Andreia Oliveira

Systematic review of saturated fatty acids on inflammation and circulating levels of adipokines

Diet is one factor that plays a part in coronary heart disease risk through multiple biological mechanisms including subclinical inflammation. In this review, we aimed to systematically assess and summarize evidence regarding the association of saturated fatty acids (SFAs) with inflammatory markers and adipokines. An electronic search of the literature was conducted up to September 2010 using Medline, Scopus, Web of Science, and Science Direct (updated from September 2010 to August 2011 through Medline). Original studies that were written in Portuguese, English, Spanish, or French, and addressed the effects of SFA (not dietary sources or SFA-rich diets) on inflammatory markers or adipokines in adult populations were considered eligible. Data from 15 studies providing adjusted estimates were extracted. The publication year varied from 1995 to 2010 and the sample size from 54 to 4900. Most studies were cross sectional, with 3 studies using a prospective design. Twelve studies assessed total SFA, and 3 studies considered their subtypes, which were measured through dietary assessments (11 studies) or in blood samples (4 studies). Significant positive associations were observed between SFA and soluble intercellular adhesion molecule-1 and interleukin-6, whereas no significant associations were observed with E-selectin, tumor necrosis factor α, granulocyte-macrophage colony-stimulating factor, fibrinogen, and adiponectin. For high-sensitivity C-reactive protein, 2 studies showed significant positive associations, whereas 3 studies reported no significant associations. One study reported a significant inverse association of SFA with leptin, although the other 3 found no significant associations. Based on this systematic review, a potential positive association of SFA with high-sensitivity C-reactive protein but not with adipokines is suggested, which should be confirmed by future research.

Organic acids composition of Cydonia oblonga Miller leaf

Organic acid profiles of 36 Cydonia oblonga Miller leaf samples, from three different geographical origins of northern (Bragança and Carrazeda de Ansiães) and central Portugal (Covilhã), harvested in three collection months (June, August and October of 2006), were determined by HPLC/UV (214nm). Quince leaves presented a common organic acid profile, composed of six constituents: oxalic, citric, malic, quinic, shikimic and fumaric acids. C. oblonga leaves total organic acid content varied from 1.6 to 25.8g/kg dry matter (mean value of 10.5g/kg dry matter). Quinic acid was the major compound (72.2%), followed by citric acid (13.6%). Significant differences were found in malic and quinic acids relative abundances and total organic acid contents according to collection time, which indicates a possible use of these compounds as maturity markers. Between June and August seems to be the best period to harvest quince leaves for preparation of decoctions or infusions, since organic acids total content is higher in this season.

Alcohol Intake and Systemic Markers of Inflammation—Shape of the Association According to Sex and Body Mass Index

AIMS To assess the association of alcohol intake with high-sensitivity C-reactive protein (hs-CRP), uric acid and leukocyte count in blood, and whether sex and body mass index (BMI) modify these associations. METHODS Individuals aged > or =18 years were randomly selected from the population of Porto, Portugal (70% of participation). A total of 840 women and 490 men with reliable information on inflammatory markers and alcohol intake, obtained from a validated food frequency questionnaire, were studied. Associations and their respective trends were estimated from generalized linear models, with adjustment for potential confounders. Analyses were stratified by sex and BMI. RESULTS In women, adjusted hs-CRP levels (mg/l) were 2.69 in non-drinkers, 2.25 in drinkers of >0-15 g alcohol/day, 2.32 in drinkers of >15-30 g alcohol/day and 3.18 in drinkers of >30 g alcohol/day (P-value for the quadratic trend <0.001). In men, the association between alcohol intake and hs-CRP was positive and linear (P-value for the linear trend = 0.014). Alcohol intake was also positively and linearly associated with uric acid in each sex. Body weight modified these associations, which remained statistically significant only in normal-weight (BMI <25 kg/m(2)) women and overweight (BMI > or =25 kg/m(2)) men for hs-CRP, and in normal-weight individuals for uric acid. No significant association between alcohol intake and leukocyte count was found. CONCLUSIONS The association of alcohol intake with hs-CRP was J-shaped in women but positive and linear-shaped in men. Alcohol intake was directly associated with uric acid in men and women. BMI modifies the effect of alcohol on hs-CRP and uric acid levels in each sex.

Self-reporting weight and height: misclassification effect on the risk estimates for acute myocardial infarction

BACKGROUND The accuracy of self-reported weight and height to measure obesity has been evaluated, but no information is available on the possible error effects of self-reporting when estimating the association between body mass index (BMI) categories and the occurrence of acute myocardial infarction (AMI). We aim to evaluate if two different sources of information on height and weight (reported vs. measured) result in different risk estimates for non-fatal AMI events. METHODS A population-based case-control study was conducted with 732 cases of first AMI and 1914 community controls, recruited from the same catchment area of hospitals. As part of an interview, participants self-reported weight and height immediately before having it measured. Data were analysed separately by sex and age strata (< or =45; >45 years). RESULTS Women under-reported their weight and over-reported their height, and the mean differences between measured and self-reported data were significantly larger in controls. Male controls also under-reported their weight, but cases over-reported it. After adjustment, in younger women the use of self-reported data underestimated the AMI risk according to BMI categories, but in older ones the self-reporting overestimated AMI risk, although with no statistical significance. In younger men, the association between AMI and self-reported obesity (BMI > or = 30 kg/m(2)) was overestimated in approximately 50% (measured: OR = 2.05, 95% CI 1.08-3.87; self-reported: OR = 3.06, 95% CI 1.56-6.00). In older participants, a significant association was only found for overweight men when using self-reported data. CONCLUSIONS Self-reporting of height and weight produced a differential misclassification and biased risks for AMI according to BMI, affecting not only the magnitude, but also the estimates direction.

