A Oliveira

The association of fruits, vegetables, antioxidant vitamins and fibre intake with high-sensitivity C-reactive protein: sex and body mass index interactions

Objective:To study the associations of fruits, vegetables, antioxidant vitamins and fibre intake with high-sensitivity C-reactive protein (hs-CRP). Existing literature on these associations is scarce and has rendered conflicting results.Methods:Cross-sectional study of 1060 individuals (675 women, 385 men), representative of the non-institutionalized population, aged ⩾18 years, in Porto, Portugal (70% participation rate). Diet over the previous year was assessed with a validated food frequency questionnaire. Associations between diet and hs-CRP (categorized into <1, 1–3, >3 to ⩽10u2009mg/l) were obtained from ordinal logistic regression models (odds ratio, 95% confidence intervals-OR, 95% CI) adjusted for sociodemographic and behavioural variables.Results:In normal weight men (body mass index (BMI) <25.0u2009kg/m2), for each 100u2009g increase in fruit and vegetable intake, there was 30% less probability of changing of hs-CRP category (no risk to moderate risk, or moderate to high risk). Protective associations were also observed between hs-CRP and fruits (OR=0.73, 95% CI 0.56–0.96 per 100u2009g/day), vegetables (OR=0.55, 95% CI 0.35–0.86 per 100u2009g/day), vitamin C (OR=0.34, 95% CI 0.14–0.80 per 10u2009mg/day) and vitamin E (OR=0.14, 95% CI 0.02–0.88 per 1000 retinol equivalents per day). Overall, associations tended to be weaker in overweight participants. In men (BMI ⩾25.0u2009kg/m2), fibre was also negatively associated with hs-CRP. In women, no significant associations were found between dietary variables and hs-CRP. A significant modification effect of the evaluated associations was found by sex for fruits and vegetables, vitamin C and fibre, but not by BMI.Conclusion:Intake of fruits and vegetables, vitamin C, E and fibre were negatively associated with hs-CRP in men.

The effect of current and lifetime alcohol consumption on overall and central obesity

BACKGROUND/OBJECTIVE:To evaluate the association between current and lifetime alcohol consumption, and overall and central obesity in adults of an urban Portuguese population.SUBJECTS/METHODS:Participants were randomly selected from the non-institutionalized Porto inhabitants, aged ⩾18 years (EPIPorto Study: 1999–2003). The study included 2366 participants for evaluating current alcohol consumption and overall obesity, and 2377 participants for central obesity. A trained interviewer applied a questionnaire and anthropometrics were measured. Data on alcohol intake were obtained by using a food frequency questionnaire. Overall obesity was considered when body mass index was ⩾30.0u2009kg/m2, and central obesity when waist circumference (WC) was ⩾88u2009cm in women and ⩾102u2009cm in men. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated, separately by sex, using unconditional logistic regression models.RESULTS:After adjustment for age, education, smoking, energy intake and regular physical exercise, men who consumed >60g/day of alcohol were more frequently obese compared with non-drinkers (OR=2.26, 95% CI: 1.17–4.35). When considering lifetime alcohol consumption, the magnitude of the association was stronger in both women (OR=2.41, 95% CI: 1.28–4.56) and men (OR=4.22, 95% CI: 1.93–9.24). For central obesity, women consuming 15.1–30u2009g/day and >30u2009g/day had higher probability of being obese, considering both current and lifetime alcohol consumption. In men, the same positive associations were observed, which were particularly stronger between lifetime alcohol consumption and central obesity (>60g/day vs non-drinkers: OR=4.02, 95% CI: 1.80–8.98).CONCLUSION:Independently of social and behavioural features, current and lifetime alcohol consumption were positively associated with overall and central obesity, in both women and men.

Indices of central and peripheral body fat: association with non-fatal acute myocardial infarction.

