M.D.V. de Almeida

Validity of a questionnaire to assess fruit and vegetable intake in adults

Objective:To validate a method for assessing fruit and vegetable intake among adults in a population of low intake. The method assesses mean intake and ranks individuals by their usual intake.Design:A precoded fruit and vegetable Questionnaire included a 24-h recall and a food frequency. The participants filled in the Questionnaire, a week later they started a 7-day food record, 1-day weighed record and 6 days using household measures.Subjects:Following advertisements 40 participants were recruited, 36 returned food records(mean age=37 years).Results:No difference was observed between the average intake yielded by the 24-h recall and that from the 1-day weighed food record of fruits or vegetables. Correlation coefficients between results from the food frequency questionnaire and the 7-day food records were 0.45 (P=0.007) for vegetables, 0.63 (P<0.001) for fruits and 0.73 (P<0.001) for fruits and vegetables combined. Cross-classification into quartiles showed that the proportion of participants in the same or the adjacent quartile of the intake distribution were 94% for fruit intake and 80% for vegetable intake. Registered intake of fruits and vegetables was higher the first 4 days of the record than the last 3 days (P=0.002). The 4-day food record correlated with the food frequency questionnaire in similar manner as the 7-day record.Conclusion:The present study indicates that the precoded 24-h recall may be valuable tool for measuring average intake of fruits and vegetables among adults in a population of low intake. Moreover, the food frequency questionnaire was valid for ranking individuals according to their usual intake. A 4-day food record might be sufficient when validating food frequency questionnaires for fruits and vegetables.

Portuguese households' diet quality (adherence to Mediterranean food pattern and compliance with WHO population dietary goals): trends, regional disparities and socioeconomic determinants.

Objective:To evaluate households’ diet-quality trends and regional disparities, as well as to identify the influence of its socioeconomic determinants.Methods/Subjects:Two dietary indexes were applied: a revised Healthy Diet Indicator version (HDIr) and the Mediterranean Adequacy Index (MAI). The socioeconomic differences between households with low-diet quality (if their scoring in HDIr or MAI was below the national median) and the remaining ones were analysed by means of logistic regression. Representative samples of households among each region were analysed.Results:Adherence to a Mediterranean diet was poor in all Portuguese regions; the proportion of households adhering to it has diminished in the North, Centre, Lisbon and Tejo valley. The proportion of households with high HDIr decreased in the North, Centre, Lisbon and Tejo valley and Algarve. In multivariate analysis, households whose head had secondary or higher education, living in semi-urban or urban areas, from the Azores region, within the higher income or outside home food expenditures groups were more likely to be in low-quality diet.Conclusions:The decreasing adherence to a Mediterranean food pattern and the diminishing compliance with World Health Organization dietary goals show that Portuguese households have reduced their diet quality. The observed influence of urbanization and region on diet quality highlights the importance of considering regional nutrition strategies.

Nutritional risk of European elderly

Background/objectives:The elderly constitute a population group with a high prevalence of non-communicable chronic diseases and high risk of malnutrition. The aim of this study was to identify factors associated to nutritional risk in free-living European elderly.Subjects/methods:The sample included 644 European citizens, free living in the community, aged 65 years or more. The sample was quota controlled for age groups (65–74, ⩾75 years), gender (male/female) and living circumstances (living alone/with others). Logistic regression was performed to identify factors associated with nutritional risk.Results:Several variables regarding socio-demographic characteristics, food choice, health status and the satisfaction with food-related life were included in the analysis. According to the recoded score of the ‘Determine your nutritional health’ (NSI checklist), 53% of the elderly were at nutritional risk. Nutritional risk was more likely to occur in elderly who considered that it was more important to choose foods ‘easy to chew’; with lower average number of fruit and vegetables (F&V) intake episodes and lower score for general health. It was also found in non-married participants; those that did not identify changes in their appetite; and those that felt changes in health status. In this sample, the lowest nutritional risk was found for body mass index (BMI) around 18.5 kg/m2. Country of residence, gender and age were not found to have a significant effect on nutritional risk.Conclusions:Attention should be drawn to the living circumstances, changes in appetite or health, the general heath perception, F&V intake, choice of foods easy to chew and having a low or high BMI.