Fish intake in pregnancy and child growth: A pooled analysis of 15 European and US birth cohorts

IMPORTANCE Maternal fish intake in pregnancy has been shown to influence fetal growth. The extent to which fish intake affects childhood growth and obesity remains unclear. OBJECTIVE To examine whether fish intake in pregnancy is associated with offspring growth and the risk of childhood overweight and obesity. DESIGN, SETTING, AND PARTICIPANTS Multicenter, population-based birth cohort study of singleton deliveries from 1996 to 2011 in Belgium, France, Greece, Ireland, Italy, the Netherlands, Norway, Poland, Portugal, Spain, and Massachusetts. A total of 26,184 pregnant women and their children were followed up at 2-year intervals until the age of 6 years. EXPOSURES Consumption of fish during pregnancy. MAIN OUTCOMES AND MEASURES We estimated offspring body mass index percentile trajectories from 3 months after birth to 6 years of age. We defined rapid infant growth as a weight gain z score greater than 0.67 from birth to 2 years and childhood overweight/obesity at 4 and 6 years as body mass index in the 85th percentile or higher for age and sex. We calculated cohort-specific effect estimates and combined them by random-effects meta-analysis. RESULTS This multicenter, population-based birth cohort study included the 26,184 pregnant women and their children. The median fish intake during pregnancy ranged from 0.5 times/week in Belgium to 4.45 times/week in Spain. Women who ate fish more than 3 times/week during pregnancy gave birth to offspring with higher body mass index values from infancy through middle childhood compared with women with lower fish intake (3 times/week or less). High fish intake during pregnancy (>3 times/week) was associated with increased risk of rapid infant growth, with an adjusted odds ratio (aOR) of 1.22 (95% CI, 1.05-1.42) and increased risk of offspring overweight/obesity at 4 years (aOR, 1.14 [95% CI, 0.99-1.32]) and 6 years (aOR, 1.22 [95% CI, 1.01-1.47]) compared with an intake of once per week or less. Interaction analysis showed that the effect of high fish intake during pregnancy on rapid infant growth was greater among girls (aOR, 1.31 [95% CI, 1.08-1.59]) than among boys (aOR, 1.11 [95% CI, 0.92-1.34]; P = .02 for interaction). CONCLUSIONS AND RELEVANCE High maternal fish intake during pregnancy was associated with increased risk of rapid growth in infancy and childhood obesity. Our findings are in line with the fish intake limit proposed by the US Food and Drug Administration and Environmental Protection Agency.

Overall and central obesity incidence in an urban Portuguese population.

OBJECTIVE To provide overall and central obesity incidence estimates by gender, age and educational level in an urban Portuguese population. METHODS As part of the EPIPorto study, 1,621 Porto, Portugal adult residents were evaluated in 1999-2003 and 2005-2008. Overall obesity was defined by a BMI > or = 30.0 kg/m(2) and central obesity by a WC >88.0 cm in women and >102.0 cm in men. Relative risks (RR) and 95% confidence intervals (95% CI) were computed using Poisson regression. Survival analysis was also performed. RESULTS The age-adjusted incidence rates/100 person-years of overall and central obesity were, respectively, 1.70, 95% CI: 1.34-2.19 and 5.97, 95% CI: 5.09-7.03 in women; 1.08, 95% CI: 0.73-1.64 and 2.38, 95% CI: 1.81-3.20 in men. In multivariate analysis, older women presented a higher risk of overall obesity. Moreover, a significant inverse association was found between obesity and education in women (>11 vs. <5 years: RR=0.43, 95% CI: 0.22-0.84, for overall obesity; RR=0.45 95% CI: 0.29-0.69, for central obesity). For overall obesity, 10.1% of women and 5.1% of men became obese during the 5-year study period. Higher proportions were observed regarding central obesity, 29.1% and 11.4% for women and men, respectively. CONCLUSIONS Over time, individuals developed central obesity faster than overall obesity. Our results support that increasing levels of education limit this ongoing development of obesity, particularly among women.

