https://hdl.handle.net/10216/5611 2026-04-07T11:29:07Z https://hdl.handle.net/10216/173504 Title: Feasibility and Effectiveness of a Social Network-Based Intervention for Adolescents Undergoing Weight Loss Treatment: A Randomized Controlled Trial Abstract: Background/Objectives: Digital interventions can have a positive effect on the health-related behaviors of adolescents. However, it is unclear if social network-based interventions using Facebook can help to optimize medical treatment as usual (TAU) for adolescent obesity in public health care centers. We examined the feasibility, usability, and effectiveness of APOLO-Teens, a Cognitive Behavioral Therapy Facebook-based intervention as a supplement to TAU on changing eating habits/behaviors, physical activity levels, and psychological functioning of adolescents with overweight/obesity. Methods: This was a Randomized Controlled Trial (Trial registration number: NCT04642222). One-hundred and thirty-five adolescents aged 13 to 18 years (67.5% females) were randomly assigned to the TAU control group (n = 66) and the APOLO-Teens intervention group (n = 69). Intervention outcomes were measured at baseline and the end of the intervention (6 months later). Using per-protocol analysis, the sample size retained for final analysis included 77 participants (Control group = 39; Intervention group = 38). Two-way mixed ANOVAs were used to test within-and between-group changes. Results: The APOLO-Teens social network-based intervention was feasible (adherence rate: 85.5%) and the intervention group had a significant increase in fruit consumption (F (1,35) = 6.99, p = 0.012; significant group-by-time interaction). Both groups increased vegetables on the plate consumption and decreased pastries/cakes intake, depressive symptomatology, grazing eating pattern, and BMI z-score (p < 0.05; significant time interaction). Conclusions: The APOLO-Teens social network-based intervention was feasible, and the effectiveness results suggest that it can be a beneficial supplementary intervention to TAU in adolescent obesity. 2025-01-01T00:00:00Z https://hdl.handle.net/10216/168448 Title: Insights towards the impact of subinhibitory chlorhexidine on antimicrobial susceptibility and horizontal gene transfer in Enterococcus faecium Abstract: Enterococcus faecium, a human and animal commensal broadly distributed in the environment, is currently one of the most challenging multidrug-resistant (MDR) healthcare-associated pathogens worldwide. It is often exposed to chlorhexidine (CHX), a broad-spectrum antiseptic, extensively used in healthcare, domestic, and food production settings, and a diffused polluter. However, the impact of gradients of CHX concentrations, including at subinhibitory levels, on E. faecium adaptation to various antimicrobials remains unclear. Our study aimed to explore the effects of subinhibitory CHX concentrations on biocides and antibiotics susceptibility as well as in the transfer of clinically relevant antibiotic resistance genes among E. faecium (n = 11) from diverse sources and clonal backgrounds. Serial exposure to increasing CHX concentrations resulted in strain-specific MICCHX and MBCCHX changes among six E. faecium studied. These strains presented different CHX genotypes, namely the P102H mutation in DNA-binding response regulator ChtR in two strains showing twofold increased MICCHX and/or MBCCHX, and an absent EfrEF transporter in a strain exhibiting increased CHX susceptibility after exposure. Whole-genome comparison between parental and CHX-adapted strains found no alterations in genes with a recognized role in CHX reduced susceptibility. Additionally, in a different assay, subinhibitory CHX exposure enhanced the transfer (up to 12.5-fold) of vancomycin or linezolid resistance genes among most E. faecium strains tested, except one lacking a functional EfrEF transporter. Our data suggest that subinhibitory CHX concentrations could have a role in Enterococcus adaptation to CHX and in the spread of antibiotic resistance through horizontal transfer events. Further investigation is warranted to elucidate the underlying mechanisms driving these phenomena in E. faecium, ensuring the continued effectiveness of both CHX and antibiotics, and safeguarding Public Health. (c) 2025 The Authors 