Sofia Vilela

Patterns of breast cancer mortality trends in Europe.

OBJECTIVES To identify patterns of variation in breast cancer mortality in Europe (1980-2010), using a model-based approach. METHODS Mortality data were obtained from the World Health Organization database and mixed models were used to describe the time trends in the age-standardized mortality rates (ASMR). Model-based clustering was used to identify clusters of countries with homogeneous variation in ASMR. RESULTS Three patterns were identified. Patterns 1 and 2 are characterized by stable or slightly increasing trends in ASMR in the first half of the period analysed, and a clear decline is observed thereafter; in pattern 1 the median of the ASMR is higher, and the highest rates were achieved sooner. Pattern 3 is characterised by a rapid increase in mortality until 1999, declining slowly thereafter. CONCLUSION This study provides a general model for the description and interpretation of the variation in breast cancer mortality in Europe, based in three main patterns.

The influence of socioeconomic factors and family context on energy-dense food consumption among 2-year-old children

Background/Objectives:Adverse effect on health has been described for a high consumption of energy-dense food, among children and adults. Limited research has been performed among pre-school children. The objective of this study is to evaluate the association between socioeconomic characteristics and family structure, and the consumption of energy-dense food among 2-year-old children.Subjects/Methods:The study sample includes 808 2-year-old children from the Portuguese birth cohort Generation XXI with information on food consumption. Data were obtained from questionnaires administered by interviewers to parents. Based on a food frequency questionnaire, four groups of energy-dense food were defined: soft drinks (sweetened drinks), sweets (chocolate and candies), cakes (creamy and not creamy cakes and sweet pastry) and salty snacks (crisps, pizza and burger). Multinomial logistic regression models (odds ratio and 95% confidence intervals) were fitted to estimate the associations.Results:Intakes of energy-dense food were much lower than in similar aged children in other Westernized countries. Maternal age and education, grandparents’ education, household income and maternal occupation were inversely associated with the consumption of energy-dense food, particularly soft drinks and sweets. Children with older siblings were more likely to have a daily consumption of any energy-dense food. Few significant associations were found between socioeconomic characteristics and family structure and consumption of cakes and sweets less than once a week.Conclusion:High socioeconomic characteristics were associated with lower consumption of energy-dense food by 2-year-old children, mainly soft drinks and sweets. This influence is not only from parents’ background but also from the preceding generations.

Association between energy-dense food consumption at 2 years of age and diet quality at 4 years of age

The present study aimed to evaluate the association between the consumption of energy-dense foods at 2 years of age and the consumption of foods and diet quality at 4 years of age. The sample included 705 children evaluated at 2 and 4 years of age, as part of the population-based birth cohort Generation XXI (Porto, Portugal). Data on sociodemographic and lifestyle factors of both children and mothers were collected by face-to-face interviews. The weight and height of children were measured by trained professionals. Based on FFQ, four energy-dense food groups were defined: soft drinks; sweets; cakes; salty snacks. A healthy eating index was developed using the WHO dietary recommendations for children (2006) aged 4 years. The associations were evaluated through Poisson regression models. After adjustment for maternal age and education, childs carer, childs siblings and childs BMI, higher consumption of energy-dense foods at 2 years of age was found to be associated with higher consumption of the same foods 2 years later. An inverse association was found between the intake (≥ median) of soft drinks (incidence rate ratio (IRR) = 0.74, 95% CI 0.58, 0.95), salty snacks (IRR = 0.80, 95% CI 0.65, 1.00) and sweets (IRR = 0.73, 95% CI 0.58, 0.91) at 2 years of age and the consumption of fruit and vegetables at 4 years of age (≥ 5 times/d). Weekly and daily consumption of energy-dense foods at 2 years of age was associated with a lower healthy eating score at 4 years of age (IRR = 0.75, 95% CI 0.58, 0.96; IRR = 0.56, 95% CI 0.41, 0.77, respectively). The consumption of energy-dense foods at young ages is negatively associated with the diet quality of children a few years later.

