1
|
Pereira de Araújo T, de Moraes MM, Afonso C, Rodrigues SSP. Trends in ultra-processed food availability and its association with diet-related non-communicable disease health indicators in the Portuguese population. Br J Nutr 2024; 131:1600-1607. [PMID: 38174417 DOI: 10.1017/s0007114523003045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Broad variations in dietary and physical activity patterns are part of nutritional transition concept. An additional nutritional transition has as main characteristic the change of consumption of processed foods for ultra-processed foods (UPF). This study aims to evaluate trends of UPF availability in Portuguese population and its association with diet-related non-communicable diseases (NCD) health indicators. This ecological study used data from the Household Budget Surveys conducted by the National Statistics Institute each 5 years within a national representative sample of households. The percentage of UPF was calculated based on the total daily amount of food and beverages available per capita (in grams). Data from the years 1990, 1995, 2000 and 2005 were used, which were retrieved from DAFNE-Anemos Software. NCD age-standardised mortality, prevalence and incidence were obtained from the Global Burden of Disease database, for the years 2000, 2005, 2010 and 2015. Between 1990 and 2005, the UPF availability increased from 3·9 % to 13·8 %. Over the years, almost all food and beverages categories increased the UPF availability contribution, mainly noticeable for milk, sugar, cereal and meat products. Positive correlations were observed between UPF availability and digestive diseases both in prevalence (r = 0·062; P = 0·037) and incidence (r = 0·005; P = 0·010) measures. Neoplasms incidence also showed positive correlation with UPF availability (r = 0·002; P = 0·012). Trends in UPF availability in Portugal increased exponentially. At the same time, there is a trend towards a decrease in unprocessed and processed food availability. The Portuguese population should be made aware of the health risks resulting from excessive consumption of UPF.
Collapse
Affiliation(s)
- Taissa Pereira de Araújo
- Faculty of Nutrition and Food Sciences, University of Porto - Rua do Campo Alegre, 823 Porto4150-180, Portugal
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
| | - Milena Miranda de Moraes
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
| | - Cláudia Afonso
- Faculty of Nutrition and Food Sciences, University of Porto - Rua do Campo Alegre, 823 Porto4150-180, Portugal
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
| | - Sara Simões Pereira Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto - Rua do Campo Alegre, 823 Porto4150-180, Portugal
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health - Institute of Public Health, University of Porto - Rua das Taipas, 135/139 Porto4050-600, Portugal
| |
Collapse
|
2
|
Valentim J, Afonso C, Gomes R, Gomes-Bispo A, Prates JA, Bandarra NM, Cardoso C. Influence of cooking methods and storage time on colour, texture, and fatty acid profile of a novel fish burger for the prevention of cognitive decline. Heliyon 2024; 10:e27171. [PMID: 38495145 PMCID: PMC10943333 DOI: 10.1016/j.heliyon.2024.e27171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 02/19/2024] [Accepted: 02/26/2024] [Indexed: 03/19/2024] Open
Abstract
Western diets are poor in healthy n-3 polyunsaturated fatty acids (n-3 PUFA), namely eicosapentaenoic (EPA) and docosahexaenoic acid (DHA), iodine (I), and other nutrients that may protect against cognitive ageing. Given DHA richness in chub mackerel (Scomber colias), high vitamin B9 levels in quinoa (Chenopodium quinoa), and I abundance in the seaweed Saccorhiza polyschides, a functional hamburger rich in these nutrients by using these ingredients was developed. This research focused on the factors affecting its quality by examining the impact of cooking (steaming at 100 °C, roasting at 180 °C, grilling at 180 °C) and storage time (after 4 and 6 months at -20 °C) upon the product's properties. Cooking treatments were found to influence the burger's colour and texture, whereas storage duration impacted FA levels and the polyene index. Cooked burgers presented lighter (L*, 45.1-55.0 vs 36.9 ± 2.4) and more yellow colouration (b*, 15.8-17.8 vs 13.6 ± 1.0) than raw burgers. Cooked burgers also exhibited higher textural values across various parameters than their raw versions. Grilled burgers (excluding initial time) were firmer (50.0 ± 5.1 N) than those cooked otherwise (37.0-39.9 N). Regarding FA levels, a decrease in DHA was recorded after four months (21.8-23.0% vs 26.4-30.6%). The polyene index followed a similar trajectory, declining from 2.6 to 3.6 initially to 1.8-1.9 in the fourth month. Hence, the studied mackerel burger could be a promising source of EPA, DHA, and other n-3 PUFAs in human diets, optimally with a frozen storage duration of fewer than four months to preserve nutritional integrity.
Collapse
Affiliation(s)
- Jorge Valentim
- Faculty of Science, University of Lisbon, Campo Grande, 1749-016 Lisbon, Portugal
- Division of Aquaculture, Upgrading, and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMAIP), Avenida Alfredo Magalhães Ramalho, 6, 1495-165, Algés, Portugal
| | - Cláudia Afonso
- Division of Aquaculture, Upgrading, and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMAIP), Avenida Alfredo Magalhães Ramalho, 6, 1495-165, Algés, Portugal
- CIIMAR, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Rua dos Bragas 289, 4050-123, Porto, Portugal
| | - Romina Gomes
- Division of Aquaculture, Upgrading, and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMAIP), Avenida Alfredo Magalhães Ramalho, 6, 1495-165, Algés, Portugal
- MEtRICs/DCTB/NOVA, School of Science and Technology, NOVA University Lisbon, Caparica Campus, 2829-516, Almada, Portugal
| | - Ana Gomes-Bispo
- Division of Aquaculture, Upgrading, and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMAIP), Avenida Alfredo Magalhães Ramalho, 6, 1495-165, Algés, Portugal
- CIIMAR, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Rua dos Bragas 289, 4050-123, Porto, Portugal
| | - José A.M. Prates
- Centro de Investigação Interdisciplinar em Sanidade Animal (CIISA), Faculdade de Medicina Veterinária, Universidade de Lisboa, 1300-477, Lisbon, Portugal
- Laboratório Associado para Ciência Animal e Veterinária (AL4AnimalS), Faculdade de Medicina Veterinária, Universidade de Lisboa, 1300-477, Lisbon, Portugal
| | - Narcisa M. Bandarra
- Division of Aquaculture, Upgrading, and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMAIP), Avenida Alfredo Magalhães Ramalho, 6, 1495-165, Algés, Portugal
- CIIMAR, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Rua dos Bragas 289, 4050-123, Porto, Portugal
| | - Carlos Cardoso
- Division of Aquaculture, Upgrading, and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMAIP), Avenida Alfredo Magalhães Ramalho, 6, 1495-165, Algés, Portugal
- CIIMAR, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Rua dos Bragas 289, 4050-123, Porto, Portugal
| |
Collapse
|
3
|
Vara-Luiz F, Mendes I, Elisa Teles A, Oliveira C, Pascoal A, Afonso C, Patita M, Mocanu I, Vieira A, Fernandes V, Moniz Pereira P, Fonseca J. Malignant transformation in fistula after proctosigmoidectomy: A rare complication of long-standing Crohn's disease. Gastroenterol Hepatol 2024:S0210-5705(24)00033-5. [PMID: 38316172 DOI: 10.1016/j.gastrohep.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/14/2024] [Accepted: 01/29/2024] [Indexed: 02/07/2024]
Affiliation(s)
- Francisco Vara-Luiz
- Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal; Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Caparica, Portugal.
| | - Ivo Mendes
- Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Ana Elisa Teles
- Pathology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Carla Oliveira
- Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Ana Pascoal
- Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Cláudia Afonso
- Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Marta Patita
- Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Irina Mocanu
- Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Ana Vieira
- Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Vítor Fernandes
- Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal
| | | | - Jorge Fonseca
- Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal; Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Caparica, Portugal
| |
Collapse
|
4
|
Sales S, Lourenço HM, Bandarra NM, Afonso C, Matos J, Botelho MJ, Pessoa MF, Félix PM, Veronez A, Cardoso C. How Biological Activity in Sea Cucumbers Changes as a Function of Species and Tissue. Foods 2023; 13:35. [PMID: 38201062 PMCID: PMC10778530 DOI: 10.3390/foods13010035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Biological activity and bioactive compound content in sea cucumbers was assessed, considering Parastichopus regalis, Holothuria mammata, Holothuria forskali, and Holothuria arguinensis as species and intestine, muscle band, respiratory tree, body wall, and gonads as tissues. P. regalis had the lowest content in phenolic compounds and antioxidant activity in contrast to Holothuria species. In the respiratory tree, the highest phenolic concentration was recorded in H. arguinensis, 76.4 ± 1.2 mg GAE/100 g dw vs. 21.0-49.0 mg GAE/100 g dw in the other species. H. arguinensis had the highest DPPH and FRAP results in the gonads, 13.6 ± 0.7 mg AAE/100 g dw vs. 2.6-3.5 mg AAE/100 g dw and 27.1 ± 0.3 μmol Fe2+/g dw vs. 8.0-15.9 μmol Fe2+/g dw, respectively. Overall, P. regalis biomass presented the highest anti-inflammatory activity levels and H. arguinensis the lowest anti-inflammatory levels. The respiratory tree was the most anti-inflammatory (measured by the inhibition of cyclooxygenase-2, COX-2) tissue in H. mammata and H. forskali (also the muscle band in this case), 76.3 ± 6.3% and 59.5 ± 3.6% COX-2 inhibition in 1 mg/mL aqueous extracts, respectively. The results demonstrated a variable bioactive potential and advantage in targeting antioxidant properties in the muscle band and anti-inflammatory activity in the respiratory tree, which may constitute a starting point for a biorefinery approach envisaging multiple applications.
Collapse
Affiliation(s)
- Sabrina Sales
- Division of Aquaculture and Upgrading (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Rua Alfredo Magalhães Ramalho 6, 1495-006 Lisbon, Portugal; (S.S.); (H.M.L.); (N.M.B.); (C.A.); (J.M.)
- Division of Oceanography and Marine Environment (DivOA), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), 1495-165 Lisbon, Portugal;
- GeoBioTec, Department of Earth Sciences, Faculty of Science and Technology (UNL), Largo da Torre, 2829-516 Caparica, Portugal;
| | - Helena M. Lourenço
- Division of Aquaculture and Upgrading (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Rua Alfredo Magalhães Ramalho 6, 1495-006 Lisbon, Portugal; (S.S.); (H.M.L.); (N.M.B.); (C.A.); (J.M.)
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR), University of Porto, Rua dos Bragas 289, 4050-123 Porto, Portugal
| | - Narcisa M. Bandarra
- Division of Aquaculture and Upgrading (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Rua Alfredo Magalhães Ramalho 6, 1495-006 Lisbon, Portugal; (S.S.); (H.M.L.); (N.M.B.); (C.A.); (J.M.)
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR), University of Porto, Rua dos Bragas 289, 4050-123 Porto, Portugal
| | - Cláudia Afonso
- Division of Aquaculture and Upgrading (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Rua Alfredo Magalhães Ramalho 6, 1495-006 Lisbon, Portugal; (S.S.); (H.M.L.); (N.M.B.); (C.A.); (J.M.)
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR), University of Porto, Rua dos Bragas 289, 4050-123 Porto, Portugal
| | - Joana Matos
- Division of Aquaculture and Upgrading (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Rua Alfredo Magalhães Ramalho 6, 1495-006 Lisbon, Portugal; (S.S.); (H.M.L.); (N.M.B.); (C.A.); (J.M.)
| | - Maria João Botelho
- Division of Oceanography and Marine Environment (DivOA), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), 1495-165 Lisbon, Portugal;
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR), University of Porto, Rua dos Bragas 289, 4050-123 Porto, Portugal
| | - Maria Fernanda Pessoa
- GeoBioTec, Department of Earth Sciences, Faculty of Science and Technology (UNL), Largo da Torre, 2829-516 Caparica, Portugal;
| | - Pedro M. Félix
- MARE—Marine and Environmental Sciences Centre/ARNET—Aquatic Research Network, Faculty of Sciences, University of Lisbon, 1749-017 Lisbon, Portugal;
| | - Arthur Veronez
- Centre for Functional Ecology—Science for People & the Planet, Department of Life Sciences, Faculty of Science and Technology, University of Coimbra, Calçada Martim de Freitas, 3000-456 Coimbra, Portugal;
| | - Carlos Cardoso
- Division of Aquaculture and Upgrading (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Rua Alfredo Magalhães Ramalho 6, 1495-006 Lisbon, Portugal; (S.S.); (H.M.L.); (N.M.B.); (C.A.); (J.M.)
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR), University of Porto, Rua dos Bragas 289, 4050-123 Porto, Portugal
| |
Collapse
|
5
|
Parente H, Pontes Ferreira M, Soares C, Guimarães F, Azevedo S, Santos-Faria D, Tavares-Costa J, Peixoto D, Afonso C, Roriz D, Teixeira F. Lumbosacral pain in a patient with psoriatic arthritis: when the rheumatic disease is innocent. Reumatismo 2023; 75. [PMID: 38115779 DOI: 10.4081/reumatismo.2023.1565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/30/2023] [Indexed: 12/21/2023] Open
Abstract
Lumbar pain is a very common symptom that derives from benign musculoskeletal conditions, rheumatic inflammatory diseases, neoplasms, and referred and/or nociplastic pain. A 70-year-old man with psoriatic arthritis presented with early-onset lumbosacral pain without evident red flags. Symptomatic treatment was unhelpful. Radiographic imaging showed subtle signs of a disease that could easily be missed. Magnetic resonance imaging revealed a massive prostatic malignancy with bone (sacral and iliopubic) metastasis. Awareness must be given not to disregard every lumbar pain as part of the preexisting rheumatic inflammatory disease (spondyloarthropathy in this case) or a common muscle/ligament/articular disarrangement. Persistence of pain, albeit not inflam-matory nor sharp in nature, despite adequate treatment might be just as important as an acute red flag and requires proper follow-up.
Collapse
Affiliation(s)
- H Parente
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - M Pontes Ferreira
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - C Soares
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - F Guimarães
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - S Azevedo
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - D Santos-Faria
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - J Tavares-Costa
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - D Peixoto
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - C Afonso
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - D Roriz
- Department of Radiology, Unidade Local de Saúde do Alto Minho, Viana do Castelo.
| | - F Teixeira
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| |
Collapse
|
6
|
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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| | | |
Collapse
|
7
|
Öztürk ME, Poínhos R, Afonso C, Ayhan NY, de Almeida MDV, Oliveira BMPM. Nutritional Status among Portuguese and Turkish Older Adults Living in the Community: Relationships with Sociodemographic, Health and Anthropometric Characteristics. Nutrients 2023; 15:nu15061333. [PMID: 36986063 PMCID: PMC10058781 DOI: 10.3390/nu15061333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/04/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023] Open
Abstract
Malnutrition is widespread among older adults, and its determinants may differ between countries. We compared Portuguese and Turkish non-institutionalized older adults regarding nutritional status, sociodemographic, health and anthropometric characteristics and studied the relationships between nutritional status and those characteristics. This cross-sectional study analyzed data from 430 Portuguese and 162 Turkish non-institutionalized older adults regarding sociodemographics, health conditions, the Mini-Nutritional Assessment (MNA-FF) and anthropometry. Turkish older adults were more likely to be malnourished or at risk of malnutrition and had lower average BMI but a higher calf circumference. A higher proportion of the Portuguese sample had tooth loss, diabetes, hypertension, oncologic diseases, kidney diseases, osteoarticular problems or eye problems, while less had anemia. A better nutritional status (higher MNA-FF score) was found among the Portuguese, males, people using dentures, those without tooth loss, hypertension, cardiovascular diseases, anemia or oncological diseases and was related to younger age, higher BMI and a higher calf circumference. Malnutrition and its risk were higher among older adults from Turkey, despite Portuguese older adults presenting a higher prevalence of chronic diseases. Being female, older age, tooth loss, hypertension, anemia, CVD or oncological disorders and having a lower BMI or CC were associated with higher rates of malnutrition among older adults from Portugal and Turkey.