2025-01-01T00:00:00Z https://hdl.handle.net/10216/172078 Title: Trihydroxylated Anthocyanins Potentiate Effects of Docetaxel in Mesenchymal Triple Negative Breast Cancer Cells Abstract: Triple negative breast cancer (TNBC) presents a significant therapeutic challenge due to its poor prognosis and limited treatment options. While anthocyanins, a group of flavonoids, exhibit promising anticancer potential, their structureactivity relationship and adjuvant properties in TNBC remain underexplored. This study evaluated the anti-proliferative effects of five structurally distinct anthocyani(di)nscyanidin-3-O-glucoside (C3G), delphinidin-3-O-glucoside (D3G), delphinidin-3-O-rutinoside (D3R), malvidin-3-O-glucoside (M3G), and luteolinidin (LT)on mesenchymal TNBC cells. Combination assays of docetaxel (DT), a first-line chemotherapeutic agent, with the most potent anthocyani(di)ns were conducted with TNBC and MCF-12A non-cancerous cells. Trihydroxylated anthocyanins (D3G and D3R), particularly those with a monosaccharide at C3, demonstrated the strongest anti-proliferative effects, reducing MDA-MB-231 cell proliferation by 95% and 70%, respectively, at 400 M (IC<inf>50</inf>: 253.28 and 341.33 M) without affecting MCF-12A cells. These were followed by 3-deoxy (LT), dihydroxylated (C3G), and O-methylated (M3G) anthocyani(di)ns. In Hs 578T mesenchymal TNBC cells, the trihydroxylated anthocyanins tested also induced strong anti-proliferative effects. Synergistic effects (combination index < 0.9) were observed for binary (D3G + DT or D3R + DT) and ternary (D3G + D3R + DT) combinations, reducing DT concentrations by up to 37-fold and anthocyanin concentrations by up to 21.9-fold to achieve similar inhibition. The ternary combination was the most effective, requiring the lowest concentrations of DT and anthocyanins. These results underscore the critical role of the ortho-trihydroxylated structure in the anti-proliferative effects of anthocyani(di)ns, highlighting trihydroxylated anthocyanins as promising adjuvants in TNBC treatment, with the potential to lower DT dosage, minimize side effects, delay resistance, and reduce treatment costs while maintaining efficacy. (c) 2025 The Author(s). BioFactors published by Wiley Periodicals LLC on behalf of International Union of Biochemistry and Molecular Biology. 2025-01-01T00:00:00Z https://hdl.handle.net/10216/172956 Title: Psychological aspects of grazing in adolescents: psychometric properties and measurement invariance of the Rep(eat)‑Q in community and clinical samples 2025-01-01T00:00:00Z https://hdl.handle.net/10216/151207 Title: Accuracy of Assessing Weight Status in Adults by Structured Observation Abstract: <jats:p>The assessment of weight status is important in many epidemiological studies, but its direct measurement is not always possible. Self-reported weight and height are often used, although previous research reported low accuracy. This study aimed to test the ability of trained observers to accurately estimate weight status in adults using structured observation. A cross-sectional study was conducted. For each participant, height and weight were estimated in categories, and weight status was recorded using Stunkards body figures, by two trained observers. Height and weight were also measured, using standardized procedures. Subjects were classified according to World Health Organization body mass index (BMI) cut-offs from objective measurements and from the BMI assigned to each body figure. Sensitivity, specificity, and likelihood ratios were calculated to assess the accuracy of estimating weight status by observation. Kappa was used to test inter-observer reliability. A total of 127 participants were assessed, 70 women and 57 men, aged between 19 and 89 years (mean ± standard deviation: 50.3 ± 16.3 years). Most participants were overweight or obese (64.3% women; 78.9% men). The sensitivity and specificity of overweight/obesity status identification were 72.8% and 78.4%, respectively. Observers gender, participants gender, and participants age were significantly associated with the estimation of overweight/obesity. The agreement between observers was moderate for BMI estimates ( = 0.52) but substantial when distinguishing normal weight from overweight/obesity ( = 0.67). Trained observers were able to distinguish normal weight from overweight/obesity with high sensitivity and specificity, and substantial interrater reliability. This innovative methodology showed potential for improvement through enhanced training techniques. The use of structured observation may be a useful and accurate alternative to self-reported weight status assessment, whenever anthropometric measurement is not achievable.