Body fat distribution and C-reactive protein – a principal component analysis

BACKGROUND AND AIMS To assess, using principal component analysis, the independent associations of general, central and peripheral subcutaneous fat with high-sensitivity C-reactive protein (hs-CRP), in men and women from the general population. METHODS AND RESULTS We studied 833 women and 486 men, randomly selected from the non-institutionalized population of Porto, Portugal, with information on hs-CRP (≤10 mg/l) and anthropometrics (1999-2003). Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and a skinfold composite index to estimate the proportion of arm subcutaneous fat (PSFA), were ascertained by trained personnel. Beta regression coefficients were obtained from generalized linear models with adjustment for the main confounders. Direct associations were found between BMI, WC, WHR and hs-CRP. PSFA was inversely associated with hs-CRP in women (β=-0.080, p-trend=0.010). Since the anthropometric measures were strongly correlated, we used principal component analysis to identify new independent anthropometric factors. The first one, representing a generalized fat distribution (high BMI and WC), was directly associated with hs-CRP (β=0.226, p-trend<0.001 in women; β=0.138, p-trend=0.002 in men). The second factor, characterized by a high PSFA, showed an inverse association with hs-CRP in women (β=-0.071, p-trend=0.048). The third factor, representing a central pattern of fat distribution (low BMI, but high WC and high WHR), was directly associated with hs-CRP in men (β=0.090, p-trend=0.005). CONCLUSION A central pattern of fat distribution is directly associated with hs-CRP levels in men, while a high proportion of peripheral subcutaneous fat seems to be inversely associated with hs-CRP, but only in women.

Could the Food Neophobia Scale be adapted to pregnant women? A confirmatory factor analysis in a Portuguese sample

BACKGROUND The Food Neophobia Scale (FNS) is widely used in different countries, however appropriate psychometric analyses are required to allow cross-cultural comparisons. To our knowledge, most studies have been conducted among children and adult populations, with no reference to pregnant women. The objective of this study was to translate and test the psychometric properties of a Portuguese version of the FNS, and to identify clusters of food neophobia during pregnancy. METHODS The FNS was translated into Portuguese by three health researchers, and back-translated into English by an independent native English speaker and professional translator. The scale was self-administered in a sample of 219 women from the baseline evaluation of the Taste intervention study (HabEat project: http://www.habeat.eu/), who attended medical visits in two hospitals from Porto, Portugal, reporting food neophobia during the last trimester of pregnancy. The FNS consists of 10 items with a 7-point rating scale. An exploratory analysis was performed to evaluate the scales dimensionality, followed by a confirmatory factor analysis to test the fit of the previous model by using different indexes. Cronbachs alpha coefficient was calculated to evaluate the internal reliability of the scale. The construct validity was assessed by comparing the FNS scores by categories of education, age and fruit and vegetables intake by ANOVA. A Model-based clustering was used to identify patterns of food neophobia; the number of latent classes was defined according to the Bayesian information criterion. RESULTS A two-factor model solution was obtained (after excluding item 8 with a factor loading <0.4), explaining 51% of the total variance. Cronbachs alpha was 0.75 for factor 1 (5 items) and 0.71 for factor 2 (4 items). Items 1, 4, 6, 9 and 10 loaded into the first factor (i.e. more willingness to try new foods; less neophobic traits) and items 2, 3, 5 and 7 loaded into a second factor (i.e. more neophobic traits). A good global of fitness of the model was confirmed by fit indexes: TLI=0.876, CFI=0.911, RMSEA=0.088 and SRMR=0.051. The higher the education, age, and fruit and vegetables intake the lower the neophobic tendency, measured by the Portuguese FNS. Three patterns (i.e. clusters) of food neophobia, characterizing neophobia traits of pregnant women were identified: Moderate Neophilic, Moderate Neophobic, and Extreme Neophilic (cut-off points were provided). CONCLUSION The Portuguese version of the FNS has the basic requirements of a valid and reliable measure of food neophobia and permits the identification of clusters of neophobic traits during pregnancy.

Metabolic and biological prospecting of Coreopsis tinctoria

Coreopsis tinctoria Nutt., Asteraceae, flowering tops infusion has been traditionally used in many countries to control hyperglycaemia. In this work we report for the first time fatty acids and volatile compounds in this species. Fifteen fatty acids and sixteen volatile compounds were determined by GC-ITMS, being saturated fatty acids and monoterpenes the main compounds. The antioxidant and antibacterial potential of this matrix was checked for the first time by several in vitro assays. A concentration-dependent activity was noticed against DPPH, nitric oxide and superoxide radicals. Antibacterial capacity was assessed against Gram-positive and Gram-negative bacteria, being more effective against the first. Additionally, acetylcholinesterase and butyrylcholinesterase inhibitory activity was also evaluated, but no effect was found. Our results provide evidence of a wide diversity of compounds with several biological properties, improving the knowledge on this poorly studied matrix, which can lead to an increment of the use of C. tinctoria flowering tops, namely in food and pharmaceutical applications.

Low‐grade systemic inflammation and suboptimal bone mineral density throughout adolescence: a prospective study in girls

We aimed at quantifying the associations between high‐sensitivity C‐reactive protein (hs‐CRP) and forearm bone mineral density (BMD) throughout adolescence in overweight and normal‐weight girls.