Collapse
Affiliation(s)
- Meryem Elif Öztürk
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Karamanoğlu Mehmetbey University, İbrahim Öktem Cd., 70100 Karaman, Turkey
| | - Rui Poínhos
- Faculty of Nutrition and Food Sciences, University of Porto, Rua do Campo Alegre, 823, 4150-180 Porto, Portugal
- Correspondence:
| | - Cláudia Afonso
- Faculty of Nutrition and Food Sciences, University of Porto, Rua do Campo Alegre, 823, 4150-180 Porto, Portugal
| | - Nurcan Yabancı Ayhan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara University, Fatih Caddesi 197/7, 06290 Ankara, Turkey
| | - Maria Daniel Vaz de Almeida
- Faculty of Nutrition and Food Sciences, University of Porto, Rua do Campo Alegre, 823, 4150-180 Porto, Portugal
- GreenUPorto—Sustainable Agrifood Production Research Center, Rua da Agrária 747, 4485-646 Vairão, Portugal
| | - Bruno M. P. M. Oliveira
- Faculty of Nutrition and Food Sciences, University of Porto, Rua do Campo Alegre, 823, 4150-180 Porto, Portugal
- Artificial Intelligence and Decision Support, Institute for Systems and Computer Engineering—Technology and Science, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| |
Collapse
|
8
|
Sapatinha M, Afonso C, Cardoso C, Pires C, Mendes R, Montero M, Gómez‐Guillén M, Bandarra N. Lipid Nutritional Value and Bioaccessibility of Novel
Ready‐To‐Eat
Seafood Products with Encapsulated Bioactives. Int J Food Sci Technol 2022. [DOI: 10.1111/ijfs.16062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M. Sapatinha
- Division of Aquaculture, Upgrading, and Bioprospection (DivAV) Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Avenida Alfredo Magalhães Ramalho, 6 1495‐165 Algés Portugal
| | - C. Afonso
- Division of Aquaculture, Upgrading, and Bioprospection (DivAV) Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Avenida Alfredo Magalhães Ramalho, 6 1495‐165 Algés Portugal
- CIIMAR, Interdisciplinary Centre of Marine and Environmental Research University of Porto, Rua dos Bragas 289 4050‐123 Porto Portugal
| | - C. Cardoso
- Division of Aquaculture, Upgrading, and Bioprospection (DivAV) Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Avenida Alfredo Magalhães Ramalho, 6 1495‐165 Algés Portugal
- CIIMAR, Interdisciplinary Centre of Marine and Environmental Research University of Porto, Rua dos Bragas 289 4050‐123 Porto Portugal
| | - C. Pires
- Division of Aquaculture, Upgrading, and Bioprospection (DivAV) Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Avenida Alfredo Magalhães Ramalho, 6 1495‐165 Algés Portugal
- CIIMAR, Interdisciplinary Centre of Marine and Environmental Research University of Porto, Rua dos Bragas 289 4050‐123 Porto Portugal
| | - R. Mendes
- Division of Aquaculture, Upgrading, and Bioprospection (DivAV) Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Avenida Alfredo Magalhães Ramalho, 6 1495‐165 Algés Portugal
- CIIMAR, Interdisciplinary Centre of Marine and Environmental Research University of Porto, Rua dos Bragas 289 4050‐123 Porto Portugal
| | - M.P. Montero
- Department of Meat and Fish Products Institute of Food Science, Technology and Nutrition (ICTAN‐CSIC) 28040 Madrid Spain
| | - M.C. Gómez‐Guillén
- Department of Meat and Fish Products Institute of Food Science, Technology and Nutrition (ICTAN‐CSIC) 28040 Madrid Spain
| | - N.M. Bandarra
- Division of Aquaculture, Upgrading, and Bioprospection (DivAV) Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Avenida Alfredo Magalhães Ramalho, 6 1495‐165 Algés Portugal
- CIIMAR, Interdisciplinary Centre of Marine and Environmental Research University of Porto, Rua dos Bragas 289 4050‐123 Porto Portugal
| |
Collapse
|
9
|
Afonso C, Cardoso C, Gomes-Bispo A, Ferreira I, Rego A, Coelho I, Motta C, Prates J, Castanheira I, Bandarra N. Fatty Acids, Selenium, and Vitamin B12 in Chub Mackerel (Scomber colias) as Nourishment Considering Seasonality and Bioaccessibility as Factors. Food Chem 2022; 403:134455. [DOI: 10.1016/j.foodchem.2022.134455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/20/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022]
|
10
|
Silvério-António M, Martinho J, Melo AT, Guimarães F, Santos Oliveira D, Pestana Lopes JM, Saraiva A, Gago L, Gomes Correia AM, Fernandes AL, Dinis SP, Nicolau R, Silva SP, Costa C, Beirão T, Furtado A, Azevedo Abreu PM, Afonso C, Peixoto D, Dourado E, Khmelinskii N. POS0901 INTERSTITIAL LUNG DISEASE IN MIXED CONNECTIVE TISSUE DISEASE: CLINICAL AND SEROLOGICAL ASSOCIATIONS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundMixed connective tissue disease (MCTD) is a rare systemic rheumatic disease characterized by the expression of autoantibodies targeting the U1-ribonucleoprotein and overlapping clinical features of systemic sclerosis, systemic lupus erythematosus, and inflammatory myopathies. Interstitial lung disease (ILD) is present in 47% to 78% of patients and has been associated with higher mortality rates. Associations of ILD with Raynaud’s phenomenon, dysphagia, anti-Ro52 antibodies, and a scleroderma pattern on nailfold capillaroscopy have been reported in MCTD patients.ObjectivesThis study aims to identify clinical and serological associations and independent predictors of ILD for patients with MCTD.MethodsMulticenter retrospective study using data collected from clinical records. Adult patients who underwent lung computed tomography (CT) and met at least one of four MCTD diagnostic criteria (Sharp, Alarcón-Segovia, Kasukawa, or Kahn criteria) were included. Univariate analysis was performed using Chi-Square, Fischer’s Exact, and Mann-Whitney tests, as appropriate. Multivariate analysis was performed using binary logistic regression modelling. The linearity of the continuous variables concerning the logit of the dependent variable was assessed via the Box-Tidwell procedure. Cases with missing information and outliers were excluded from the multivariate analysis to fulfil all assumptions necessary to assure the validity of the regression.ResultsFifty-seven patients, of whom 37 were Caucasian (64.9%) and 48 were females (84.2%), with a mean age of 39.4±14.0 years, were included. Twenty-seven patients had ILD (47.4%), of whom 22 had nonspecific interstitial pneumonia (81.5%), 4 had usual interstitial pneumonia (14.8%), and 1 had lymphoid interstitial pneumonia (3.7%) pattern on CT. Among patients with ILD, 13 were asymptomatic (48.1%), while 14 had respiratory symptoms (51.9%), including dyspnea (N=13, 48.1%), cough (N=7, 25.9%), and pleuritic chest pain (N=1, 3.7%). Pulmonary function tests were performed in 22 patients (81.5%), 20 of whom had a restrictive pattern (90.9%).In the univariate analysis, lymphadenopathy at disease onset (22.2% vs 3.3%, p=0.045) and esophageal involvement at any time point (40.7% vs 16.7%, p=0.043), were associated with ILD.The binary logistic regression model predicting ILD included 56 patients, and the model explained 36.5% (Nagelkerke R2) of the variance in ILD and correctly classified 75% of all cases. Older age at diagnosis (OR 1.10/year, 95%CI: 1.00-1.12, p=0.046) and lymphadenopathy at disease onset (OR 19.65, 95%CI: 1.91-201.75, p=0.012) were identified as predictors of ILD in MCTD patients, irrespective of sex and esophageal involvement.ConclusionOlder age at diagnosis and lymphadenopathy at disease onset were independent predictors of ILD in MCTD. Therefore, these factors should be considered when evaluating MCTD patients, especially at the time of diagnosis. To the best of our knowledge, this is the largest study ever describing predictors of ILD for MCTD patients.References[1]Fagundes MN, Caleiro MT, Navarro-Rodriguez T, Baldi BG, Kavakama J, Salge JM, Kairalla R, Carvalho CR. Esophageal involvement and interstitial lung disease in mixed connective tissue disease. Respir Med. 2009 Jun;103(6):854-60. doi: 10.1016/j.rmed.2008.12.018. Epub 2009 Feb 6. PMID: 19201182.[2]Gunnarsson R, Aaløkken TM, Molberg Ø, Lund MB, Mynarek GK, Lexberg AS, Time K, Dhainaut AS, Bertelsen LT, Palm O, Irgens K, Becker-Merok A, Nordeide JL, Johnsen V, Pedersen S, Prøven A, Garabet LS, Gran JT. Prevalence and severity of interstitial lung disease in mixed connective tissue disease: a nationwide, cross-sectional study. Ann Rheum Dis. 2012 Dec;71(12):1966-72. doi: 10.1136/annrheumdis-2011-201253. Epub 2012 May 1. PMID: 22550317Disclosure of InterestsNone declared
Collapse
|
11
|
Guimarães F, Silvério-António M, Martinho J, Melo AT, Santos Oliveira D, Pestana Lopes JM, Saraiva A, Gago L, Gomes Correia AM, Fernandes AL, Dinis SP, Nicolau R, Silva SP, Costa C, Beirão T, Furtado A, Azevedo Abreu PM, Khmelinskii N, Afonso C, Peixoto D. AB0655 Clinical and immunological features of a Portuguese cohort of Mixed Connective Tissue Disease. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundVarious nationwide studies have been already published to better understand Mixed Connective Tissue Disease (MCTD) (1,2). However, Portuguese data is not available.ObjectivesTo characterize clinical and immunological features of a Portuguese cohort of patients with MCTD.MethodsRetrospective, multicenter study including adult-onset patients with clinical diagnosis of MCTD and fulfilling at least one of the following classification criteria: Sharp, Kasukawa, Alarcón-Segovia or the Kahn’s criteria. Positivity to other autoantibodies besides anti-U1-RNP were allowed. SPSS was used for statistical analysis and significance level was defined as 2-sided p<.05.ResultsA total of 98 patients were included, with a mean age at diagnosis and disease duration of 40.5±13.7 and 7.0±6.5 years, respectively. Most patients were female (87.8%) and Caucasian (70.4%). Raynaud’s phenomenon (96.9%), arthralgia/arthritis (94.9/74.5%) and puffy fingers (60.2%) were the most common and early manifestations. Gastroesophageal (GE), respiratory and muscular involvement were also prevalent, mostly during the follow up, affecting 30.6%, 34.7% and 43.9% of the patients, respectively. Clinical and immunological characteristics are described in Table 1. Males were older at symptom’s onset (65.0 VS 46.7, p=.035), having more respiratory involvement (OR=4.5, 95% CI 1.3-16.4), and positivity to anti-ACPA (OR=20.0, 95% CI: 3.1-129.4). GE involvement occurred more often in Caucasian patients (OR=3.8; 95% CI: 1.0-14.1), while anemia of chronic diseases (OR=2.7; 95% CI: 1.0-7.2), myositis (OR=3.6; 95% CI: 1.3-9.9) and constitutional symptoms (OR=3.2; 95% CI: 1.2-8.3) were more frequent in Afro-American patients, whose were also younger at disease (34.1 VS 50.6, p=.01). After a median follow-up time of 4 (IQR 8) years, 4 deaths occurred (4.1%), mostly (75%) due to infectious complications.Table 1.Clinical and immunological characteristicsClinical ManifestationsAt presentationFollow-upMucocutaneous systemRaynaud’s phenomenon, n (%)85 (86.7)95 (96.9)Puffy hands, n (%)48 (49.0)59 (60.2)SSc-like, n (%)43 (44.8)59 (60.8)SLE-like, n (%)28 (28.9)35 (35.7)Musculoskeletal systemArthralgia/Arthritis, n (%)/n (%)81 (82.7) / 56 (57.1)93 (94.9) / 73 (74.5)Myositis, n (%)26 (25.6)43 (43.9)Hematological system, n (%)46 (46.9)70 (71.4)Respiratory system, n (%)14 (14.3)34 (34.7)Cardiovascular system3 (3.1)4 (4.1)Pulmonary hypertension*2 (2.0)15 (15.3)Gastroesophageal involvement, n (%)11 (11.2)30 (30.6)Renal involvement, n (%)2 (2.0)10 (10.2)Neurological involvement, n (%)6 (6.3)14 (14.3)Constitutional symptoms, n (%)26 (26.5)30 (30.6)Immunological characteristicsAnti-dsDNA, n (%)21 (21.4)Anti-smith antibody, n (%)21 (21.4)Anti-Ro/SSA, n (%)31 (31.6)Anti-La/SSB, n (%)7 (7.1)Anti-centromere, n (%)3 (4.1)Rheumatoid Factor, n (%)39 (39.8)Anti- anti-citrullinated protein antibodies, n (%)6 (6.1)Antiphospholipid antibodies, n (%)7 (7.1)Myositis antibodies, n (%)9 (9.2)Complement activation, n (%)27 (27.6)Hypergammaglobulinemia, n (%)51 (52.0)Legend: Anti-dsDNA: anti-double stranded deoxyribonucleic acid antibody; SLE: systemic lupus erythematosus, SSc: systemic sclerosis. *No information regarding cardiac catheterism, then compatible alterations in the echocardiogram.ConclusionRaynaud’s phenomenon, puffy fingers and arthritis were the most common manifestations in Portuguese patients, with similar proportions found in literature (1,2). However, we reported some differences in mucocutaneous, renal and serosa involvement and higher prevalence of probable pulmonary hypertension (1,2), which may be explained by the heterogeneity of the inclusion criteria. Except for respiratory, myositis, GE and constitutional symptoms, there were no differences regarding gender and ethnicity.Here, we characterize the largest cohort of MCTD in Portugal.References[1]Cappelli S, et al. Semin Arthritis Rheum. 2012 Feb;41(4):589–98.[2]Alves MR et al. Clin Exp Med. 2020 May;20(2):159–66.Disclosure of InterestsNone declared
Collapse
|
12
|
Parente H, Azevedo S, Costa E, Guimarães F, Dantas Soares C, Pontes Ferreira M, Faria D, Peixoto D, Tavares-Costa J, Afonso C, Teixeira F. POS1290 EFFICACY AND SAFETY OF SODIUM THIOSULFATE IN CALCIFIC TENDINITIS OF THE ROTATOR CUFF – AN INTERIM ANALYSIS OF A RANDOMIZED CLINICAL TRIAL. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundCalcific tendinitis of the rotator cuff is one of the most common causes of shoulder pain. (1) Ultrasound guided percutaneous lavage (UGPL) is indicated when conservative treatments have failed. (2) Recent reports have shown the interest of topical sodium thiosulfate (STS) in the treatment of other diseases characterizes by ectopic calcifications (3, 4, 5).ObjectivesTo assess the efficacy and safety of UGPL with STS versus with saline solution (standard of care - SOC) in calcific tendinitis.MethodsDouble-blinded randomized clinical trial including adult patients with calcific tendinitis, shoulder pain for more than 3 months and at least one positive shoulder impingement test. Only dense type A calcifications (according to the Molé Classification) > 5 mm in diameter were included. Patients were randomized in two groups: STS and saline solution lavage. Informed consents were collected. Both groups were reevaluated at week 1, month 1 and month 3 after UGPL. Pain Visual Analogue Scale (VAS) at rest and during activities, shoulder range of motion and strength, impingement tests, Disabilities of the Arm, Shoulder and Hand (DASH), DASH-Work, EuroQol five-dimensional (EQ5D) and University of California at Los Angeles (UCLA) scores, ultrasound (US) and radiographic evaluations were performed on all follow up visits.SPSS was used for statistical analysis and significance level was defined as 2-sided p<0.05.ResultsTwenty-six patients were included, where 76.9% (20) were women, with a mean age of 51.2 (SD=9.0) years old. The mean duration of pain before the procedure was 12.7 months (SD=11.3) (minimum of 3 months and a maximum of 48 months).Fifteen patients (57.7%) were randomized to the control group (SOC) and performed a saline UGPL; the other 11 patients (42.3%) were randomized to the treatment group (STS). Demographic and baseline clinical characteristics are shown in Table 1. Since patient inclusion is dynamic, our sample met 23 patients at week 1 (SOC group = 13 and STS group = 10), 19 patients at month 1 (SOC group = 10 and STS group = 9) and 16 patients at month 3 (SOC group = 8 and STS group = 8).Table 1.Demographic and baseline clinical characteristics.STS lavage(n=11)Saline solution lavage (n=15)p-valueAge (years), M (SD)52.3 (10.6)50.3 (8.0)NSSex, female % (n/N)72.7% (8/11)80% (12/15)NSDominant side, right % (n/N)100% (11/11)93.3% (14/15)NSNocturnal pain, yes % (n/N)100% (11/11)100% (15/15)NSVAS at rest (0–10), M (SD)5.7 (2.0)5.9 (2.1)NSVAS during activities (0–10), M (SD)7.1 (1.8)6.0 (2.5)NSDASH Score, M (SD)60.2 (14.0)52.6 (13.8)NSDASH-Work Score, M (SD73.4 (11.0)63.4 (22.6)NSEQ5D, M (SD)0.2897 (0.3)0.4070 (0.2)NSVAS EQ5D (0–100), M (SD)54 (15.9)58 (20.0)NSUCLA score, M (SD)18.7 (4.1)14.7 (3.3)0.014Bursitis, yes % (n/N)72.7% (8/11)66.7% (10/15)NSCalcification morphology, % (n/N)Acr-shaped18.2% (2/11)40% (6/15)0.039Fragmented18.2% (2/11)26.7% (4/15)Nodular and dense, well-defined63.6% (7/11)33.3% (5/15)Calcification size, median (IQR)12.6 (5.7)10.5 (6.3)NSSD: Standard deviation; M: Mean; NS: non-significant; IQR: interquartile rangeOverall, there were no differences between control (SOC) and treatment group (STS). Both procedures were effective improving pain at rest (p=0.024), EQ5D (p=0.019), DASH-Work (p=0.032) and UCLA scores (p=0.009) and calcification size measured by US (p=0.031) at month 3.No adverse effects or complications were reported on both groups.ConclusionAlthough well tolerated with no side effects, STS UGPL has failed to show increased benefit for calcific tendinopathy local treatment. Further studies using STS will be needed to ascertain its interest in this disease. This on-going work will be reevaluated with a larger sample.References[1]Louwerens JK et al. J Shoulder Elbow Surg. 2015; 24:1588–93.[2]De Witte PB et al. Am J Sports Med. 2013; 41:1665-73.[3]Ossorio-García L et al. Actas Dermosifiliogr. 2016; 107:359-62. 21.[4]Jost J et al. J Clin Endocrinol Metab. 2016; 101:2810-5. 22.[5]Guigonis V et al. Ann Endocrinol (Paris). 2015; 76:183-4.Disclosure of InterestsNone declared