</jats:p> 2023-01-01T00:00:00Z https://hdl.handle.net/10216/118069 Title: Street food in Maputo, Mozambique: Availability and nutritional value of homemade foods Abstract: Background: A nutrition transition is occurring in the urban areas of developing countries, where street food makes an important contribution to daily food intake. Aim: We aimed to characterise street food offer in Maputo, Mozambique, and to evaluate the nutritional composition of the most common homemade foods. Methods: A cross-sectional study was conducted in 2014. Streets in the surroundings (500 m buffer) of randomly selected public transport stops in KaMpfumu district, Maputo, were canvassed to identify all street food vending sites (n = 968). Information regarding vending site characteristics and the food offered was gathered through interview and observation. Samples (n = 80) of the most common homemade foods were collected for laboratorial analysis. Results: Most street food vending sites identified were stationary (77.4%) and sold exclusively industrial food (51.9%). Frequency of fruit, beverages and food other than fruit was 24.5%, 32.5% and 73.9%, respectively. Fried cakes were the most energy-dense (430 kcal/100 g), and richest in fats (21.0g/100 g) and carbohydrates (53.4 g/100 g). The richest sources of protein were the stewed meat/fish/liver dishes (10.711.6 g/100 g). Fried cakes showed the lowest sodium and potassium content (90 mg/100 g and 81 mg/100 g, respectively) whereas hamburgers exhibited the highest content of those micronutrients (455 mg/100 g and 183 mg/100 g, respectively). Stewed liver dishes presented the highest sodium/potassium ratio (11.95). Fried snacks presented the highest trans-fatty acid content (0.20 g/100 g). Conclusions: Street food in Maputo is abundant and scattered throughout the urban district, exhibiting high variability in the nutritional composition of homemade foods. Public health policies should be targeted to improve the street food offer, promoting nutrient-dense foods and the reduction of added salt. (c) The Author(s) 2018. 2018-01-01T00:00:00Z https://hdl.handle.net/10216/151371 Title: Methodological approaches for the assessment of bisphenol A exposure 2023-01-01T00:00:00Z https://hdl.handle.net/10216/130167 Title: Street food in Eastern Europe: a perspective from an urban environment in Moldova Abstract: Street food is popular in Eastern Europe, but its diversity and nutritional value are unknown. This study aimed to characterise the street food environment in Chisinau, Moldova, including the vending sites and vendors, food availability and nutritional composition of foods and beverages. All street food vending sites (single point of sale) located in a 1-km buffer centred on the main public market were systematically selected (n439;n328 participants). Data on vending sites' characteristics (mobility, type of physical set-up and access to electricity), operating periods and food availability were collected. Samples of the most commonly available foods of unknown composition were collected (twenty-eight home-made and twenty-four industrial). Macronutrients, Na and K were quantified through chemical analysis. Fruits, beverages and food other than fruits were available in 2 center dot 5, 74 center dot 3 and 80 center dot 8 % of the vending sites, respectively. Among the latter, 66 center dot 4 % sold only industrial foods (e.g. pretzels, biscuits, wafers, chocolate and ice cream), 21 center dot 5 % only home-made (e.g. savoury and sweet pastries) and 12 center dot 1 % both. Home-made foods presented larger serving sizes and energy/serving (median kJ/serving: 1312 center dot 5v.670 center dot 3,P= 0 center dot 022); industrial foods were more energy-dense (median kJ/100 g: 1797 center dot 0v.1269 center dot 8,P= 0 center dot 002). High SFA,trans-fat and Na contents were found, reaching 10 center dot 9 g/serving, 1 center