Patrícia Padrão

Food Patterns According to Sociodemographics, Physical Activity, Sleeping and Obesity in Portuguese Children

Our study aimed to describe the association between food patterns and gender, parental education, physical activity, sleeping and obesity in 1976 children aged 5−10 years old. Dietary intake was measured by a semi quantitative food frequency questionnaire; body mass index was calculated and categorized according to the IOTF classification. Factor analysis and generalized linear models were applied to identify food patterns and their associations. TV viewing and male gender were significant positive predictors for fast-food, sugar sweetened beverages and pastry pattern, while a higher level of maternal education and longer sleeping duration were positively associated with a dietary patterns that included fruit and vegetables.

Smoking, alcohol, and dietary choices: evidence from the Portuguese National Health Survey

BackgroundUnhealthy lifestyle choices tend to cluster, but controversy remains regarding relationships between smoking and dietary habits. The aim of this study was to compare dietary intake and alcohol consumption, according to smoking status, in the Portuguese population.MethodsThe study sample included all participants in the third Portuguese National Health Survey who were older than 19 years (20,302 women and 17,923 men).Participants were selected from households in the five regions of Portugal (NUTS II classification), using a multi-stage random probability design. Trained interviewers conducted face-to-face interviews in each household and obtained information on social and demographic characteristics, lifestyle and health, smoking, and intakes of selected food and beverages. Age-adjusted and education-adjusted binomial and multinomial logistic regression models were fitted separately for males and females, to estimate the magnitude of the association between smoking and the consumption of various food and beverage groups.ResultsWhen heavy smokers were compared with non-smokers, the odds ratio (OR) favouring soup consumption was 0.60 (95% Confidence Interval [95%CI]: 0.54–0.68) in males and 0.46 (95% CI: 0.33–0.65) in females. Similar ORs were observed for vegetables (males: OR = 0.56, 95%CI: 0.49–0.64; females: OR = 0.47, 95%CI: 0.32–0.69) and fruit (males: OR = 0.36, 95%CI: 0.31–0.41; females: OR = 0.29, 95%CI: 0.19–0.44). Overall, these food items were consumed at significantly lower levels as cigarette consumption increased. Heavy male smokers, compared to non-smokers, presented lower odds favouring milk consumption (OR = 0.89; 95%CI: 0.67–0.89). When heavy smokers were compared with non-smokers, the ORs favouring wine drinking, among heavy drinkers, were 1.47 (95%CI: 1.27–1.70) in men and 3.97 (95%CI: 2.07–7.61) in women. Similar ORs were observed for beer (males: OR = 3.30; 95%CI: 2.87–3.78; females: OR = 23.1; 95%CI: 12.2–43.6), Port wine (males: OR = 2.21 95%CI: 1.65–2.98; females: OR = 2.85; 95%CI: 0.68–12.1), brandy (males: OR = 3.67 95%CI: 2.98–4.52; females: OR = 13.2; 95%CI: 3.72–46.6) and whisky (males: OR = 3.31; 95%CI: 2.71–4.03; females: OR = 41.4; 95%CI: 18.5–92.5).ConclusionThis study showed that smokers have a higher intake of alcoholic beverages and a lower consumption of food items rich in fibre, antioxidants, or phytochemicals, which are suspected to have beneficial roles in the prevention of multiple chronic diseases.

Educational and economic determinants of food intake in Portuguese adults: a cross-sectional survey

BackgroundUnderstanding the influences of educational and economic variables on food consumption may be useful to explain food behaviour and nutrition policymaking. The aim of this study was to evaluate the importance of educational and economic factors in determining food pattern in Portuguese adults.MethodsA cross-sectional study in a representative sample of Portuguese adults (20977 women and 18663 men). Participants were distributed in four categories according to years of education (≤4, 5–9, 10–12, and >12) and income (≤314 euros, 315–547 euros, 548–815 euros, and >815 euros). Logistic regression models were fitted to estimate the magnitude of the association between food groups and education/income, adjusting for confounders.ResultsIn both genders, the odds favouring milk, vegetable soup, vegetables, fruit, and fish consumption, increased significantly with education, for those having >12 years of education compared to those with ≤4 years; the odds favouring wine, and spirits consumption decreased significantly with education, for those having >12 years of education compared to those with ≤4 years. In males, the odds favouring starchy foods and meat consumption decreased significantly with income, while for milk, the odds increased with higher income (those having >815 euros compared to those with ≤314 euros).ConclusionsThe low and high income groups are or tend to be similar in regard to several food groups consumption, and access to education/information appears to be the key element to a better food pattern as indicated by higher frequency of milk, vegetable soup, vegetables, fruit, and fish consumption.

