional study. Socio-demographic data, health status, independence level, lifestyle characteristics, nutritional status, and food and nutrient intake data were collected. The acceptability and liking for clean-label products comprised two parts: Sensory analysis with overall liking evaluation of three pairs of products, using a 9-point hedonic scale and free comments; Willingness to eat and preference assessment of nine pairs of products using the Food Action scale and a simple preference test. The participants were 80% female with a mean age of 75 years old. The overall liking for clean-label versions of cookies and mayonnaise was lower than for traditional versions. However, participants were more willing to eat the clean-label versions of products, particularly ham and yogurt. Most of the participants would prefer buying the clean-label version of all nine pairs of products, especially for ham, loaf bread, sausages, and yogurt. In sum, older adults living in the community exhibit a lower liking but, a greater willingness to eat and a higher preference for buying clean-label products. Older adults who favor clean-label products have higher levels of education and are reported to have a more adequate diet.
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Affiliation(s)
- Ana Campos Fernandes
- Faculdade de Ciências da Nutrição e da Alimentação da Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal; DGAOT, Faculdade de Ciências da Universidade do Porto, Campus de Vairão, Rua da Agrária, 747, 4485-646, Vila do Conde, Portugal
| | - Cecília Morais
- GreenUPorto-Sustainable Agrifood Production Research Centre/Inov4Agro, Campus de Vairão, Rua da Agrária, 747, 4485-646, Vila do Conde, Portugal; Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal; RISE-Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal.
| | - Bela Franchini
- Faculdade de Ciências da Nutrição e da Alimentação da Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal; GreenUPorto-Sustainable Agrifood Production Research Centre/Inov4Agro, Campus de Vairão, Rua da Agrária, 747, 4485-646, Vila do Conde, Portugal
| | - Bárbara Pereira
- Faculdade de Ciências da Nutrição e da Alimentação da Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal; GreenUPorto-Sustainable Agrifood Production Research Centre/Inov4Agro, Campus de Vairão, Rua da Agrária, 747, 4485-646, Vila do Conde, Portugal
| | - Olívia Pinho
- Faculdade de Ciências da Nutrição e da Alimentação da Universidade do Porto, Rua do Campo Alegre, 823, 4150-180, Porto, Portugal; LAQV/REQUIMTE - Laboratório de Bromatologia e Hidrologia, Departamento de Ciências Químicas, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal
| | - Luís Miguel Cunha
- DGAOT, Faculdade de Ciências da Universidade do Porto, Campus de Vairão, Rua da Agrária, 747, 4485-646, Vila do Conde, Portugal; GreenUPorto-Sustainable Agrifood Production Research Centre/Inov4Agro, Campus de Vairão, Rua da Agrária, 747, 4485-646, Vila do Conde, Portugal.
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Martins J, Tapia-Serrano MÁ, Nogueira T, Sanchéz-Miguel PA. Compliance with the 24-h Movement Guidelines for Portuguese children: differences between boys and girls. Sci Rep 2024; 14:11926. [PMID: 38789500 PMCID: PMC11126725 DOI: 10.1038/s41598-023-49227-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 12/05/2023] [Indexed: 05/26/2024] Open
Abstract
The 24-h Movement Guidelines for children recommend at least 60 min per day of moderate-to-vigorous intensity physical activity (PA), ≤ 2 h/day of screen time, and 9-11 h/day of sleep for children. Since little information is available on the 24-h Movement Guidelines in Portuguese children, this research attempts to know the proportion of Portuguese children meeting individual and combinations of these 24-h Movement Guidelines. Another aim of this study is to test sex differences in compliance with 24-h Movement Guidelines. A final sample of 1351 Portuguese children (51.4% girls, aged 7.65 ± 1.21) participated in this cross-sectional study. PA, screen time and sleep duration were parent-reported through a questionnaire. Only 3.7% of children met all three 24-h Movement Guidelines, whereas 11.9% met none. Although boys showed greater compliance with PA recommendations and girls with screen time recommendations, no significant sex differences were found in the compliance of all three 24-h Movement Guidelines. Given that 96.3% of Portuguese children did not meet 24-h Movement Guidelines, promoting these three movement behaviours in both boys and girls is crucial to encouraging positive consequences early.
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Affiliation(s)
- João Martins
- Centro de Estudos em Educação, Faculdade de Motricidade Humana e UIDEF, Instituto de Educação, Universidade de Lisboa, 1649-004, Lisbon, Portugal.
| | - Miguel Ángel Tapia-Serrano
- Departamento de Didáctica de la Expresión Musical, Plástica y Corporal, Grupo Análisis Comportamental de la Actividad Física y el Deporte (ACAFYDE), Facultad de Formación del Profesorado, Universidad de Extremadura, Av. de la Universidad, S/N, 10004, Cáceres, Spain
| | - Telma Nogueira
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
- Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisbon, Portugal
| | - Pedro Antonio Sanchéz-Miguel
- Departamento de Didáctica de la Expresión Musical, Plástica y Corporal, Grupo de Investigación Análisis Didáctico y Comportamental del Deporte (ADICODE), Facultad de Formación del Profesorado, Universidad de Extremadura, Av. de la Universidad, S/N, 10004, Cáceres, Spain
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Silva M, Rodrigues SSP, Correia DM, Rei MCC, Severo M, Costa AIA, Torres DPM, Lopes CMM. Eating out of home in Portugal: characterisation and effects on dietary intake. Br J Nutr 2024:1-13. [PMID: 38772907 DOI: 10.1017/s0007114524000990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2024]
Abstract
This cross-sectional study aims to describe and compare energy, nutrient intake and food consumption according to eating location and by age groups using data from the National Food, Nutrition and Physical Activity Survey (IAN-AF 2015/2016). Dietary intake was estimated by two non-consecutive days of food diaries (children)/24-h recalls (other age groups), and four eating location categories were defined according to the proportion of meals consumed at out-of-home locations: Home (at least 80 % of meals at home), Other Homes, School or Work and Restaurants and Other Places. The majority of meals (69·1 %) were consumed at home. Meals were also often taken at school by children and adolescents and in restaurants and similar outlets by adults and elderly. Children and adolescents in the School or Work category ate more fruit, vegetables and pulses and cereals and starchy tubers, whereas adults in this category ate more red and processed meats, sugar-sweetened beverages and sweets. Compared with Home category, Restaurants and Other Places was associated with worse diet adequacies among children (β = -1·0; 95 % CI = -2·0, -0·04), adolescents: (β = -2·4; 95 % CI = -3·2, -1·5) and adults (β = -1·3; 95 % CI = -1·6, -1·0) reflecting higher intakes of energy, fat, trans-fatty acids and SFA, and Na. The elderly consumed more free sugars and fat when eating out of home in general. Overall, findings reflect important variation in nutrient profiles by eating location, with meals taken at school or work contributing to higher consumption of nutrient-dense foods and those taken in restaurants and other similar settings implying higher consumption of energy-dense foods.
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Affiliation(s)
- Mariana Silva
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Sara Simões Pereira Rodrigues
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Daniela Macedo Correia
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Mariana Correia Castro Rei
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Milton Severo
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
| | - Ana Isabel Almeida Costa
- CATÓLICA-LISBON School of Business and Economics, Portuguese Catholic University, Lisbon, Portugal
| | - Duarte Paulo Martins Torres
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Carla Maria Moura Lopes
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
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8
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Cardoso S, Correia D, Vilela S. Associations between chronotype, diet quality and timing of energy intake in Portuguese children and adolescents: The potential role of summer holidays. Chronobiol Int 2024; 41:647-657. [PMID: 38606916 DOI: 10.1080/07420528.2024.2339970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
Later chronotypes may be associated with lower diet quality and later timing of energy intake in paediatric age. Period of data collection of these variables may affect these parameters and inter-relationship. We aimed to assess the cross-sectional association of chronotype with a diet quality score (HEI) and caloric midpoint (time of achieving 50% of total daily energy intake), considering summer holidays, using data from the National Food, Nutrition and Physical Activity Survey 2015-2016 for 578 participants (6-14 years of age). Chronotype was estimated by the midpoint of sleep and categorized as Early, Intermediate and Late, using physical activity diaries, while outcomes using two food diaries/24 h recalls. Associations of chronotype with outcomes were assessed by linear regressions adjusted for sex, age, parental education (model 1), BMI, sports practice (model 2), and summer holidays (no/yes) (model 3). In model 2, a Late vs. Early chronotype was negatively associated with HEI (β ˆ = -0.74; 95% CI: -1.47, -0.07) and positively with caloric midpoint (β ˆ = 0.35; 95% CI: 0.02, 0.69). However, associations lost significance in model 3. The association between chronotype and dietary habits may be benefit from being studied considering school terms and summer holidays. Future larger prospective studies are needed to clarify the role of summer holidays on this inter-relationship.
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Affiliation(s)
- Sofia Cardoso
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Daniela Correia
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Sofia Vilela
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
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9
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Alkhaldy AA, Aljaadi AM, Jalil AMM, Alyoubi DA, Saleemani HH, Eid RH, Almohmadi NH, Al-Otaibi HH, Ajabnoor SM. Cross-continental national nutrition surveys: a narrative review. BMC Nutr 2024; 10:63. [PMID: 38649978 PMCID: PMC11034115 DOI: 10.1186/s40795-024-00868-4] [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: 11/07/2023] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
Many countries use national nutrition surveys (NNSs) to assess their population's health and nutrition needs. However, NNS aims, approaches, tools, and measurements vary among countries. To date, there has been no review evaluating the NNSs and their practices worldwide to help conduct future NSSs. Therefore, this narrative review was conducted to 1) explore and tabulate current NNSs in five continents (Asia, Europe, Africa, North America, and Australia) and 2) help lay the foundation for establishing clear guidelines for future NNSs. The NNSs were identified using two approaches. First, an electronic database search was conducted with key terms in PubMed database. Second, a general web-based search on the survey webpages of governmental organizations was conducted using the same key terms to identify eligible surveys. The review included general adult population (≥ 18 years) with a cross-sectional design, excluding NNSs related to household-only surveys, specific age groups, or insufficient sample sizes. A total of 41 NNSs were identified in 37 countries across four continents: Asia (n = 15), Europe (n = 21), North America (n = 3), and Australia (n = 2). Broad differences between the surveys were identified, including survey purposes and designs, definitions of geographic areas and target groups, and dietary assessments. Currently, there are 26 ongoing NNSs, while 15 have ended. Among the ongoing NNSs, the cycles of the surveys were either at regular intervals (n = 8) or irregular intervals (n = 8). Of the 41 surveys, 24-h dietary recalls were used in 27 surveys, while only 6 surveys used diet diaries and 8 surveys relied on FFQs. Some surveys (n = 17) utilized multiple tools to assess dietary intake. Most of the surveys that assessed biochemical status (n = 12) focused on blood glucose, haemoglobin A1c (HbA1c), and lipid status, whereas some surveys (n = 6) tested for vitamin and mineral status in blood and/or urine samples. The review identified key characteristics, time frames, sampling methods, and dietary and physical assessment methods obtained from different surveys worldwide. The information organized in this review will be important for researchers, policymakers, and public health programme developers in developing and improving NNS.
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Affiliation(s)
- Areej A Alkhaldy
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80215, Jeddah, 21589, Saudi Arabia.
| | - Abeer M Aljaadi
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Abbe M Mhd Jalil
- School of Nutrition & Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, 21300, Malaysia
| | - Doaa A Alyoubi
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80215, Jeddah, 21589, Saudi Arabia
| | - Haneen H Saleemani
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80215, Jeddah, 21589, Saudi Arabia
| | - Ruba H Eid
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Najlaa H Almohmadi
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Hala H Al-Otaibi
- Department of Food and Nutrition Science, College of Agricultural and Food Science, King Faisal University, Al-Ahsa, 31982, Saudi Arabia
| | - Sarah M Ajabnoor
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80215, Jeddah, 21589, Saudi Arabia
- Food, Nutrition and Lifestyle Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia
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Sousa AC, Pádua I, Gonçalves VM, Ribeiro C, Leal S. Exploring tea and herbal infusions consumption patterns and behaviours: The case of Portuguese consumers. Heliyon 2024; 10:e28779. [PMID: 38601558 PMCID: PMC11004536 DOI: 10.1016/j.heliyon.2024.e28779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/14/2024] [Accepted: 03/25/2024] [Indexed: 04/12/2024] Open
Abstract
Consumption of tea and herbal infusions (THIs) have a long history in traditional medicine and cultural practices. The health-promoting benefits attributed to THIs are considered influential factors in consumer choices. However, there is limited data on consumer choices and attitudes that might interfere with the positive effects associated with THIs consumption. The aim of this study was to investigate the consumption pattern and behavior of THIs consumers in Portugal, assessing the influence of socio-demographic factors on the selection of THIs products and consumer practices related to these beverages. An online survey was conducted, and from the collected data, 720 responses met the aim of the study and were further analyzed. Most of the respondents were female, 74.4%, belonging to the 40-60 age group (40.6%) and were medium consumers of THIs (47.2%). Green tea was the most consumed type among participants, and its consumption was associated not only with age but also with the pattern of THIs consumption. Despite that, participants preferred herbal infusions, with citronella, chamomile, and lemon verbena being the most consumed types. For certain types of herbal infusions, consumption was associated with age, while other types were preferred by moderate or heavy consumers. Most participants purchased THIs in supermarkets, registered trademark and brand stores, in the form of THIs bag. Light consumers use only bag, while medium/heavy consumers indicated the use of other forms. Almost half of the respondents admitted to not reading the information on product labels before consumption and using THIs after the expiry date, while only one-third of them declared paying attention to the label instructions. This study revealed the impact of socio-demographic factors as age on the consumption patterns and preferences of THIs of consumers. Of concern is the neglect of label usage among Portuguese consumers. This emphasizes the urgency of implementing interventions to guide proper label use and promote good consumption practices to ensure the quality of THIs products.