Background:The majority of the studies have focused on the effect of general and central fat on coronary risk, neglecting the potential role of peripheral body fat.Objective:To assess the effect of surrogate measures for general, central and peripheral body fat on the occurrence of non-fatal acute myocardial infarction (AMI).Methods:Population-based case–control study; cases were patients aged ⩾40 years consecutively hospitalized with an incident AMI (n=653), and controls were community participants without previous AMI, selected randomly from the hospitals’ catchment area population (n=1713). Body mass index (BMI), waist circumference (WC), hip circumference and a skinfolds composite index to estimate the proportion of peripheral subcutaneous fat in the arms were ascertained. Associations were summarized with odds ratios (OR) and 95% confidence intervals (95% CI), obtained from unconditional logistic regression with adjustment for the main confounders.Results:WC, and in particular waist-to-hip ratio (WHR), had strong direct associations with AMI risk. Peripheral subcutaneous fat was inversely associated with AMI in women, but directly in men. Using principal component analysis, three uncorrelated factors were identified representing different patterns of fat distribution: (1) generalized fat, with high BMI and high WC; (2) central fat, with high WC and WHR; and (3) peripheral subcutaneous fat. The first factor showed no significant association with AMI, but the second factor increased AMI risk in each sex (upper vs lower fourth: OR 12.2, 95% CI 5.34–27.9 in women; OR 25.0, 95% CI 14.0–44.7 in men). In contrast, the third factor was inversely associated with AMI in women (upper vs lower fourth: OR 0.59, 95% CI 0.36–0.96) and directly associated in men (OR 2.45, 95% CI 1.69–3.55; P-value for sex interaction<0.001).Conclusions:Central fat was associated with increased risk of AMI in women and men, while the peripheral subcutaneous fat index predicted a lower risk of AMI in women and a higher risk in men.

Early problematic eating behaviours are associated with lower fruit and vegetable intake and less dietary variety at 4-5 years of age. A prospective analysis of three European birth cohorts

Problematic eating behaviours during early childhood could be mediators of poor dietary habits. This study aims to prospectively relate early eating behaviours with fruit and vegetable (F&V) intake and a healthy diet variety score of children aged between 4 and 5 years. Eating behaviours were assessed in three European birth cohorts (Generation XXI from Portugal, ALSPAC from the UK and EDEN from France) at 4-6, 12-15, 24 and 48-54 months of age, based on the childs feeding difficulties, mothers perception of childs poor eating (eating small quantities at each meal, not eating enough or needing to be stimulated to eat), food refusal and difficulties in the establishment of daily food routines. Daily servings of F&V (>1 v. ≤1 serving/d, except in Generation XXI: >3 v. ≤3) and the Healthy Plate Variety Score (categorised by the median score of each sample) were calculated using FFQ. Associations were tested by logistic regressions adjusted for maternal age, education, smoking during pregnancy, any breast-feeding and the childs z-score BMI at 4-5 years of age. Children with more feeding difficulties, poor eating, food refusal/neophobia and difficulties in establishing a daily routine at 12-15, 24 and 48-54 months of age had in general lower F&V intake at 4-5 years of age. The association with vegetables was slightly stronger than with fruits. These early feeding problems were also inversely associated with the variety score at 4-5 years of age, particularly when eating behaviours were reported after 12-15 months of age. A better understanding of these early feeding difficulties may help define strategies to increase the dietary quality in children.

Potassium urinary excretion and dietary intake: a cross-sectional analysis in 8–10 year-old children

BackgroundData from studies assessing the intake of potassium, and the concomitant sodium-to-potassium ratio are limited. The aim of this study was to evaluate potassium and sodium-to-potassium ratio intake in 8–10 year-old children.MethodsA cross-sectional survey was carried out from January to June 2014 and data from 163 children (81 boys) were included. Potassium intake was estimated by 24-h urine collection and coefficient of creatinine was used to validate completeness of urine collections. Urinary sodium and sodium-to-potassium ratio were also analysed. A 24-h dietary recall was used to provide information on dietary sources of potassium. Height and weight were measured according to international standards.ResultsThe mean urinary potassium excretion was 1701u2009±u2009594xa0mg/day in boys, and 1682u2009±u2009541xa0mg/day in girls (pu2009=u20090.835); 8.0xa0% of children met the WHO recommendations for potassium intake. The mean sodium excretion was 2935u2009±u20091075xa0mg/day in boys and 2381u2009±u20091045xa0mg/day in girls (pu2009<0.001) and urinary sodium-to-potassium ratio was 3.2u2009±u20091.4 in boys, and 2.5u2009±u20091.1 in girls (pu2009=u20090.002). The mean fruit and vegetable intake was 353.1u2009±u2009232.5xa0g/day in boys, and 290.8u2009±u2009213.1xa0g/day in girls (pu2009=u20090.101).ConclusionsThis study reported a low compliance of potassium intake recommendations in 8–10 year-old children. Health promotion interventions are needed in order to broaden public awareness of potassium inadequacy and to increase potassium intake.