Collapse
|
13
|
Melo AT, Silvério-António M, Martinho J, Dourado E, Guimarães F, Santos Oliveira D, Pestana Lopes JM, Saraiva A, Gago L, Gomes Correia AM, Fernandes AL, Dinis SP, Nicolau R, Silva SP, Costa C, Beirão T, Furtado A, Azevedo Abreu PM, Afonso C, Peixoto D, Khmelinskii N. AB0688 Predictors of muscle involvement in Portuguese patients with mixed connective tissue disease. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundMixed connective tissue disease (MCTD) is a rare heterogeneous disease, characterized by overlapping features of classic connective tissue diseases. Myositis may be present in up to two-thirds of patients with MCTD and it is included in all diagnostic criteria available. Although some possible associations have been reported, to the best of our knowledge, no independent predictors of MCTD-related myositis have been described.ObjectivesTo identify clinical and laboratorial predictors for muscular involvement in a cohort of Portuguese patients with MCTD.MethodsMulticentre retrospective cohort study including adult-onset patients with a clinical diagnosis of MCTD and fulfilling at least one of the following diagnostic criteria: Sharp, Kasukawa, Alarcón-Segovia or Kahn criteria. Myositis was defined as proximal muscle weakness, creatine kinase elevation, electromyography (EMG) suggestive changes or a positive muscular biopsy. Univariate analysis was performed using Chi-Square, Fischer’s Exact Test and Mann-Whitney Test, as appropriate. Multivariate analysis was performed using binary logistic regression modelling. The linearity of the continuous variables concerning the logit of the dependent variable was assessed via the Box-Tidwell procedure. Cases with missing information and outliers were excluded from the multivariate analysis to fulfil all assumptions necessary to assure the validity of the regression.ResultsA total of 98 patients were included, 43 (44.3%) of whom had muscular involvement at any time of the disease course. Concerning patients with MCTD-related myositis, the mean age at diagnosis was 34.8±12.5 years and the mean disease duration of 4.1±4.9 years. The majority of patients were female (90.7%) and of European ancestry (66.7%).EMG was performed in 24 patients, of whom 10 (41.7%) had a myopathic pattern. Seventeen patients were submitted to a muscular biopsy, of whom 8 (47.1%) had histological myositis features. Capillaroscopy was performed in 24 patients and 12 (50%) had a scleroderma pattern.African ancestry and leukopenia were positively associated with myositis at disease onset. Furthermore, fever at the onset of disease, younger age at diagnosis and shorter disease duration were positively associated with the occurrence of myositis at any phase of the disease.The multivariate analyses predicting myositis at diagnosis included 54 patients and at any time of the disease included 90 patients. These models explained 37.8% and 26.9% (Nagelkerke R2) of the variance in myositis and correctly classified 79.6% and 73.3% of all cases, respectively.African ancestry (OR 8.39, 95%CI: 1.43-49.37, p=0.019), leukopenia (OR 6.24, 95%CI: 1.32-29.48, p=0.021) and younger age at diagnosis (OR 1.07/year, 95%CI: 1.01-1.14, p=0.035) were identified as independent predictors of myositis at diagnosis. Fever (OR 6.51, 95%CI: 1.23-34.37, p=0.027) was an independent predictor of muscular involvement at any time of the disease in MCDT patients.ConclusionAfrican ancestry, leukopenia and younger age at diagnosis are independent predictors of myositis at presentation in MCTD patients, while fever is an independent predictor of myositis at any time of the disease. While evaluating patients with MCTD, these predictive factors should be considered.References[1]Ciang NCO, Pereira N, Isenberg DA. Mixed connective tissue disease-enigma variations? Rheumatol. 2017 Mar 1;56(3):326–33.[2]Hall S, Hanrahan P. Muscle involvement in mixed connective tissue disease. Rheum Dis Clin North Am. 2005 Aug;31(3):509–17, vii.Disclosure of InterestsNone declared
Collapse
|
14
|
Rego A, Coelho I, Motta C, Cardoso C, Gomes-Bispo A, Afonso C, Prates J, Bandarra N, Silva J, Castanheira I. Seasonal variation of chub mackerel (Scomber colias) selenium and vitamin B12 content and its potential role in human health. J Food Compost Anal 2022. [DOI: 10.1016/j.jfca.2022.104502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
15
|
Carletti A, Cardoso C, Lobo-Arteaga J, Sales S, Juliao D, Ferreira I, Chainho P, Dionísio MA, Gaudêncio MJ, Afonso C, Lourenço H, Cancela ML, Bandarra NM, Gavaia PJ. Antioxidant and Anti-inflammatory Extracts From Sea Cucumbers and Tunicates Induce a Pro-osteogenic Effect in Zebrafish Larvae. Front Nutr 2022; 9:888360. [PMID: 35614979 PMCID: PMC9125325 DOI: 10.3389/fnut.2022.888360] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/31/2022] [Indexed: 12/24/2022] Open
Abstract
Bone metabolic disorders such as osteoporosis are characterized by the loss of mineral from the bone tissue leading to its structural weakening and increased susceptibility to fractures. A growing body of evidence suggests that inflammation and oxidative stress play an important role in the pathophysiological processes involved in the rise of these conditions. As the currently available therapeutic strategies are often characterized by toxic effects associated with their long-term use, natural antioxidants and anti-inflammatory compounds such as polyphenols promise to be a valuable alternative for the prevention and treatment of these disorders. In this scope, the marine environment is becoming an important source of bioactive compounds with potential pharmacological applications. Here, we explored the bioactive potential of three species of holothurians (Echinodermata) and four species of tunicates (Chordata) as sources of antioxidant and anti-inflammatory compounds with a particular focus on polyphenolic substances. Hydroethanolic and aqueous extracts were obtained from animals' biomass and screened for their content of polyphenols and their antioxidant and anti-inflammatory properties. Hydroethanolic fractions of three species of tunicates displayed high polyphenolic content associated with strong antioxidant potential and anti-inflammatory activity. Extracts were thereafter tested for their capacity to promote bone formation and mineralization by applying an assay that uses the developing operculum of zebrafish (Danio rerio) to assess the osteogenic activity of compounds. The same three hydroethanolic fractions from tunicates were characterized by a strong in vivo osteogenic activity, which positively correlated with their anti-inflammatory potential as measured by COX-2 inhibition. This study highlights the therapeutic potential of polyphenol-rich hydroethanolic extracts obtained from three species of tunicates as a substrate for the development of novel drugs for the treatment of bone disorders correlated to oxidative stress and inflammatory processes.
Collapse
Affiliation(s)
- Alessio Carletti
- Faculty of Biomedical Sciences and Medicine (FCBM), University of Algarve, Faro, Portugal
- Centre of Marine Sciences, University of Algarve, Faro, Portugal
| | - Carlos Cardoso
- Division of Aquaculture, Upgrading and Bioprospection, Portuguese Institute for the Sea and Atmosphere (IPMA), Algés, Portugal
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR), University of Porto, Porto, Portugal
| | - Jorge Lobo-Arteaga
- Division of Environmental Oceanography, Portuguese Institute for the Sea and Atmosphere, Algés, Portugal
- Marine and Environmental Sciences Centre (MARE), NOVA University of Lisbon, Lisbon, Portugal
| | - Sabrina Sales
- Division of Aquaculture, Upgrading and Bioprospection, Portuguese Institute for the Sea and Atmosphere (IPMA), Algés, Portugal
| | - Diana Juliao
- Division of Aquaculture, Upgrading and Bioprospection, Portuguese Institute for the Sea and Atmosphere (IPMA), Algés, Portugal
| | - Inês Ferreira
- Division of Aquaculture, Upgrading and Bioprospection, Portuguese Institute for the Sea and Atmosphere (IPMA), Algés, Portugal
| | - Paula Chainho
- Marine and Environmental Sciences Centre (MARE), NOVA University of Lisbon, Lisbon, Portugal
| | - Maria Ana Dionísio
- Marine and Environmental Sciences Centre (MARE), NOVA University of Lisbon, Lisbon, Portugal
| | - Maria J. Gaudêncio
- Division of Environmental Oceanography, Portuguese Institute for the Sea and Atmosphere, Algés, Portugal
| | - Cláudia Afonso
- Division of Aquaculture, Upgrading and Bioprospection, Portuguese Institute for the Sea and Atmosphere (IPMA), Algés, Portugal
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR), University of Porto, Porto, Portugal
| | - Helena Lourenço
- Division of Aquaculture, Upgrading and Bioprospection, Portuguese Institute for the Sea and Atmosphere (IPMA), Algés, Portugal
| | - M. Leonor Cancela
- Faculty of Biomedical Sciences and Medicine (FCBM), University of Algarve, Faro, Portugal
- Centre of Marine Sciences, University of Algarve, Faro, Portugal
- Algarve Biomedical Center (ABC), University of Algarve, Faro, Portugal
- Centre for BioMedical Research (CBMR), University of Algarve, Faro, Portugal
| | - Narcisa M. Bandarra
- Division of Aquaculture, Upgrading and Bioprospection, Portuguese Institute for the Sea and Atmosphere (IPMA), Algés, Portugal
- Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR), University of Porto, Porto, Portugal
| | - Paulo J. Gavaia
- Faculty of Biomedical Sciences and Medicine (FCBM), University of Algarve, Faro, Portugal
- Centre of Marine Sciences, University of Algarve, Faro, Portugal
| |
Collapse
|
16
|
de Araújo TP, de Moraes MM, Afonso C, Santos C, Rodrigues SSP. Food Processing: Comparison of Different Food Classification Systems. Nutrients 2022; 14:nu14040729. [PMID: 35215379 PMCID: PMC8877594 DOI: 10.3390/nu14040729] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 12/14/2022] Open
Abstract
The substitution of minimally processed food and culinary home preparations for ready-to-eat products is increasing worldwide, which is overlooked as a cause of concern. The technological developments and the rise in highly processed food availability have introduced the concept of ultra-processed food (UPF). Food classification systems based on processing are now a new basis for epidemiological research. Different results from these classifications might influence conclusions on the population’s consumption of UPF or its association with health outcomes. The aim of this study was to compare classification systems and to find out if their results are comparable when evaluating the extent of high/UPF on the overall diet. Portuguese data from the year 2000 was extracted from the DAFNE-AnemosSoft, and 556 food/beverages items were classified according to five systems. The contribution of UPF was calculated as a percentage of total available amount and discrepancy ranges used for comparisons. Results of UPF availability contributions were: NOVA 10.2%; UNC 15.2%; IFPRI 16.7%; IFIC 17.7%; IARC 47.4%. The highest discrepancy ranges were from alcoholic beverages (97.4%), milk/milk products (94.2%), sugar/sugar products (90.1%), added lipids (74.9%), and cereals/cereal products (71.3%). Inconsistencies among classifications were huge and the contribution from highly/UPF presented high discrepancies. Caution must be taken when comparing and interpreting such data.
Collapse
Affiliation(s)
- Taissa Pereira de Araújo
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (M.M.d.M.); (C.A.); (C.S.); (S.S.P.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: or
| | - Milena Miranda de Moraes
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (M.M.d.M.); (C.A.); (C.S.); (S.S.P.R.)
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health—Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
| | - Cláudia Afonso
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (M.M.d.M.); (C.A.); (C.S.); (S.S.P.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; (M.M.d.M.); (C.A.); (C.S.); (S.S.P.R.)
- Associate Laboratory RISE—Health Research Network, Center for Health Technology and Services Research (CINTESIS), University of Porto, 4200-450 Porto, Portugal
| | - Sara S. P. Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (M.M.d.M.); (C.A.); (C.S.); (S.S.P.R.)
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health—Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
| |
Collapse
|
17
|
Motta C, Rego A, Cardoso C, Coelho I, Gomes-Bispo A, Afonso C, Prates J, Castanheira I, Bandarra N. Seasonality as experienced in the market and the resulting variation in the amino acid and elemental composition of chub mackerel (Scomber colias). J Food Compost Anal 2021. [DOI: 10.1016/j.jfca.2021.104151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
18
|
Teixeira B, Afonso C, Rodrigues S, Oliveira A. Healthy and Sustainable Dietary Patterns in Children and Adolescents: A Systematic Review. Adv Nutr 2021; 13:1144-1185. [PMID: 34850824 PMCID: PMC9340991 DOI: 10.1093/advances/nmab148] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/18/2021] [Accepted: 11/24/2021] [Indexed: 01/02/2023] Open
Abstract
The need for adherence to a healthy and sustainable dietary pattern in the pediatric stage is discussed worldwide, being linked to a progressive incidence of noncommunicable diseases in adulthood. The aims of this systematic review were to summarize the healthy and/or sustainable dietary patterns, defined a priori, described in the literature for use during the pediatric stage; to evaluate the adherence to these dietary patterns; and identify the health-related benefits associated with adherence to these patterns. A literature search was carried out on Medline, Scopus, and Web of Science from 2010 up to 2021, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 128 articles were included according to the following criteria: participants 2-17 y old, healthy and/or sustainable dietary patterns defined by an a priori methodology; articles written in English or Portuguese; and published since 2010. Fifty instruments with 14 adaptations that measure adherence to healthy and/or sustainable dietary patterns in children and adolescents were found. The Mediterranean Diet was the most studied dietary pattern. Adherence to healthy and/or sustainable dietary patterns has wide variations worldwide. Most of the instruments described have been little studied at pediatric ages, reducing the ability to extrapolate results. Higher adherence to these dietary patterns was associated with lower body fat, waist circumference, blood pressure, and metabolic risk. There is no consensus regarding the association with BMI. No studies have proofs of the sustainability characteristics of these instruments, it being necessary to produce a new sustainable instrument or test the association of the previous ones with, for example, the ecological footprint. Further validations of these instruments in each country and more prospective studies are needed to establish temporal relations with health-related outcomes. This systematic review was registered at www.crd.york.ac.uk/prospero/ as CRD42020221788.