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Affiliation(s)
- Ana Catarina Sousa
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, University Institute of Health Sciences - CESPU, 4585-116, Gandra, Portugal
- UCIBIO - Applied Molecular Biosciences Unit, Toxicologic Pathology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), 4585-116, Gandra, Portugal
| | - Inês Pádua
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, University Institute of Health Sciences - CESPU, 4585-116, Gandra, Portugal
- UCIBIO - Applied Molecular Biosciences Unit, Translational Toxicology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), 4585-116, Gandra, Portugal
| | - Virgínia M.F. Gonçalves
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, University Institute of Health Sciences - CESPU, 4585-116, Gandra, Portugal
- UCIBIO - Applied Molecular Biosciences Unit, Translational Toxicology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), 4585-116, Gandra, Portugal
- UNIPRO - Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS-CESPU), 4585-116, Gandra, Portugal
| | - Cláudia Ribeiro
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, University Institute of Health Sciences - CESPU, 4585-116, Gandra, Portugal
- UCIBIO - Applied Molecular Biosciences Unit, Translational Toxicology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), 4585-116, Gandra, Portugal
| | - Sandra Leal
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, University Institute of Health Sciences - CESPU, 4585-116, Gandra, Portugal
- UCIBIO - Applied Molecular Biosciences Unit, Toxicologic Pathology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), 4585-116, Gandra, Portugal
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11
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Pinto E, Viegas C, Martins PV, Marreiros C, Nascimento T, Schurgers L, Simes D. Mediterranean Diet Favors Vitamin K Intake: A Descriptive Study in a Mediterranean Population. Nutrients 2024; 16:1098. [PMID: 38674788 PMCID: PMC11054598 DOI: 10.3390/nu16081098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 03/26/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
The Mediterranean diet (MD) is associated with improved longevity and the prevention and management of chronic inflammatory diseases (CIDs). Vitamin K, which is present in MD core components such as leafy green vegetables, is also known as a protective factor for CIDs. Estimates of vitamin K intake in Mediterranean settings are still scarce, and the association between MD and vitamin K intake is yet to be established. This study analyzed vitamin K intake and MD adherence in the Algarve region, in Portugal. We conducted a cross-sectional study in a nonrandom sample of adults using an online questionnaire which included a validated food-frequency questionnaire and a screener for MD adherence. A total of 238 participants were recruited (68% women and 32% men). Adherence to the MD was low (11%). Only 10% of the participants had vitamin K intake below the adequate intake. Adherence to the MD was positively correlated with vitamin K intake (r = 0.463; p < 0.001) and age (r = 0.223; p < 0.001). Our findings underscore the importance of promoting adherence to the MD for optimal vitamin K intake, and future research should focus on developing effective interventions to promote this dietary pattern, particularly among younger individuals and men.
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Affiliation(s)
- Ezequiel Pinto
- Centro de Estudos e Desenvolvimento em Saúde, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (E.P.); (T.N.)
- Algarve Biomedical Center Research Institute (ABC-RI), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
| | - Carla Viegas
- Centre of Marine Sciences (CCMAR), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (C.V.); (C.M.)
- GenoGla Diagnostics, Centre of Marine Sciences (CCMAR), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
| | - Paula Ventura Martins
- Algarve Cyber-Physical Systems Research Centre (CISCA), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal;
| | - Catarina Marreiros
- Centre of Marine Sciences (CCMAR), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (C.V.); (C.M.)
| | - Tânia Nascimento
- Centro de Estudos e Desenvolvimento em Saúde, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (E.P.); (T.N.)
- Algarve Biomedical Center Research Institute (ABC-RI), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
| | - Leon Schurgers
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, 6200 MD Maastricht, The Netherlands;
| | - Dina Simes
- Centre of Marine Sciences (CCMAR), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (C.V.); (C.M.)
- GenoGla Diagnostics, Centre of Marine Sciences (CCMAR), Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
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Nazareth M, Pinto E, Severo M, Graça P, Lopes C, Rêgo C. Early feeding and nutritional status of Portuguese children in the first 36 months of life: EPACI Portugal 2012-a national representative cross-sectional study. Porto Biomed J 2024; 9:250. [PMID: 38681517 PMCID: PMC11049788 DOI: 10.1097/j.pbj.0000000000000250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/07/2024] [Accepted: 02/21/2024] [Indexed: 05/01/2024] Open
Abstract
Background Early feeding practices have a critical role in the future not only in health but also in modulating eating habits. This study aimed to assess breastfeeding and complementary feeding practices and the nutritional status of Portuguese toddlers aged 0-36 months. Methods EPACI Portugal 2012 is a cross-sectional study of a national representative sample. Trained interviewers collected data about early feeding practices and anthropometrics. Body mass index was classified according to World Health Organization criteria. Frequencies and survival analysis were used to characterize variables. Results More than 90% of children were initiated breastfeeding, around 20% were exclusively breastfed for six months, and about 20% were breastfed at 12 months while complementary feeding was taking place. Exclusive breastfeeding was determined by maternal prepregnancy body mass index (HR 1.01; 95% CI 1.00, 1.03, P=.03) and low birth weight (HR 1.61; IC 95% 1.21, 2.15, P=.001) of the infants. About 90% were initiated complementary feeding between four and six months, and almost 10% were introduced to cow's milk before 12 months. In the second year of life, 83.2% and 61.6% of toddlers have already consumed nectars and sweet desserts, respectively. About one-third of Portuguese toddlers showed a body mass index z-score >1, and 6.6% were overweight/obese (z-score >2). No association was found between the duration of breastfeeding or timing of complementary feeding and the body mass index z-score in children. Conclusions Despite the low prevalence of exclusive breastfeeding at six months, Portuguese infants effectively comply with dietary recommendations during the first year of life. The transition to the family diet must be carefully made. There is a high prevalence of Portuguese toddlers at least at overweight risk. The duration of breastfeeding or timing of complementary feeding was not associated with the expression of overweight/obesity.
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Affiliation(s)
- Margarida Nazareth
- Universidade Católica Portuguesa, CBQF—Centro de Biotecnologia e Química Fina-Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
| | - Elisabete Pinto
- Universidade Católica Portuguesa, CBQF—Centro de Biotecnologia e Química Fina-Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
- EPIUnit—Institute of Public Health, University of Porto, Porto, Portugal
| | - Milton Severo
- EPIUnit/ITR—Laboratory for Integrative and Translational Research in Population Health—Institute of Public Health, University of Porto, Porto, Portugal
- ICBAS—School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Pedro Graça
- EPIUnit/ITR—Laboratory for Integrative and Translational Research in Population Health—Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Carla Lopes
- EPIUnit/ITR—Laboratory for Integrative and Translational Research in Population Health—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
| | - Carla Rêgo
- Universidade Católica Portuguesa, CBQF—Centro de Biotecnologia e Química Fina-Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
- Child and Adolescent Centre, CUF Hospital Porto, Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
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13
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Le Turc N, Silva AJ, Florença SG, Raposo A, Gonçalves JC, Lima MJ, Teixeira-Lemos E, Guiné RPF. Consumer Knowledge about Dietary Relevance of Fruits and Vegetables: A Study Involving Participants from Portugal and France. Nutrients 2024; 16:287. [PMID: 38257181 PMCID: PMC10818577 DOI: 10.3390/nu16020287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/14/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
Fruits and vegetables are recommended as low-calorie foods that contribute to the proper intake of necessary micronutrients, macronutrients, and bioactive compounds with health benefits. However, the recommendations for the dietary intake of these foods fail to be attained in most European countries. For this reason, promoting more knowledge about the health effects of fruits and vegetables is essential to decrease the incidence of chronic diseases. This study was conducted to investigate the knowledge of the health benefits of fruits and vegetables among the population of Portugal and France. The present work involved a questionnaire survey of 639 participants (257 from Portugal and 382 from France). The results revealed that most participants were young females (68.9%) with good education (76%) and an average weight range. They consumed a varied diet (57%) but had body dissatisfaction (63.2%). The respondents had good knowledge about the health effects of fruits and vegetables. However, the French population knew more about the theme than the Portuguese. Portuguese individuals were more likely to have incomplete information. Gender and education significantly influenced knowledge levels, with females and highly educated individuals demonstrating greater understanding. Dissatisfaction with body weight drives individuals to seek nutrition information. This investigation enhances our comprehension of the factors that affect knowledge of vegetable and fruit consumption among young adults in Portugal and France. Moreover, it highlights the importance of implementing focused educational programs to enhance nutrition literacy, particularly for less-aware demographic groups. Going forward, a more in-depth analysis of these factors could assist in creating more efficient strategies to encourage healthier dietary habits and improve nutrition literacy among these communities.
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Affiliation(s)
- Nolwenn Le Turc
- Department of Food Industry, Agrarian School of Viseu, 3500-606 Viseu, Portugal; (N.L.T.); (A.J.S.); (J.C.G.); (M.J.L.); (R.P.F.G.)
- IUT University Institute of Technology, Angers University, 49035 Angers, France
| | - Ana Jaquelina Silva
- Department of Food Industry, Agrarian School of Viseu, 3500-606 Viseu, Portugal; (N.L.T.); (A.J.S.); (J.C.G.); (M.J.L.); (R.P.F.G.)
| | - Sofia G. Florença
- CERNAS-IPV Research Centre, Polytechnic University of Viseu, 3504-510 Viseu, Portugal;
| | - António Raposo
- CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Campo Grande 376, 1749-024 Lisboa, Portugal
| | - João Carlos Gonçalves
- Department of Food Industry, Agrarian School of Viseu, 3500-606 Viseu, Portugal; (N.L.T.); (A.J.S.); (J.C.G.); (M.J.L.); (R.P.F.G.)
- CERNAS-IPV Research Centre, Polytechnic University of Viseu, 3504-510 Viseu, Portugal;
| | - Maria João Lima
- Department of Food Industry, Agrarian School of Viseu, 3500-606 Viseu, Portugal; (N.L.T.); (A.J.S.); (J.C.G.); (M.J.L.); (R.P.F.G.)
- CERNAS-IPV Research Centre, Polytechnic University of Viseu, 3504-510 Viseu, Portugal;
| | - Edite Teixeira-Lemos
- Department of Food Industry, Agrarian School of Viseu, 3500-606 Viseu, Portugal; (N.L.T.); (A.J.S.); (J.C.G.); (M.J.L.); (R.P.F.G.)
- CERNAS-IPV Research Centre, Polytechnic University of Viseu, 3504-510 Viseu, Portugal;
| | - Raquel P. F. Guiné
- Department of Food Industry, Agrarian School of Viseu, 3500-606 Viseu, Portugal; (N.L.T.); (A.J.S.); (J.C.G.); (M.J.L.); (R.P.F.G.)
- CERNAS-IPV Research Centre, Polytechnic University of Viseu, 3504-510 Viseu, Portugal;
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Caldo-Silva A, Furtado GE, Chupel MU, Letieri RV, Neves RS, Direto F, Barros MP, Bachi ALL, Matheu A, Martins F, Massart A, Teixeira AM. Empowering frail older adults: multicomponent elastic-band exercises and BCAA supplementation unleash physical health and preserve haematological biomarkers. Front Sports Act Living 2023; 5:1171220. [PMID: 37720080 PMCID: PMC10502309 DOI: 10.3389/fspor.2023.1171220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 08/03/2023] [Indexed: 09/19/2023] Open
Abstract
The effectiveness of Branched Chain Amino Acids (BCAAs) supplementation on enhancing exercise performance in both young and older adults remains a topic of debate. Recent research suggests that BCAAs combined with regular exercise might have an impact on human erythropoiesis, blood dynamics, and iron homeostasis. Given the increasing longevity of the global population, it is crucial to investigate the potential benefits of BCAA supplementation and regular exercise as non-pharmacological interventions for improving the overall health of frail older adults. To assess the influence of a 40-week multicomponent exercise intervention (MEP) combined BCCA supplementation on the haematological indicators of frail older adults (83-93 years old) residing in nursing homes. A prospective, naturalistic, controlled clinical trial employing an intervention-washout-intervention was conducted for this purpose. The study included four experimental groups: MEP plus BCAA supplementation (MEP + BCAA, n = 8), MEP only (n = 7), BCAA supplementation only (n = 7), and control group non exercising (CG, n = 13). Fried's physical frailty (PF) protocol was employed to stratify the participants. Additionally, the assessment included the evaluation of nutritional status, comorbidities, and anthropometric measurements. Among the several haematological markers examined, only mean cellular Haemoglobin Concentration (MCH) [F = 4.09; p < 0.03] and Mean Cell haemoglobin Concentration (MCHC) [F = 10, 323; p < 0,0001] showed significant effects of time group. Our findings demonstrate that a long-term intervention with BCAA plus MEP did not lead to significant alterations in the haematological profile. An 8-week withdrawal from interventions did not affect the frailty status in the MEP and MEP + BCAA groups, whereas the control group exhibited an increase in PF status. The findings, demonstrating the potential pro-immune effect and maintenance of MCH and MCHC levels, highlight the relevance of incorporating exercise and nutritional strategies to promote healthy aging. This study contributes to the achievement of the United Nations Sustainable Development Goals 3 (good health and well-being) and 10 (reduced Inequalities) for all.
