The assessment of food consumption data using harmonized methodologies at the European level is fundamental to support the development of public policies. Portugal is one of the countries with the ...most outdated information on individual food consumption.
The objective of this study was to describe the design and methodology of the National Food, Nutrition and Physical Activity Survey, 2015-2016, developed to collect national and regional data on dietary habits, physical activity (PA), and nutritional status, in a representative sample of the Portuguese general population (3 months-84 years).
Participants were selected by multistage sampling, using the National Heath Registry as the sampling frame. Data collection, during 12 months, was harmonized according to European guidelines (EU-MENU, European Food Safety Authority EFSA). Computer-assisted personal interviewing (CAPI) was performed on a specific electronic platform synchronized with nutritional composition data and considering the FoodEx2 classification system. Dietary assessment was performed using 24-hour recalls (two nonconsecutive, 8-15 days apart) or food diaries in the case of children aged <10 years, complemented with a food propensity questionnaire; PA data (International Physical Activity Questionnaire IPAQ, the Activity Choice Index ACI, and 4-days PA diaries); sociodemographic data, and other health-related data were also collected.
A sample of 6553 individuals completed the first interview, and 5811 participants completed two dietary assessments. The participation rate among eligible individuals was 33.38% (6553/19,635), considering the first interview, and 29.60% (5811/19,635) for the participants with two completed interviews (about 40% in children and adolescents and 20% in elderly individuals). Results of the survey will be disseminated in national and international scientific journals during 2018-2019.
The survey will assist policy planning and management of national and European health programs on the improvement of nutritional status and risk assessment related to food hazards, and the enhancement of PA. The infrastructures and data driven from this Survey are a solid basis to the development of a future national surveillance system on diet, PA, and other health behaviors reproducible over time.
This study includes, for the first time, estimates of general and abdominal obesity prevalence for all ages of the Portuguese population, using common standardized methodologies. Results are compared ...by sex, age groups, educational level and geographical regions.
Participants were a representative sample of the Portuguese population aged between 3 months and 84 years of age (n = 6553), enrolled in the National Food, Nutrition and Physical Activity Survey, 2015-2016. Objective anthropometric measurements included length/height, weight and body circumferences, performed according to standard procedures. Body mass index (BMI) was classified according to the World Health Organization (WHO) growth charts for children and adolescents, and WHO criteria for adults. Abdominal obesity was defined in adults as waist-hip ratio ≥ 0.85 in women or ≥ 0.90 in men. Prevalence estimates and 95% confidence intervals (95%CI) were weighted according to a complex sampling design, considering stratification by seven geographical regions and cluster effect for the selected Primary Health Care Unit.
The national prevalence of obesity is 22.3% (95%CI: 20.5-24.0), significantly higher in women. Obesity prevalence is much higher in the elderly (39.2%, 95%CI. 34.2-44.2), while children and adolescents have the lowest prevalence around 8-9%. In a regression model, three knot points denoting an inflection of obesity prevalence across the life span were observed around 5, 15 and 75 years. The prevalence of pre-obesity at national level is 34.8% (95%CI: 32.9-36.7), higher in men, and almost 18% of children and 24% of adolescents have pre-obesity. The sex- and age-standardized prevalence of obesity ranged from 38.3% (95%CI: 34.6-42.1) to 13.1% (95%CI: 10.3-15.9) for the less and the most educated individuals, respectively. Although some geographical region disparities, obesity prevalence did not significantly differed across regions (p = 0.094). The national prevalence of abdominal obesity in adults is 50.5% (95%CI: 47.9-53.1), particularly high in the elderly (80.2%).
Almost 60% of the general Portuguese population is obese or pre-obese. Women, elderly and less educated individuals present the highest obesity prevalence. Abdominal obesity, in particular, seems to be a relevant public health problem among the elderly men.
The aim of the current study was to evaluate energy intake misreporting prevalence, its associated factors and its effects on nutrient intake, in the Portuguese population aged from 18 to 84 years.
...Cross-sectional study.
Portugal.