Collapse
Affiliation(s)
| | - Cláudia Afonso
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal,EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), [Laboratory for Integrative and Translational Research in Population Health (ITR)], Porto, Portugal
| | - Sara Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal,EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), [Laboratory for Integrative and Translational Research in Population Health (ITR)], Porto, Portugal
| | - Andreia Oliveira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), [Laboratory for Integrative and Translational Research in Population Health (ITR)], Porto, Portugal,Faculty of Medicine, University of Porto, Porto, Portugal
| |
Collapse
|
19
|
Costa M, Cardoso C, Afonso C, Bandarra NM, Prates JAM. Current knowledge and future perspectives of the use of seaweeds for livestock production and meat quality: a systematic review. J Anim Physiol Anim Nutr (Berl) 2021; 105:1075-1102. [PMID: 33660883 DOI: 10.1111/jpn.13509] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 01/09/2021] [Accepted: 01/17/2021] [Indexed: 12/12/2022]
Abstract
The effects of dietary macroalgae, or seaweeds, on growth performance and meat quality of livestock animal species are here reviewed. Macroalgae are classified into Phaeophyceae (brown algae), Rhodophyceae (red algae) and Chlorophyceae (green algae). The most common macroalga genera used as livestock feedstuffs are: Ascophyllum, Laminaria and Undaria for brown algae; Ulva, Codium and Cladophora for green algae; and Pyropia, Chondrus and Palmaria for red algae. Macroalgae are rich in many nutrients, including bioactive compounds, such as soluble polysaccharides, with some species being good sources of n-3 and n-6 polyunsaturated fatty acids. To date, the incorporation of macroalgae in livestock animal diets was shown to improve growth and meat quality, depending on the alga species, dietary level and animal growth stage. Generally, Ascophyllum nodosum can increase average daily gain (ADG) in ruminant and pig mostly due to its prebiotic activity in animal's gut. A. nodosum also enhances marbling score, colour uniformity and redness, and can decrease saturated fatty acids in ruminant meats. Laminaria sp., mainly Laminaria digitata, increases ADG and feed efficiency, and improves the antioxidant potential of pork. Ulva sp., and its mixture with Codium sp., was shown to improve poultry growth at up to 10% feed. Therefore, seaweeds are promising sustainable alternatives to corn and soybean as feed ingredients, thus attenuating the current competition among food-feed-biofuel industries. In addition, macroalgae can hinder eutrophication and participate in bioremediation. However, some challenges need to be overcome, such as the development of large-scale and cost-effective algae production methods and the improvement of algae digestibility by monogastric animals. The dietary inclusion of Carbohydrate-Active enZymes (CAZymes) could allow for the degradation of recalcitrant macroalga cell walls, with an increase of nutrients bioavailability. Overall, the use of macroalgae as feedstuffs is a promising strategy for the development of a more sustainable livestock production.
Collapse
Affiliation(s)
- Mónica Costa
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
| | - Carlos Cardoso
- DivAV - Division of Aquaculture and Upgrading, Portuguese Institute for the Sea and Atmosphere, Lisbon, Portugal
| | - Cláudia Afonso
- DivAV - Division of Aquaculture and Upgrading, Portuguese Institute for the Sea and Atmosphere, Lisbon, Portugal
| | - Narcisa M Bandarra
- DivAV - Division of Aquaculture and Upgrading, Portuguese Institute for the Sea and Atmosphere, Lisbon, Portugal
| | - José A M Prates
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
| |
Collapse
|
20
|
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: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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;
| |
Collapse
|
21
|
Pereira de Araújo T, Moraes MD, Afonso C, Rodrigues S. Food and nutrition literacy: an education booklet and video on ultra-processed food. Eur J Public Health 2021. [PMCID: PMC8574675 DOI: 10.1093/eurpub/ckab164.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background The COVID-19 pandemic appears to have contributed to change in eating habits for a significant part of the Portuguese population. The increase in the snacks consumption during the confinement period was reported by almost a third of the population. Often the snacks chosen are ultra-processed foods: industrial formulations that include excess of sugar, oils, fats, salt, and additives, antioxidant, stabilizers and preservatives substances in their ingredients. Excessive ultra-processed food consumption has been associated with worse health indicators. Objectives To develop informative educational material about ultra-processed foods and their health risks to be available to the general Portuguese population, and thus to promote food and nutrition literacy. Results The development of this new tool started in September 2020 and in April 2021 the booklet was approved by the UPPER Project team to be made available through digital media (cell phone, computer, laptop and tablet) or print. The booklet contains 33 pages with illustrative images and simple and didactic language. It is focused in seven main topics: “What are ultra-processed foods?”, “Which are they?”, “How to recognize them when purchasing?”, “What are worth for?”, “What is the relationship with health?”, and “What foods to choose?”. A short video with 2 minutes duration, summarizing and explaining the booklet, was also produced. The booklet impact will be piloted in a school intervention project that has been designed and submitted for ethical approval. Conclusions The developed booklet and explanatory video are didactic materials in simple language to achieve all general Portuguese population. Key messages The booklet is an instrument intending to improve literacy in ultra-processed foods. The booklet is a tool that can be used in health promotion programs and public policies in food and nutrition.
Collapse
Affiliation(s)
- T Pereira de Araújo
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- Public Health Institute, University of Porto, Porto, Portugal
| | - M de Moraes
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - C Afonso
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- Public Health Institute, University of Porto, Porto, Portugal
| | - S Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- Public Health Institute, University of Porto, Porto, Portugal
| |
Collapse
|
22
|
Guarda I, Fonseca I, Pereira H, Martins LL, Gomes R, Matos J, Gomes-Bispo A, Bandarra NM, Afonso C, Cardoso C. Key Constituents and Antioxidant Activity of Novel Functional Foods Developed with Skeletonema Sp. Biomass. Journal of Aquatic Food Product Technology 2021. [DOI: 10.1080/10498850.2021.1975003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Inês Guarda
- Instituto Superior de Agronomia, Universidade de Lisboa, Lisbon, Portugal
- Division of Aquaculture and Upgrading (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Lisbon, Portugal
| | - Inês Fonseca
- Instituto Superior de Agronomia, Universidade de Lisboa, Lisbon, Portugal
- Division of Aquaculture and Upgrading (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Lisbon, Portugal
| | - Hugo Pereira
- Centre of Marine Sciences, University of Algarve, Faro, Portugal
| | | | - Romina Gomes
- Division of Aquaculture and Upgrading (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Lisbon, Portugal
| | - Joana Matos
- Division of Aquaculture and Upgrading (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Lisbon, Portugal
- Faculdade de Ciências da Universidade de Lisboa, Lisbon, Portugal
| | - Ana Gomes-Bispo
- Division of Aquaculture and Upgrading (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Lisbon, Portugal
- Ciimar, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Porto, Portugal
| | - Narcisa Maria Bandarra
- Division of Aquaculture and Upgrading (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Lisbon, Portugal
- Ciimar, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Porto, Portugal
| | - Cláudia Afonso
- Division of Aquaculture and Upgrading (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Lisbon, Portugal
- Ciimar, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Porto, Portugal
| | - Carlos Cardoso
- Division of Aquaculture and Upgrading (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Lisbon, Portugal
- Ciimar, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Porto, Portugal
| |
Collapse
|
23
|
Moraes M, Oliveira B, Afonso C, Santos C, Torres D, Lopes C, Miranda R, Rauber F, Antoniazzi L, Levy R, Rodrigues S. 1431Dietary patterns and diet quality of Portuguese children and adolescents: the UPPER project. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Based on a classification that considers the nature, extent and purpose of food processing, this study aims to identify dietary patterns (DPs) and their associations with diet quality.
Methods
Sample from the 2015-2016 National Food, Nutrition and Physical Activity Survey (n = 1153;3-17y). Dietary intake from 2 non-consecutive 24h-recalls. Foods classified by NOVA system into 42 subgroups from 4 groups: unprocessed/minimally processed (G1), processed culinary ingredients (G2), processed (G3) and ultra-processed (UPF) (G4). Percentage of grams related to total daily grams consumed were considered to identify DPs by latent class analysis. Adjusted linear regressions were performed to test association with nutritional indicators.
Results
Subjects followed 3 DPs: “Unhealthy” (51%), “Traditional” (36%), and “Dairy” (13%). Consumption in NOVA groups/subgroups differentiated them: “Unhealthy”, high in G4 and low in G1; “Traditional”, high in G1, G2 and G3, but also some subgroups from G4; and “Dairy”, high in milk, yogurt and milk-based beverages from G1 or G4 and low in most G3 subgroups. Energy from UPF represented 39% in “Unhealthy” and 34-35% in “Traditional” and “Dairy”. Compared to “Traditional” DP, “Unhealthy” was higher in free sugars, and lower in fibre, vitamin A, vitamin C, folates, sodium, potassium, magnesium, and iron. “Dairy” had lower total energy, energy density, fats and sodium, and higher carbohydrates, potassium, calcium, phosphorus and magnesium.
Conclusions
“Unhealthy” had the worst nutrient profile, although all DPs presented significant consumption of UPF. This should be considered in food-based interventions and school-feeding policies.
Key messages
Half of Portuguese <18 years presented an “Unhealthy” DP.
Collapse
Affiliation(s)
- Milena Moraes
- Faculty Of Nutrition And Food Sciences, University Of Porto, Porto, Portugal
- Epidemiology Research Unit (EPIUnit) - Institute of Public Health of the University of Porto (ISPUP)/ Associated Laboratory ITR- Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal
| | - Bruno Oliveira
- Faculty Of Nutrition And Food Sciences, University Of Porto, Porto, Portugal
- Artificial Intelligence and Decision Support (LIAAD)-Institute for Systems and Computer Engineering, Technology and Science (INESC TEC), Porto, Portugal
| | - Cláudia Afonso
- Faculty Of Nutrition And Food Sciences, University Of Porto, Porto, Portugal
- Epidemiology Research Unit (EPIUnit) - Institute of Public Health of the University of Porto (ISPUP)/ Associated Laboratory ITR- Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal
| | - Cristina Santos
- Faculty Of Nutrition And Food Sciences, University Of Porto, Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), University of Porto/ Associate Laboratory RISE - Health Research Network, Porto, Portugal
| | - Duarte Torres
- Faculty Of Nutrition And Food Sciences, University Of Porto, Porto, Portugal
- Epidemiology Research Unit (EPIUnit) - Institute of Public Health of the University of Porto (ISPUP)/ Associated Laboratory ITR- Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal
| | - Carla Lopes
- Epidemiology Research Unit (EPIUnit) - Institute of Public Health of the University of Porto (ISPUP)/ Associated Laboratory ITR- Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Renata Miranda
- Department of Preventative Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Fernanda Rauber
- Department of Preventative Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Luiza Antoniazzi
- Department of Preventative Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Renata Levy
- Department of Preventative Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Sara Rodrigues
- Faculty Of Nutrition And Food Sciences, University Of Porto, Porto, Portugal
- Epidemiology Research Unit (EPIUnit) - Institute of Public Health of the University of Porto (ISPUP)/ Associated Laboratory ITR- Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal
| |
Collapse
|
24
|
Carvalho C, Correia D, Severo M, Afonso C, Bandarra NM, Gonçalves S, Lourenço HM, Graça Dias M, Oliveira L, Nabais P, Carmona P, Monteiro S, Borges M, Lopes C, Torres D. 1243Quantitative risk-benefit assessment of fish and seafood consumption scenarios to support recommendations. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Fish/seafood consumption has health benefits, namely due to its omega-3 fatty acids levels and risks due to methylmercury contamination. This study aims to quantify the health impact of hypothetical scenarios of fish/seafood consumption through a risk-benefit assessment and provide support for recommendations, using Portuguese food consumption data.
Methods
We used data from the National Food, Nutrition and Physical Activity Survey 2015-2016 (n = 5811) to estimate the mean exposure to methylmercury and EPA+DHA in the current and alternative scenarios. Alternative scenarios were modelled using probabilistic approaches to reflect substitutions from the current consumption in the type of fish/seafood (predatory vs low-mercury species) or its frequency (1-7x/week). The overall scenarios’ impact was quantified using Disability-Adjusted Life Years (DALYs).
Results
About 14% of the Portuguese population exceeds the methylmercury tolerable weekly intake, and this prevalence is higher among small children (36.6%). Nevertheless, if the fish/seafood consumption increased to once a day, ≈11450 DALYs could be prevented each year. However, such a scenario would result in higher risk for pregnant women (1398 extra DALYs). Moreover, excluding predatory species consumption resulted in small but significant health gains (-1078 DALYs).
Conclusions
For the general population, the maximum health gains are obtained by consuming fish/seafood up to 7x/week, but among children and pregnant women, the frequency should be limited to 3-5x/week. All population should preferably choose non-predatory species.
Key messages
Daily fish consumption results in the highest overall populational health gain, but children and pregnant women need to limit it to 3-5x/week, due to methylmercury exposure.
Collapse
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
| | - Cláudia Afonso
- Division of Aquaculture, Upgrading, and Bioprospecting (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Algés, Portugal
- CIIMAR, Centro Interdisciplinar de Investigação Marinha e Ambiental, Universidade do Porto, Porto, Portugal
| | - Narcisa M. Bandarra
- Division of Aquaculture, Upgrading, and Bioprospecting (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Algés, Portugal
- CIIMAR, Centro Interdisciplinar de Investigação Marinha e Ambiental, Universidade do Porto, Porto, Portugal
| | - Susana Gonçalves
- Division of Aquaculture, Upgrading, and Bioprospecting (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Algés, Portugal
| | - Helena M. Lourenço
- Division of Aquaculture, Upgrading, and Bioprospecting (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Algés, Portugal
- CIIMAR, Centro Interdisciplinar de Investigação Marinha e Ambiental, Universidade do Porto, Porto, Portugal
| | - M. Graça Dias
- Departamento de Alimentação e Nutrição, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP (INSA, IP), Lisboa, Portugal
| | - Luísa Oliveira
- Departamento de Alimentação e Nutrição, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP (INSA, IP), Lisboa, Portugal
| | - Pedro Nabais
- Divisão de Riscos Alimentares, Autoridade de Segurança Alimentar e Económica, Lisboa, Portugal
| | - Paulo Carmona
- Divisão de Riscos Alimentares, Autoridade de Segurança Alimentar e Económica, Lisboa, Portugal
| | - Sarogini Monteiro
- Divisão de Riscos Alimentares, Autoridade de Segurança Alimentar e Económica, Lisboa, Portugal
| | - Marta Borges
- Divisão de Alimentação Humana, Direção-Geral de Alimentação e Veterinária, Lisboa, 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 Alimentos da Universidade do Porto, Portugal
| |
Collapse
|
25
|
Cardoso C, Matos J, Gomes‐Bispo A, Afonso C, Motta C, Castanheira I, Prates JAM, Bandarra NM. Antioxidant and anti‐inflammatory activities of ethyl acetate extracts of chub mackerel (
Scomber colias
): a thorough seasonal evaluation. Int J Food Sci Technol 2021. [DOI: 10.1111/ijfs.15185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Carlos Cardoso
- Division of Aquaculture, Upgrading, and Bioprospection (DivAV) Portuguese Institute for the Sea and Atmosphere (IPMA, IP) Avenida Alfredo Magalhães Ramalho, 6 Algés 1495‐165 Portugal
- CIIMAR Interdisciplinary Centre of Marine and Environmental Research University of Porto Rua dos Bragas 289 Porto 4050‐123 Portugal
| | - Joana Matos
- Division of Aquaculture, Upgrading, and Bioprospection (DivAV) Portuguese Institute for the Sea and Atmosphere (IPMA, IP) Avenida Alfredo Magalhães Ramalho, 6 Algés 1495‐165 Portugal
- Faculdade de Ciências da Universidade de Lisboa Campo Grande, 16 Lisboa 1749‐016 Portugal
| | - Ana Gomes‐Bispo
- Division of Aquaculture, Upgrading, and Bioprospection (DivAV) Portuguese Institute for the Sea and Atmosphere (IPMA, IP) Avenida Alfredo Magalhães Ramalho, 6 Algés 1495‐165 Portugal
- CIIMAR Interdisciplinary Centre of Marine and Environmental Research University of Porto Rua dos Bragas 289 Porto 4050‐123 Portugal
| | - Cláudia Afonso
- Division of Aquaculture, Upgrading, and Bioprospection (DivAV) Portuguese Institute for the Sea and Atmosphere (IPMA, IP) Avenida Alfredo Magalhães Ramalho, 6 Algés 1495‐165 Portugal
- CIIMAR Interdisciplinary Centre of Marine and Environmental Research University of Porto Rua dos Bragas 289 Porto 4050‐123 Portugal
| | - Carla Motta
- Instituto Nacional de Saúde Doutor Ricardo Jorge Av. Padre Cruz Lisbon 1600‐560 Portugal
| | - Isabel Castanheira
- Instituto Nacional de Saúde Doutor Ricardo Jorge Av. Padre Cruz Lisbon 1600‐560 Portugal
| | - José A. M. Prates
- Centro de Investigação Interdisciplinar em Sanidade Animal (CIISA) Faculdade de Medicina Veterinária Universidade de Lisboa Lisbon 1300‐477 Portugal
| | - Narcisa M. Bandarra
- Division of Aquaculture, Upgrading, and Bioprospection (DivAV) Portuguese Institute for the Sea and Atmosphere (IPMA, IP) Avenida Alfredo Magalhães Ramalho, 6 Algés 1495‐165 Portugal
- CIIMAR Interdisciplinary Centre of Marine and Environmental Research University of Porto Rua dos Bragas 289 Porto 4050‐123 Portugal
| |
Collapse
|
26
|
Matos J, Afonso C, Cardoso C, Serralheiro ML, Bandarra NM. Yogurt Enriched with Isochrysis galbana: An Innovative Functional Food. Foods 2021; 10:1458. [PMID: 34202539 PMCID: PMC8306745 DOI: 10.3390/foods10071458] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/09/2021] [Accepted: 06/21/2021] [Indexed: 01/19/2023] Open
Abstract
Microalgae are a valuable and innovative emerging source of natural nutrients and bioactive compounds that can be used as functional ingredients in order to increase the nutritional value of foods to improve human health and to prevent disease. The marine microalga Isochrysis galbana has great potential for the food industry as a functional ingredient, given its richness in ω3 long chain-polyunsaturated fatty acids (LC-PUFAs), with high contents of oleic, linoleic, alpha-linolenic acid (ALA), stearidonic, and docosahexaenoic (DHA) acids. This study focuses on the formulation of a functional food by the incorporation of 2% (w/w) of I. galbana freeze-dried biomass and 2% (w/w) of I. galbana ethyl acetate lipidic extract in solid natural yogurts preparation. In the functional yogurt enriched with microalgal biomass, the ω3 LC-PUFA's content increased (to 60 mg/100 g w/w), specifically the DHA content (9.6 mg/100 g ww), and the ω3/ω6 ratio (augmented to 0.8). The in vitro digestion study showed a poor bioaccessibility of essential ω3 LC-PUFAs, wherein linoleic acid (18:2 ω6) presented a bioaccessibility inferior to 10% and no DHA or eicosapentaenoic acid (EPA) was detected in the bioaccessible fraction of the functional yogurts, thus indicating a low accessibility of lipids during digestion. Notwithstanding, when compared to the original yogurt, an added value novel functional yogurt with DHA and a higher ω3 LC-PUFAs content was obtained. The functional yogurt enriched with I. galbana can be considered important from a nutritional point of view and a suitable source of essential FAs in the human diet. However, this needs further confirmation, entailing additional investigation into bioavailability through in vivo assays.