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Affiliation(s)
- Adriana Caldo-Silva
- Research Centre for Sport and Physical Activity, CIDAF, Faculty of Sport Science and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Guilherme E. Furtado
- Research Centre for Sport and Physical Activity, CIDAF, Faculty of Sport Science and Physical Education, University of Coimbra, Coimbra, Portugal
- Polytechnic Institute of Coimbra, Applied Research Institute, Rua da Misericórdia, Lagar dos Cortiços-S, Martinho do Bispo, Coimbra, Portugal
- Research Centre for Natural Resources Environment and Society (CERNAS), Polytechnic Institute of Coimbra, Bencanta, Coimbra, Portugal
| | - Matheus Uba Chupel
- Biological Sciences Platform- Hurvitz Brain Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Rubens Vinícius Letieri
- Multidisciplinary Research Nucleus in Physical Education (NIMEF), Physical Education Department, Avenida Nossa Senhora de Fátima, Federal University of North of Tocantins (UFNT), Tocantinópolis, Brazil
| | - Rafael Santos Neves
- Research Centre for Sport and Physical Activity, CIDAF, Faculty of Sport Science and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Fábio Direto
- Research Centre for Sport and Physical Activity, CIDAF, Faculty of Sport Science and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Marcelo P. Barros
- Institute of Physical Activity Sciences and Sports (ICAFE), Interdisciplinary Program in Health Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - André L. L. Bachi
- Post-Graduation Program in Health Sciences, Santo Amaro University (UNISA), São Paulo, Brazil
| | - Ander Matheu
- Group of Cellular Oncology, Biodonostia Health Research Institute, San Sebastian, Spain
- CIBER On Frailty and Healthy Aging (CIBERfes), Institute of Health Carlos III, Madrid, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Faber Martins
- Laboratory for the Evaluation of Sports Performance, Physical Exercise, and Health (LABMOV), Polytechnic of Guarda, Guarda, Portugal
| | - Alain Massart
- Research Centre for Sport and Physical Activity, CIDAF, Faculty of Sport Science and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Ana Maria Teixeira
- Research Centre for Sport and Physical Activity, CIDAF, Faculty of Sport Science and Physical Education, University of Coimbra, Coimbra, Portugal
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Maia I, Oliveira A, Santos AC. Food insecurity is associated with an unhealthy lifestyle score in middle- and older-aged adults: findings from the EPIPorto cohort. Food Secur 2023; 15:661-671. [PMID: 37223752 PMCID: PMC10088709 DOI: 10.1007/s12571-023-01366-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 03/15/2023] [Indexed: 05/25/2023]
Abstract
The association of food insecurity with the combined effect of lifestyles is still limited. This study evaluated the association between food insecurity and a lifestyle score in middle- and older-aged adults. A cross-sectional study (2013-2016) was performed among 595 individuals (≥ 50 years) from the EPIPorto cohort (Porto, Portugal). Food security status was assessed using the US Household Food Security Survey Module: Six-Item Short Form. Information on fruit and vegetable consumption (F&V), physical activity (PA) practice, tobacco smoking, and alcohol consumption were included in a lifestyle score. Those with F&V < five portions/day, < 150 min/week of moderate-intensity PA or < 75 min/week of vigorous-intensity PA, current smokers, consumers of > one drink of alcoholic beverages in women, and > two in men were assigned with one point; all the others had nil points. The score could range from 0 to 4, and was further categorised into three categories. Food insecurity was positively associated with an unhealthy lifestyle profile (OR = 2.272; 95%CI:1.079-4.782), independently of the adjustment variables. Analysing each lifestyle component, food insecurity was associated with low PA practice (OR = 2.365; 95%CI:1.020-5.485). Individuals from food insecure households were more likely to have an unhealthy lifestyle profile. Public health strategies should be developed among food insecure individuals to promote healthy lifestyles.
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Affiliation(s)
- Isabel Maia
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Andreia Oliveira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Ana Cristina Santos
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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16
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Antoniazzi L, de Miranda RC, Rauber F, de Moraes MM, Afonso C, Santos C, Lopes C, Rodrigues S, Levy RB. Ultra-processed food consumption deteriorates the profile of micronutrients consumed by Portuguese adults and elderly: the UPPER project. Eur J Nutr 2023; 62:1131-1141. [PMID: 36414867 DOI: 10.1007/s00394-022-03057-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/10/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE This study aims to describe micronutrient intake according to food processing degree and to investigate the association between the dietary share of ultra-processed foods and micronutrient inadequacies in a representative sample of Portuguese adult and elderly individuals. METHODS Cross-sectional data from the National Food, Nutrition and Physical Activity Survey (2015/2016) were used. Food consumption data were collected through two 24-h food recalls, and food items were classified according to the NOVA system. Linear regression models were used to assess the association between the micronutrient density and the quintiles of ultra-processed food consumption-crude and adjusted. Negative Binomial regressions were performed to measure the prevalence ratio of micronutrient inadequacy according to ultra-processed food quintiles. RESULTS For adults, all evaluated vitamins had significantly lower content in the fraction of ultra-processed foods compared to unprocessed or minimally processed foods, except vitamin B2. For the elderly, out of ten evaluated vitamins, seven presented significantly less content in ultra-processed foods compared to non-processed ones. The higher energy contribution of ultra-processed foods in adults was associated with a lower density of vitamins and minerals. This association was not observed in the elderly. For adults, compared with the first quintile of ultra-processed food consumption, the fifth quintile was positively associated with inadequate intakes of vitamin B6 (PR 1.51), vitamin C (PR 1.32), folate (PR 1.14), magnesium (PR 1.21), zinc (PR 1.33), and potassium (PR 1.19). CONCLUSION Our results corroborate the importance of public health actions that promote a reduction in the consumption of ultra-processed foods.
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Affiliation(s)
- Luiza Antoniazzi
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil.
- Department of Preventive Medicine, School of Medicine, University of São Paulo, Dr. Arnaldo Avenue, 455, São Paulo, 01246-903, Brazil.
| | - Renata Costa de Miranda
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
- Department of Preventive Medicine, School of Medicine, University of São Paulo, Dr. Arnaldo Avenue, 455, São Paulo, 01246-903, Brazil
- Department of Nutrition, Institute of Health Sciences, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Fernanda Rauber
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
- Department of Preventive Medicine, School of Medicine, University of São Paulo, Dr. Arnaldo Avenue, 455, São Paulo, 01246-903, Brazil
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Milena Miranda de Moraes
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, Porto, Portugal
| | - Cláudia Afonso
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, Porto, Portugal
| | - Cristina Santos
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Associate Laboratory RISE-Health Research Network, University of Porto, Porto, Portugal
| | - Carla Lopes
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Sara Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, Porto, Portugal
| | - Renata Bertazzi Levy
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
- Department of Preventive Medicine, School of Medicine, University of São Paulo, Dr. Arnaldo Avenue, 455, São Paulo, 01246-903, Brazil
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17
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Carvalho C, Severo M, Correia D, Lopes C, Torres D. Meat or meatless meals at lunch and dinner – exploring the associated factors and transition between meals. Int J Food Sci Nutr 2023:1-12. [PMID: 36971097 DOI: 10.1080/09637486.2023.2190504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
This study aimed to explore the factors associated with the consumption of meat vs. meatless meals and to assess the applicability of a multi-state model to describe transitions between lunch and dinner. Fifteen thousand four hundred and eight main meals (lunch and dinner) from a sample of adults (18-84 years, n = 3852) from the Portuguese Food, Nutrition and Physical Activity Survey (IAN-AF 2015-2016) were categorised as meat, fish, ovolactovegetarian or snack. Adjusted generalised-mixed-effects models were used to explore the associations and a time-homogeneous Markov-multi-state model was applied to study the transitions. Women, older and higher educated individuals presented higher odds of consuming meatless meals and lower hazard of transitioning to meat in the following main meal. Strategies for replacing meat with more sustainable foods should be specific towards different population groups. Studying transitions across main meals, using multi-state models, can support the development of feasible, realistic and group-specific strategies to replace meat and promote dietary variety.
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Mavragani A, Al Hourani H, Alkhatib B, Alboqai O, AlHalaika D, Al-Jawaldeh A. Jordan's Population-Based Food Consumption Survey: Protocol for Design and Development. JMIR Res Protoc 2023; 12:e41636. [PMID: 36800239 PMCID: PMC9984996 DOI: 10.2196/41636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/28/2023] [Accepted: 01/28/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND One of the factors influencing health and well-being is dietary patterns. Data on food consumption are necessary for evaluating and developing community nutrition policies. Few studies on Jordanians' food consumption and dietary habits at various ages have been conducted, despite the increased prevalence of overweight, obesity, and chronic diseases. This will be the first study focusing on Jordanians' food consumption patterns that includes children, adolescents, adults, and older adults. OBJECTIVE This cross-sectional study aims to describe the design and methodology of the Jordan's Population-based Food Consumption Survey, 2021-2022, which was developed to collect data on food consumption, including energy, nutrients, and food group intake, from a representative sample of Jordanians and to determine the prevalence of overweight and obesity and their relationship to food consumption. METHODS Participants were selected by stratified random sampling, using the Estimated Population of the Kingdom by Governorate, Locality, Sex, and Households, 2020 as the sampling frame. The food consumption survey sample was at the population level, representing gender and age classes (8-85 years old). The data collection period was 6 months. Food consumption was assessed using 24-hour dietary recall (2 nonconsecutive days, 1 week apart) interviews representing weekdays and weekends. In addition to data on food consumption, information on the use of food supplements, sociodemographic and socioeconomic status, and health was gathered. Weight, height, and waist circumference were all measured. RESULTS The survey included 632 households with 2145 participants, of which 243 (11.3%) were children, 374 (17.4%) were adolescents, 1428 (66.6%) were adults, and 99 (4.6%) were older adults. Three food consumption databases were used to stratify the mean 24-hour dietary recall food consumption into energy intake, carbohydrates, proteins, fats, fiber, vitamins and minerals, and food groups. BMI was calculated and classified as normal, overweight, or obese. Central obesity was classified as normal or abnormal based on the waist-to-height ratio. The survey results will be disseminated based on age, energy, nutrient, and food group consumption. The prevalence of overweight and obesity by age group will be presented, as well as a comparison to the situation in Eastern Mediterranean countries. CONCLUSIONS The survey data will be helpful in nutritional studies, assessing changes in dietary patterns, and developing and evaluating nutrition or health policies. It will be a solid base for developing a future national surveillance system on food consumption patterns with comprehensive food consumption, physical activity, biochemical, and blood pressure data. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41636.
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Affiliation(s)
| | - Huda Al Hourani
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Buthaina Alkhatib
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Omar Alboqai
- Department of Nutrition and Food Science, Faculty of Agriculture and Sciences, Jerash University, Jerash, Jordan
| | - Dima AlHalaika
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, Egypt
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19
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Sampaio J, Carvalho J, Pizarro A, Pinto J, Moreira A, Padrão P, Guedes de Pinho P, Moreira P, Barros R. Multidimensional Health Impact of Multicomponent Exercise and Sustainable Healthy Diet Interventions in the Elderly (MED-E): Study Protocol. Nutrients 2023; 15:nu15030624. [PMID: 36771331 PMCID: PMC9920022 DOI: 10.3390/nu15030624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/07/2023] [Accepted: 01/16/2023] [Indexed: 01/27/2023] Open
Abstract
Data concerning the combined effect of diet and exercise interventions on overall health in the elderly are scarce. The MED-E project's primary aim is to assess the effect of the different 3-month sustainable healthy diet (SHD) and multicomponent training (MT) interventions on several health outcomes in the elderly. A quasi-experimental study assigned older adults into four groups: (1) SHD, (2) MT, (3) SHD + MT, or (4) control group (CG). The SHD intervention included a weekly offer of a mixed food supply and individual and group nutritional sessions on the principles of an SHD. The MT groups were submitted to 50-min exercise sessions three times a week. The primary outcomes were blood biomarkers and metabolic profile alterations that were assessed pre- and post-intervention. Additionally, data on dietary intake and nutritional adequacy, physical fitness, body composition and anthropometry, cognitive function, quality of life, and geographical data were assessed at the same time points. The MED-E project's study protocol and future results will add to knowledge about the importance and beneficial contribution of combined SHD and MT interventions on healthy ageing policies.
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Affiliation(s)
- Joana Sampaio
- Faculty of Sport (FADEUP), University of Porto, 4200-450 Porto, Portugal
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), University of Porto, 4200-450 Porto, Portugal
- Epidemiology Research Unit (EPIUnit), Public Health Institute (ISPUP), University of Porto, 4050-600 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
- Correspondence: (J.S.); (R.B.)
| | - Joana Carvalho
- Faculty of Sport (FADEUP), University of Porto, 4200-450 Porto, Portugal
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), University of Porto, 4200-450 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
| | - Andreia Pizarro
- Faculty of Sport (FADEUP), University of Porto, 4200-450 Porto, Portugal
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), University of Porto, 4200-450 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
| | - Joana Pinto
- Associate Laboratory Institute for Health and Bioeconomy (i4HB), Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- Research Unit on Applied Molecular Biosciences (UCIBIO/REQUIMTE), Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - André Moreira
- Epidemiology Research Unit (EPIUnit), Public Health Institute (ISPUP), University of Porto, 4050-600 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
- Faculty of Medicine (FMUP), University of Porto, 4200-319 Porto, Portugal
| | - Patrícia Padrão
- Epidemiology Research Unit (EPIUnit), Public Health Institute (ISPUP), University of Porto, 4050-600 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
- Faculty of Nutrition and Food Sciences (FCNAUP), University of Porto, 4150-180 Porto, Portugal
| | - Paula Guedes de Pinho
- Associate Laboratory Institute for Health and Bioeconomy (i4HB), Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- Research Unit on Applied Molecular Biosciences (UCIBIO/REQUIMTE), Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Pedro Moreira
- Research Centre in Physical Activity, Health, and Leisure (CIAFEL), University of Porto, 4200-450 Porto, Portugal
- Epidemiology Research Unit (EPIUnit), Public Health Institute (ISPUP), University of Porto, 4050-600 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
- Faculty of Nutrition and Food Sciences (FCNAUP), University of Porto, 4150-180 Porto, Portugal
| | - Renata Barros
- Epidemiology Research Unit (EPIUnit), Public Health Institute (ISPUP), University of Porto, 4050-600 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
- Faculty of Nutrition and Food Sciences (FCNAUP), University of Porto, 4150-180 Porto, Portugal
- Correspondence: (J.S.); (R.B.)