Fatty acids derived from a food frequency questionnaire and measured in the erythrocyte membrane in relation to adiponectin and leptin concentrations

Background/objectives:Evidence on the association between fatty acids and adiponectin and leptin concentrations is scarce and inconsistent, which may in part be due to limitations of dietary reporting methods. We aimed to estimate the association of fatty acids, derived from a food frequency questionnaire (FFQ) and measured in the erythrocyte membrane, with adiponectin and leptin concentrations.Subjects/methods:We studied 330 non-institutionalized inhabitants of Porto (52.4% women; age range: 26–64 years) evaluated in 2010–2011, as part of the EPIPorto cohort study. Fatty acids were derived from a validated semiquantitative FFQ and measured in the erythrocyte membrane by gas chromatography. Serum concentrations of adiponectin and leptin were determined through radioimmunoassay. Regression coefficients (β) and 95% confidence intervals (95% CI) were obtained from linear regression models, after controlling for gender, age, education, leisure time physical activity and total body fat percentage (obtained from dual energy X-ray absorptiometry).Results:Fatty acids measured by FFQ showed no significant associations with both adipokines. Lauric and linoleic acids, measured in the erythrocyte membrane, were significantly and positively associated with adiponectin (β=0.292, 95% CI: 0.168–0.416; β=0.150, 95% CI: 0.020–0.280) and leptin (β=0.071, 95% CI: 0.003–0.138; β=0.071, 95% CI: 0.002–0.140), whereas total n-3, eicosapentaenoic and docosahexaenoic acids were significantly but negatively associated with adiponectin (β=−0.289, 95% CI: −0.420 to −0.159; β=−0.174, 95% CI −0.307 to −0.040; β=−0.253, 95% CI −0.383 to −0.124) and leptin (β=−0.151, 95% CI: −0.220 to −0.083; β=−0.080, 95% CI: −0.151 to −0.009; β=−0.146, 95% CI: −0.214 to −0.078). Positive significant associations of palmitic and trans-fatty acids with adiponectin were also observed.Conclusions:A positive association of lauric and linoleic acids and a negative association of total n-3 fatty acids with both adipokines were observed only with fatty acids measured in the erythrocyte membrane.

The role of prenatal exposures on body fat patterns at 7 years: Intrauterine programming or birthweight effects?

BACKGROUND AND AIMSnIt remains unknown whether the effects of prenatal exposures on childs adiposity reflect entirely intrauterine programming. We aimed to assess the effects of maternal gestational weight gain, diabetes and smoking on the childs body fat patterns, disentangling the direct (through intrauterine programming) and indirect (through birthweight) effects.nnnMETHODS AND RESULTSnWe included 4747 singleton 7-year-old children from the Generation XXI birth cohort (Porto, Portugal). At birth, maternal and newborns characteristics were obtained. Anthropometrics were measured at age 7 years and body fat patterns were identified by principal component analysis. Path analysis was used to quantify direct, indirect and total effects of gestational weight gain, diabetes and smoking on body fat patterns. Pattern 1 was characterized by strong factor loadings with body mass index, fat mass index and waist-to-height ratio (fat quantity) and pattern 2 with waist-to-hip ratio, waist-to-thigh ratio, and waist-to-weight ratio (fat distribution). The positive total effect of maternal gestational weight gain and diabetes on the childs fat quantity was mainly through a direct pathway, responsible for 91.7% and 83.7% of total effects, respectively (βxa0=xa00.022; 95% Confidence Interval (CI): 0.017, 0.027; βxa0=xa00.041; 95% CI: -0.011, 0.093). No effects on fat distribution were found. Maternal prenatal smoking had a positive direct effect on patterns 1 and 2, explaining 94.9% and 76.1% of total effects, respectively.nnnCONCLUSIONnThe effects of maternal gestational weight gain, diabetes and smoking on a childs fat quantity seem to be mainly through intrauterine programming. Maternal smoking also showed a positive direct effect on childs fat distribution.