dot 4 g/serving and 773 center dot 7 mg/serving, respectively. Soft drinks and alcoholic beverages were available in 80 center dot 7 and 42 center dot 0 % of the vending sites selling beverages, respectively. Concluding, industrial snacks and home-made pastries high in Na and unhealthy fat were frequent in Chisinau. Prevention of diet-related diseases in Moldova may benefit from the improvement of the nutritional profile of street food. 2020-01-01T00:00:00Z https://hdl.handle.net/10216/168458 Title: Iodine supplementation for pregnancy in Portugal: identification of nutritional composition of iodine containing supplements and characterization of pharmacy dispenses from 2008-2022 Abstract: Background Iodine is essential for the proper development of the central nervous system. In Portugal, despite of self-reports of iodine supplements intake by pregnant women, iodine deficiency still prevails. This study intended to characterize the pharmacy sales of iodine-containing supplements and their use by women in Portugal.Methods Data from all available supplements with indication for use in the prenatal time, for the period 2008-2022, was obtained from the Portuguese Association of Pharmacies. To infer from the use of iodine supplements by women during preconception, pregnancy and lactation, pharmacy dispenses, between 2019 and 2021, were collected from a sample of female consumers, identified with at least one prescription of iodine-containing supplements.Results Eighty-eight per cent of the iodine-containing supplements state the recommended iodine concentration. The annual sales increased continuously, reaching an estimated of 109 mu g per day in 2022. Estimated mean duration of supplementation to women prescribed with iodine-containing supplements for preconception/pregnancy/lactation was of 4.5 months (SD = 3.8) and less than 1% of women was covered for the advisable period of 18 months.Conclusion The estimated duration of iodine supplementation to women during preconception, pregnancy and lactation is below recommendations. Additional public health measures, such as universal salt iodization and literacy campaigns are needed to ensure iodine sufficiency to women and their developing fetus. 2025-01-01T00:00:00Z https://hdl.handle.net/10216/159082 Title: Bisphenol A and cardiometabolic risk in adolescents: Data from the Generation XXI cohort Abstract: Background and aims: Bisphenol A (BPA), an endocrine disruptor widely used in food contact materials, has been linked to a worse health pro file. This study intends to estimate the association between BPA exposure and cardiometabolic patterns at adolescence. Methods and results: Data from the Portuguese population -based birth cohort Generation XXI at the age of 13 were used (n = 2386 providing 3 -day food diaries and fasting blood samples). BPA exposure was measured in 24-h urine from a subsample (n = 206) and then predicted in all participants using a random forest method and considering dietary intake from diaries. Three cardiometabolic patterns were identi fied (normal, modi fied lipid pro file and higher cardiometabolic risk) using a probabilistic Gaussian mixture model. Multinomial regression models were applied to associate BPA exposure (lower, medium, higher) and cardiometabolic patterns, adjusting for confounders. The median BPA exposure was 1532 ng/d, corresponding to 29.4 ng/kg/d. Adolescents higher exposed to BPA (compared to medium and lower levels) had higher BMI z -score (kg/m 2 ) (0.68 vs. 0.39 and 0.52, respectively; p = 0.008), higher levels of body fat (kg) (16.3 vs. 13.8 and 14.6, respectively; p = 0.002), waist circumference (76.2 vs. 73.7 and 74.9, respectively; p = 0.026), insulinemia (ug/mL) (14.1 vs. 12.7 and 13.1, respectively; p = 0.039) and triglyceridemia (mg/dL) (72.7 vs. 66.1 and 66.5, respectively; p = 0.030). After adjustment, a signi ficant association between higher BPA and a higher cardiometabolic risk pattern was observed (OR: 2.55; 95%CI: 1.41, 4.63). Conclusion: Higher BPA exposure was associated with a higher cardiometabolic risk pattern in adolescents, evidencing the role of food contaminants in health. (c) 2024 The Author(s). Published by Elsevier B.V. on behalf of The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. This is an open access article under the CC BY -NC -ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). 