Collapse
Affiliation(s)
- Joana Matos
- Division of Aquaculture, Upgrading and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, I.P.), Avenida Alfredo Magalhães Ramalho, 6, 1495-165 Algés, Portugal; (C.A.); (C.C.); (N.M.B.)
- Faculty of Sciences, BioISI—Biosystems & Integrative Sciences Institute, University of Lisboa, Campo Grande 016, 1749-016 Lisboa, Portugal;
| | - Cláudia Afonso
- Division of Aquaculture, Upgrading and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, I.P.), Avenida Alfredo Magalhães Ramalho, 6, 1495-165 Algés, Portugal; (C.A.); (C.C.); (N.M.B.)
- CIIMAR, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Rua dos Bragas 289, 4050-123 Porto, Portugal
| | - Carlos Cardoso
- Division of Aquaculture, Upgrading and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, I.P.), Avenida Alfredo Magalhães Ramalho, 6, 1495-165 Algés, Portugal; (C.A.); (C.C.); (N.M.B.)
- CIIMAR, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Rua dos Bragas 289, 4050-123 Porto, Portugal
| | - Maria L. Serralheiro
- Faculty of Sciences, BioISI—Biosystems & Integrative Sciences Institute, University of Lisboa, Campo Grande 016, 1749-016 Lisboa, Portugal;
| | - Narcisa M. Bandarra
- Division of Aquaculture, Upgrading and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, I.P.), Avenida Alfredo Magalhães Ramalho, 6, 1495-165 Algés, Portugal; (C.A.); (C.C.); (N.M.B.)
- CIIMAR, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Rua dos Bragas 289, 4050-123 Porto, Portugal
| |
Collapse
|
27
|
Duarte S, Afonso C, Marques B, Barros Lima C, Neves D, Lai AC, Julião MJ, Roque A, Ruzickova L, Carda J, Gomes M, Cipriano A, Espadana A. SURVIVAL INDEPENDENT PREDICTIVE VALUE OF INTERIM FDG
18
‐PET IN NEWLY DIAGNOSED DIFFUSE LARGE B CELL LYMPHOMA. Hematol Oncol 2021. [DOI: 10.1002/hon.94_2881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- S. Duarte
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - C. Afonso
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - B. Marques
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - C. Barros Lima
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - D. Neves
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - A. C. Lai
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | - M. J. Julião
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | - A. Roque
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - L. Ruzickova
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - J. Carda
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - M. Gomes
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - A. Cipriano
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | - A. Espadana
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| |
Collapse
|
28
|
Azevedo S, Parente H, Esperança Almeida D, Guimarães F, Rodrigues J, Faria D, Peixoto D, Tavares-Costa J, Afonso C, Teixeira F. POS0162 PREDICTIVE FACTORS OF A NEW FRAGILITY FRACTURE AFTER WRIST FRAGILITY FRACTURE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Fragility fractures (FF) are fractures that result from mechanical forces that would not ordinarily result in fracture, known as low-level (or ‘low energy’) trauma.1 Studies have shown that history of wrist fracture increases the risk for subsequent FF.2Objectives:To assess predictive factors of FF occurring after a wrist fracture.Methods:Retrospective monocentric study that included patients with a wrist FF observed at the emergency department (ED) in a tertiary center, between 1st January 2017 and 31st December 2018. Wrist fractures were identified through the 10th International Classification of Diseases and FF were identified after revision of the clinical record. Patients with relevant missing data were excluded. Seven hundred thirty-three wrist FF were identified. After calculating a representative sample (90% confidence interval), 188 patients were included. Their clinical records until 31th December 2020 (2 to 3 years after FF) were reviewed. SPSS was used for statistical analysis and significance level was defined as 2-sided p<0.05. In multivariate analysis we included variables with a significant association in univariate analysis and those with clinical relevance (reported in others studies).Results:Wrist fractures represented 44.3% of the FF observed at the ED.Most patients were woman (83.5%) with a mean age of 70.7 (SD=11.2) years-old at the time of their wrist fracture. A previous FF was seen in 22.9% of patients and 13.3% had a new FF during the follow-up period.We found an association between the occurrence of a new FF and the number of comorbidities (p=0.012), number of visits to the ED due to falls (p<0.001), previous diagnosis of chronic pulmonary disease (p=0.029) and hematologic pathologies (p=0.047), and the need for hospitalization at time of the wrist FF (p=0.018).No associations were found between the age at the wrist fracture time, number of drugs taken daily nor its type (anxiolytics, antiepileptics, corticoids), previous fractures (and localization), overweight/obesity and other cardiovascular risk factors, endocrinopathies, psychiatric or neurologic disease or other comorbidities.After adjustment for age, gender, anti-osteoporotic treatment and comorbidities, the main predictors of a new FF were visits to the ED for falls (p=0.005), chronic pulmonary disease (p=0.040), hematologic pathologies (p=0.004) and need for hospitalization (p=0.040) (table 1).Table 1.Multivariate analyses: linear multiple regression for predictive factors of new fragility fracture.DeterminantsUnstandardized CoefficientsBStandardized Coefficients Beta95.0% CIp-valueAge-0.0250.9750.924 – 1.030NSGender2.0657.8890.757 – 82.165NSNumber of comorbidities0.1861.2040.846 – 1.713NSVisits to the emergency service for falls-2.1360.1180.026 – 0.5290.005Chronic pulmonary disease-1.3260.2660.075 – 0.9400.040Hematologic pathologies-4.2960.0140.001 – 0.2550.004Need for hospitalization-2.7640.0630.004 – 0.8870.040Anti-osteoporotic treatment0.1571.1700.227 – 6.017NSCI: Confidence Interval; NS: non-significant;Conclusion:Certain comorbidities seem to be associated with new FF. Patients with visits to the emergency service after falls and those who needed hospitalization due to the wrist fracture were more prone to have a new FF. There might be a substantial missed opportunity for intervention in these patients.References:[1]Osteoporosis: assessing the risk of fragility fracture. London: National Institute for Health and Care Excellence (UK); 2017 Feb. PMID: 32186835.[2]Crandall CJ, Hovey KM, Cauley JA, Andrews CA, Curtis JR, Wactawski-Wende J, Wright NC, Li W, LeBoff MS. Wrist Fracture and Risk of Subsequent Fracture: Findings from the Women’s Health Initiative Study. Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research. 2015;30(11):2086–2095. doi: 10.1002/jbmr.2559.Disclosure of Interests:None declared
Collapse
|
29
|
Marques B, Duarte S, Afonso C, Lima CB, Neves D, Lai AC, Julião MJ, Roque A, Ruzickova L, Carda J, Gomes M, Cipriano A, Espadana AI. DIFFUSE LARGE B‐CELL LYMPHOMA IN ELDERLY PATIENTS: OUTCOME IN REAL‐WORLD CLINICAL PRACTICE. Hematol Oncol 2021. [DOI: 10.1002/hon.63_2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- B. Marques
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - S. Duarte
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - C. Afonso
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - C. B. Lima
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - D. Neves
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - A. C. Lai
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | - M. J. Julião
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | - A. Roque
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - L. Ruzickova
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - J.P. Carda
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - M. Gomes
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - A. Cipriano
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | - A. I. Espadana
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| |
Collapse
|
30
|
Esperança Almeida D, Costa E, Guimarães F, Pinto AS, Parente H, Azevedo S, Rodrigues J, Tavares-Costa J, Afonso C, Faria D, Cerqueira M, Teixeira F. AB0799 DO WE OVERDIAGNOSE SERONEGATIVE RHEUMATOID ARTHRITIS? – THE ROLE OF MUSCULOSKELETAL ULTRASOUND IN CLARIFYING SERONEGATIVE INFLAMMATORY ARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Several data indicate that seronegative rheumatoid arthritis (RA-) and seropositive RA (RA+) may have different mechanisms and prognosis, being well established that rheumatoid factor (RF) and anti-citrullinated peptide antibodies (ACPA) have diagnostic and prognostic value. Several conditions, like peripheral spondyloarthritis (SpA), psoriatic arthritis or crystal-related arthropathies may mimic the presentation of RA. Mechanisms and treatment of each of these conditions differ significantly. The authors speculate that RA- may be overdiagnosed in the setting of seronegative chronic inflammatory arthritis and that musculoskeletal ultrasound (US) may help us to better classify these patients through the identification of characteristic lesions of the mentioned diseases.Objectives:To compare the frequency of US lesions found in joints and entheses between RA- and RA+ patients.Methods:Cross-sectional study: systematic US evaluation of ten joints, twelve entheses and both flexor and extensor tendons of four fingers (Table 1) in consecutive RA- patients. RA+ patients matched for sex and age were recruited. RA- patients included met every of the following criteria: history of chronic polyarthritis, RF and ACPA negativity, no extra-articular features of SpA or RA nor family history of SpA, no suspected crystal-related arthritis.Results:Twenty-one RA- patients were included and twenty RA+ patients were recruited as controls. No differences between groups were found in sex, age, body mass index, time of disease evolution or use of biological therapy.RA- patients had a significantly higher number of entheseal structural and/or inflammatory lesions than RA+ patients (median 2.0 vs. 0.5, U 111.5, p=.008**), with triceps enthesitis being significantly more frequent in RA- patients (p=.036*). In total, 18.7% of RA- entheses had enthesitis lesions vs. only 8.3% of RA+ entheses. One RA- patient had ultrasonographic features of dactylitis which was not clinically evident.As expected, considering the role of RF and ACPA in erosive RA, RA- patients had a significantly lower number of joints with erosions compared to RA+ patients (median 0.0 vs. 3.0, U 64.5, p<.001***), with significant differences in every considered joint. Erosions were found in 6.7% of RA- joints vs. 32.0% RA+ joints.Additionally, two RA- patients had hyperechogenic foci in knee cartilage or carpal fibrocartilage suggestive of calcium pyrophosphate deposition.Table 1.Comparative frequency of ultrasound lesions found in joints and entheses of RA- and RA+ patients.RA-(n=21)RA+(n=20)p-valueMdn number of ENTHESES with any lesion per patient ± IQR2.0 ± 3.00.5 ± 2.0.008**Triceps – n (%)8 (38.1%)2 (10.0%).036*Quadriceps – n (%)9 (42.9%)6 (30.0%).393Superior patellar – n (%)4 (19.0%)1 (5.0%).169Inferior patellar – n (%)---Achilles – n (%)9 (42.8%)4 (20.0%).116Plantar fascia – n (%)5 (23.8%)1 (5.0%).089DACTYLITIS – 2nd + 5th finger – n (%)1 (4.8%)--Mdn number of joints with EROSIONS per patient ± IQR0.0 ± 1.03.0 ± 3.0<.001***Ulnar styloid process – n (%)5 (23.8%)11 (55.0%).041*Metacarpophalangeal 2 – n (%)3 (14.3%)11 (55.0%).006**Metacarpophalangeal 5 – n (%)1 (4.8%)10 (50.0%).001**Metatarsophalangeal 1 – n (%)-3 (15.0%)-Metatarsophalangeal 5 – n (%)3 (14.3%)11 (55.0%).006**CHONDROCALCINOSIS – triangular fibrocartilage + knee – n (%)2 (9.5%)--DOUBLE CONTOUR – any joint – n (%)---RA- – seronegative rheumatoid arthritis; RA+ – seropositive rheumatoid arthritis Mdn – median; IQR – interquartile range; n (%) – absolute number (percentage) of patients with the indicated lesion.Conclusion:We found that some patients diagnosed with RA- had, in fact, ultrasonographic features of different diseases, namely enthesitis/dactylitis and crystal deposition. These data suggest that RA- may be overdiagnosed in clinical practice. Systematic US evaluation of joints and entheses may provide valuable diagnostic information in patients with chronic inflammatory seronegative arthritis and improve patient care.Disclosure of Interests:None declared
Collapse
|
31
|
Neves DS, Duarte S, Afonso C, Marques B, Lima CB, Lai A, Roque A, Ruzickova L, Carda J, Gomes M, Cipriano A, Espadana A. CLINICAL RISK SCORES IN DIFFUSE LARGE B CELL LYMPHOMA ‐ IS THERE STILL ROOM FOR IMPROVEMENT? Hematol Oncol 2021. [DOI: 10.1002/hon.54_2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- D. S Neves
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - S Duarte
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - C Afonso
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - B Marques
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - C. B Lima
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - A Lai
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | - A Roque
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - L Ruzickova
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - J Carda
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - M Gomes
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - A Cipriano
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | - A Espadana
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| |
Collapse
|
32
|
Barros Lima C, Marques B, Duarte S, Afonso C, Neves D, Lai A, Julião M, Ruzickova L, Carda J, Gomes M, Cipriano A, Espadana A. PROGNOSTIC IMPACT OF NUTRITIONAL STATUS ON DLBCL PATIENTS. Hematol Oncol 2021. [DOI: 10.1002/hon.50_2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- C. Barros Lima
- Centro Hospitalar e Universitário de Coimbra Hematology Department Coimbra Portugal
| | - B. Marques
- Centro Hospitalar e Universitário de Coimbra Hematology Department Coimbra Portugal
| | - S. Duarte
- Centro Hospitalar e Universitário de Coimbra Hematology Department Coimbra Portugal
| | - C. Afonso
- Centro Hospitalar e Universitário de Coimbra Hematology Department Coimbra Portugal
| | - D. Neves
- Centro Hospitalar e Universitário de Coimbra Hematology Department Coimbra Portugal
| | - A. Lai
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | - M. Julião
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | - L. Ruzickova
- Centro Hospitalar e Universitário de Coimbra Hematology Department Coimbra Portugal
| | - J. Carda
- Centro Hospitalar e Universitário de Coimbra Hematology Department Coimbra Portugal
| | - M. Gomes
- Centro Hospitalar e Universitário de Coimbra Hematology Department Coimbra Portugal
| | - A. Cipriano
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | - A. Espadana
- Centro Hospitalar e Universitário de Coimbra Hematology Department Coimbra Portugal
| |
Collapse
|
33
|
Duarte S, Afonso C, Marques B, Barros Lima C, Neves D, Lai AC, Julião MJ, Roque A, Ruzickova L, Carda J, Gomes M, Cipriano A, Espadana A. BONE MARROW INFILTRATION ASSESSMENT BY FDG
18
‐PET: CAN THIS IMAGING TEST REPLACE BONE MARROW TREPHINE BIOPSY IN DIFFUSE LARGE B CELL LYMPHOMA STAGING? Hematol Oncol 2021. [DOI: 10.1002/hon.84_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- S. Duarte
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - C. Afonso
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - B. Marques
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - C. Barros Lima
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - D. Neves
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - A. C. Lai
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | - M. J. Julião
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | - A. Roque
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - L. Ruzickova
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - J. Carda
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - M. Gomes
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - A. Cipriano
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | | |
Collapse
|
34
|
Afonso C, Duarte S, Marques B, Barros Lima C, Neves D, Lai A, Julião MJ, Ruzickova L, Roque A, Carda JP, Gomes M, Cipriano A, Espadana AI. NEUTROPHIL/LYMPHOCYTE RATIO AND MONOCYTE/LYMPHOCYTE RATIO – PROMISING PROGNOSTIC BIOMARKERS IN DIFFUSE LARGE B‐CELL LYMPHOMA? Hematol Oncol 2021. [DOI: 10.1002/hon.52_2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- C. Afonso
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - S. Duarte
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - B. Marques
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - C. Barros Lima
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - D. Neves
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - A. Lai
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | - M. J. Julião
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | - L. Ruzickova
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - A. Roque
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - J. P. Carda
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - M. Gomes
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| | - A. Cipriano
- Centro Hospitalar e Universitário de Coimbra Pathology Department Coimbra Portugal
| | - A. I. Espadana
- Centro Hospitalar e Universitário de Coimbra Clinical Hematology Department Coimbra Portugal
| |
Collapse
|
35
|
Paulo MC, Marques J, Cardoso C, Coutinho J, Gomes R, Gomes-Bispo A, Afonso C, Bandarra NM. The development of a novel functional food: bioactive lipids in yogurts enriched with Aurantiochytrium sp. biomass. Food Funct 2021; 11:9721-9728. [PMID: 33063067 DOI: 10.1039/d0fo01884h] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Western diets are poor in healthy n3 polyunsaturated fatty acids, such as docosahexaenoic acid. Since microalga Aurantiochytrium sp. is rich in docosahexaenoic acid, a functional food based on lean yogurt and this microalga was tested. This study entailed characterizing the lipid fraction and determining the fatty acid bioaccessibility. The tested yogurts (control and 2% w/w, Aurantiochytrium sp.) had differences. Docosahexaenoic acid was not detected in the control product, but it was the second most important fatty acid in Aurantiochytrium sp. and Aurantiochytrium yogurt, 29.7 ± 0.4% and 18.7 ± 2.0%, respectively. Based on the fatty acid profile only, an amount of 158.7 g of Aurantiochytrium yogurt in wet weight terms would be required to ensure an appropriate intake of healthy fatty acids. Generally, the fatty acid bioaccessibility was not high, remaining below 60-70% in almost all cases. Considering the docosahexaenoic acid bioaccessibility (44 ± 3%), an amount of 360.7 g of Aurantiochytrium yogurt would be advisable. A reasonable dietary prescription would be a daily consumption of 125 ml of Aurantiochytrium yogurt.