Comparison of national food supply, household food availability and individual food consumption data in Portugal

The present study aimed to compare Portuguese food and nutrient data retrieved from three distinct sources of dietary data: national food supply, household food availability and individual food consumption. In particular it was intended to validate the use of the dietary data derived from the Portuguese household budget surveys (HBS). The data sources used were food balance sheets (FBS) (1990, 1995 and 2000) generated by the Food and Agriculture Organization (FAO), HBS (1990, 1995 and 2000) collected by the National Statistics Institute (INE) and individual consumption obtained through a food frequency questionnaire (FFQ) applied in the context of the EpiPorto study circa 2000. Thirteen comparable food groups were established for analysis. Total energy, macronutrients and other selected dietary components were considered. The average daily values of different dietary sources were compared in absolute amounts (g/person per day) and in relative energy contribution (%E). To evaluate association and agreement between sources, Spearman’s correlation coefficients and distance matrices based on Euclidian distances were computed. The obtained average daily per capita amounts reflect the different points of data collection in the food chain; HBS fall in the expected position, below FBS and closer to FFQ. Agreement between FBS, HBS and FFQ was higher when data were expressed in relative energy contribution than when absolute amounts were considered. In general, the observed discrepancies between the three data sources could be attributed to known differences in the methodological approaches. This study supports the finding that despite their constraints the HBS-derived data are a valid option to evaluate dietary habits in Portugal.

Ageing and food consumption in Portugal: new or old paradigms?

Purpose – The purpose of this paper is to illustrate the effects of ageing on food choice according to Portuguese elderly narratives within an eight‐country research project, the Food in Later Life (www.foodinlaterlife.org).Design/methodology/approach – The project was organized into eight interrelated but independent work packages (WPs) using semi‐structured interviews, structured questionnaires and food diaries. Each interview took approximately one hour and was complemented by a background questionnaire (SF36) and seven day food diaries (shopping and consumption). The data from the interviews were transcribed and analysed using MaxQDA. Data from the Portuguese sample are presented and complemented by the eight country samples in the case of meal patterns, functional and convenience products. The sentences used to illustrate the memories of older people are quoted.Findings – Health problems and physiological restraints along with social changes, loss of a partner and/or loneliness were identified as maj...

Availability of foods and beverages in nationally representative samples of Portuguese households from 1990 to 2000: the DAFNE initiative

The aim of the study was to identify time trends and socio-demographic disparities in Portuguese food habits and to compare Portuguese food habits to those of other European countries. Data collected through the Portuguese Household Budget Surveys (HBS) of 1989/1990, 1994/1995 and 2000/2001 were analysed. The classification scheme developed in the context of the Data Food Networking (DAFNE) initiative was applied to form comparable food and beverage groups. The mean availability in quantity/person per day was estimated for the overall population and by socio-demographic groups (according to locality of the dwelling, education and occupation of the household head). Trends in food availability suggest a departure from the traditional Mediterranean dietary pattern. In 2000, Portugal was among the European countries with high daily availability of several of the components of the Mediterranean diet. The Portuguese were identified among the highest consumers of cereals, pulses, fruits, potatoes, fish and seafood, fats and oils (mainly of vegetable origin) and alcoholic beverages (wine in particular), but also of meat and meat products, and among the lowest consumers of vegetables, milk and milk products, eggs, sugar and sugar products, fruit and vegetable juices, soft drinks and stimulants (coffee, tea and cocoa). Even if socio-demographic disparities in food availability have narrowed in the 1990s, they can still be identified in the most recent 2000 data. Despite some methodological constraints, data derived from the DAFNE databank contributed to better documentation of Portuguese food habits and allowed evaluation of the country’s situation compared to other European countries.

Effect of sociodemographic variables and time on food group contribution to total food availability in Portuguese elderly households

ObjectiveTo analyze the simultaneous effects of sociodemographic variables and time on each food group contribution to total Portuguese elderly household food availability.DesignFour cross sectional Portuguese Household Budget Surveys were used. A multivariate analysis of variance (MANOVA), using a general linear model (GLM), was applied to analyze the simultaneous effects of sociodemographic variables and time.SettingPortuguese population.SubjectsNationally representative samples of households with members aged ≥ 65 years were selected and categorized as solitary elderly female, solitary elderly male, or couple (one elderly female and one elderly male). Samples included 1,967 households in 1989–1990, 2,219 households in 1994–1995, 2,533 households in 2000–2001 and 2,441 households in 2005–2006.ResultsThe simultaneous effects of sociodemographic variables and time were significant for all food groups (P<0.001). The highest contribution for the total household food availability was found for cereals, potatoes, alcoholic beverages, nonalcoholic beverages and fruits. The effects were large for “household food availability” and medium for “elderly household type”, “urbanization degree”, “income”, “food expenses” and “eating out expenses”. Solitary elderly male households had the highest proportion of cereals and alcoholic beverages, whilst solitary elderly female households had higher availability of milk/milk products and fruits. Households located in urban areas had higher contribution of milk/milk products while rural, had higher contribution of potatoes.ConclusionsThe simultaneous effect of the studied variables on food group contribution to total household food availability can be considered when addressing dietary recommendation for providing an insight into the motivations associated with food purchases.