2024-01-01T00:00:00Z https://hdl.handle.net/10216/144274 Title: Patterns of Street Food Purchase in Cities From Central Asia Abstract: Street food makes a significant contribution to the diet of many dwellers in low- and middle-income countries and its trade is a well-developed activity in the central Asian region. However, data on its purchase and nutritional value is still scarce. This study aimed to describe street food purchasing patterns in central Asia, according to time and place of purchase. A multicentre cross-sectional study was conducted in 2016/2017 in the main urban areas of four central Asian countries: Dushanbe (Tajikistan), Bishkek (Kyrgyzstan), Ashgabat (Turkmenistan) and Almaty (Kazakhstan). Street food markets (n = 34) and vending sites (n = 390) were selected by random and systematic sampling procedures. Data on the purchased foods and beverages were collected by direct observation. Time and geographic location of the purchases was registered, and their nutritional composition was estimated. A total of 714 customers, who bought 852 foods, were observed. Customers' influx, buying rate and purchase of industrial food were higher in city centers compared to the outskirts (median: 4.0 vs. 2.0 customers/10 min, p < 0.001; 5.0 vs. 2.0 food items/10 min, p < 0.001; 36.2 vs. 28.7%, p = 0.004). Tea, coffee, bread and savory pastries were most frequently purchased in the early morning, bread, main dishes and savory pastries during lunchtime, and industrial products in the mid-morning and mid-afternoon periods. Energy and macronutrient density was highest at 11:00-12:00 and lowest at 09:00-10:00. Purchases were smaller but more energy-dense in city centers, and higher in saturated and trans-fat in the peripheries. This work provides an overview of the street food buying habits in these cities, which in turn reflect local food culture. These findings from the main urban areas of four low- and middle-income countries which are currently under nutrition transition can be useful when designing public health interventions customized to the specificities of these food environments and their customers. 2022-01-01T00:00:00Z https://hdl.handle.net/10216/144250 Title: Availability and Nutritional Composition of Street Food in Urban Central Asia: Findings From Almaty, Kazakhstan Abstract: Objective: To describe the availability and nutritional composition of commonly available street foods in Almaty, Kazakhstan. Methods: 384 street food vending sites (in 10 public markets) were assessed; information on vending sites characteristics and food availability and samples of the most commonly available street foods (81 homemade; 40 industrial) were collected for chemical analysis. Results: Fruit, beverages and food other than fruit were available in 1.0%, 47.4% and 92.7% of all vending sites. Homemade food other than fruit (e.g., bread, main dishes, snacks, pastries, sandwiches, and cakes) were available in 63.4% of stationary vending sites, while industrial (e.g., snacks, chocolate, cakes, and cookies) in 45.6% of them. Industrial foods were the most energy-dense [median kcal/100 g: 438.8 vs. 267.2, p < 0.001 (homemade)]. Traditional homemade dishes were high in sodium, reaching 2,248 mg/serving (lagman) and major contributors of protein and fat to energy content (shashlik: 22.8% from protein, 68.3% from fat). Industrial chocolate and homemade cake presented the highest saturated (14.6 g/serving) and trans-fat (3.20 g/serving) contents. Conclusion: These findings advocate for the implementation of health promotion strategies targeted at vendors, consumers and other stakeholders. Copyright (c) 2022 Albuquerque, Lança de Morais, Gelormini, Sousa, Casal, Pinho, Damasceno, Moreira, Breda, Lunet and Padrão. 