Adults participants from the National Food, Nutrition and Physical Activity Survey, IAN-AF, 2015-2016, who provided two complete 24 h dietary recall and complete covariate information.
Under, plausible and over-reporters were identified according to the Goldberg method. Total misreporting prevalence was 29·9 %, being 28·5 % of under-reporting and 1·4 % of over-reporting. The current study found higher odds of being classified as an under-reporter especially in participants with higher BMI and in those who self-reported health perception status as non-favourable. Energy intake estimation increases by 853.5 kJ/d (204 kcal/d) when misreporters are excluded, and the same tendency is observed for macro and micronutrients. It is worth mentioning that the prevalence of inadequacy for protein intake decreases by about 5 % when considering plausible reporters.
The exclusion of misreporters has a small impact on the crude energy and nutrient estimates as well as on assessing the contribution of nutrients to total energy intake. However, a moderate impact was observed in the estimation of nutrient inadequacy prevalence.
To evaluate daily eating frequency (main meals and snacks) in relation to weight status in children aged 3-9 years, representative of the Portuguese population.
Cross-sectional study. Dietary intake ...was estimated as the mean of two non-consecutive days of food diaries, followed by face-to-face interviews. Weight and height were measured by trained observers. Eating occasions (EO) were defined by the children's caregiver; an EO was considered separate if the time of consumption was different from other EO and it provided at least 209 kJ (50 kcal). Main meals defined as 'breakfast', 'lunch' and 'dinner' could be selected only once per day. The remaining EO were considered snacks. The association between eating frequency and overweight/obesity was evaluated through logistic regressions weighted for the population distribution.
National Food, Nutrition and Physical Activity Survey of the Portuguese population, 2015-2016.
Portuguese children aged 3-9 years with complete dietary data and anthropometric measurements (n 517).
Overall, the number of daily EO ranged from 3·5 to 11, and on average children had 5·7 daily EO. After adjustment for child's sex, age and total energy intake, and considering only plausible energy intake reporters, having < 3 snacks/d was positively associated with being overweight/obese (OR = 1·98; 95 % CI 1·00, 3·90), compared with having ≥ 3 snacks/d.
Lower daily frequency of EO was associated with increased odds of being overweight or obese in children. A higher eating frequency, maintaining the same energy intake, seems to contribute to a healthy body weight in children.
Background: Diabetes mellitus is associated with atherosclerosis that has, in part, been ascribed to abnormalities in the reverse cholesterol transport system.
Methods: We determined, in the fasting ...and post-alimentary periods, rates of HDL cholesterol esterification and transfer to apoB-containing lipoproteins, cholesteryl ester transfer protein (CETP) concentration, and apoB lipoprotein size in 10 type 1 diabetics and 10 well-matched controls. Autologous HDL was labeled with
14Ccholesterol and incubated at 37°C during a period of 30 min for measurement of the cholesterol esterification rate (CER), as well as for 24 h for measurement of the endogenous HDL
14Ccholesteryl ester (
14CCE) transfer rate to apoB-containing lipoproteins after 2- and 4-h incubations with the subject’s own plasma. Exogenous cholesteryl ester transfer activity (CETA) was estimated by incubation of the participant’s plasma (CETP source) with
14CCE-HDL and VLDL from a pool of plasma donors. ApoB lipoprotein size was determined using non-denaturing polyacrylamide gradient gel electrophoresis of whole plasma.
Results: Contrary to previous studies, we showed that even not well-controlled type 1 diabetics did not differ from lipid-matched, non-diabetic subjects in HDL-
14Ccholesterol esterification rate, transfer rates, or CETP concentration. CETP concentration correlates with the exogenous method of
14CCE transfer and with the endogenous method only when the latter is corrected for plasma triacylglycerol (TG) concentration. In addition, during the postprandial phase, diabetic patients’ VLDL are smaller and IDL size increases less than in controls.
Conclusion: In type 1 diabetes mellitus, CETA is not altered when the plasma levels of donor and/or acceptor lipoproteins are within the normal range.
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