Browsing by Author "Carvalho, M.A."
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- Breakfast consumption in primary school children from cosi portugal 2010 studyPublication . Duarte, D.; Ramos, C.; Carvalho, M.A.; Rito, AnaIntroduction: Breakfast is considered the most important meal of the day. Given the association of childhood obesity with less frequent breakfast consumption and since Portuguese studies on this subject are still scarce, the present study assesses breakfast consumption among Portuguese school age children and its association with obese and overweight children. Methods: The analysis was undertaken from data of the COSI Portugal 2010 study. Breakfast consumption (defined as the consumption of food, and beverage taken before school time) and place where it was held, was obtained from 4064 children aged between 6 to 8 years from a National representative sample of 189 primary schools. IOTF criteria was used to classify children´s nutritional status. For this study, descriptive and analytic statistics were used. The significance level was set at p <0.05. Results: 95.1% of the children had breakfast every day at home. Most children took breakfast at home (95.9%). Concerning the food eaten in this meal, the study showed that most of the children (87.7%) consumed milk/yogurt/cheese, and only 2.0% had fruit. Children, who did not have breakfast, had higher prevalence of overweight and obesity (33.2% and 14.8%, respectively) compared with the ones that took breakfast (26.0% and 9.0%, respectively). These differences were statistically significant (p <0.05). Conclusion: This study suggests that children who do not consume breakfast, appears, itself, to be associated positively with obesity. Given rising obesity rates in children, public health advocates would do well to renew their emphasis on the importance of a good breakfast.
- Development of a new computer program to assess dietary intake among Portuguese school-age children: a qualitative approachPublication . Carvalho, M.A.; Santos, O.; Rito, A.; Foster, E.; Moore, H.J.; Pereira Miguel, J.Introduction: Twenty-four-hour dietary recall is the method of choice for assessing food intake among school-age children. Because they require highly trained interviewers, recalls are expensive and impractical for large-scale nutrition research. A new method for assessing dietary intake in children is being developed: the Portuguese self-administered computerized 24-hour dietary recall (PAC24). Objectives: To identify and select food items to comprise PAC24; to better understand the way children report their food consumption on the previous day; and, to know the different meanings and labels children give to some specific food items. Methods: Data were collected through 21 Focus Groups (FG), conducted in 7 primary schools from the 7 regions of Portugal in 2011. 204 children from second to fourth grade participated. FG were homogeneous for children’s grade and area of residence and heterogeneous for gender and socioeconomic status. Children participated in FG after parent’s written informed consent. Topics for discussion were food consumption on the previous day and individual meanings and labeling of some specific food items. Content analysis followed a thematic coding process. Results: A total of 3959 food items were identified and classified into 12 food groups. Children generally reported foods chronologically organized by the three main meals (breakfast, lunch and dinner). Snacks and candies consumption were reported after prompting for snacks and forgotten foods. Not all children were able to record foods successfully; both descriptions and quantities of food posed problems. Different regional culture-specific terms were identified for some of the food-items. Conclusions: This qualitative approach enriched the food-items pool that was originally developed by literature review and revealed the main aspects that should be taken into account in PAC24 development
- Estratégias de base comunitária e de base escolar na promoção de estilos de vida saudáveis Childhood Health at Municipality LevePublication . Rito, Ana; Siopa, M.; Carvalho, M.A.
- Food consumption, family income and childhood obesity in the municipalities of Oeiras, Seixal and Viana do Castelo - MUNSI projectPublication . Bernarda, L.; Carvalho, M.A.; Rito, AnaIntroduction: Increasing evidence suggests that the dietary intake of children can be influenced by family income and this condition may be associated with development of obesity. This study aims to evaluate the association between food intake, family income and childhood obesity in children in the municipalities of Oeiras, Seixal and Viana do Castelo. Methodology: Data from MUN-SI project (2010/2011) was analysed regarding food consumption, family income and children´s nutritional status. 1585 children aged 9-11 years old were evaluated. CDC criteria was used to classify nutritional status. Descriptive analysis consisted on obtaining frequencies of the explanatory variables. The binomial logistic regression model was used in order to calculate odds ratio for confidence intervals at 95%. Results: 31,1% of children were overweight and 14.4% were obese. Children whose family income was 501-850€/month had a significantly increased risk of developing obesity (OR = 2.919; 95% CI: 1,428-5,966). Children whose family income was 0-500€/month and 501-850€/month, consumed fast food (9,2%; 4,8%), salty snacks (11,5%; 5,6%), candy (10,9%; 10,6%) and ice cream (9,5%; 8%) more than 3 times per week (p<0,05), and fruit (47,7%; 37,5%) and vegetable soup (34.3%; 27.8%) less than one time per day (p<0,05). Conclusion: Families with low income may represent a risk for developing childhood obesity. This reinforces the need for public health advocates and the continuity of community and family based projects interventions at local level.