Length of Migration and Eating Habits of Portuguese University Students Living in London, United Kingdom

Several studies have pointed adverse effects of long term migration on eating habits. Research is needed to understand if this effect occurs also with a short length of migration, as is the case of international students. Our aim was to evaluate the effect of short and long term migration on eating habits of Portuguese university students. Participants were 46 English and 55 Portuguese students from universities in London, United Kingdom. The findings from this study highlight the difficulties that Portuguese students faced in maintaining a traditional Mediterranean diet after moving to a Northern European environment.

Sex-related dietary changes of Portuguese university students after migration to London, UK

Aim: To assess the changes in eating habits and food choice motives of Portuguese university students after migration to London, according to sex. Methods: Fifty-five Portuguese university students (52.7% female) from 12 randomly selected London universities underwent a face-to-face interview. Trained interviewers administered a structured questionnaire comprising questions on socio-demographic characteristics, the frequency of consumption of selected food and beverage items, and the motives underlying food choices regarding Portugal and London practices. Results: Some dietary changes occurred in both male and female Portuguese students such as a decrease in the intake of red meat, fish, pastries and vegetable soup, and an increase in the intake of hamburger and tea with milk. Men also reported a decrease in the intake of cheese, dairy desserts, eggs, smoked sausages, ham, sweet spreads, potatoes, rice and fresh fruit, and an increase in the intake of bacon. For women, the consumption frequency of chips and chocolate increased and of vegetables decreased. Regarding food choice, the motives related to food purchasing and preparation became more important after migration to London for both sexes. The importance of nutritional information for women and weight control for men also increased after migration. Conclusions: A shift from a Mediterranean diet towards a more Western diet was observed after migration. Men were more likely to change their dietary habits whereas women were more likely to maintain. Food choice in London was greatly influenced by food purchasing and preparation.

Association Between Physical Activity Level and Pelvic Floor Muscle Variables in Women

In order to investigate the potential impact of physical activity (PA) on pelvic floor muscle (PFM) function, a cross-sectional study was made to analyse the association between PA level and vaginal resting pressure (VRP) and PFM strength and endurance. Thirty-eight continent women and 20 women with stress urinary incontinence (SUI) aged 19 to 49 years were enrolled in the study. PFM variables were assessed by manometry. The PA level was assessed through the International Physical Activity Questionnaire - Short Form. The International Consultation on Incontinence Questionnaire-Urinary Incontinence - Short Form was applied to identify SUI. Pearsons correlation coefficients were applied to estimate the association between PA and PFM variables. Incontinent women were classified as having a high PA level compared to the continent ones (65.0% vs 34.2%, respectively; p=0.030). There was a positive weak association between PA and VRP in continent (r=0.377) and an inverse association in incontinent women (r=-0.458). No associations were found between PA and PFM strength and endurance. Further studies are needed in order to identify a causal association between PA and SUI.

Evaluation of a short food frequency questionnaire for dietary intake assessment among children

Background/objectivesThe objective of this study was to evaluate the performance of a short food frequency questionnaire (FFQ) to assess dietary intake at 4 and 7 years of age, against 3d food diaries (FD) and serum biomarkers, using two methods to convert the FFQ to daily intake in grams and nutrients (standard and z-score method).Subjects/methodsThe present analysis comprises data from 2482 4-year-old children and 3511 7-year-old children, from the birth cohort Generation XXI (Porto, Portugal). To estimate daily consumption from the FFQ, the frequency response was multiplied by a standard mean portion (standard method) or adjusted with data from the FD (z-score method). The dietary intake obtained from the FFQ was compared with the FD and serum biomarkers, using Intra-Class Correlation Coefficients (ICC), de-attenuated Pearson’s correlation coefficients and Bland Altman analysis.ResultsIn general, the mean daily food intake estimated by the z-score method had a higher agreement with the FD, than the standard method. The highest ICC was obtained for “vegetable soup” (ICC = 0.536), using the z-score method, compared to an ICC of 0.373 using the standard method. Significant correlation coefficients were observed for all nutrients; the average of correlation coefficients was 0.39 at 4 years and 0.42 at 7 years of age. For the majority of nutrients, the correlation between mean and mean difference was lower using the z-score method, in comparison with the standard method.ConclusionsThe results suggest that the FFQ is a reasonably good instrument to estimate dietary intake in children. Moreover, adjusting the FFQ portion size, by using a z-score method, seems to increase the accuracy of dietary data in children.