2022-01-01T00:00:00Z https://hdl.handle.net/10216/137503 Title: The Price of Homemade Street Food in Central Asia and Eastern Europe: Is There a Relation with Its Nutritional Value? Abstract: The aim was to describe the price of homemade street foods in four cities of Central Asia and Eastern Europe and to analyze its association with energy density, macronutrients, sodium and potassium contents. Cross-sectional evaluations of street food vending sites were conducted in Dushanbe, Tajikistan (n = 562), Bishkek, Kyrgyzstan (n = 384), Almaty, Kazakhstan (n = 236) and Chis,inau, Moldova (n = 89) in 2016-2017. Information on the homemade street foods available, including price, was systematically collected; the most commonly available foods (n = 64) were sampled for chemical analysis. Prices were converted to international dollars ($) and expressed as $/serving, $/100 g and $/100 kcal. The median street food price was $1.00/serving, $0.85/100 g and $0.33/100 kcal. Traditional foods were cheaper per 100 g than the westernized ($0.77 vs. $1.00, p = 0.011). For each unit increase in energy density (kcal/g), the homemade street foods were $0.12 cheaper per 100 kcal and $0.11 more expensive per 100 g. The carbohydrate content was negatively associated with price per 100 kcal, while total fat, monounsaturated, saturated and trans-fatty acids content were positively associated with price per 100 g. Energy-dense homemade street foods were the cheapest. Further insight on food preparation might clarify the association between carbohydrates and monounsaturated fatty acids content and street food price. 2021-01-01T00:00:00Z https://hdl.handle.net/10216/130152 Title: Macronutrient composition of street food in Central Asia: Bishkek, Kyrgyzstan Abstract: Background: Urban areas in central Asia are currently undergoing nutrition transition. Street food is very popular, but the specific foods available and their nutritional composition are unknown. The aim was to describe the availability and macronutrient composition of street foods in Bishkek, Kyrgyzstan. Results: Trained interviewers collected data on street food vending sites' characteristics and food availability (n = 596). Samples of the most commonly available foods and drinks were collected (n = 80 homemade;n = 40 industrial). Macronutrients were quantified through chemical analysis. Fruit, beverages, and food other than fruit were available in 4.0%, 61.7%, and 81.0% of the vending sites, respectively. Among those selling food other than fruit, 56.5% sold only homemade (e.g., bread, main dishes, snacks, pastries, sandwiches, and cakes), 23.3% both homemade and industrial and 20.2% only industrial foods (e.g., bread, snacks, pastries, cakes, and cookies). Homemade foods presented the highest energy/serving (median kcal/serving: 357 versus 145,p < .001). A high content in saturated and trans-fatty acids was observed in some homemade traditional dishes and snacks, reaching, respectively, 30.2 g/serving and 2.9 g/serving (in homemademanty,a traditional dish). Tea and soft drinks were available in over 50% of the vending sites selling beverages. Conclusion: The high availability of street food in Bishkek highlights its importance for this urban population. Traditional snacks, dishes, and beverages coexist with more westernized products. The variability in energy, macronutrients, and lipid profile of homemade and industrial products reflects heterogeneous culinary practices and ingredients. Policies promoting the availability of healthy foods and ingredients should be implemented. 2020-01-01T00:00:00Z https://hdl.handle.net/10216/138821 Title: Nutritional content of the street food purchased in Chisinau, Moldova: Opportunity for policy action 2022-01-01T00:00:00Z https://hdl.handle.net/10216/125260 Title: Street food in Dushanbe, Tajikistan: Availability and nutritional value Abstract: Street food is part of the culture in central Asia. Although nourishing foods can be found, unhealthier options are becoming increasingly popular - a marker of nutrition transition. The nutritional composition of street foods in urban settings is, however, unknown. The objective of this study was, thus, to characterise the street food availability in Dushanbe, Tajikistan. A total of 800 street food vending sites in public markets were selected through random and systematic procedures. Trained interviewers collected data on vending sites' characteristics, location and food available. Samples of the most commonly available foods were collected (99 homemade and 35 industrial). Macronutrients were quantified through proximate analysis. Fruit, drinks and foods other than fruit were available, respectively, in 4.5%, 40.5%, and 87.4%, of the vending sites. Among the latter, 63.6% sold only