Contribution of vegetable soup to total vegetables intake and its determinants among mothers in Portugal

Purpose – This papers aim is to assess vegetable soup intake and its contribution to total vegetable intake among mothers of Portuguese schoolchildren as well as to examine the association between relative vegetable soup intake and sociodemographic characteristics.Design/methodology/approach – A cross‐sectional survey was carried out in Portugal as part of the Pro Children study. In total 1,673 women, mothers of 11‐13 year old children, took part in the study. The vegetable intake and sociodemographic characteristics were collected with a self‐administered questionnaire in which a precoded 24‐hour recall was applied. The analysed sociodemographic characteristics were the number of people and composition of household, educational level, social class and region of residence. The associations between preferential or exclusive consumer mothers of vegetable soup (i.e. ≥50 per cent of total vegetable intake) and sociodemographic characteristics were analysed by a logistic regression model.Findings – The mean i...

Growth trends in boys and girls (10–17 years-old) from autonomous region of Madeira, Portugal between 1996–1998 and 2007–2009

Background: Growth trends have never been studied in adolescents of the Autonomous Region of Madeira, Portugal. Aims: To analyse growth trends in weight, height, body mass index (BMI), waist circumference (WC), mid-upper arm circumference (MUAC) and triceps skin-fold thickness (TST) of adolescents (10–17 years old) of the Autonomous Region of Madeira between 1996–1998 and 2007–2009. Subjects and methods: A cross-sectional study was carried out between 2007–2009, including 4314 adolescents, 2237 girls and 2077 boys (10–17 years old). To study secular growth trends, data were compared with a sample from 1996–1998, comparing the means for each anthropometric variable by age and sex using the independent-sample t-test. Results: An average increase was found in weight of 5.8 kg in boys and 6.3 kg in girls; in height of 3.0 cm in boys and 3.7 cm in girls; in BMI of 1.5 kg/m2 in boys and 1.7 kg/m2 in girls; in WC a difference of 5.6 cm and 4.9 cm for boys and girls, respectively, and for MUAC a difference of 2.7 cm in boys and 2.0 cm in girls. No differences were found in TST in boys, but in girls an increase of 1.2 mm was observed. Conclusions: A general increase in anthropometric measurements, more marked in weight, BMI, WC and MUAC and at younger ages, was observed.

Dietary habits and the metabolic syndrome in middle-aged Europeans

The metabolic syndrome is a cluster of conditions (central obesity, elevated blood pressure, abnormal lipid profile and insulin resistance) associated with increased risk of developing CHD and/or diabetes. Metabolic syndrome may be dietary related. The aim of the present analysis has been to explore associations between dietary habits, body fat distribution and patterns in the reporting of conditions related to metabolic syndrome in European consumers. Data were collected from a representative sample aged ‡ 40 years by survey (n 1722) in Great Britain (n 1182) and Portugal (n 540) as part of the LIPGENE project. Dietary habits for major food groups were assessed using a short FFQ. Anthropometric measures were BMI and waist circumference (WC). FFQ data were factor analysed (maximum likelihood extraction, promax rotation; Kaiser normalised) and self-reported conditions associated with metabolic syndrome (high blood cholesterol, high blood pressure, mid-waist obesity, high or low blood sugar) underwent latent class analysis Mplusg version 4 software. Based on the factor analysis of FFQ, three clusters of dietary habits (Table 1) emerged that were characterised by: first, frequent alcohol consumption and infrequent intake of fruit and vegetables and other food groups (factor 1); second, infrequent alcohol consumption, but frequent intake of high-fat-containing foods (factor 2); third, frequent consumption of wine (but infrequent intake of other alcoholic beverages) and consumption of a variety of food groups including fish and low-fat-containing foods (factor 3). Four latent classes emerged from patterns of self-reported metabolic syndrome signs (Table 2). One-way ANOVA tests were conducted for each dietary group in relation to metabolic syndrome classes (Table 1). The metabolic syndrome class were less likely to be in either the unhealthy (P£ 0.001) or alcohol (P= 0.023) dietary group than the overweight class; the metabolic syndrome class were also less likely to be in the unhealthy (P £ 0.001) or alcohol group (P = 0.007) than the healthy class.