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20
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Differential Patterns in Motivations for Practicing Sport and Their Effects on Physical Activity Engagement across the Lifespan. Healthcare (Basel) 2023; 11:healthcare11020274. [PMID: 36673642 PMCID: PMC9858934 DOI: 10.3390/healthcare11020274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
This study aims to report what motivates individuals to be physically active, to determine whether motivating factors influence physical activity (PA) levels, and whether this differs across the lifespan. This is a cross-sectional study with 498 individuals: 117 adolescents, 306 adults, and 75 older adults. PA was assessed using Baecke’s questionnaire, and motivating factors for practicing sports were investigated using a scale with twelve questions. The factor analysis identified three motivating factors for sports practice: psychosocial, bodily, and well-being. The scale’s overall reliability and internal consistency indicated a Cronbach’s alpha of 0.885. The analysis of covariance (ANCOVA) adjusted for sex indicated the three factors as having a significant effect on PA (p < 0.050); however, only the well-being factor showed a significant interaction with age groups (p = 0.023, ηp2 = 0.030). Subsequently, the effect of the well-being factor on PA scores in each age group was explored through regression analyses. Only older adults showed a significant association in the unadjusted [OR = 0.378, p = 0.001, R2 = 0.243] and the sex-adjusted analysis [OR = 0.377, p = 0.001, R2 = 0.288]. These results help us to better understand the underlying motivational reasons in different age groups for engaging in sports.
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Gonzaga I, Ribovski M, Claumann GS, Folle A, Beltrame TS, Laus MF, Pelegrini A. Secular trends in body image dissatisfaction and associated factors among adolescents (2007-2017/2018). PLoS One 2023; 18:e0280520. [PMID: 36656894 PMCID: PMC9851498 DOI: 10.1371/journal.pone.0280520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 12/29/2022] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE To assess secular trends in body image dissatisfaction and associated factors among adolescents over a 10-year period (2007-2017/2018). METHODS The sample included 1,479 (2007, n = 531; 2017/2018, n = 948) high school adolescents of both sexes, aged 14 to 18 years, of schools in a city in southern Brazil, in 2007 and 2017/2018. Data were collected on sex, age, physical activity (IPAQ, short form), anthropometric measurements (body weight, height, and triceps and subscapular skinfolds), and body image dissatisfaction (figure rating scale). The variables were compared with Independent samples t-test and Mann-Whitney U-test. The associations between sex and other variables were examined with chi-square test, and the factors associated with body image were identified with multinomial logistic regression. RESULTS Most adolescents were dissatisfied with their body image in 2007 (65,2%) and 2017/2018 (71,1%). The prevalence of body dissatisfaction increased by 9.2% over the 10-year period, particularly dissatisfaction with thinness (21.3%). After stratification by sex, in 2017/2018 sample, dissatisfaction with overweight was 46.1% greater in boys, and dissatisfaction with thinness was 66.9% greater in girls. Factors found to be significantly associated with body image dissatisfaction were physical activity level, and body adiposity. CONCLUSIONS There was a secular trend toward increased body image dissatisfaction in both sexes. Future efforts should go beyond scientific production, in public and private environments aimed at increasing awareness of health issues related to body care in the physical, psychological, and environmental domains.
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Affiliation(s)
- Isadora Gonzaga
- Department of Physical Education, Santa Catarina State University, Florianópolis, Santa Catarina, Brazil
| | - Marina Ribovski
- Department of Physical Education, Santa Catarina State University, Florianópolis, Santa Catarina, Brazil
| | - Gaia Salvador Claumann
- Department of Physical Education, Santa Catarina State University, Florianópolis, Santa Catarina, Brazil
| | - Alexandra Folle
- Department of Physical Education, Santa Catarina State University, Florianópolis, Santa Catarina, Brazil
| | - Thais Silva Beltrame
- Department of Physical Education, Santa Catarina State University, Florianópolis, Santa Catarina, Brazil
| | - Maria Fernanda Laus
- Department of Nutrition, University of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
| | - Andreia Pelegrini
- Department of Physical Education, Santa Catarina State University, Florianópolis, Santa Catarina, Brazil
- * E-mail:
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22
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Quantitative risk-benefit assessment of Portuguese fish and other seafood species consumption scenarios. Br J Nutr 2022; 128:1997-2010. [PMID: 34872627 DOI: 10.1017/s0007114521004773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Portugal has high fish/seafood consumption, which may have both risks and benefits. This study aims to quantify the net health impact of hypothetical scenarios of fish/seafood consumption in the Portuguese population using a risk-benefit assessment methodology. Consumption data from the National Food, Nutrition and Physical Activity Survey 2015-2016 (n 5811) were used to estimate the mean exposure to methylmercury and EPA + DHA in the current and the alternative scenarios considered. Alternative scenarios (alt) were modelled using probabilistic approaches to reflect substitutions from the current consumption in the type of fish/seafood (alt1: excluding predatory fishes; alt2: including only methylmercury low-level fishes) or in the frequency of weekly fish/seafood consumption (alt3 to alt6: 1, 3, 5 or 7 times a week, replacing fish/seafood meals with meat or others). The overall health impact of these scenarios was quantified using disability-adjusted life years (DALY). In the Portuguese population, about 11 450 DALY could be prevented each year if the fish/seafood consumption increased to a daily basis. However, such a scenario would result in 1398 extra DALY considering the consumption by pregnant women and the respective risk on fetal neurodevelopment. Our findings support a recommendation to increase fish/seafood consumption up to 7 times/week. However, for pregnant women and children, special considerations must be proposed to avoid potential risks on fetal neurodevelopment due to methylmercury exposure.
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Nutritional intake and malnutrition in institutionalised and non-institutionalised older adults. Br J Nutr 2022; 128:921-931. [PMID: 34583786 DOI: 10.1017/s0007114521003925] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Malnutrition (synonym: undernutrition) is prevalent among older adults, which may be partly related to changes in dietary intake, but evidence on the link between malnutrition and diet is scarce. The aims of this study were to estimate the association between energy/nutrients intake and malnutrition, and to characterise nutritional inadequacy in institutionalised and non-institutionalised older adults. A national survey was conducted including a Portuguese representative sample of nursing home (NH) residents (n 563) and community-dwellers (n 837) aged ≥ 65 years. Data included socio-demographic characteristics, self-reported health, loneliness feelings, nutritional status (Mini Nutritional Assessment®) and dietary intake (two non-consecutive 24-h recalls). A higher energy intake was associated with lower odds of malnutrition risk (being 'at risk of malnutrition' or 'malnourished') in both settings, but only significant among NH residents after adjusting for confounders (NH: OR = 0·66, 95 % CI 0·50, 0·86; community: OR = 0·64, 95 % CI 0·37, 1·10). The intake of carbohydrates, fat, fibre, vitamin C, Na, K and Mg was inversely associated with malnutrition risk in NH residents, and protein, fat, vitamin B6, folates, Na, K, Ca and Mg intake in community-dwellers. After additional adjustment for total energy, only Na and Mg intake of community-dwellers remained significantly associated. The prevalence of inadequate nutrient intake was generally higher for the malnutrition risk group, which was particularly evident among community-dwellers. The effect of dietary intake on nutritional status seems more dependent on total energy and carbohydrates intake in institutionalised elders, whereas among community-dwellers protein and some micronutrients appear to have a greater impact.
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Interaction effects of socio-economic position in the association between eating location and diet quality in Portuguese children and adolescents: results from the National Food, Nutrition and Physical Activity Survey 2015-2016. Br J Nutr 2022; 128:940-947. [PMID: 34743770 DOI: 10.1017/s0007114521004049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study aims to evaluate the interaction effect of socio-economic environment (SEE) in the relationship between the eating location (EL) and diet quality, in children and adolescents. Data included Portuguese children and adolescents (3-17 years) from a National Dietary Survey Sample (IAN-AF 2015/2016, n 987). Dietary intake was obtained by 2-d food diaries (children) or 2-24-h-recall (adolescents). Participants were classified into four groups of EL: 'Home', 'Other homes', 'School' and 'Restaurants'. Diet quality was measured as a higher adherence to a healthy eating pattern. A previous developed socio-economic classification was used, and participants were grouped as belonging to a low socio-economic environment (LSE) or middle-high socio-economic environment (MHSE). Linear regression models were used to evaluate the association between EL and diet quality, stratified by the SEE. A statistically significant interaction effect was found (P < 0·01) for the SEE in the association between EL and diet quality. After adjustment for potential confounders, in LSE, participants belonging to 'Other homes' (β = -2·07; 95 % CI:-3·70, -0·44) and 'Restaurants' (β = -3·31; 95 % CI: -5·08, -1·54) had lower scores in the diet quality score, comparing to 'Home'. In MHSE, comparing with 'Home', 'Restaurants' showed lower diet quality (β = -1·56; 95 % CI:-2·65, -0·48), while the 'School' had better diet quality (β = 0·90; 95 % CI: 0·16, 1·64). The SEE influences the association between EL and diet quality and, belonging to more disadvantaged SEE, might represent a higher risk of unhealthy eating habits when eating out-of-home.
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Goiana-da-Silva F, Cruz-e-Silva D, Rito A, Lopes C, Muc M, Darzi A, Araújo F, Miraldo M, Morais Nunes A, Allen LN. Modeling the health impact of legislation to limit the salt content of bread in Portugal: A macro simulation study. Front Public Health 2022; 10:876827. [PMID: 36176524 PMCID: PMC9513608 DOI: 10.3389/fpubh.2022.876827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 07/20/2022] [Indexed: 01/21/2023] Open
Abstract
Background Excessive salt consumption-associated with a range of adverse health outcomes-is very high in Portugal, and bread is the second largest source. Current Portuguese legislation sets a maximum limit of 1.4 g salt per 100 g bread, but imported and traditional breads are exempted. In 2017 the Ministry of Health proposed reducing the salt threshold to 1.0/100 g by 2022, however the legislation was vetoed by the European Commission on free-trade grounds. Aims To estimate the health impact of subjecting imported and traditional breads to the current 1.4 g threshold, and to model the potential health impact of implementing the proposed 1.0 g threshold. Methods We gathered bread sales, salt consumption, and epidemiological data from robust publicly available data sources. We used the open source WHO PRIME modeling tool to estimate the number of salt-related deaths that would have been averted in 2016 (the latest year for which all data were available) from; (1) Extending the 1.4 g threshold to all types of bread, and (2) Applying the 1.0 g threshold to all bread sold in Portugal. We used Monte Carlo simulations to generate confidence intervals. Results Applying the current 1.4 g threshold to imported and traditional bread would have averted 107 deaths in 2016 (95% CI: 43-172). Lowering the current threshold from 1.4 to 1.0 g and applying it to all bread products would reduce daily salt consumption by 3.6 tons per day, saving an estimated 286 lives a year (95% CI: 123-454). Conclusions Salt is an important risk factor in Portugal and bread is a major source. Lowering maximum permissible levels and removing exemptions would save lives. The European Commission should revisit its decision on the basis of this new evidence.
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Affiliation(s)
- Francisco Goiana-da-Silva
- Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, United Kingdom,Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal
| | - David Cruz-e-Silva
- Center for Innovation, Technology and Policy Research, IN+, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Ana Rito
- National Institute of Health, Porto, Portugal
| | - Carla Lopes
- Department of Public Health and Forensic Sciences, and Medical Education, University of Porto Medical School, Porto, Portugal,Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Magdalena Muc
- Appetite and Obesity Research Group, Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Ara Darzi
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Fernando Araújo
- Centro Hospitalar Universitário São João, Faculty of Medicine, Porto University, Porto, Portugal
| | - Marisa Miraldo
- Department of Management, Centre for Health Economics and Policy Innovation, Imperial College Business School, London, United Kingdom
| | - Alexandre Morais Nunes
- Centro de Administração e Políticas Públicas, Instituto Superior de Ciências Sociais e Políticas, Universidade de Lisboa, Lisboa, Portugal
| | - Luke N. Allen
- London School of Hygiene and Tropical Medicine, London, United Kingdom,*Correspondence: Luke N. Allen
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The influence of item order of the Household Food Security Survey Module on the assessment of food insecurity in households with children. Public Health Nutr 2022; 25:2371-2379. [PMID: 35603679 PMCID: PMC9991806 DOI: 10.1017/s1368980022001239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Changes in the item order of the US Household Food Security Survey Module (USHFSSM) were performed throughout time. This study aimed to compare the psychometric properties of the general and specific factors of the 2000 and 2012 versions of the USHFSSM to measure the construct of food insecurity in two Portuguese samples of households with children. DESIGN Cross-sectional. SETTING Portugal. PARTICIPANTS An adaptation of the 2000 version was applied to 839 adults (from households with children aged 7-17 years) from the National Food, Nutrition and Physical Activity Survey 2015-2016, while the 2012 version was used among 2855 families from the Generation XXI birth cohort. RESULTS The 2000 version showed to have a stronger ωh than the 2012 version (0·89 v. 0·78 for the general factor), as well as eigenvalues higher than 1 for the general factor (eigenvalues equal to 9·54, 0·97 and 0·80, for the general factor, specific factor 1 and specific factor 2, respectively), while the 2012 version had also the contribution of specific factors to explain food insecurity (eigenvalues equal to 9·40, 2·40 and 1·20, for general factor and specific factors 1 and 2, respectively). Good internal consistency (ωt = 0·99, for both versions) was obtained. CONCLUSIONS In conclusion, the 2000 and 2012 versions of the USHFSSM showed good psychometric properties; however, the 2000 version has stronger general factor, while the 2012 version also has the contribution of specific factors.