homemade (e.g., bread, traditional dishes, snacks, pastries, sandwiches and cakes), 19.3% only industrial (e.g., bread, snacks, pastries and cookies) and 17.1% both types of food. Homemade foods presented higher energy per serving than industrial foods (median kcal/serving: 452 vs 276, p<0.001). A high content in saturated (soup: 10.9 g/serving) and trans-fatty acids (cakes: 1.8 g/serving) was also found in homemade foods. However, the highest content in these fatty acids was found in industrial wafers (12.9 g/serving and 2.5 g/serving, respectively). Soft drinks were available in 68.5% of the vending sites selling beverages. Homemade and industrial street foods, with heterogeneous nutritional value, were widely available in Dushanbe. Policies promoting the availability of healthy foods should be encouraged. 2019-01-01T00:00:00Z https://hdl.handle.net/10216/137513 Title: A Cross-Sectional Study of the Street Foods Purchased by Customers in Urban Areas of Central Asia Abstract: This study aimed to describe street food purchases in cities from Central Asia, considering customers' characteristics and the nutritional composition of the foods and beverages. Cross-sectional studies were conducted in 2016/2017 in Dushanbe (Tajikistan), Bishkek (Kyrgyzstan), Ashgabat (Turkmenistan) and Almaty (Kazakhstan). Direct observation was used to collect data on the purchases made by street food customers, selected by random and systematic sampling. Nutritional composition was estimated using data from chemical analyses, food composition tables or food labels. A total of 714 customers (56.6% females, 55.5% aged & GE;35 years, 23.3% overweight/obese) were observed, who bought 852 foods and beverages, the most frequent being savoury pastries/snacks (23.2%), main dishes (19.0%), sweet pastries/confectionery (17.9%), tea/coffee (11.3%) and soft drinks/juices (9.8%). Fruit was the least purchased food (1.1%). Nearly one-third of customers purchased industrial food items (31.9%). The median energy content of a street food purchase was 529 kcal/serving. Saturated and trans-fat median contents were 4.7 g/serving and 0.36 g/serving (21.4% and 16.5% of maximum daily intake recommendations, respectively). Median sodium and potassium contents were 745 mg/serving (37.3% of maximum recommendation) and 304 mg/serving (8.7% of minimum recommendation), respectively. In general, the purchases observed presented high contents of energy, saturated-fat, trans-fat and sodium, and low levels of potassium. Policies towards the improvement of these urban food environments should be encouraged.</p> 2021-01-01T00:00:00Z https://hdl.handle.net/10216/147529 Title: Lessons from Four Decades of Systemic Amyloidosis with Renal Involvement Abstract: Background: Apart from ATTR amyloidosis, the epidemiology and outcomes of the most common subtypes of systemic amyloidosis in Portugal remain primarily unknown. Methods: This retrospective cohort study evaluated patients with renal biopsy-proven amyloidosis, diagnosed from January 1978 to December 2019. Follow-up started at kidney disease presentation and ended at death or August 2020. Clinical presentation, survival, and prognostic factors were analysed. Results: Of 123 patients with amyloid nephropathy, 111 had definite amyloid typing and were analysed. AA amyloidosis was the most frequent type (56.1%) and was related mainly to chronic infection (47.8%) and chronic inflammatory arthritis (29.0%). AL amyloidosis was present in 25.2% of patients and hereditary forms in 6.5% (4.1% AFibE526V, 2.4% ATTRV30M). During follow-up, 73.9% of AA and 54.8% of AL patients progressed to end-stage renal disease, and 79.7% of AA and 77.4% of AL died; median overall survival was 66.0 (95% CI, 33.0-99.0) and 18.0 (95% CI, 9.3-26.7) months (p = 0.025), respectively. There were no significant differences in renal outcome and survival on dialysis between these two types. In multivariate analysis, cardiac involvement at presentation (HR 6.26 [95% CI, 2.89-13.56]) and estimated glomerular filtration rate <30 mL/min/1.73 m(2) (HR 2.05 [95% CI, 1.06-3.99]) independently influenced AA and AL amyloidosis survival. Cardiac involvement at presentation was an independent predictor of death (HR 9.65 [95% CI, 2.91-31.95]) and early mortality in AL amyloidosis. Conclusions: In Portugal, AA amyloidosis and related chronic infections are still relevant. Regarding AL amyloidosis, the low incidence and advanced disease at presentation result from missed and erroneous diagnoses, leading to delayed referrals and poor outcomes in these patients. 