Association between tobacco consumption and alcohol, vegetable and fruit intake across urban and rural areas in Mozambique

Background Smoking, alcohol consumption and unhealthy diet are known to cluster, but evidence from developing countries at the early phases of the tobacco epidemics and with markedly different cultures, lifestyles and forms of tobacco use is scarce. The objective of this study was to quantify the association between tobacco consumption (manufactured cigarettes, hand-rolled cigarettes and smokeless tobacco) and alcohol, fruit and vegetable intake in Mozambique according to place of residence (urban/rural). Methods A representative sample of 12 902 Mozambicans aged 25–64 years was evaluated in a national household survey conducted in 2003 using a structured questionnaire. Age- and education-adjusted ORs were computed to estimate the association between tobacco consumption and alcohol, fruit and vegetable intake. Results Tobacco use and overall alcohol drinking were positively associated, regardless of type of tobacco consumed, but smoking of hand-rolled cigarettes and consumption of smokeless tobacco was negatively associated with beer drinking. Smokers of manufactured cigarettes had a less frequent intake of fruit, but smokeless tobacco consumption and hand-rolled cigarette smoking were not inversely related with intake of fruit or vegetables. This pattern was relatively consistent across genders and urban/rural areas, with the observed differences likely to be explained either by random variation or heterogeneity in tobacco consumption patterns across genders or places of residence. Conclusion Strong associations between tobacco consumption and the intake of alcoholic beverages, vegetable and fruit intake are found, but not consistently for all forms of tobacco use.

The Impact of an Intervention Taught by Trained Teachers on Childhood Overweight

The purpose of this study was to assess the effects of a six-months’ nutrition program, delivered and taught by classroom teachers with in-service nutrition training, on the prevention of overweight and obesity among children in grades 1 to 4. In this randomized trial, four hundred and sixty four children from seven elementary schools were allocated to a nutrition educational program delivered by their own teachers. Intervened teachers had 12 sessions of three hours each with the researchers throughout six months, according to the topics nutrition and healthy eating, the importance of drinking water and healthy cooking activities. After each session, teachers were encouraged to develop activities in class focused on the learned topics. Sociodemographic, anthropometric, dietary, and physical activity assessments were performed at baseline and at the end of the intervention. In the intervention group the increase in Body Mass Index (BMI) z-score was significantly lower than in the control group (p = 0.009); fewer proportion of children became overweight in the intervened group compared with the control (5.6% vs. 18.4%; p = 0.037). Our study provides further support to decrease the overweight epidemic, involving classroom teachers in a training program and making them dedicated interventionists.

Alcohol consumption in Mozambique: regular consumption, weekly pattern and binge drinking

This study aimed to describe alcohol consumption in Mozambique, discriminating binge drinking behaviour and the weekday variation in drinking patterns, and to quantify the association between socio-demographic characteristics and alcohol intake. A representative sample of 3265 Mozambicans aged 25-64 years was evaluated in 2005 following the World Health Organization Stepwise approach to Chronic Disease Risk Factor Surveillance (STEPS). The consumption of any type of alcoholic beverage, during life and in the previous year, was recorded. Current drinkers were also asked about the number of standard drinks consumed in each day of the previous week. The overall prevalence of current drinking was 28.9% [95% confidence interval (95% CI): 22.6-35.2] in women and 57.7% (95% CI: 49.8-65.7) in men. Forty percent of the current drinkers reported to have had at least one binge drinking occasion in the previous week. The prevalence of current drinking increased with age and education among women and with income among men. No consistent pattern was observed in binge drinking by education in both genders and by annual income among men, but it was significantly less frequent among the more affluent women. Both drinking and binge drinking peaked at the weekend. Knowing the drinking patterns in Mozambique enables the planning of interventions according to the local needs. Future surveys should also include non-adult populations as risk factors for chronic diseases occurs as early as childhood and adolescence, and are associated with increased risk of disease later in life.