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The effect of non-participation on the prevalence of food insecurity in a population-based cohort in Portugal. J Public Health Policy 2022; 43:391-402. [PMID: 36038767 DOI: 10.1057/s41271-022-00362-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 11/21/2022]
Abstract
Non-participation can be a source of selection bias. We evaluated the effect of non-participation on food insecurity prevalence among 2942 young adults from the EPITeen cohort (Portugal), which we have followed since assembling the cohort in 2003-2004. We conducted a cross-sectional study when the cohort participants were 26 years old. To examine the effect of non-participation, we statistically imputed the missing data on food security status using multivariate imputation by chained equations based on characteristics associated with food insecurity, specifically household income perception, education and household structure from 21 or 24 years of age follow-ups. In our cohort, non-participation caused ~ 2% difference in the food insecurity prevalence: 11.0% (95% CI 9.0-13.0) for 954 participants and 12.6% (95% CI 11.1-14.1) after imputation. These estimates are close to evidence from other European countries and sustain the relevance of developing public health interventions to promote food security, especially considering the negative nutritional and health outcomes associated with food insecurity.
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Martins C, Assunção R, Costa A, Serrano D, Visintin L, De Boevre M, Lachat C, Vidal A, De Saeger S, Namorado S, Vidigal C, Almeida E, Alvito P, Nunes C. earlyMYCO: A Pilot Mother-Child Cohort Study to Assess Early-Life Exposure to Mycotoxins—Challenges and Lessons Learned. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137716. [PMID: 35805375 PMCID: PMC9265400 DOI: 10.3390/ijerph19137716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022]
Abstract
Early-life exposure occurs during gestation through transfer to the fetus and later, during lactation. Recent monitoring data revealed that the Portuguese population is exposed to mycotoxins, including young children. This study aimed to develop a pilot study to assess the early-life exposure to mycotoxins through a mother–child cohort, and to identify the associated challenges. Participants were recruited during pregnancy (1st trimester) and followed-up in three moments of observation: 2nd trimester of pregnancy (mother), and 1st and 6th month of the child’s life (mother and child), with the collection of biological samples and sociodemographic and food consumption data. The earlyMYCO pilot study enrolled 19 mother–child pairs. The analysis of biological samples from participants revealed the presence of 4 out of 15 and 5 out of 18 mycotoxins’ biomarkers of exposure in urine and breast milk samples, respectively. The main aspects identified as contributors for the successful development of the cohort were the multidisciplinary and dedicated team members in healthcare units, reduced burden of participation, and the availability of healthcare units for the implementation of the fieldwork. Challenges faced, lessons learned, and suggestions were discussed as a contribution for the development of further studies in this area.
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Affiliation(s)
- Carla Martins
- National Institute of Health Dr Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisbon, Portugal; (R.A.); (S.N.); (P.A.)
- Centre for Environmental and Marine Studies, Campus Universitário de Santiago, University of Aveiro, 3810-193 Aveiro, Portugal; (A.C.); (D.S.)
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisbon, Portugal;
- Comprehensive Health Research Center, Campo Mártires da Pátria, Universidade NOVA de Lisboa, 1169-056 Lisbon, Portugal
- Correspondence:
| | - Ricardo Assunção
- National Institute of Health Dr Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisbon, Portugal; (R.A.); (S.N.); (P.A.)
- Centre for Environmental and Marine Studies, Campus Universitário de Santiago, University of Aveiro, 3810-193 Aveiro, Portugal; (A.C.); (D.S.)
- Comprehensive Health Research Center, Campo Mártires da Pátria, Universidade NOVA de Lisboa, 1169-056 Lisbon, Portugal
- Instituto Universitário Egas Moniz (IUEM), Egas Moniz-Cooperativa de Ensino Superior, CRL, 2829-511 Caparica, Portugal
| | - Ana Costa
- Centre for Environmental and Marine Studies, Campus Universitário de Santiago, University of Aveiro, 3810-193 Aveiro, Portugal; (A.C.); (D.S.)
| | - Débora Serrano
- Centre for Environmental and Marine Studies, Campus Universitário de Santiago, University of Aveiro, 3810-193 Aveiro, Portugal; (A.C.); (D.S.)
| | - Lia Visintin
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium; (L.V.); (M.D.B.); (C.L.); (A.V.); (S.D.S.)
| | - Marthe De Boevre
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium; (L.V.); (M.D.B.); (C.L.); (A.V.); (S.D.S.)
| | - Carl Lachat
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium; (L.V.); (M.D.B.); (C.L.); (A.V.); (S.D.S.)
| | - Arnau Vidal
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium; (L.V.); (M.D.B.); (C.L.); (A.V.); (S.D.S.)
| | - Sarah De Saeger
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium; (L.V.); (M.D.B.); (C.L.); (A.V.); (S.D.S.)
| | - Sónia Namorado
- National Institute of Health Dr Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisbon, Portugal; (R.A.); (S.N.); (P.A.)
- Centre for Environmental and Marine Studies, Campus Universitário de Santiago, University of Aveiro, 3810-193 Aveiro, Portugal; (A.C.); (D.S.)
| | - Cristina Vidigal
- ACES Lisboa Central, Regional Health Administration of Lisbon and Tagus Valley (ARSLVT), 1700-179 Lisbon, Portugal; (C.V.); (E.A.)
| | - Elisabete Almeida
- ACES Lisboa Central, Regional Health Administration of Lisbon and Tagus Valley (ARSLVT), 1700-179 Lisbon, Portugal; (C.V.); (E.A.)
| | - Paula Alvito
- National Institute of Health Dr Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisbon, Portugal; (R.A.); (S.N.); (P.A.)
- Centre for Environmental and Marine Studies, Campus Universitário de Santiago, University of Aveiro, 3810-193 Aveiro, Portugal; (A.C.); (D.S.)
| | - Carla Nunes
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisbon, Portugal;
- Comprehensive Health Research Center, Campo Mártires da Pátria, Universidade NOVA de Lisboa, 1169-056 Lisbon, Portugal
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Carvalho C, Correia D, Severo M, Magalhães V, Casal S, Ramos E, Lopes C, Torres D. Dietary exposure to artificial sweeteners and associated factors in the Portuguese population. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2022; 39:1206-1221. [PMID: 35604339 DOI: 10.1080/19440049.2022.2075039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study aimed to evaluate the risk of the Portuguese population's exposure to six non-nutritive intense sweeteners (NNIS) and their main associated factors. A tiered approach was used to estimate the usual exposure to the NNIS obtained from two 1-day food diaries among children and two 24-hour recalls among adults in the Portuguese national dietary survey (IAN-AF 2015-2016; age: 3-84 y; n = 5005). The tiers considered were the following: Tier 2.1 represents the most conservative tier, in which all foods reported were matched with the respective maximum permitted levels (MPLs); in Tier 2.2, the MPLs were attributed only to the foods for which the brand's label information identified the presence of an added NNIS; finally, Tier 3 was identical to Tier 2.2, but analytical NNIS occurrence data were used, instead of MPLs. The usual exposure of the Portuguese population to each NNIS was very low in all tiers across all age groups, as was the estimated prevalence of exposure above the acceptable daily intake. Soft drinks were the main source of exposure for most sweeteners, and acesulfame K and aspartame were the most consumed NNIS. The odds of exposure to at least one NNIS were higher in more highly educated adults and elderly, obese elderly, women, and people with lower healthy diet scores. The estimated risk of exceeding the safety levels of NNIS intake was very low in all evaluated population groups, even when considering the most conservative approach.
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Affiliation(s)
- Catarina Carvalho
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Daniela Correia
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Milton Severo
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Vânia Magalhães
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Susana Casal
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Faculdade de Farmácia, LAQV/REQUIMTE, Laboratório de Bromatologia e Hidrologia, Universidade do Porto, Porto, Portugal
| | - Elisabete Ramos
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Carla Lopes
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Duarte Torres
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
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30
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Gurugubelli VS, Fang H, Shikany JM, Balkus SV, Rumbut J, Ngo H, Wang H, Allison JJ, Steffen LM. A review of harmonization methods for studying dietary patterns. SMART HEALTH (AMSTERDAM, NETHERLANDS) 2022; 23:100263. [PMID: 35252528 PMCID: PMC8896407 DOI: 10.1016/j.smhl.2021.100263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Data harmonization is the process by which each of the variables from different research studies are standardized to similar units resulting in comparable datasets. These data may be integrated for more powerful and accurate examination and prediction of outcomes for use in the intelligent and smart electronic health software programs and systems. Prospective harmonization is performed when researchers create guidelines for gathering and managing the data before data collection begins. In contrast, retrospective harmonization is performed by pooling previously collected data from various studies using expert domain knowledge to identify and translate variables. In nutritional epidemiology, dietary data harmonization is often necessary to construct the nutrient and food databases necessary to answer complex research questions and develop effective public health policy. In this paper, we review methods for effective data harmonization, including developing a harmonization plan, which common standards already exist for harmonization, and defining variables needed to harmonize datasets. Currently, several large-scale studies maintain harmonized nutrient databases, especially in Europe, and steps have been proposed to inform the retrospective harmonization process. As an example, data harmonization methods are applied to several U.S longitudinal diet datasets. Based on our review, considerations for future dietary data harmonization include user agreements for sharing private data among participating studies, defining variables and data dictionaries that accurately map variables among studies, and the use of secure data storage servers to maintain privacy. These considerations establish necessary components of harmonized data for smart health applications which can promote healthier eating and provide greater insights into the effect of dietary patterns on health.
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Affiliation(s)
| | - Hua Fang
- University of Massachusetts Dartmouth, 285 Old Westport Rd, North Dartmouth, 02747, Massachusetts, USA
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 N Lake Ave, Worcester, 01655, Massachusetts, USA
- Corresponding author. Tel.: +0-508-910-6411;
| | - James M Shikany
- Division of Preventive Medicine, University of Alabama at Birmingham, 1720 University Blvd, Birmingham, 35294, Alabama, USA
| | - Salvador V Balkus
- University of Massachusetts Dartmouth, 285 Old Westport Rd, North Dartmouth, 02747, Massachusetts, USA
| | - Joshua Rumbut
- University of Massachusetts Dartmouth, 285 Old Westport Rd, North Dartmouth, 02747, Massachusetts, USA
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 N Lake Ave, Worcester, 01655, Massachusetts, USA
| | - Hieu Ngo
- University of Massachusetts Dartmouth, 285 Old Westport Rd, North Dartmouth, 02747, Massachusetts, USA
| | - Honggang Wang
- University of Massachusetts Dartmouth, 285 Old Westport Rd, North Dartmouth, 02747, Massachusetts, USA
| | - Jeroan J Allison
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 N Lake Ave, Worcester, 01655, Massachusetts, USA
| | - Lyn M. Steffen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, 55455, Minnesota, USA
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Sugar-sweetened beverages, effects on appetite and public health strategies to reduce the consumption among children: a review. Porto Biomed J 2022; 7:e172. [PMID: 35146179 PMCID: PMC8824388 DOI: 10.1097/j.pbj.0000000000000172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 10/04/2021] [Indexed: 11/26/2022] Open
Abstract
Sugar-sweetened beverages (SSBs) consumption have been of public health concern and a target of interventions due to their high consumption and burden in health-related consequences, particularly in children and adolescents. SSBs provide high energy intake with low nutritional value and are a major contributor for added and free sugars intake of Portuguese in all age-groups, especially adolescents. Despite its recognized effect on weight gain, it might also disrupt appetite regulation. Research on the effect of SSBs on appetitive traits is still scarce and unclear, and the current knowledge of these potential effects will be discussed in this review. This review also aims to describe public health strategies implemented to decrease SSBs consumption among children, particularly in Portugal, such as: (i) implemented taxation measures and its impact in sales and in preventable cases of disease and death, (ii) marketing regulations applied to children and adolescents, and ultimately (iii) the intention of application of a single Front-of-Package labeling system in all countries, aiming to increase consumers’ food literacy.
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Active and sedentary behaviors in youth (6–14 years old): Data from the IAN-AF survey (2015–2016). Porto Biomed J 2022; 7:e161. [PMID: 35146174 PMCID: PMC8824390 DOI: 10.1097/j.pbj.0000000000000161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 03/04/2021] [Accepted: 06/07/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Strategic health interventions must be guided by effective surveillance systems that monitor population trends and patterns, therefore we aimed to provide youth's (6–14 years) national prevalence estimates of physical activity (PA), active outdoor play (AOP), sedentary behaviur (SB), and structured PA (SPA). Methods: Measures of moderate-to-vigorous PA, SB, AOP, and SPA, were obtained for 719 participants in 2 groups (6–9 and 10–14 years) using diaries and questionnaires. National estimates were calculated, by sex, region, and parental education. Results: While 54% (95%CI: 47.4–61.3) of youth meet PA recommendations, the prevalence is lower for the older group (P = .034). Similarly, AOP decreases with age both on weekends, from 94.3% (95%CI: 90.8–97.8) to 68.7% (95%CI: 62.2–75.1), and on weekdays from 84% (95%CI: 76.5–91.5) to 64.8% (95%CI: 59–70.6). Watching TV for ≥2 h/day is extremely high on weekends [71.3% (95%CI: 65.4–77.2)] and more prevalent in boys than girls on weekdays (P = .043). Higher parental education significantly increased SPA and active time. Time in SB was greater in boys [7.26 h (95%CI: 6.87–7.65)] than girls [6.48 h (95%CI: 6.09–6.87)] and increased with age (P < .001). Conclusions: Almost half of the youth failed to achieve PA guidelines, whereas 71% exceeded recommended TV time on weekends, suggesting the urgency of intervention measures.