Collapse
Affiliation(s)
- M C Paulo
- Depsiextracta Tecnologias Biológicas Lda, Zona Industrial do Monte da Barca, lote 62, rua H, Coruche, Portugal
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Guerra RS, Sousa-Santos AR, Sousa AS, Valdiviesso R, Afonso C, Moreira P, Padrão P, Borges N, Santos A, Ferro G, Martins C, Amaral TF. Prediction equations for estimating body weight in older adults. J Hum Nutr Diet 2021; 34:841-848. [PMID: 33966329 DOI: 10.1111/jhn.12879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Assessing body weight in older adults may be challenging. Hence, the present study aimed to develop and cross-validate updated and reproducible equations to estimate body weight in a large sample of older adults, namely among the older-old. METHODS In total, 1456 individuals aged ≥ 65 years, from the Nutrition UP 65 study, were included in the present analysis. The participants were randomly assigned to one of two sub-samples: development (n = 991) and validation samples (n = 465). Prediction equations using height, mid-upper arm circumference (MUAC), waist circumference (WC), calf circumference (CC) and triceps skinfold thickness (TST) were generated for the development sample using multiple regression analysis and then validated using the validation sample. RESULTS The model with five predictor variables generated the following equations: females 65-79 years: -114.682 + 0.522 × height (cm) + 0.620 × MUAC (cm) + 0.517 × WC (cm) + 0.893 × CC (cm) + 0.111 × TST (mm) (adjusted r2 = 0.883, standard error of the estimate (SEE) = 4.4); females ≥ 80 years: -110.806 + 0.494 × height (cm) + 0.637 × MUAC (cm) + 0.500 × WC (cm) + 0.986 × CC (cm) + 0.021 × TST (mm) (adjusted r2 = 0.890, SEE = 3.9); males 65-79 years: -114.875 + 0.558 × height (cm) + 0.073 × MUAC (cm) + 0.671 × WC (cm) + 0.717 × CC (cm) + 0.182 × TST(mm) (adjusted r2 = 0.820, SEE=5.0); and males ≥ 80 years: -128.789 + 0.546 × height (cm) + 0.202 × MUAC (cm) + 0.612 × WC (cm) + 1.236 × CC (cm) + 0.093 × TST (mm) (adjusted r2 = 0.906, SEE = 3.5). CONCLUSIONS Body weight can be estimated with good accuracy in older adults using these sex- and age-specific equations generated from regression models using three to five anthropometric predictor variables.
Collapse
Affiliation(s)
- Rita S Guerra
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,LAETA-INEGI - Universidade do Porto, Porto, Portugal
| | - Ana R Sousa-Santos
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Ana S Sousa
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Rui Valdiviesso
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Cláudia Afonso
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Pedro Moreira
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,CIAFEL - Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - Patrícia Padrão
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Nuno Borges
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | - Alejandro Santos
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,I3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Graça Ferro
- Alto Minho Local Health Unit, EPE, Estrada de Santa Luzia, Viana do Castelo, Portugal
| | - Cátia Martins
- Obesity Research Group, Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Teresa F Amaral
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,LAETA-INEGI - Universidade do Porto, Porto, Portugal
| |
Collapse
|
37
|
Thomsen ST, Assunção R, Afonso C, Boué G, Cardoso C, Cubadda F, Garre A, Kruisselbrink JW, Mantovani A, Pitter JG, Poulsen M, Verhagen H, Ververis E, Voet HVD, Watzl B, Pires SM. Human health risk-benefit assessment of fish and other seafood: a scoping review. Crit Rev Food Sci Nutr 2021; 62:7479-7502. [PMID: 33951954 DOI: 10.1080/10408398.2021.1915240] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Fish and other seafood are important sources of nutrients, but they are also sources of chemical contaminants that may cause adverse health effects. This article aimed to identify existing risk-benefit assessments (RBA) of fish, shellfish, and other seafood, compare methodologies, discuss differences and commonalities in findings, and identify limitations and ways forward for future studies. We conducted a scoping review of the scientific literature of studies in all languages published from 2000 through April 2019. We identified 106 RBA of fish and other seafood across Europe, Asia, North America, Africa, and at the global level. Studies were heterogeneous in terms of types of fish and other seafood considered, beneficial and adverse compounds assessed, and overall methodology. Collected data showed that a diet consisting of a variety of lean and fatty fish and other seafood is recommended for the overall population and that women of childbearing age and children should limit the consumption of fish and other seafood types that have a high likelihood of contamination. Our review emphasizes the need for evidence-based, up-to-date, and harmonized approaches in RBA in general.
Collapse
Affiliation(s)
- Sofie Theresa Thomsen
- Division of Diet, Disease Prevention and Toxicology, Technical University of Denmark, Copenhagen, Denmark
| | - Ricardo Assunção
- Food and Nutrition Department, National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal.,CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Cláudia Afonso
- Division of Aquaculture, Upgrading and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Portugal
| | - Géraldine Boué
- National Research Institute for Agriculture, Food and Environment (INRAe), Oniris, Secalim UMR 1014, Nantes, France
| | - Carlos Cardoso
- Division of Aquaculture, Upgrading and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Portugal
| | - Francesco Cubadda
- Istituto Superiore di Sanità - National Institute of Health, Rome, Italy
| | - Alberto Garre
- Wageningen University & Research, Wageningen, the Netherlands
| | | | - Alberto Mantovani
- Istituto Superiore di Sanità - National Institute of Health, Rome, Italy
| | | | - Morten Poulsen
- Division of Diet, Disease Prevention and Toxicology, Technical University of Denmark, Copenhagen, Denmark
| | - Hans Verhagen
- Division of Diet, Disease Prevention and Toxicology, Technical University of Denmark, Copenhagen, Denmark.,European Food Safety Authority (EFSA), Parma, Italy.,University of Ulster, Northern, Ireland
| | - Ermolaos Ververis
- European Food Safety Authority (EFSA), Parma, Italy.,School of Medicine, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | | | - Bernhard Watzl
- Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
| | - Sara M Pires
- Division of Diet, Disease Prevention and Toxicology, Technical University of Denmark, Copenhagen, Denmark
| |
Collapse
|
38
|
Gamba M, Moreira P, Borges N, Santos A, Afonso C, Amaral TF, Padrão P. Are older adults with excessive sodium intake at increased risk of hypohydration? J Hum Nutr Diet 2021; 34:834-840. [PMID: 33513297 DOI: 10.1111/jhn.12859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sodium intake is expected to affect water needs, although compensation mechanisms may not work efficiently particularly in older adults. The aim of this cross-sectional study was to quantify the association between sodium excretion and hydration status in a representative sample of Portuguese older adults. METHODS A cluster sampling approach was used, representing Portuguese older adults (≥65 years) according to sex, education level and region. From a sample size of 1500 participants, 1318 were eligible for the present analysis. A 24-h urine sample was collected, and volume, osmolality, creatinine and sodium were quantified. Free water reserve (FWR) was used to assess hydration status. Excessive sodium intake was defined as above 2000 mg day-1 as recommended by the World Health Organization. A multivariable binary logistic regression model was used to estimate the association between FWR and sodium excretion. Odds ratios (OR) and respective 95% confidence intervals (95% CI) were calculated. RESULTS Excessive sodium excretion was observed in 80.0% of women and 91.5% of men, whereas hypohydration affected 10.9% of women and 23.6% of men. After adjusting for confounders, excessive sodium excretion was associated with an increased risk of hypohydration among men (OR = 2.75; 95% CI = 1.06-7.15). CONCLUSIONS These results stress the positive association between excessive sodium intake and hypohydration in men and highlight the need for implementing strategies regarding the reduction of salt consumption and the promotion of water intake.
Collapse
Affiliation(s)
- Marta Gamba
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Pedro Moreira
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Centro de Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - Nuno Borges
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | - Alejandro Santos
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,I3S-Instituto de Investigação e Inovação em Saúde, Porto, Portugal
| | - Cláudia Afonso
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Teresa F Amaral
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,UISPA-IDMEC, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| | - Patrícia Padrão
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| |
Collapse
|
39
|
Afonso C, Sousa-Santos AR, Santos A, Borges N, Padrão P, Moreira P, Amaral TF. Frailty status is related to general and abdominal obesity in older adults. Nutr Res 2020; 85:21-30. [PMID: 33422742 DOI: 10.1016/j.nutres.2020.10.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 08/28/2020] [Accepted: 10/23/2020] [Indexed: 02/04/2023]
Abstract
The association between frailty and obesity may differ according to the heterogeneity of body mass index (BMI) and waist circumference (WC) phenotypes in older adults. We hypothesized that the use of simple indicators of general and abdominal obesity combined, may more accurately represent obesity and allow to further elucidate on how frailty status and its criteria are related to obesity. A sample of 1444 older adults, aged ≥65 years (Nutrition UP 65 study) was included in a cross-sectional analysis. General and abdominal obesity were defined according to World Health Organization BMI and WC cut-offs, and frailty by Fried et al. phenotype. A cluster analysis defined groups according to BMI and WC levels. Overweight (BMI between 25.0 and 29.9 kg/m2; 44.6%), general obesity (BMI ≥30.0 kg/m2; 39.0%), and abdominal obesity (WC >102 cm for men and >88 cm for women) were highly frequent (66.5%). Prefrailty (odds ratio [OR]: 2.33; 95% confidence interval [CI]: 1.52-3.57) and frailty (OR: 2.87; 95% CI: 1.58-5.22) were directly associated with the "general and abdominal obesity" cluster. Regarding frailty criteria, low handgrip strength (OR: 2.29; 95% CI: 1.55-3.38) and weight loss (OR: 0.27; 95% CI: 0.14-0.52) were also associated with this cluster. In this sample of older adults presenting a high frequency of overweight and obesity, prefrailty and frailty are linked to higher levels of adiposity, but only when both general and abdominal obesity are present. Present results emphasize the importance of the evaluation of both BMI and WC in the geriatric clinical practice and suggest that older adults presenting both general and abdominal obesity should be routinely screened for frailty.
Collapse
Affiliation(s)
- Cláudia Afonso
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Ana Rita Sousa-Santos
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.
| | - Alejandro Santos
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal; I3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Nuno Borges
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal; CINTESIS - Centro de Investigação em Tecnologia e Serviços de Saúde, Porto, Portugal
| | - Patrícia Padrão
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Pedro Moreira
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; CIAFEL - Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - Teresa F Amaral
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal; UISPA, LAETA-INEGI - Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| |
Collapse
|
40
|
Afonso C, Guarda I, Mourato M, Martins L, Fonseca I, Gomes R, Matos J, Gomes A, Bandarra N, Cardoso C. Treptacantha abies-marina (S.G. Gmelin) Kützing: Characterization and Application as a Whole Food Ingredient. Journal of Aquatic Food Product Technology 2020. [DOI: 10.1080/10498850.2020.1826617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- C. Afonso
- Division of Aquaculture and Upgrading (Divav), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Lisbon, Portugal
- CIIMAR, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Porto, Portugal
| | - I. Guarda
- Division of Aquaculture and Upgrading (Divav), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Lisbon, Portugal
- Instituto Superior De Agronomia, Universidade De Lisboa, Lisbon, Portugal
| | - M. Mourato
- Instituto Superior De Agronomia, Universidade De Lisboa, Lisbon, Portugal
| | - L.L. Martins
- Instituto Superior De Agronomia, Universidade De Lisboa, Lisbon, Portugal
| | - I. Fonseca
- Division of Aquaculture and Upgrading (Divav), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Lisbon, Portugal
- Instituto Superior De Agronomia, Universidade De Lisboa, Lisbon, Portugal
| | - R. Gomes
- Division of Aquaculture and Upgrading (Divav), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Lisbon, Portugal
| | - J. Matos
- Division of Aquaculture and Upgrading (Divav), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Lisbon, Portugal
- Faculdade De Ciências, Universidade De Lisboa, Lisbon, Portugal
| | - A. Gomes
- Division of Aquaculture and Upgrading (Divav), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Lisbon, Portugal
- CIIMAR, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Porto, Portugal
| | - N.M. Bandarra
- Division of Aquaculture and Upgrading (Divav), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Lisbon, Portugal
- CIIMAR, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Porto, Portugal
| | - C. Cardoso
- Division of Aquaculture and Upgrading (Divav), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Lisbon, Portugal
- CIIMAR, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Porto, Portugal
| |
Collapse
|
41
|
Ferreira I, Gomes-Bispo A, Lourenço H, Matos J, Afonso C, Cardoso C, Castanheira I, Motta C, Prates JAM, Bandarra NM. The chemical composition and lipid profile of the chub mackerel (Scomber colias) show a strong seasonal dependence: Contribution to a nutritional evaluation. Biochimie 2020; 178:181-189. [PMID: 32980464 DOI: 10.1016/j.biochi.2020.09.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/10/2020] [Accepted: 09/21/2020] [Indexed: 12/27/2022]
Abstract
The seasonal variation in chemical and lipid composition of chub mackerel (Scomber colias) was evaluated monthly over one year (proximate chemical composition and lipid profile: fatty acid (FA) and lipid classes distribution). Significant seasonal changes regarding fat content were noticed (1.3-10.3 g/100 g), with the lowest fat content obtained in February (during spawning period), and the highest in September. Regarding the FA profile, the main fluctuations were recorded in saturated (SFA) and polyunsaturated fatty acids (PUFA). The highest SFA content was registered between March and August (25.3-32.3%). PUFA (the most abundant group) reached its maximum percentual content between December and February (60.9 and 66.9%, respectively). In absolute terms, PUFA attained 5352.6 mg/100 g edible part in September, where 2473.8 mg/100 g of docosahexaenoic acid (DHA, C22:6n-3), representing 46.2% of total PUFA. DHA lowest level was 519.8 mg/100 g, registered in low-fat chub mackerel. Together DHA and EPA (eicosapentaenoic acid, C20:5n-3) represented 75% of the total PUFA and 84% of n-3 PUFA. Triacylglycerols (TAG) with 82.2-92.1% of total lipid content) and phospholipids (4.4-8.4%) were the main lipid classes. Polar lipid fraction (phospholipids), was predominantly constituted by PUFA (68.6-74.5%), mainly DHA (45.2-55.1%), with the highest percentage recorded in low-fat chub mackerel. High relative contents of PUFA (36.6-49.1%) were also found in TAG. Having into account the data obtained, chub mackerel is a privileged source of DHA even in a lean species whereby its consumption should be recommended as part a healthy dietary regime.