Physical activity patterns in Mozambique: urban/rural differences during epidemiological transition.

OBJECTIVE To assess the socio-demographic determinants of physical activity, by intensity and domain, across urban and rural areas in Mozambican adults. METHOD A national representative sample (n=3323) of subjects aged 25-64 years was evaluated in 2005 following the World Health Organization (WHO) Stepwise Approach to Chronic Disease Risk Factor Surveillance (STEPS), which includes the Global Physical Activity Questionnaire. We computed prevalences, and age- and education-adjusted prevalence ratios (PR), with 95% confidence intervals (95%CI). RESULTS Most of the Mozambicans reported a high physical activity level, according to the WHO criteria (urban women: 83.2%, 95%CI 77.4, 89.0; rural women: 93.2%, 95%CI 89.0, 97.3; urban men: 78.9%, 95%CI 74.7, 83.1; rural men: 91.6%, 95%CI 85.5, 97.6). The prevalences of <75 min/week of vigorous activities were higher in urban settings (women: PR=2.21; men: PR=2.28) and increased with education, regardless of place of residence (PR ranging between 1.75 and 5.72 for more vs. less educated subjects). Work activities were the most important contributor to the overall physical activity, followed by transport. CONCLUSION Most of the Mozambicans reported to be physically active. Vigorous activities were less common in urban areas and among the more educated subjects, depicting an ongoing shift to more sedentary behaviours in this setting.

The impact of an intervention taught by trained teachers on childhood fruit and vegetable intake: A randomized trial

Our study aimed to assess the impact of a six-months nutrition program, taught by trained teachers, on fruit and vegetable consumption among children in grades 1 to 4. Four hundred and sixty-four children (239 female), 6 to 12 years old, from seven elementary schools were assigned to this randomized trial. Teachers were trained by researchers over six months, according to the following topics: nutrition, healthy eating, and strategies to increase physical activity. After each session, teachers were encouraged to develop activities in the classroom on the topics learned. Childrens sociodemographic, anthropometric, dietary, and physical activity data were assessed at baseline and at the end of the intervention. The effect sizes ranged between small (Cohens d = 0.12 on “other vegetables”) to medium (0.56 on “fruit and vegetable”), and intervened children reported a significantly higher consumption of vegetables and fruit. Interventions involving trained teachers offer promise to increase consumption of fruit and vegetable in children.

Sugar-sweetened beverage intake and overweight in children from a Mediterranean country.

OBJECTIVE To assess the association between sugar-sweetened beverage (SSB) consumption and overweight in children from a Mediterranean country. DESIGN The childrens dietary intake was measured using a semi-quantitative FFQ completed by the parents. Overall, 2512 questionnaires were returned and 837 children were removed, leaving a final sample of 1675 children, aged between 5 and 10 years. Height and weight were measured according to international standards, and BMI was calculated. The definition of overweight and obesity was based on average centiles according to the International Obesity Task Force cut-offs. To determine the magnitude of the association between SSB consumption and overweight, OR estimates, including CI, were computed using unconditional logistic regression, adjusting for confounders. SETTING Elementary schools throughout the city of Porto, Portugal. SUBJECTS We invited 5867 children, randomly selected, and their parents to participate in the study. Of those schools that agreed to take part, 3391 parents signed and returned the fully filled out consent form. RESULTS The prevalence of overweight (including obesity) was 36.6 % for girls and 38.8 % for boys. With regard to SSB consumption (serving/d), no differences between with overweight and non-overweight children were found even after adjustment for confounders (1-2 servings/d: OR = 1.67, 95 % CI 0.76, 3.66, in girls; OR = 1.63, 95 % CI 0.76, 3.47, in boys; and >2 servings/d: OR = 0.63, 95 % CI 0.33, 1.22, in girls; OR = 0.64, 95 % CI 0.33, 1.52, in boys). CONCLUSIONS The intake of SSB was not associated with increased risk of overweight in Portuguese schoolchildren.

Dietary patterns and asthma prevalence, incidence and control

The increased asthma prevalence in westernized societies has been suggested to be related to environment exposures and lifestyle changes, particularly diet. We aimed to explore the association between dietary patterns and asthma prevalence, incidence and control in a nationally representative population.