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UCHIZAWA A, FUNAYAMA A, OSUMI H, ENOMOTO Y, ZHANG S, TOKUYAMA K, OMI N, SAGAYAMA H. Food Quotient Assessments Using One-Week Dietary Records and Food Frequency Questionnaires of Young Japanese Runners. J Nutr Sci Vitaminol (Tokyo) 2022; 68:47-54. [DOI: 10.3177/jnsv.68.47] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Akiko UCHIZAWA
- Graduate School of Comprehensive Human Science, University of Tsukuba
| | - Airi FUNAYAMA
- Graduate School of Comprehensive Human Science, University of Tsukuba
| | - Haruka OSUMI
- Graduate School of Comprehensive Human Science, University of Tsukuba
| | | | - Simeng ZHANG
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba
| | - Kumpei TOKUYAMA
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba
| | - Naomi OMI
- Faculty of Health and Sport Sciences, University of Tsukuba
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Vellinga RE, Sam M, Verhagen H, Jakobsen LS, Ravn-Haren G, Sugimoto M, Torres D, Katagiri R, Thu BJ, Granby K, Hoekstra J, Temme EHM. Increasing Seaweed Consumption in the Netherlands and Portugal and the Consequences for the Intake of Iodine, Sodium, and Exposure to Chemical Contaminants: A Risk-Benefit Study. Front Nutr 2022; 8:792923. [PMID: 35071298 PMCID: PMC8770327 DOI: 10.3389/fnut.2021.792923] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/11/2021] [Indexed: 01/26/2023] Open
Abstract
Background: Seaweed has a high potential for nourishing the future planet. However, besides being beneficial, it also contains adverse components; this poses the question whether consumption of seaweed foods overall contributes beneficially or detrimentally to human health, and hence if their consumption should be promoted or restricted. Methods: This study evaluated the impact of substituting regular foods with seaweed foods in the diet, both in terms of nutritional quality (via iodine and sodium) and food safety (via arsenic, cadmium, lead, and mercury). Food consumption data from the Netherlands and Portugal (adults aged >18 years) were used, in which 10% of the amounts of pasta, bacon, and lettuce consumed were replaced by seaweed-derived products made from kelp (Saccharina latissima). Using Monte Carlo Risk Assessment software (MCRA), long-term nutrient intake and exposure to contaminants were assessed. The results obtained for the Netherlands and Portugal were compared with data from Japan, a country that has a high natural consumption of seaweed. Results: This low-tier risk-benefit study reveals that an increased seaweed consumption (as assessed by the 10% replacement with seaweed products) has no consequences in terms of intake of sodium and exposure to cadmium, lead, and mercury, and the associated (absence of) adverse health aspects. The alternative scenario almost doubled the mean iodine intake in the Netherlands (to 300 μg/day) and Portugal (to 208 μg/day) and increased the average exposure to arsenic levels in the Netherlands (to 1.02 μg/kg bw/day) and Portugal (to 1.67 μg/kg bw/day). Conclusion: The intake of iodine and exposure to arsenic in the Netherland and Portugal were certainly higher due to the modeled increase of seaweed foods. If seaweed consumption increases close to the 10% substitution, the public health consequences thereof may trigger further research.
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Affiliation(s)
- Reina Elisabeth Vellinga
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Matthijs Sam
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Hans Verhagen
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | | | - Gitte Ravn-Haren
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Minami Sugimoto
- Department of Social and Preventive Epidemiology, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Duarte Torres
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Ryoko Katagiri
- Division of Epidemiology, Center for Public Health Science, National Cancer Center, Tokyo, Japan
| | | | - Kit Granby
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Jeljer Hoekstra
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Elisabeth Helena Maria Temme
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
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Fernandes AC, Marinho AR, Lopes C, Ramos E. Dietary glycemic load and its association with glucose metabolism and lipid profile in young adults. Nutr Metab Cardiovasc Dis 2022; 32:125-133. [PMID: 34893403 DOI: 10.1016/j.numecd.2021.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 09/08/2021] [Accepted: 10/01/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM To evaluate the association of Glycemic Load (GL) with glucose metabolism and blood lipids among young adults. METHODS AND RESULTS This study included 1538 participants (51% females), evaluated at 21 years of age as part of the EPITeen cohort. The GL of each individual was obtained from the assessment of their dietary intake by using a 86-item semi-quantitative food frequency questionnaire. The evaluation included anthropometric measurements and a fasting blood sample was used to measure glucose, insulin, triglycerides, total cholesterol, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Insulin resistance was calculated based on the homeostasis model method (HOMA-IR). The association between the GL and the biochemical parameters was evaluated by linear regression models using β and 95% confidence intervals (95% CI), stratified by sex and adjusted for body mass index (BMI), energy and fiber intake, and self-perceived social class. No association was found between GL and the glucose metabolism parameters after adjustment. Regarding blood lipids, a positive association was found with LDL-C (β = 1.507, 95% CI 0.454; 2.561 for females; β = 0.216, 95% CI -0.587; 1.020 for males) and a negative association with HDL-C (β = -0.647, 95% CI -1.112; -0.181 for females; β = -0.131, 95% CI -0.422; 0.160 for males). CONCLUSIONS Our results suggest that, in healthy young subjects, a high GL diet may have a negative impact on lipid profile.
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Affiliation(s)
| | - Ana Rita Marinho
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Portugal
| | - Carla Lopes
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Portugal
| | - Elisabete Ramos
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Portugal.
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Magalhães V, Severo M, Torres D, Goios A, Ramos E, Lopes C. Energy intake misreport: how different methods affect its prevalence and nutrient intake estimates. Ann Hum Biol 2021; 48:557-566. [PMID: 34818956 DOI: 10.1080/03014460.2021.2010805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Although different methods for the evaluation of energy intake (EI) misreport have been described, it is unclear which one is the most appropriate. AIM To assess the performance of these methods in the prevalence of EI misreports and accuracy of nutrient intake estimates. METHODS Reports of 3,639 adults from the Portuguese National Food, Nutrition and Physical Activity Survey 2015-2016 were classified using univariate (Willett; interquartile range) and multivariate (Goldberg; predicted total energy expenditure [pTEE], testing different standard deviations [SD]) methods. Self-reported intakes were compared to their respective estimates by urinary excretion in a sub-sample of 80. The effect of the exclusion of misreporters on nutrient estimates was assessed by the differences in linear regression coefficients between plausible and total sample. RESULTS The highest prevalence of EI misreport was observed using pTEE 1SD (63.9%). Differences in the associations between nutrient self-reported intake and estimated intake using urinary biomarkers were verified with misreporters' exclusion by pTEE 1SD method (β-protein = 0.209; 95% CI = 0.074-0.529; β-potassium = 0.276; 95% CI = 0.060-0.560) and Goldberg 2SD (β-protein = 0.080; 95% CI = 0.025-0.235; β-potassium = 0.106; 95% CI = -0.048-0.246). CONCLUSIONS Multivariate methods lead to a higher prevalence of misreports and larger differences in nutrient estimates. The application of the pTEE 1SD and Goldberg 2SD methods resulted in more accurate nutrient estimates.
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Affiliation(s)
- Vânia Magalhães
- EP IUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal
| | - Milton Severo
- EP IUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto - Alameda Professor Hernâni Monteiro, Porto, Portugal
| | - Duarte Torres
- EP IUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal.,Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto - Rua Dr. Roberto Frias, Porto, Portugal
| | - Ana Goios
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto - Rua Dr. Roberto Frias, Porto, Portugal
| | - Elisabete Ramos
- EP IUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto - Alameda Professor Hernâni Monteiro, Porto, Portugal
| | - Carla Lopes
- EP IUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto - Alameda Professor Hernâni Monteiro, Porto, Portugal
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An Ultra-Processed Food Dietary Pattern Is Associated with Lower Diet Quality in Portuguese Adults and the Elderly: The UPPER Project. Nutrients 2021; 13:nu13114119. [PMID: 34836373 PMCID: PMC8619325 DOI: 10.3390/nu13114119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/10/2021] [Accepted: 11/15/2021] [Indexed: 11/17/2022] Open
Abstract
This study aimed to identify dietary patterns (DPs) and their associations with sociodemographic factors and diet quality in Portuguese adults and the elderly. Cross-sectional data were obtained from the National Food, Nutrition and Physical Activity Survey (2015-2016), with two non-consecutive dietary 24 h recalls. Food items were classified according to the NOVA system and its proportion (in grams) in the total daily diet was considered to identify DPs by latent class analysis, using age and sex as concomitant variables. Multinomial logistic and linear regressions were performed to test associations of DPs with sociodemographic characteristics and diet quality, respectively. Three DPs were identified: "Traditional" (higher vegetables, fish, olive oil, breads, beer and wine intake), "Unhealthy" (higher pasta, sugar-sweetened beverages, confectionery and sausages intake) and "Diet concerns" (lower intake of cereals, red meat, sugar-sweetened and alcoholic beverages). "Unhealthy" was associated with being younger and lower intake of dietary fiber and vitamins and the highest free sugars and ultra-processed foods (UPF). "Diet concerns" was associated with being female and a more favorable nutrient profile, but both DPs presented a higher contribution of UPF than the "Traditional" DP. These findings should be considered for the design of food-based interventions and public policies for these age groups in Portugal.
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Maia I, Santos AC. Prevalence and determinants of children self-reports of food insecurity: evidence from a Portuguese population-based birth cohort. Food Secur 2021. [DOI: 10.1007/s12571-021-01233-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Associated factors to the consumption of ultra-processed foods and its relation with dietary sources in Portugal. J Nutr Sci 2021; 10:e89. [PMID: 34733501 PMCID: PMC8532074 DOI: 10.1017/jns.2021.61] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/13/2021] [Accepted: 07/30/2021] [Indexed: 12/15/2022] Open
Abstract
Ultra-processed foods (UPFs) are common worldwide and associated with poorer health outcomes. This work aimed to explore the UPF consumption associated factors and its main dietary sources, by sex, in Portugal. Participants from the National Food, Nutrition and Physical Activity Survey (IAN-AF) 2015-2016, aged 3-84 years, were included (n 5005). Dietary intake was assessed through two 1-day food diaries/24 h recalls. UPFs were identified using the NOVA classification. Associations were evaluated through linear regression models. Median UPF consumption was 257 g/d (10⋅6 % of total quantity; 23⋅8 % of total energy). Adolescents were those with higher consumption (490 g/d). Compared to adults, younger ages were positively associated with UPF consumption (e.g. adolescents (-females: 192, 95 % confidence interval (CI): 135, 249; -males: 327, 95 % CI: 277, 377)). A lower educational level was associated with lower UPF consumption (-females: -63; 95 % CI: -91, -34; -males: -68; 95 % CI: -124, -12). Also, a lower UPF consumption was observed in married males/couples compared to singles (: -48, 95 % CI: -96, -1). Furthermore, female current/former smokers were associated with a higher UPF consumption v. never smokers (: 79, 95 % CI: 41, 118; : 42, 95 % CI: 8, 75, respectively). Main UPF sources were yoghurts, soft drinks and cold meats/sausages differing strongly by sex, age and education level. Yoghurts containing additives were the main contributors to the UPF consumption in children and adult females from all education (~20 %). Soft drinks were leaders in adolescents (females: 26⋅0 %; males: 31⋅6 %) and young male adults (24⋅4 %). Cold meats/sausages stood out among low-educated males (20⋅5 %). Males, younger age groups, higher education, children with less-educated parents, married/couple males and smoking females were positively associated with UPF consumption.
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de Moraes MM, Oliveira B, Afonso C, Santos C, Torres D, Lopes C, de Miranda RC, Rauber F, Antoniazzi L, Levy RB, Rodrigues S. Dietary Patterns in Portuguese Children and Adolescent Population: The UPPER Project. Nutrients 2021; 13:nu13113851. [PMID: 34836107 PMCID: PMC8622610 DOI: 10.3390/nu13113851] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 02/07/2023] Open
Abstract
Considering the nature, extent, and purpose of food processing, this study aims to identify dietary patterns (DPs) and their associations with sociodemographic factors and diet quality in Portuguese children and adolescents. Cross-sectional data were obtained from the National Food, Nutrition and Physical Activity Survey (2015-2016) of the Portuguese population. Dietary intake was obtained from two non-consecutive days and food items were classified according to the NOVA system. The proportion (in grams) of foods in the total daily diet was considered to identify DPs by latent class analysis, with age and sex as concomitant variables. Associations of DPs with sociodemographic characteristics were assessed using multinomial logistic regression. Linear regressions adjusted by sociodemographic characteristics tested associations of DPs with diet quality. DPs identified were: "Unhealthy" (higher sugar-sweetened beverages, industrial breads, and sausages intake), "Traditional" (higher vegetables, fish, olive oil, breads, ultra-processed yogurts, and sausages intake), and "Dairy" (higher intake of milk, yogurt, and milk-based beverages). "Unhealthy" was associated with older ages and lower intake of dietary fibre and vitamins and the highest free sugars and ultra-processed foods (UPF), although all DPs presented significant consumption of UPF. These findings should be considered for the design of food-based interventions and school-feeding policies in Portugal.
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Affiliation(s)
- Milena Miranda de Moraes
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (B.O.); (C.A.); (C.S.); (D.T.); (S.R.)
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal;
- Correspondence: ; Tel.: +351-22-507-4320
| | - Bruno Oliveira
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (B.O.); (C.A.); (C.S.); (D.T.); (S.R.)
- Artificial Intelligence and Decision Support (LIAAD), Institute for Systems and Computer Engineering, Technology and Science (INESC TEC), 4200-465 Porto, Portugal
| | - Cláudia Afonso
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (B.O.); (C.A.); (C.S.); (D.T.); (S.R.)