2023-01-01T00:00:00Z https://hdl.handle.net/10216/171979 Title: Pre-packaged food targeted to gastrointestinal pathologies: are they low in FODMAP? Abstract: A diet low in fermentable carbohydrates, oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) has been described as an effective nutritional approach in irritable bowel syndrome. There has been an increased demand for gluten- and lactose-free foodstuffs in the last few years, which are associated with gastrointestinal symptoms and are consumed by patients with gastrointestinal disease. This study aims to estimate the FODMAP content of industrial pre-packaged food products containing the 'gluten-free' and 'lactose-free' claims. The ingredient lists of the foodstuffs from a Portuguese food retail chain were verified and classified according to their estimated FODMAP content as 'low' and 'high', using as a reference the FODMAP cutoff values and the serving sizes established by the Monash University App. Descriptive statistics and the Pearson chi 2 test were applied. From the 436 eligible products identified, most were classified as 'low' (530 %, n 231), 243 % (n 106) were classified as 'high' and 227 % (n 99) were classified as having 'unknown' FODMAP content. 'High FODMAP' products accounted for 122 % of those with 'lactose-free' claims and 316 % of those with 'gluten-free' claims. The 'ready meals' and 'sauces, dressings, creams and soups' were the food categories with the highest proportion of products with high FODMAP sources. This study showed that approximately a quarter of pre-packaged industrial foods targeted to gastrointestinal pathologies are high in FODMAP. The nutritional information on the label should be more specific, enabling more accurate dosing of FODMAP contents in foodstuffs and the establishment of the recommended serving sizes. 2025-01-01T00:00:00Z https://hdl.handle.net/10216/171897 Title: Interventions to Reduce Sodium Consumption Through a Reduction in Salt Usage in Cooking-A Systematic Review and Meta-analysis Abstract: Context: Public health experts have identified salt as a primary dietary risk factor, leading many countries worldwide, recognizing its cost-effectiveness, to implement salt-reduction programs to combat cardiovascular disease and other chronic illnesses. Some nations found that a substantial portion of dietary salt comes from cooking practices. Objectives: This systematic review aims to describe and assess the effectiveness of interventions aimed at decreasing salt usage in cooking. Data Sources: A search across Scopus, PubMed, and Web of Science was conducted to identify interventions from the past decade that target reduced salt usage during cooking, with effectiveness measured through 24-hour urinary sodium excretion. Data Extraction: Thirteen studies were ultimately included (comprising 5 intervention study protocols and 8 randomized controlled trials). Data Analysis: The interventions primarily focused on adult participants (n = 11). The interventions ranged from educational initiatives, education combined with salt-restricted utensils, warning labels on salt containers, substitution of salt with potassium-enriched low-sodium alternatives to the use of dosing devices for cooking at home. While 3 studies reported a significant reduction in urinary sodium excretion (mainly through educational efforts), others showed decreases without statistically significant differences between groups. The performed meta-analysis with data from 3185 participants indicated that interventions to reduce salt usage during cooking showed a significant trend towards reducing sodium intake (Hedges' g, -1.06; 95% CI, -1.68 to -0.44; P < .001). Conclusion: The findings suggest that interventions targeting reduced salt usage are effective on sodium intake reduction, assessed by 24-hour urinary sodium excretion, particularly among hypertensive individuals. This approach could aid in achieving the World Health Organization's goal of a 30% reduction in salt intake by 2030. 2025-01-01T00:00:00Z