Collapse
Affiliation(s)
- Inês Ferreira
- Division of Aquaculture, Upgrading and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, I.P.), Avenida Alfredo Magalhães Ramalho, 6, 1495-165 Algés, Portugal; University of Lisbon, Faculty of Sciences, Campo Grande, 16, 1749-016 Lisbon, Portugal
| | - Ana Gomes-Bispo
- Division of Aquaculture, Upgrading and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, I.P.), Avenida Alfredo Magalhães Ramalho, 6, 1495-165 Algés, Portugal; Interdisciplinary Centre of Marine and Environmental Research (CIIMAR), University of Porto, Rua dos Bragas 289, 4050-123 Porto, Portugal.
| | - Helena Lourenço
- Division of Aquaculture, Upgrading and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, I.P.), Avenida Alfredo Magalhães Ramalho, 6, 1495-165 Algés, Portugal
| | - Joana Matos
- Division of Aquaculture, Upgrading and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, I.P.), Avenida Alfredo Magalhães Ramalho, 6, 1495-165 Algés, Portugal; University of Lisbon, Faculty of Sciences, Campo Grande, 16, 1749-016 Lisbon, Portugal
| | - Cláudia Afonso
- Division of Aquaculture, Upgrading and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, I.P.), Avenida Alfredo Magalhães Ramalho, 6, 1495-165 Algés, Portugal; Interdisciplinary Centre of Marine and Environmental Research (CIIMAR), University of Porto, Rua dos Bragas 289, 4050-123 Porto, Portugal
| | - Carlos Cardoso
- Division of Aquaculture, Upgrading and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, I.P.), Avenida Alfredo Magalhães Ramalho, 6, 1495-165 Algés, Portugal; Interdisciplinary Centre of Marine and Environmental Research (CIIMAR), University of Porto, Rua dos Bragas 289, 4050-123 Porto, Portugal
| | - Isabel Castanheira
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1600-560 Lisbon, Portugal
| | - Carla Motta
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1600-560 Lisbon, Portugal
| | - José A M Prates
- Centro de Investigação Interdisciplinar em Sanidade Animal (CIISA), Faculdade de Medicina Veterinária, Universidade de Lisboa, 1300-477 Lisbon, Portugal
| | - Narcisa M Bandarra
- Division of Aquaculture, Upgrading and Bioprospection (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, I.P.), Avenida Alfredo Magalhães Ramalho, 6, 1495-165 Algés, Portugal; Interdisciplinary Centre of Marine and Environmental Research (CIIMAR), University of Porto, Rua dos Bragas 289, 4050-123 Porto, Portugal
| |
Collapse
|
42
|
Moraes MM, Oliveira B, Afonso C, Santos C, Miranda RC, Rauber F, Levy RB, Rodrigues S. Mediterranean diet, sociodemographic factors and ultra-processed food consumption in Portugal. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Mediterranean diet has been shown to promote beneficial effects on health, while ultra-processed food (UPF) consumption has been associated with lower diet quality and higher risk for non-communicable diseases. Our aims were to explore the adherence to a Mediterranean dietary pattern (MDP) in Portugal and its association with sociodemographic factors and UPF consumption.
Methods
Participants were from the Portuguese National Food, Nutrition and Physical Activity Survey 2015-2016, aged 18-84y (n = 3,852). CAPI face-to-face interviews were used including 2 dietary 24-h recalls. UPF were identified using NOVA classification. Adherence to MDP was defined by the Mediterranean Diet Score (MDS), which may vary from 0 to 9. MDS≥6 was considered as high adherence. Weighted multivariate logistic regression analysis was used to explore associations of high adherence to MDP with sex, age, region, educational level, family income and dietary share of UPF groups.
Results
High adherence to MDP was observed for 19.6% of participants and was inversely associated with higher consumption of UPF, namely, sugar-sweetened beverages (OR = 0.924; 95%CI 0.883-0.966), confectionery (OR = 0.893; 95%CI 0.816-0.977), sweet snacks (OR = 0.953; 95%CI 0.923-0.985), cakes/desserts (OR = 0.956; 95%CI 0.934-0.978) and meat products (OR = 0.922; 95%CI 0.874-0.972). Being female (OR = 0.629; 95%CI 0.471-0.841) and not from the North or Alentejo regions were inversely associated with high adherence to MDP. There was no relation between income and adherence to MDP. The higher the level of education or age, the higher the odds of high adherence to MDP (OR = 2.573; 95%CI 1.741-3.803 and OR = 1.028; 95%CI 1.020-1.037, respectively).
Conclusions
Actions to improve adherence to MDP in Portugal should consider discouraging UPF consumption and be addressed to specific subgroups.
Funding
POCI-01-0145-FEDER-032090 (FCT/FEDER); FAPESP 2018/07391-9, 2019/05972-7 (MCR), 2016/14302-7 (FR).
Key messages
High adherence to a Mediterranean dietary pattern was observed for near 20% of Potuguese over 18 years old. The higher the level of education or age, the higher the odds of high adherence to MDP. High adherence to a Mediterranean dietary pattern was inversely associated with higher consumption of sugar-sweetened beverages, confectionery, sweet snacks, cakes/desserts and meat products.
Collapse
Affiliation(s)
- M M Moraes
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - B Oliveira
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- Laboratório de Inteligência Artificial e Apoio à Decisão, Instituto de Engenharia de Sistemas e Computadores, Tecnologia e Ciência, Porto, Portugal
| | - C Afonso
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - C Santos
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - R C Miranda
- Department of Preventative Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - F Rauber
- Department of Preventative Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - R B Levy
- Department of Preventative Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - S Rodrigues
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| |
Collapse
|
43
|
Pereira de Araújo T, Moraes M, Magalhães V, Afonso C, Rodrigues S. Availability of ultra-processed food associated with health outcomes: a systematic review. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Ultra-processed food (UPF) consumption increases worldwide, which can be harm to population's health. To establish associations between UPF and health outcomes, food consumption can be assessed individually or by using availability data, such as purchase lists or household budget surveys. The aim of this review was to search for studies on the availability of UPF related with mortality and morbidity from noncommunicable diseases or their risk factors.
Methods
PRISMA guideline was used. Searches were performed on PubMED, EBSCO, Scopus and Web of Science on December 2019. Search strategy included terms related with exposure (UPF) and outcomes (mortality or morbidity from noncommunicable diseases and their risk factors). Studies were selected based on the title and abstracts. Full texts were screened for eligibility and the snowballing method was used to find other relevant studies. To be based on UPF availability data and its relation with health outcomes were the inclusion criteria. Studies that assessed only food consumption at an individual level and did not present health outcome were excluded. Selection was conducted by two reviewers and a third helped when disagreement occurred.
Results
After duplicates removal, 560 records were analyzed. From the 11 eligible studies, 55% were conducted in more than one country. Others were performed in Brazil (27%), Guatemala (9%) and Sweden (9%). Studies were ecological (64%), cross-sectional (27%) and longitudinal (9%). All had representative samples, 45.5% were national samples, and the others were from particular population subgroups. In all studies, the only health outcomes that showed positive association with UPF availability were overweight and obesity prevalence.
Conclusions
Studies relating ultra-processed food availability and health outcomes are mainly focused on overweight and obesity. It is thus necessary to further explore the relationship between UPF availability and other health outcomes.
Key messages
It is necessary to further research association between ultra-processed food availability and other health outcomes, such as morbidity and mortality from cardiovascular diseases, diabetes or cancer. Purchase lists or household budget surveys are an important source of food availability data and can be used to relate the consumption of ultra-processed foods to health outcomes.
Collapse
Affiliation(s)
- T Pereira de Araújo
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - M Moraes
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - V Magalhães
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - C Afonso
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - S Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| |
Collapse
|
44
|
Lima JPM, Viegas C, Afonso C, Tóth A, Illés CB, Bittsánszky A, Šatalić Z, Filipec SV, Fabijanić V, Rocha A. Children-menus in restaurants of Portuguese, Hungarian and Croatian shopping centres: A qualitative study. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Families to eat out frequently use shopping centres and, there is evidence that children's menus are poor nutritional quality. Obesity rates have increased all over the world, and it has been associated to the observed out of home food consumption. This study aimed to characterise children's menus in shopping center restaurants in Portugal, Hungary and Croatia, as a preliminary study to further develop strategies to intervene.
Methods
An observational cross-sectional study was carried out in shopping centres in Portugal, Hungary and Croatia. Only the ones providing a children's menu were selected. Data collection tool was developed by the research team, consisting of a three-section form to identify and characterise the restaurant and analyses the quality of children's menu.
Results
Researcher visited 295 restaurants, from which only 69 provided a children's menu. From these 12 restaurants offered gifts associated with it. The most frequently featured items on the menu were hamburgers (22%), grilled or fried chicken (19%), nuggets (17%) and pizza (12%). Potato chips were the most frequent side dish option (33%). Only 11 restaurants offered vegetable soup or vegetables. Although water was available, a variety of soft drinks and sugary fruit juices were also options. Sweet dessert is a common part of the menu. Nutritional information is present in only 13% of the menus. Menu prices do not differ much, Portugal having the higher average (x ̅ = €5.35±1.45). Hungary had the lower average (x ̅ = €4.30±1.50) and Croatia the lowest range (min=€3.00, max=€7.40).
Conclusions
Children's menu options have poor quality. Shifting foods offered to children in restaurants has the potential to improve diet quality, reduce excess energy intake and promote healthy eating habits.
Key messages
European strategies are needed to promote children healthy food environment. Following aim is to develop and test balanced menus for children among food chains.
Collapse
Affiliation(s)
- J P M Lima
- GreenUPorto, Centro de Investigação em Produção Agroalimentar Sustentável, Porto, Portugal
- Escola Superior de Tecnologias de Saúde, Instituto Politécnico de Coimbra – Escola Superior de Tecnologia da Saúde de Coimbra, Coimbra, Portugal
- LAQV-Requimte, Universidade do Porto, Porto, Portugal
| | - C Viegas
- Food Health and Science, Escola Superior de Hotelaria e Turismo do Estoril, Estoril, Portugal
- CITUR, Centre for Tourism Research, Development and Innovation, Estoril, Portugal
| | - C Afonso
- FCNAUP, Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
- EpiUnit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- GreenUPorto, Centro de Investigação em Produção Agroalimentar Sustentável, Porto, Portugal
| | - A Tóth
- InDeRe, Institute for Food System Research and Innovation Nonprofit Ltd, Budapest, Hungary
- Department of Business Economics and Management, Szent István University, Budapest, Hungary
| | - C B Illés
- Department of Business Economics and Management, Szent István University, Budapest, Hungary
| | - A Bittsánszky
- InDeRe, Institute for Food System Research and Innovation Nonprofit Ltd, Budapest, Hungary
- Department of Business Economics and Management, Szent István University, Budapest, Hungary
| | - Z Šatalić
- Faculty of Food Technology and Biotechnology, University of Zagreb, Zagreb, Croatia
| | - S V Filipec
- Faculty of Food Technology and Biotechnology, University of Zagreb, Zagreb, Croatia
| | - V Fabijanić
- Faculty of Food Technology and Biotechnology, University of Zagreb, Zagreb, Croatia
| | - A Rocha
- FCNAUP, Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
- GreenUPorto, Centro de Investigação em Produção Agroalimentar Sustentável, Porto, Portugal
- LAQV-Requimte, Universidade do Porto, Porto, Portugal
| |
Collapse
|
45
|
Afonso C, Matos J, Campos AM, Gomes R, Delgado I, Coelho I, Castanheira I, Bandarra NM, Cardoso C. Elemental composition and bioaccessibility of three insufficiently studied Azorean macroalgae. Int J Food Sci Technol 2020. [DOI: 10.1111/ijfs.14647] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Cláudia Afonso
- Avenida Alfredo Magalhães Ramalho, 6 1495-165 Algés Lisbon Portugal
- CIIMAR Interdisciplinary Centre of Marine and Environmental Research University of Porto Rua dos Bragas 289 4050‐123 Porto Portugal
| | - Joana Matos
- Avenida Alfredo Magalhães Ramalho, 6 1495-165 Algés Lisbon Portugal
- Faculdade de Ciências da Universidade de Lisboa Campo Grande, 16 1749‐016 Lisbon Portugal
| | - Ana M. Campos
- Avenida Alfredo Magalhães Ramalho, 6 1495-165 Algés Lisbon Portugal
- Faculdade de Ciências da Universidade de Lisboa Campo Grande, 16 1749‐016 Lisbon Portugal
| | - Romina Gomes
- Avenida Alfredo Magalhães Ramalho, 6 1495-165 Algés Lisbon Portugal
| | - Inês Delgado
- Food and Nutrition Department National Health Institute Doutor Ricardo Jorge (INSA, IP) Av. Padre Cruz 1649‐016 Lisbon Portugal
| | - Inês Coelho
- Food and Nutrition Department National Health Institute Doutor Ricardo Jorge (INSA, IP) Av. Padre Cruz 1649‐016 Lisbon Portugal
| | - Isabel Castanheira
- Food and Nutrition Department National Health Institute Doutor Ricardo Jorge (INSA, IP) Av. Padre Cruz 1649‐016 Lisbon Portugal
| | - Narcisa M. Bandarra
- Avenida Alfredo Magalhães Ramalho, 6 1495-165 Algés Lisbon Portugal
- CIIMAR Interdisciplinary Centre of Marine and Environmental Research University of Porto Rua dos Bragas 289 4050‐123 Porto Portugal
| | - Carlos Cardoso
- Avenida Alfredo Magalhães Ramalho, 6 1495-165 Algés Lisbon Portugal
- CIIMAR Interdisciplinary Centre of Marine and Environmental Research University of Porto Rua dos Bragas 289 4050‐123 Porto Portugal
| |
Collapse
|
46
|
Sousa-Santos AR, Afonso C, Borges N, Santos A, Padrão P, Moreira P, F Amaral T. Sarcopenia, physical frailty, undernutrition and obesity cooccurrence among Portuguese community-dwelling older adults: results from Nutrition UP 65 cross-sectional study. BMJ Open 2020; 10:e033661. [PMID: 32546486 PMCID: PMC7305469 DOI: 10.1136/bmjopen-2019-033661] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES To investigate the coexistence of sarcopenia, frailty, undernutrition and obesity and to identify the factors associated with the cooccurrence of these conditions in an older population. DESIGN Cross-sectional. SETTING Portugal. PARTICIPANTS 1454 older adults with 65 years or older, from Nutrition UP 65 study. PRIMARY AND SECONDARY OUTCOME MEASURES Sarcopenia was identified using the European Working Group on Sarcopenia in Older People 2 guidelines and physical frailty using Fried phenotype. Mini-Nutritional Assessment-Short Form was used to ascertain undernutrition, and obesity was evaluated by body mass index. RESULTS 57.3% presented at least one condition, 38.0% were identified with one and 19.3% were identified with two or more conditions. When all preconditions were considered, 95.7% of the older adults presented at least one of these preconditions or conditions. Multinomial logistic regression multivariate analysis revealed that being male (OR 0.61; 95% CI 0.43 to 0.88), being married or in a common-law marriage (OR 0.58; 95% CI 0.40 to 0.84) and having a higher educational level (OR 0.23; 95% CI 0.07 to 0.73) were inversely associated with having two or more conditions, while age >75 years (OR 1.60; 95% CI 1.14 to 2.24), a poor self-perception of health status (OR 5.61; 95% CI 3.50 to 9.01), ≥5 medications (OR 3.11; 95% CI 1.77 to 5.46) and cognitive impairment (OR 1.84; 95% CI 1.37 to 2.48) were directly associated. CONCLUSIONS Almost three out of five older adults presented at least one of the conditions related to nutritional status, and about one in five had two or more of these occurrences. However, the low coexistence observed between all of these reinforces the need to assess them all individually during the geriatric assessment.