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal;
| | - Cristina Santos
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (B.O.); (C.A.); (C.S.); (D.T.); (S.R.)
- Center for Health Technology and Services Research (CINTESIS), Associate Laboratory RISE-Health Research Network, University of Porto, 4200-450 Porto, Portugal
| | - Duarte Torres
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (B.O.); (C.A.); (C.S.); (D.T.); (S.R.)
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal;
| | - Carla Lopes
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal;
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Renata Costa de Miranda
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo 01246-90, Brazil; (R.C.d.M.); (F.R.); (L.A.); (R.B.L.)
- Department of Nutrition, Institute of Health Sciences, Federal University of Triângulo Mineiro, Uberaba 38025-440, Brazil
| | - Fernanda Rauber
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo 01246-90, Brazil; (R.C.d.M.); (F.R.); (L.A.); (R.B.L.)
- Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo 01246-90, Brazil
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-90, Brazil
| | - Luiza Antoniazzi
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo 01246-90, Brazil; (R.C.d.M.); (F.R.); (L.A.); (R.B.L.)
- Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo 01246-90, Brazil
| | - Renata Bertazzi Levy
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo 01246-90, Brazil; (R.C.d.M.); (F.R.); (L.A.); (R.B.L.)
- Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo 01246-90, Brazil
| | - Sara Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (B.O.); (C.A.); (C.S.); (D.T.); (S.R.)
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal;
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Assunção R, Boué G, Alvito P, Brazão R, Carmona P, Carvalho C, Correia D, Fernandes P, Lopes C, Martins C, Membré JM, Monteiro S, Nabais P, Thomsen ST, Torres D, Pires SM, Jakobsen LS. Risk-Benefit Assessment of Cereal-Based Foods Consumed by Portuguese Children Aged 6 to 36 Months-A Case Study under the RiskBenefit4EU Project. Nutrients 2021; 13:3127. [PMID: 34579004 PMCID: PMC8467172 DOI: 10.3390/nu13093127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 11/22/2022] Open
Abstract
Cereal-based foods, including breakfast (BC) and infant cereals (IC), are among the first solid foods introduced to infants. BC and IC are sources of macro and micronutrients that have beneficial effects on health, but can also be sources of harmful chemical and microbiological contaminants and nutrients that may lead to adverse health effects at high consumption levels. This study was performed under the RiskBenefit4EU project with the aim of assessing the health impact associated with consumption of BC and IC by Portuguese children under 35 months. Adverse effects associated with the presence of aflatoxins, Bacillus cereus, sodium and free sugars were assessed against the benefits of fiber intake. We applied a risk-benefit assessment approach, and quantified the health impact of changes in consumption of BC and IC from current to various alternative consumption scenarios. Health impact was assessed in terms of disability-adjusted life years. Results showed that moving from the current consumption scenario to considered alternative scenarios results in a gain of healthy life years. Portuguese children can benefit from exchanging intake of IC to BC, if the BC consumed has an adequate nutritional profile in terms of fiber, sodium and free sugars, with levels of aflatoxins reduced as much as possible.
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Affiliation(s)
- Ricardo Assunção
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, 1649-016 Lisboa, Portugal; (P.A.); (R.B.); (C.M.)
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, 3810-193 Aveiro, Portugal
- IUEM, Instituto Universitário Egas Moniz, Egas Moniz-Cooperativa de Ensino Superior, CRL, 2829-511 Caparica, Portugal
| | - Géraldine Boué
- INRAe, Oniris, Secalim, 44307 Nantes, France; (G.B.); (P.F.); (J.-M.M.)
| | - Paula Alvito
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, 1649-016 Lisboa, Portugal; (P.A.); (R.B.); (C.M.)
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Roberto Brazão
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, 1649-016 Lisboa, Portugal; (P.A.); (R.B.); (C.M.)
| | - Paulo Carmona
- Food Risks Unit, Economic and Food Safety Authority (ASAE), 1649-038 Lisboa, Portugal; (P.C.); (S.M.); (P.N.)
| | - Catarina Carvalho
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (C.C.); (D.T.)
- EPIUnit—Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (D.C.); (C.L.)
| | - Daniela Correia
- EPIUnit—Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (D.C.); (C.L.)
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
| | - Paulo Fernandes
- INRAe, Oniris, Secalim, 44307 Nantes, France; (G.B.); (P.F.); (J.-M.M.)
| | - Carla Lopes
- EPIUnit—Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (D.C.); (C.L.)
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
| | - Carla Martins
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, 1649-016 Lisboa, Portugal; (P.A.); (R.B.); (C.M.)
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, 3810-193 Aveiro, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal
| | | | - Sarogini Monteiro
- Food Risks Unit, Economic and Food Safety Authority (ASAE), 1649-038 Lisboa, Portugal; (P.C.); (S.M.); (P.N.)
| | - Pedro Nabais
- Food Risks Unit, Economic and Food Safety Authority (ASAE), 1649-038 Lisboa, Portugal; (P.C.); (S.M.); (P.N.)
| | - Sofie T. Thomsen
- Division for Diet, Disease Prevention and Toxicology, The National Food Institute, Technical University of Denmark, 2800 Kgs Lyngby, Denmark; (S.T.T.); (S.M.P.); (L.S.J.)
| | - Duarte Torres
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (C.C.); (D.T.)
- EPIUnit—Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (D.C.); (C.L.)
| | - Sara M. Pires
- Division for Diet, Disease Prevention and Toxicology, The National Food Institute, Technical University of Denmark, 2800 Kgs Lyngby, Denmark; (S.T.T.); (S.M.P.); (L.S.J.)
| | - Lea S. Jakobsen
- Division for Diet, Disease Prevention and Toxicology, The National Food Institute, Technical University of Denmark, 2800 Kgs Lyngby, Denmark; (S.T.T.); (S.M.P.); (L.S.J.)
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Santos M, Matias F, Rito AI, Castanheira I, Torres D, Loureiro I, Assunção R. Breakfast Cereals Intended for Children: Opportunities for Reformulation and Potential Impact on Nutrient Intake. Foods 2021; 10:1772. [PMID: 34441549 PMCID: PMC8394760 DOI: 10.3390/foods10081772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/15/2021] [Accepted: 07/28/2021] [Indexed: 11/17/2022] Open
Abstract
Ready-to-eat cereals (RTECs) have become a popular breakfast option claiming to provide important nutrients to children's diets, despite being a source of excess sugar and, therefore, a health concern. Thus, food reformulation constitutes an important public health strategy that could benefit from inputs provided by nutrient profiling. This study aimed to assess the adequacy of the RTECs for children available in Portuguese supermarkets, applying three nutrient profile models (NPMs)-the nutrient profile model of the World Health Organization's Regional Office for Europe (WHO-EURO), the profile of the private-sector EU Pledge (EU-Pledge), and the national model developed by the Directorate-General of Health (NPM-PT)-in order to explore the potential for reformulation of the RTECs identified as not adequate and evaluate the impact of RTECs' reformulation on the nutritional quality of Portuguese children's diets. In total, 78 RTECs intended for children were assessed and two scenarios-current (not considering reformulation) and alternative (considering reformulation to accomplish the nutrient profile requirements)-were considered to assess the impact of reformulation on nutritional quality. Across all RTECs, only 5.1% could be promoted to children according to the considered NPMs. The most common nutrients requiring reformulation were sugar, saturated fatty acids (SFA), salt, and dietary fiber. The scenarios of reformulation considered could reduce the RTECs average content of total sugars, SFA, and salt by 43%, 8.7%, and 1.1%, respectively, and dietary fiber intake could be increased by 34%. Thus, these results support policies to implement reformulation strategies for developing healthier food products to be promoted to children.
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Affiliation(s)
- Mariana Santos
- Food and Nutrition Department, National Health Institute Dr Ricardo Jorge, Av Padre Cruz, 1649-016 Lisboa, Portugal; (M.S.); (F.M.); (A.I.R.); (I.C.)
- NOVA National School of Public Health, NOVA University of Lisbon, Av Padre Cruz, 1600-560 Lisboa, Portugal
| | - Filipa Matias
- Food and Nutrition Department, National Health Institute Dr Ricardo Jorge, Av Padre Cruz, 1649-016 Lisboa, Portugal; (M.S.); (F.M.); (A.I.R.); (I.C.)
| | - Ana Isabel Rito
- Food and Nutrition Department, National Health Institute Dr Ricardo Jorge, Av Padre Cruz, 1649-016 Lisboa, Portugal; (M.S.); (F.M.); (A.I.R.); (I.C.)
- Center for Studies and Research in Social Dynamics and Health (CEIDSS), Av Padre Cruz, 1649-016 Lisboa, Portugal
| | - Isabel Castanheira
- Food and Nutrition Department, National Health Institute Dr Ricardo Jorge, Av Padre Cruz, 1649-016 Lisboa, Portugal; (M.S.); (F.M.); (A.I.R.); (I.C.)
| | - Duarte Torres
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Rua Das Taipas 135, 4050-091 Porto, Portugal;
- Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - Isabel Loureiro
- NOVA National School of Public Health, Public Health Research Center (CISP), Comprehensive Health Research Center, NOVA University of Lisbon, Avenida Padre Cruz, 1600-560 Lisboa, Portugal;
| | - Ricardo Assunção
- Food and Nutrition Department, National Health Institute Dr Ricardo Jorge, Av Padre Cruz, 1649-016 Lisboa, Portugal; (M.S.); (F.M.); (A.I.R.); (I.C.)
- NOVA National School of Public Health, Public Health Research Center (CISP), Comprehensive Health Research Center, NOVA University of Lisbon, Avenida Padre Cruz, 1600-560 Lisboa, Portugal;
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
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Abstract
BACKGROUND Adherence to the Mediterranean diet has been decreasing in southern Europe, which could be linked to several cultural or educational factors. Our aim is to evaluate the extent to which economic aspects may also play a role, exploring the relationship between food prices in Portugal and adherence to the Mediterranean diet. METHODS We evaluated data from the Portuguese National Food, Nutrition, and Physical Activity Survey (IAN-AF 2015-2016) (n=3,591). Diet expenditures were estimated by attributing a retail price to each food group and the diet was transposed into the Mediterranean Diet Score used in the literature. Prices were gathered from five supermarket chains (65% of the Portuguese market share). Linear regression models were used to assess the association between different adherence levels to the MD levels and dietary costs. RESULTS Greater adherence to the MD was associated with a 21.2% (p< 0.05) rise in total dietary cost, which accounts for more 0.59€ in mean daily costs when compared with low adherence. High adherence individuals (vs. low adherence) had higher absolute mean daily costs with fish (0.62€/+285.8%; p< 0.05), fruits (0.26€/+115.8%; p< 0.05), and vegetables (0.10€/+100.9%; p< 0.05). The analysis stratified by education and income level showed significantly higher mean daily diet cost only amongst higher income groups. CONCLUSIONS Our findings suggest that greater adherence to the MD was positively and significantly associated with higher total dietary cost. Policies to improve population's diet should take into consideration the cost of healthy foods, especially for large low- and middle-income families.
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Vasco E, Dias MG, Oliveira L. The first harmonised total diet study in Portugal: Planning, sample collection and sample preparation. Food Chem 2021; 363:130258. [PMID: 34214890 DOI: 10.1016/j.foodchem.2021.130258] [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: 12/31/2020] [Revised: 05/27/2021] [Accepted: 05/30/2021] [Indexed: 11/30/2022]
Abstract
The first Total Diet Study (TDS) was carried out in Portugal using harmonised procedures developed under the TDS-Exposure project. This publication describes in detail the TDS planning, sample collection and preparation, filling a gap found in literature. TDS food list (1070 items) by food group for 18-74 years olds was derived using 24 h recall food consumption survey data. Of the 164 TDS samples defined based on FoodEx2, the most represented belonged to 'Composite dishes' (21%) and 'Fish and Fish products' (15%). A total of 227 TDS samples (12 subsamples each), were collected (2014-2016) in Greater Lisbon region as 126 'national', 17 'regional non-seasonal' and 21 'regional seasonal'. Seasonal samples were mostly fruits, vegetables and some fish. Subsamples were prepared as consumed, pooled, homogenised and stored at -18 °C. The harmonised procedures used allow comparison of exposure assessment with other countries and evaluation of exposure trends if TDS are used.
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Affiliation(s)
- Elsa Vasco
- Food and Nutrition Department, National Institute of Health Doutor Ricardo Jorge, IP (INSA), Av. Padre Cruz, 1649-016 Lisboa, Portugal
| | - M Graça Dias
- Food and Nutrition Department, National Institute of Health Doutor Ricardo Jorge, IP (INSA), Av. Padre Cruz, 1649-016 Lisboa, Portugal.
| | - Luísa Oliveira
- Food and Nutrition Department, National Institute of Health Doutor Ricardo Jorge, IP (INSA), Av. Padre Cruz, 1649-016 Lisboa, Portugal
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Oliveira A, Lopes C, Torres D, Ramos E, Severo M. Application of a Latent Transition Model to Estimate the Usual Prevalence of Dietary Patterns. Nutrients 2020; 13:nu13010133. [PMID: 33396483 PMCID: PMC7823363 DOI: 10.3390/nu13010133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 11/30/2022] Open
Abstract
Background: This study aims to derive habitual dietary patterns of the Portuguese adult population by applying two methodological approaches: a latent class model and a latent transition model. The novel application of the latent transition model allows us to determine the day-to-day variability of diet and to calculate the usual prevalence of dietary patterns. Methods: Participants are from the National Food, Nutrition and Physical Activity Survey of the Portuguese population, 2015–2016 (2029 women; 1820 men, aged ≥18 years). Diet was collected by two 24 h dietary recalls (8–15 days apart). Dietary patterns were derived by: (1) a latent class model using the arithmetic mean of food weigh intake, with concomitant variables (age and sex); (2) a latent transition model allowing the transition from one pattern to another, with the same concomitant variables. Results: Six dietary patterns were identified by a latent class model. By using a latent transition model, three dietary patterns were identified: “In-transition to Western” (higher red meat and alcohol intake; followed by middle-aged men), “Western” (higher meats/eggs and energy-dense foods intake; followed by younger men), and “Traditional-Healthier” (higher intake of fruit, vegetables and fish, characteristic of older women). Most individuals followed the same pattern on both days, but around 26% transited between “In-transition to Western” and “Western”. The prevalence of the dietary patterns using a single recall day (40%, 27%, 33%, respectively) is different from the usual prevalence obtained by the latent transition probabilities (48%, 36%, 16%). Conclusion: Three dietary patterns, largely dependent on age and sex, were identified for the Portuguese adult population: “In-transition to Western” (48%), “Western” (36%), and “Traditional-Healthier” (16%), but 26% were transient between patterns. Dietary patterns are, in general, deviating from traditional habits.