Urinary hydration biomarkers and dietary intake in children

INTRODUCTIONnThe importance of hydration is undoubtable but reliable data on hydration status and its relation with diet is lacking.nnnOBJECTIVESnWe aimed to evaluate the hydration status and its relation to beverages and food intake in children.nnnMETHODSnA sample of 172 (50% male), 7-11 year-old children was included in this survey. Participants completed a 24 h urine collection; a 24 hours food recall corresponding to the day of urine collection was applied, weight and height were measured and parents/caregivers fi lled a lifestyle and socio-demographic questionnaire. The free water reserve was used to assess the hydration status. The intakes of food and beverages were compared according to hydration status using the t-test, Mann-Whitney test or unconditional regression models as appropriate.nnnRESULTSnMore than half of the participants were classifi ed as hypohydrated or at risk of hypohydration (57% in girls and 58% in boys). Compared to hypohydrated children, a signifi cant higher consumption of water (276.2 ± 208.4 vs 188.2 ± 187.4 g/day) and fruit juices (77.6 ± 139.4 vs 14.4 ± 57.2 g/day) was reported by euhydrated boys and girls, respectively. Lower consumers of water and fruit juices showed a higher risk of hypohydration (OR = 2.16, 95% CI: 1.02-4.58, p = 0.045), adjusting for confounders.nnnCONCLUSIONSnMost of the children included in this analysis were classifi ed as at risk of hypohydration and those with higher water and fruit juices consumption showed a better hydration status.

Fruit, vegetable consumption and blood pressure in healthy adolescents: A longitudinal analysis from the LabMed study

BACKGROUND AND AIMSnThe associations between fruit and vegetable consumption and high blood pressure among adults are well studied. Nonetheless, data on the influence of a low consumption of fruit and vegetables on cardiovascular disease risk, particularly blood pressure, among healthy adolescents are scarce. Therefore, we aim to analyse the associations between fruit and/or vegetable intake and blood pressure over a two-year period in healthy adolescents.nnnMETHODS AND RESULTSnAs part of a cohort, 606 adolescents from the LabMed Physical Activity study were evaluated in 2011 (baseline) and 2013 (follow-up). Blood pressure was measured according to standardized procedures and fruit and vegetable consumption was assessed with a food frequency questionnaire. Anthropometric variables, socioeconomic status, pubertal stage and lifestyle determinants were gathered and used as confounders. Prospective associations between fruit and/or vegetable intake and blood pressure were examined using generalized linear models. Girls who consumed more fruit at baseline had a significant decrease in diastolic blood pressure at follow-up [unstandardized beta: -0.005xa0mmHg (95%CI: -0.01; -0.0002) (pxa0=xa00.038)].nnnCONCLUSIONnIn apparently healthy adolescents, fruit intake may already start to have an effect in blood pressure. Girls who consumed more fruit exhibited lower levels of diastolic blood pressure.

Potassium urinary excretion and dietary intake: a cross-sectional analysis in 8-10 year-old children (vol 15, 60, 2015)

After publication of the original article [1] we were contacted by the authors asking that the funding information be updated. The updated text should read as: This work was supported by ARIA Project PTDC/DTPSAP/1522/2012 from Foundation for Science and Technology (Fundação para a Ciência e Tecnologia FCT) cofinanced by European Regional Development Fundthrough Operational Competitiveness Programme (COMPETE) FCOMP −01-0124-FEDER-028797; and by the Portuguese CCDR-N for funding the research project “E2BE” (NORTE-07-0124FEDER-000036), through the European Union FEDER programme.