A. Galvão-Teles

Overweight and obesity in Portugal: national prevalence in 2003–2005

Obesity is an endemic health problem in most developed countries, requiring serious public health attention. The first Portuguese nationwide representative survey about obesity (with objective anthropometric measurement) was undertaken from 1995 to 1998. This paper presents data coming from the second and most recent nationwide representative study of obesity, with objective measurement of weight, height, waist and hip circumferences. Data were collected between January 2003 and January 2005. The survey collected objective body mass index (BMI) values of 8116 participants aged 18–64. Main findings were: 2.4% of the sample had low weight (BMI < 18.5), 39.4% were overweight (BMI between 25.0 and 29.9), and 14.2% obese (BMI ≥ 30). Waist circumference measurement showed that 45.6% of the sample suffers increased cardiovascular health risks associated with high waist circumference. The overall overweight/obesity prevalence increased from 49.6% (in 1995–1998) to 53.6% (in 2003–2005). These data suggest that although obesity was identified as a public health problem one decade ago, action to reduce it does not seem to have been very effective to date. Well‐defined public health intervention must be targeted to specific population groups where higher levels of obesity prevalence were found: low socioeconomic level groups and low‐education level groups.

Prevalence of obesity in Portugal

Obesity is a serious health problem in developed countries. Knowledge of reliable and nationwide representative data is a must for any public health action. The dimension of this problem in Portugal was first assessed in 1995–1998. A similar populational survey using objective anthropometric measures is now being conducted (field work started in January 2003). A total of 6411 subjects aged 18–64 years old have already been measured and their respective body mass indexes (BMIs) calculated. Results from 2003 to 2005 show 38.6% is overweight and 13.8% has obesity. The total of overweight and obesity is 52.4%. In 1995–1998 survey, overweight was 35.2% and obesity was 14.4%. The total was 49.6%. These results suggest an increase of the overweight/obesity (altogether) prevalence in the last 10 years. Actual results show that more than half of the adult sample has excessive weight and 2.4% of the sample has low BMI. Finally, 45.6% of the sample suffers increased health risks because of high waist circumference (≥80 cm for women; ≥94 cm for men). These results highlight the fact that, although obesity was identified as a public health problem one decade ago, action to reduce it does not seem to have been very effective to date.

Secular trends of weight, height and obesity in cohorts of young Portuguese males in the District of Lisbon: 1960 to 1990

Objective: To examine the secular trend of weight, height and obesity among young Portuguese males at the time of military inspection for national conscription purposes in the region of Lisbon, during the last thirty years. Design: Cross-sectional study, based on the review of military census files. Setting: Military selection centre of Lisbon. Subjects and methods: In Portugal, military service is obligatory and medical inspections are carried out every year on males at the age of twenty. For study purposes, representative samples were taken from the young male population undergoing inspection for the Armed Forces on a five year basis, between 1960 and 1990 in the region of Lisbon. Weight and height were evaluated by a trained team, using standard measurement instruments and procedures. Results: A progressive and significant increase in weight, height and BMI of the young male population was found between 1960 and 1990. For certain variables the increase was also statistically significant within a five-year period, as it was the case for height between 1965–1980 and for weight between 1985–1990. The increase in BMI experienced some minor fluctuation along the reference period, however, it was statistically significant between 1985–1990. The increase in weight and in BMI was greater in the highest percentiles and particularly noticeable between 1985 and 1990. The percentage of young males with BMI over 25 kg/m2 was of 8.1% in 1960 and of 18.0% in 1990, while those having a BMI over 27 kg/m2 varied between 3.6% and 6.4% in the same period, respectively. The percentage of young adult males with BMI higher than 25 kg/m2 doubled between 1960 and 1990.

Prevalence of Anorexia Nervosa: a Portuguese Population Study

There has been no epidemiological study done on Anorexia Nervosa (AN) in the Portuguese population of Continental Portugal. In the economical, social and cultural areas, this country is in a transitional situation. A population of 2422 girls from the Lisbon and Tagus Valley area was studied through a questionnaire that included the criteria definition of AN and other issues concerning the changing pattern of cultural image and eating behaviour. We found 0.4 per cent of AN, 12.6 per cent of subclinical illness and 7 per cent with only body image disturbance. The total population included 38 per cent that wished to be thinner, 49 per cent that felt they had a fat body part and 51.5 per cent that had a ‘horror of being heavier’. The results confirm the hypothesis that Portugal is in a transitional situation.

PARAGANGLIOMA E ANGIOEDEMA

Paragangliomas or extra-adrenal pheochromocytomas are rare tumors that arise from chromaffin tissues and tend to occur either sporadically or in the context of complex genetic disorders. They are clinically heterogeneous in nature - symptoms deriving either from the secretory profile of the tumor or from the mass effect of the neoplasm. Dermatologic symptoms are quite seldom described in the literature and have been classified in acute or chronic. The case of a 40 YO Caucasian female that had been enduring for the last 2 years recurring self-limited episodes of angioedema, diarrhoea, chest pain, hypertension or hypotension, dyspnoea and anxiety is reported. Biochemical studies and further imagiologic work up and, later on, pathologic exam allowed to identify a paraganglioma that drained to the left renal artery. Upon surgery, during tumor manipulation, the patient developed an additional systemic crisis that required active life support. Recovery was regular, with a quick and sustained normalization of lab results as well as on the clinical side, with no further episode for the last 17 years.