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Affiliation(s)
- Andreia Oliveira
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (C.L.); (D.T.); (E.R.); (M.S.)
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal
- Correspondence:
| | - Carla Lopes
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (C.L.); (D.T.); (E.R.); (M.S.)
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal
| | - Duarte Torres
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (C.L.); (D.T.); (E.R.); (M.S.)
- Faculty of Nutrition and Food Sciences, University of Porto, Rua do Campo Alegre 823, 4150-180 Porto, Portugal
| | - Elisabete Ramos
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (C.L.); (D.T.); (E.R.); (M.S.)
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal
| | - Milton Severo
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (C.L.); (D.T.); (E.R.); (M.S.)
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal
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Beckmann M, Wilson T, Lloyd AJ, Torres D, Goios A, Willis ND, Lyons L, Phillips H, Mathers JC, Draper J. Challenges Associated With the Design and Deployment of Food Intake Urine Biomarker Technology for Assessment of Habitual Diet in Free-Living Individuals and Populations-A Perspective. Front Nutr 2020; 7:602515. [PMID: 33344495 PMCID: PMC7745244 DOI: 10.3389/fnut.2020.602515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/29/2020] [Indexed: 12/27/2022] Open
Abstract
Improvement of diet at the population level is a cornerstone of national and international strategies for reducing chronic disease burden. A critical challenge in generating robust data on habitual dietary intake is accurate exposure assessment. Self-reporting instruments (e.g., food frequency questionnaires, dietary recall) are subject to reporting bias and serving size perceptions, while weighed dietary assessments are unfeasible in large-scale studies. However, secondary metabolites derived from individual foods/food groups and present in urine provide an opportunity to develop potential biomarkers of food intake (BFIs). Habitual dietary intake assessment in population surveys using biomarkers presents several challenges, including the need to develop affordable biofluid collection methods, acceptable to participants that allow collection of informative samples. Monitoring diet comprehensively using biomarkers requires analytical methods to quantify the structurally diverse mixture of target biomarkers, at a range of concentrations within urine. The present article provides a perspective on the challenges associated with the development of urine biomarker technology for monitoring diet exposure in free-living individuals with a view to its future deployment in "real world" situations. An observational study (n = 95), as part of a national survey on eating habits, provided an opportunity to explore biomarker measurement in a free-living population. In a second food intervention study (n = 15), individuals consumed a wide range of foods as a series of menus designed specifically to achieve exposure reflecting a diversity of foods commonly consumed in the UK, emulating normal eating patterns. First Morning Void urines were shown to be suitable samples for biomarker measurement. Triple quadrupole mass spectrometry, coupled with liquid chromatography, was used to assess simultaneously the behavior of a panel of 54 potential BFIs. This panel of chemically diverse biomarkers, reporting intake of a wide range of commonly-consumed foods, can be extended successfully as new biomarker leads are discovered. Towards validation, we demonstrate excellent discrimination of eating patterns and quantitative relationships between biomarker concentrations in urine and the intake of several foods. In conclusion, we believe that the integration of information from BFI technology and dietary self-reporting tools will expedite research on the complex interactions between dietary choices and health.
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Affiliation(s)
- Manfred Beckmann
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
| | - Thomas Wilson
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
| | - Amanda J. Lloyd
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
| | - Duarte Torres
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- Epidemiology Research Unit (EPIUnit), Institute of Public Health, University of Porto, Porto, Portugal
| | - Ana Goios
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- Epidemiology Research Unit (EPIUnit), Institute of Public Health, University of Porto, Porto, Portugal
| | - Naomi D. Willis
- Human Nutrition Research Centre, Population Health Sciences Institute, William Leech Building, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - Laura Lyons
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
| | - Helen Phillips
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
| | - John C. Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, William Leech Building, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - John Draper
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
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Martins C, Torres D, Lopes C, Correia D, Goios A, Assunção R, Alvito P, Vidal A, De Boevre M, De Saeger S, Nunes C. Deoxynivalenol exposure assessment through a modelling approach of food intake and biomonitoring data - A contribution to the risk assessment of an enteropathogenic mycotoxin. Food Res Int 2020; 140:109863. [PMID: 33648181 DOI: 10.1016/j.foodres.2020.109863] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/25/2020] [Accepted: 10/28/2020] [Indexed: 11/19/2022]
Abstract
Deoxynivalenol (DON), an enteropathogenic mycotoxin produced by Fusarium species, is usually associated with adverse health outcomes such as gastrointestinal diseases and immunotoxicity. To estimate DON exposure of the Portuguese population at national level, a modelling approach, based on data from 94 Portuguese volunteers, was developed considering the inputs of the food consumption data generated within the National Food and Physical Activity Survey and the human biomonitoring data used to assess the exposure to DON. Ten models of association between DON urinary biomarkers and food items (pasta, cookies, biscuits, sweets, bread, rusks, nuts, oilseeds, beer, meat, milk) were established. Applying the most adequate model to the consumption data (n = 5811) of the general population, the exposure estimates of the Probable Daily Intake revealed that a fraction (0.1%) of the Portuguese population might exceed the Tolerable Daily Intake defined for DON. The analysis stratified by age revealed children (3.2%) and adolescents (6.0%) are more likely to exceed the Tolerable Daily Intake for DON. Although the unavoidable uncertainties, these results are important contributions to understand the exposure to this mycotoxin in Portugal, to assess the associated risk and the potential public health consequences.
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Affiliation(s)
- Carla Martins
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal.
| | - Duarte Torres
- Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal; Epidemiology Research Unit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-091 Porto, Portugal
| | - Carla Lopes
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-091 Porto, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Daniela Correia
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-091 Porto, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Ana Goios
- Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal; Epidemiology Research Unit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-091 Porto, Portugal
| | - Ricardo Assunção
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal
| | - Paula Alvito
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - Arnau Vidal
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - Marthe De Boevre
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - Sarah De Saeger
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - Carla Nunes
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal
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Beckmann M, Lloyd AJ, Wilson T, Torres DPM, Goios ACL, Willis ND, Lyons L, Phillips H, Mathers JC, Nash RJ, Sharp H, Draper J. Calystegines are Potential Urine Biomarkers for Dietary Exposure to Potato Products. Mol Nutr Food Res 2020; 64:e2000515. [PMID: 32918337 DOI: 10.1002/mnfr.202000515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/25/2020] [Indexed: 12/27/2022]
Abstract
SCOPE Metabolites derived from specific foods present in urine samples can provide objective biomarkers of food intake (BFIs). This study investigated the possibility that calystegines (a class of iminosugars) may provide BIFs for potato (Solanum tuberosum L.) product exposure. METHODS AND RESULTS Calystegine content is examined in published data covering a wide range of potato cultivars. Rapid methods are developed for the quantification of calystegines in cooked potato products and human urine using triple quadrupole mass spectrometry. The potential of calystegines as BFIs for potato consumption is assessed in a controlled food intervention study in the United Kingdom and validated in an epidemiological study in Portugal. Calystegine concentrations are reproducibly above the quantification limit in first morning void urines the day after potato consumption, showing a good dose-response relationship, particularly for calystegine A3 . The design of the controlled intervention mimicks exposure to a typical UK diet and showed that neither differences in preparation/cooking method or influence of other foods in the diet has significant impact on biomarker performance. Calystegine biomarkers also perform well in the independent validation study. CONCLUSION It is concluded that calystegines have many of the characteristics needed to be considered as specific BFIs for potato product intake.
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Affiliation(s)
- Manfred Beckmann
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, SY23 3DA, UK
| | - Amanda J Lloyd
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, SY23 3DA, UK
| | - Thomas Wilson
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, SY23 3DA, UK
| | - Duarte P M Torres
- Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, Porto, 4200-465, Portugal.,Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Ana C L Goios
- Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, Porto, 4200-465, Portugal.,Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Naomi D Willis
- Human Nutrition Research Centre, Population Health Sciences Institute, William Leech Building, Newcastle University, Newcastle-upon-Tyne, NE2 4HH, UK
| | - Laura Lyons
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, SY23 3DA, UK
| | - Helen Phillips
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, SY23 3DA, UK
| | - John C Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, William Leech Building, Newcastle University, Newcastle-upon-Tyne, NE2 4HH, UK
| | - Robert J Nash
- PhytoQuest Ltd, Plas Gogerddan, Aberystwyth, Ceredigion, SY23 3EB, UK
| | - Hazel Sharp
- PhytoQuest Ltd, Plas Gogerddan, Aberystwyth, Ceredigion, SY23 3EB, UK
| | - John Draper
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, SY23 3DA, UK
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Vilela S, Muresan I, Correia D, Severo M, Lopes C. The role of socio-economic factors in food consumption of Portuguese children and adolescents: results from the National Food, Nutrition and Physical Activity Survey 2015-2016. Br J Nutr 2020; 124:591-601. [PMID: 32312336 DOI: 10.1017/s0007114520001373] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
This study aimed to evaluate the association between socio-economic factors and the food consumption of a young population. Participants were from the Portuguese National Food, Nutrition and Physical Activity Survey (IAN-AF 2015-2016) aged from 3 to 17 years (n 1153). Food consumption was assessed using two non-consecutive days of food diaries in children and two 24-h recalls for adolescents. A latent class analysis (LCA) was used to classify children's socio-economic status (socio-economic composite classification (SCC)), categorised in low, middle or high. The associations between socio-economic variables and food consumption were evaluated through linear or logistic regression models, weighted for the Portuguese population distribution. A positive association was found between belonging to a higher level of SCC and consumption of fruits and vegetables (FV), by children (β = 2·4, 95 % CI 1·1, 3·8) and by adolescents (β = 52·4, 95 % CI 9·6, 95·3). A higher SCC, but particularly higher maternal education, was positively associated with consumption of 'white meat, fish and eggs'. Both higher SCC and parental education were positively associated with salty snack consumption in the adolescents' group. In conclusion, children and adolescents with higher educated parents and belonging to a high socio-economic level have a higher daily intake of FV and white meat, fish and eggs. Socio-economic factors play an important role in justifying differences in the food consumption of children and adolescents and must be considered in future interventions. The relationship between higher socio-economic position and salty snack consumption in adolescents needs to be further explored in other populations.
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Affiliation(s)
- Sofia Vilela
- EPIUnit - Institute of Public Health, University of Porto, 4050-600Porto, Portugal
| | - Iasmina Muresan
- EPIUnit - Institute of Public Health, University of Porto, 4050-600Porto, Portugal
- 'Iuliu Haţieganu' University of Medicine and Pharmacy, 400337Cluj-Napoca, Romania
| | - Daniela Correia
- EPIUnit - Institute of Public Health, University of Porto, 4050-600Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319Porto, Portugal
| | - Milton Severo
- EPIUnit - Institute of Public Health, University of Porto, 4050-600Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319Porto, Portugal
| | - Carla Lopes
- EPIUnit - Institute of Public Health, University of Porto, 4050-600Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319Porto, Portugal
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The association between dietary patterns and nutritional status in community-dwelling older adults-the PEN-3S study. Eur J Clin Nutr 2020; 75:521-530. [PMID: 32951012 DOI: 10.1038/s41430-020-00745-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 08/10/2020] [Accepted: 09/02/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Diet plays a key role in the ageing process. Despite this, little is known about the effect of dietary patterns on older adults' nutritional status. The main aim of this study was to analyse the association between a posteriori derived dietary patterns (DPs) and nutritional status among community dwellers aged ≥65. METHODS Cross-sectional study including a representative sample of the community-dwelling Portuguese population aged ≥65 (n = 849, mean age 74.1 years old). Data were collected through computer-assisted, face-to-face interviews. Dietary patterns were derived a posteriori based on two 24-h recalls by a latent class transition model. Nutritional status was assessed by the Mini Nutritional Assessment (MNA®) and measured body mass index (BMI). Associations were estimated by regression models. MNA score was reversed and log-transformed considering its skewed distribution. RESULTS Two DPs were identified: 22.0% of the studied population followed a 'Protein-based foods' DP (highest consumption of legumes, meats and sweets), and 59.1% followed a 'Mediterranean' DP (highest consumption of vegetables, fruits, dairy, cereals/tubers, bread, fishery and olive oil). Moreover, 18.9% switched between those patterns ('In-between' DP). After adjustment, the 'Protein-based foods' DP was associated with better MNA score (EXP(β) = 0.716, 95% CI 0.533, 0.962), compared to the 'Mediterranean' DP, particularly for total energy intake up to 2200 kcal/day. No significant associations were found between DPs and BMI. CONCLUSIONS A protein-based pattern is associated with lower malnutrition risk in older adults, when considering an adequate energy intake. This should be taken into account when designing and disseminating food-based guidelines for healthy ageing.
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