Collapse
Affiliation(s)
- Ana Rita Sousa-Santos
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Cláudia Afonso
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Nuno Borges
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- CINTESIS - Centro de Investigação em Tecnologia e Serviços de Saúde, Porto, Portugal
| | - Alejandro Santos
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- I3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Patrícia Padrão
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Pedro Moreira
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- CIAFEL - Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - Teresa F Amaral
- FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- UISPA, LAETA-INEGI - Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| |
Collapse
|
47
|
Almeida D, Costa E, Guimarães F, Azevedo S, Rodrigues J, Silva J, Faria D, Teixeira F, Afonso C, Tavares-Costa J, Neves J, Ribeiro AR, Cerqueira M. FRI0388 ARE WE OVERLOOKING OSTEOARTHRITIS? – A COMPARATIVE STUDY OF PAIN, FUNCTION AND QUALIFY OF LIFE IN PATIENTS WITH HAND OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Osteoarthritis (OA) is frequently regarded by patients and health care providers as a normal consequence of ageing (1). On the other hand, it is well established that rheumatoid arthritis (RA) is a pathological condition requiring prompt and efficacious treatment and in which remarkable progresses have been achieved in the last decades. Pain and physical limitations are hallmarks of both conditions. Some previous studies suggest that OA and RA may have a similar burden (2,3).Objectives:To compare levels of pain, physical disability and health-related quality of life in patients with primary hand osteoarthritis (hOA) and with RA: active disease (aRA) or in remission (rRA).Methods:Observational cross-sectional study including patients of two clinical centres with hOA and RA, either in remission or with active disease (at least two swollen and/or tender hand joints). Matching for sex and age was performed. Patients were asked to complete a survey consisting of visual analogic scale (VAS) for pain, Health Assessment Questionnaire (HAQ) and Short Form 36 (SF36). Mean values for each domain were compared between the three groups using one-way ANOVA test with significance accepted for p<.05.Results:Thirty patients with hOA and 93 with RA (33 with aRA and 60 with rRA) were included. All patients were caucasian females with no significant differences in age between groups. Patients with hOA reported higher levels of pain in comparison with aRA patients (mean VAS 57.3vs49.3mm, respectively, p=.265) and with rRA patients (57.3vs28.6mm, respectively, p<.001) [F(2.120)=25.907, p<.001]. Regarding physical function, patients with hOA reported levels of disability similar to rRA patients, but significantly lower disability than patients with aRA [F(2.120)=6.962, p=.001]. Patients with hOA evaluated their quality of life significantly better than patients with aRA and in similar levels to patients with rRA, as measured by mental health and general health status domains of SF36.Conclusion:Our results show that hOA may have similar or even higher burden of pain than RA; this is in line with previous studies, although most of them did not consider the level of inflammatory activity of RA. On the other hand, patients with hOA seem to preserve function and have better health-related quality of life despite the higher levels of pain. These results highlight OA as a cause of severe pain, which should lead us to try an optimal symptom control for these patients. These findings should also encourage rheumatologists to endeavor efforts to perform more studies in the field of OA, to better understand its pathogenesis and to eventually find disease modifying drugs.References:[1]Gignac MAM, Davis AM, Hawker G, Wright JG, Mahomed N, Fortin PR, et al. “What do you expect? You’re just getting older”: A comparison of perceived osteoarthritis-related and aging-related health experiences in middle- and older-age adults. Arthritis Rheum. 2006 Dec 15;55(6):905–12.[2]El-Haddad C, Castrejon I, Gibson KA, Yazici Y, Bergman MJ, Pincus T. MDHAQ/RAPID3 scores in patients with osteoarthritis are similar to or higher than in patients with rheumatoid arthritis: a cross-sectional study from current routine rheumatology care at four sites. RMD Open. 2017 Jul;3(1):e000391.[3]Slatkowsky-Christensen B, Mowinckel P, Kvien T. Health status and perception of pain: a comparative study between female patients with hand osteoarthritis and rheumatoid arthritis. Scand J Rheumatol. 2009 Jan;38(5):342–8.Disclosure of Interests:None declared
Collapse
|
48
|
Guimarães F, Faria D, Azevedo S, Rodrigues J, Silva J, Almeida D, Teixeira F, Afonso C, Peixoto D, Tavares-Costa J. AB0192 RHEUMATOID ARTHRITIS: IS IT WORTH IT TO ADD LEFLUNOMIDE TO METHOTREXATE IN REFRACTORY DISEASE? Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:In refractory rheumatoid arthritis (RA), adding other classic synthetic disease-modifying antirheumatic drug (csDMARD) such as leflunomide (LFN) to methotrexate (MTX) is one suitable option [1,2]. Yet, there are safety issues to consider which may limit this strategy, but also regarding its true effectiveness in avoiding exposure to biological DMARDs (bDMARD) or target synthetic DMARDs (tsDMARD).Objectives:To assess the effectiveness and safety of adding LFN to MTX and to evaluate the predictors of drug retention, toxicity and inefficacy.Methods:A retrospective clinical record review of adult RA patients followed on our rheumatology department in whom LFN was added to MTX was done. Sociodemographic information, comorbidities, disease related information, adverse reactions and disease activity according to Disease Activity Score 28 – C reactive protein (DAS28) were recorded at baseline and after 3, 6 and 12 months of combination therapy (3_DAS28; 6_DAS28; 12_DAS28, respectively). Information regarding toxicity (need to dose adjustment/suspension) and inefficacy (add/switch to bDMARD/tsDMARD) were recorded. Follow-up was considered until last medical record available. SPSS was used for statistical analysis. Kaplan Meier and Cox-regression were used for univariate and multivariate analysis, respectively, significant level was 2-sidedp<.05.Results:In total, 77 patients were included, 66.20% females, with a mean age of 56±11 years old. There was a significant reduction of DAS28 only after 3 months of therapy (4.01±1.01 to 2.57±1.52,p=.003; ΔDAS28 = 1.58±1.17). However, during a median follow up time of 64 (IQR 39-83) months, 58.44% of patients needed to change treatment strategy, 66.67% due to toxicity (median time to toxicity 13 months, IQR 2-16) and 33.33% due to inefficacy (median time to inefficacy of 10 months, IQR 5.84-17.64). Gastrointestinal intolerance was the main reported toxicity (46.15%). In univariate analysis, anti-citrullinated protein antibodies (ACPA) positivity, alcohol consumption, lack of comorbidities, hepatic toxicity, higher 6_DAS28, swollen joint count and tender joint count on the 6thmonth were associated to lower retention rates.In multivariate analysis, lack of comorbidities (HR=3.3, CI 95% 1.4-7.8,p=.006) and higher 6_DAS28 (HR=0.32, CI 95% 0.14-0.72,p=.006) were independent predictors of suspension of combination therapy. Moreover, both male gender (HR=2.87, 95%CI 1.2-6.56,p=.016) and positivity to ACPA (HR=0.1, 95%CI 0.01-0.73,p=.024) were independent predictors of toxicity. There was also higher tendency to toxicity, but without statistical significance, in alcohol consumers (p=.08). Regarding inefficacy, smoking habits (HR=0.15, 95%CI 0.04-0.52) and 3_DAS28 (HR=0.15, 95%CI 0.04-0.53) were independent predictors.Conclusion:Addition of LFN to MTX showed an early positive response. However, it was frequently associated to toxicity, and less than half of the patients continued with this therapeutic strategy after 5 years of follow up. Male gender, smoking habits and positivity to ACPA were predictors of worse outcome, as already reported in literature [1]. Lack of comorbidities was an independent predictor of suspension. This can be explained by the fact that physicians tend to adopt a more aggressive strategy on patients without comorbidities, switching earlier to bDMARDs/tsDMARDs.This study also showed that early response to combination therapy is an independent predictor on drug retention, suggesting that decisions on treatment strategy should be made early after the beginning of MTX/LFN.References:[1]Smolen JS, et al. Ann Rheum Dis 2020;0:1–15. doi:10.1136/annrheumdis-2019-216655[2]Kremer J, et al. J Rheumatol. 2004 Aug;31(8):1521-31. PMID: 15290730Disclosure of Interests:None declared
Collapse
|
49
|
Azevedo S, Guimarães F, Almeida D, Faria D, Silva J, Rodrigues J, Peixoto D, Alcino S, Tavares-Costa J, Afonso C, Teixeira F. AB0236 DIFFERENCES AND DETERMINANTS OF PHYSICIAN’S AND PATIENT’S PERCEPTION IN GLOBAL ASSESSMENT OF RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Patient’s Global Assessment of Disease Activity (PtGA) and Physician’s Global Assessment of Disease Activity (PhGA) are assessed as part of commonly used measures of disease activity in RA.1Both are important measures in treat-to-target strategies in Rheumatoid Arthritis (RA), but often provide discordant results.2,3This can provide an erroneous assessment of disease activity in patients under Biologic treatment and mislead treatment decisions, namely switches.Objectives:To assess differences and determinants of PtGA and PhGA in RA patients under biologic treatment.Methods:Cross-sectional study, including 46 patients with RA diagnosed according to the ACR/EULAR criteria, under biologic treatment, consecutively evaluated in day-care unit. Participants completed patient-reported outcomes (PROs), including PtGA, and sociodemographic characteristics. Physicians collected comorbidities and parameters of inflammatory activity (erythrocyte sedimentation rate [ESR] and C-reactive protein [CRP]) and completed PhGA and disease activity score 28 with ESR (DAS28). SPSS was used for statistical analysis and significance level was defined as 2-sided p<0.05.Results:Clinical and laboratory characteristics of patients are shown in table 1. PtGA and PhGA were significantly different (36.1±27.6 mmvs8.7±14.2 mm, p< 0.001) and a positive discordance (PtGA>PhGA, more than 25mm in visual analogue scale [VAS]) was found in 54.3% of cases.PtGA had a correlation with PROs (Pain VAS, 36-Item Short Form Health Survey [SF-36], Health Assessment Questionnaire [HAQ], Functional Assessment of Chronic Illness Therapy [FACIT], EuroQol [EQ5D] and Hospital Anxiety and Depression Scale [HADS]), CRP, tender and swollen joint counts and an association with comorbidities like fibromyalgia or osteoarthritis (OA). No association was found between PtGA and age, sex, education level, profession, employment status, extra-articular manifestations, positivity of rheumatoid factor, ESR, years of disease evolution or number of biologic treatments. In multivariable analyse including SF-36, CRP, tender joints count and OA (R2adjusted= 0.672), the main predictors of PtGA were lower SF36, concomitant OA and higher CRP level.PhGA had a correlation with PtGA, pain VAS, CRP, tender and swollen joints. No association was found between PhGA and patient or physician age, patient or physician sex, extra-articular manifestations, positivity of rheumatoid factor, ESR level, years of disease evolution or number of biologic treatments. In multivariable analysis including ESR, tender and swollen joints count and CRP (R2adjusted= .800), the main predictors of PhGA were swollen joint count and higher CRP level.Conclusion:This study showed the variability implied on global assessment of RA activity. Overall PtGA is based on function and also in subjective and emotional experience of pain, whereas the PhGA is based on more objective measures, more related to disease activity.References:[1]Kanekoa Y. et al, Determinants of Patient’s Global Assessment of Disease Activity and Physician’s Global Assessment of Disease Activity in patients with rheumatoid arthritis: A post hoc analysis of overall and Japanese results from phase 3 clinical trials.Modern Rheumatology2018; 28(6):960–967[2]Furu M. et al. Discordance and accordance between patient’s and physician’s assessments in rheumatoid arthritis.Scand J Rheumatol.2014; 43(4):291-5.Ann Rheum Dis. 2016 Sep;75(9):1661-6. doi: 10.1136/annrheumdis-2015-208251. Epub 2015 Oct 22.[3]Portier A. et al, Patient-perceived flares in rheumatoid arthritis: A sub-analysis of the STRASS treatment tapering strategy trial.Joint Bone Spine. 2017; 84(5):577-581Disclosure of Interests:None declared
Collapse
|
50
|
Rodrigues J, Faria D, Silva J, Azevedo S, Guimarães F, Almeida D, Afonso C, Alcino S, Peixoto D, Teixeira F, Tavares-Costa J. AB1350-HPR SOCIOECONOMIC BURDEN OF NON-ATTENDANCE IN RHEUMATOLOGY CONSULTATION. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Outpatient non-attendance refers to the phenomenon of patients who have a medical appointment but do not show up at the specified date, time, and location without giving previous notice.1In addition to affecting the efficiency and thereby increasing the healthcare total costs, nonattendance might also delay access to care for users on waiting lists.1Nonattendance at health appointments is costly to services, and can risk patient health.2There is very little data on the nonattendance prevalence and impact in Portugal. This knowledge might be fundamental to improve effectiveness of outpatient care in Portugal.Objectives:1) describe patient’s non-attendance rate; 2) assess and characterize the sociodemographic and clinical characteristics among non-attending patients; 3) estimate the economic burden of non-attendance.Methods:Retrospective, cross-sectional and analytical study. We reviewed a one-month Rheumatology consultation period regarding performed medical consultations and non-attended consultations without previous notification from patients. Direct economic costs of non-attended appointments were calculated based on the “Amending Agreement to the ULSAM, EPE Program Agreement”.Results:982 consultations within January 2018 were included. Appointments episodes for therapeutic prescription, medical reports or programmed admissions were excluded. Fifty-seven (5.8%) of scheduled outpatient appointments were non-attended. Subsequent consultations represented 85.2% of attended appointments and 80.7% of non-attended appointments. Female gender was the most prevalent in both groups – 620 (67.0%) among attended consultations and 37 (65.0%) among non-attended consultations. Mean age was 57±15 years in the first group and 54±16 years in the second one. Among attended appointments, mean education level was 8±5 years versus 9±6 years among non-attended appointments. There were no differences between both groups in gender, age, education level, diagnosis, disease duration and activity or appointment type (first or subsequent consultation). A cost of 2,438 euros was estimated regarding non-attended appointments for this period, what could represent a burden of more than 29,000 euros yearly, in direct costs, only.Conclusion:Non-attendance at scheduled appointments in public hospitals seems to be influenced by other factors besides gender, age and education level. The burden of non-attended appointments is undeniable. In addition to the costs estimated in this study, further indirect costs such as poorer patients outcomes, impaired access to medical care and hospital penalties should be taken into account. Implementation of awareness strategies aiming the optimization and effectiveness of healthcare system are required.References:[1]Blæhr EE, Kristensen T, Væggemose U, Søgaard R. The effect of fines on nonattendance in public hospital outpatient clinics: study protocol for a randomized controlled trial.Trials. 2016;17(1):288. doi:10.1186/s13063-016-1420-3[2]Akter S. A qualitative study of staff perspectives of patient non-attendance in a regional primary healthcare setting.Australas Med J. 2014;7(5):218-226. doi:10.4066/AMJ.2014.2056Disclosure of Interests:None declared
Collapse
|