- Program Obesity Zero (POZ) – a community based intervention to address overweight primary school children from five Portuguese municipalitiesPublication . Rito, A.I.; Carvalho, M.A.; Ramos, C.; Breda, J.OBJECTIVE: Results of the WHO European Childhood Obesity Surveillance Initiative indicated that on average one out of four primary-school children is overweight or obese. Portugal presented one of the highest prevalences of obesity. Childhood obesity prevention and treatment should be a top priority. The aim of the present study was to evaluate the effectiveness of Program Obesity Zero (POZ), a multi-component, community-, family- and school-based childhood obesity intervention. DESIGN: Parents and children attended four individual nutrition and physical activity counselling sessions, a one-day healthy cooking workshop and two school extracurricular sessions of nutrition education. Waist circumference, BMI, physical activity level, sedentary behaviours, and nutrition and physical activity knowledge, attitudes and behaviour were assessed at baseline and after 6 months. Diet was assessed using two 24 h recalls, at baseline and at 6 months. SETTING: Five Portuguese municipalities and local communities. SUBJECTS: Two hundred and sixty-six overweight children (BMI ≥ 85th percentile) aged 6-10 years, from low-income families in five Portuguese municipalities, were assigned to the intervention. RESULTS: Children showed reductions in waist circumference (-2.0 cm; P < 0.0001), mean BMI (-0.7 kg/m2; P < 0.0001) and BMI-for-age percentile (-1.7; P < 0.0001) at 6 months. Overall, children's intake of fruit and vegetables was <400 g/d throughout the intervention. After 6 months, higher fibre consumption and an apparent decrease in sugary soft drinks intake to a quarter of that observed at baseline (mean intake: 198 ml/d at baseline), with improvements in physical activity levels and screen time <2 h/d, were also observed. CONCLUSIONS: The findings suggested that POZ is a promising intervention programme, at municipality level, to tackle childhood overweight and obesity.
- Validation of the Portuguese self-administered computerised 24-hour dietary recall among second-, third- and fourth-grade childrenPublication . Carvalho, M.A.; Baranowski, T.; Foster, E.; Santos, O.; Cardoso, B.; Rito, A.; Pereira Miguel, J.Background: Current methods for assessing children's dietary intake, such as interviewer-administered 24-h dietary recall (24-h DR), are time consuming and resource intensive. Self-administered instruments offer a low-cost diet assessment method for use with children. The present study assessed the validity of the Portuguese self-administered, computerised, 24-h DR (PAC24) against the observation of school lunch. Methods: Forty-one, 7–10-year-old children from two elementary schools, in Lisbon, were observed during school lunch followed by completion of the PAC24 the next day. Accuracy for reporting items was measured in terms of matches, intrusions and omissions; accuracy for reporting amounts was measured in terms of arithmetic and absolute differences for matches and amounts for omissions and intrusions; and accuracy for reporting items and amounts combined was measured in terms of total inaccuracy. The ratio of the estimated weight of food consumed with the actual weight consumed was calculated along with the limits of agreement using the method of Bland and Altman. Results: Comparison of PAC24 against observations at the food level resulted in values of 67.0% for matches, 11.5% for intrusions and 21.5% for omissions. The mean for total inaccuracy was 3.44 servings. For amounts, accuracy was high for matches (−0.17 and 0.23 servings for arithmetic and absolute differences, respectively) and lower for omissions (0.61 servings) and intrusions (0.55 servings). PAC24 was found to under-estimate the weight of food on average by 32% of actual intake. Conclusions: PAC24 is a lower-burden procedure for both respondents and researchers and, with slight modification, comprises a promising method for assessing diet among children.