Browsing by Author "Ferreira, J."
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- APOE isoforms in focal epilepsies: an association study in a Portuguese populationPublication . Martins da Silva, A.; Leal, B.; Chaves, J.; Carvalho, C.; Bettencourt, A.; Branco, R.C.; Ferreira, J.; Costa, P.; Martins da Silva, B.Purpose: Apolipoprotein E (ApoE) is the main lipoprotein secreted in brain. It has a critical immuno-modulatory function, influences neurotransmission and is involved in repairing damaged neurons. ApoE e4 allele is an isoform of ApoE with altered protein function previously associated with refractoriness and early onset epilepsy. Our purpose was to investigate if apoE isoforms are risk factors for partial epilepsy and to correlate genotypes with anti-epileptic drug response. Methods: A cohort of 230 epileptic patients with partial epilepsies from the outpatient clinic at HSA-CHP [109F, 121M; mean age = 44 13 years, age of onset = 15 13 years; 168 patients with Drug Refractory Epilepsy (DRE)] was compared with a cohort of 301 healthy individuals (HI) in a case control study. ApoE isoforms were genotype by RFLP-PCR methodology. Results: ApoE e4 allele frequency was higher in epileptic group when compared with HI (10.6% vs. 7.6%, p = n.s., OR = 1.44, 95% CI: 0.945–2.20). Anti-epileptic Drug response was not influenced by apoE isoforms. Conclusion: Our results suggest that ApoE e4 may be a risk factor for partial epilepsy development. ApoE e4 is associated with CNS network instability, with lower protection against oxidative and inflammatory cascade. These could influence neuronal growth and recovery leading to a chronic vicious cycle of damage and neuronal loss contributing to seizures development. These observations should be confirmed in a larger cohort.
- A cost-efficiency and health benefit approach to improve urban air qualityPublication . Miranda, A.I.; Ferreira, J.; Silveira, C.; Relvas, H.; Duque, L.; Roebeling, P.; Lopes, M.; Costa, S.; Monteiro, A.; Gama, C.; Sá, E.; Borrego, C.; Teixeira, J.P.When ambient air quality standards established in the EU Directive 2008/50/EC are exceeded, Member States are obliged to develop and implement Air Quality Plans (AQP) to improve air quality and health. Notwithstanding the achievements in emission reductions and air quality improvement, additional efforts need to be undertaken to improve air quality in a sustainable way - i.e. through a cost-efficiency approach. This work was developed in the scope of the recently concluded MAPLIA project "Moving from Air Pollution to Local Integrated Assessment", and focuses on the definition and assessment of emission abatement measures and their associated costs, air quality and health impacts and benefits by means of air quality modelling tools, health impact functions and cost-efficiency analysis. The MAPLIA system was applied to the Grande Porto urban area (Portugal), addressing PM10 and NOx as the most important pollutants in the region. Four different measures to reduce PM10 and NOx emissions were defined and characterized in terms of emissions and implementation costs, and combined into 15 emission scenarios, simulated by the TAPM air quality modelling tool. Air pollutant concentration fields were then used to estimate health benefits in terms of avoided costs (external costs), using dose-response health impact functions. Results revealed that, among the 15 scenarios analysed, the scenario including all 4 measures lead to a total net benefit of 0.3M€·y(-1). The largest net benefit is obtained for the scenario considering the conversion of 50% of open fire places into heat recovery wood stoves. Although the implementation costs of this measure are high, the benefits outweigh the costs. Research outcomes confirm that the MAPLIA system is useful for policy decision support on air quality improvement strategies, and could be applied to other urban areas where AQP need to be implemented and monitored.
- Evaluation of the nutritional characteristics of sweet pastry products available in the Portuguese market in 2023Publication . Ferreira, J.; Albuquerque, T.G.; Silva, M.A.; Costa, H.S.Non-communicable diseases are a public health concern that results in several deaths each year. Diseases like diabetes, hypertension, obesity, among others, continue to increase, being the majority of the cases associated with behavioural factors, such as poor dietary habits. This study aimed to evaluate the nutritional characteristics of sweet pastry products, available in the Portuguese market in 2023, through the comparison of the nutritional information with two front-of-pack schemes (traffic light and Nutri-Score) and with the recommendations from the Integrated Strategy for the Promotion of Healthy Eating (EIPAS). Information for 52 pastry products was collected, between January and February 2023, from the websites of supermarket chains available in Portugal. The data set included information concerning: ingredients list, traffic light, Nutri-Score, and nutrition declaration, among others. Products were grouped into 8 categories and some had subcategories. None of the studied products were in line with EIPAS recommendations in terms of sugar and salt contents. According to Nutri-Score, 98% of the products were classified as C (8%), D (57%) or E (33%). For salt, 96% of the products are classified as amber (medium content) and none of the products as red (high content). However, more than half of the products were classified as red (high content) for fat (56%), saturated fatty acids (63%) and sugars (62%). A considerable number of the studied sweet pastry products still have high amounts of saturated fatty acids and sugars. Therefore, it is of utmost importance to reformulate these products, not only envisaging to decrease its content on the harmful nutrients, but also increasing the content of nutrients linked with health benefits, like dietary fibre and unsaturated fatty acids.
- Influence of interleukin-6 gene polymorphisms in epicardial adipose tissue and coronary artery calcification in patients with psoriasisPublication . Torres, T.; Bettencourt, N.; Ferreira, J.; Carvalho, C.; Mendonça, D.; Pinho-Costa, P.; Vasconcelos, C.; Selores, M.; Silva, B.Psoriasis is currently considered a systemic inflammatory disorder associated with several comorbidities and increased risk of cardiovascular disease (CVD)1 cytokines are overexpressed cutaneous and systemically and may be responsible for skin lesions but also for psoriasis-associated conditions surrounding the heart, is now regarded as an important factor in the pathogenesis of coronary atherosclerosis and CVD, through inflammatory burden proximal to the coronary arteries, and has been shown to be increased in psoriasis patients independently of abdominal visceral fat (AVF) and to be associated with sub-clinical atherosclerosis IL-6 has been implicated in the pathogenesis of psoriasis1 but also of abdominal obesity atherosclerosis and CVD4 30% of total circulating concentrations in healthy subjects thought to be influenced by polymorphisms in their gene loci, and this may contribute to the development of psoriasis, but also excess adiposity and psoriasis has been investigated that could predict which patients are at risk of developing psoriasis-linked cardiovascular comorbidities may permit an earlier management, with important clinical implications. This study aimed to evaluate the potential contribution of four IL-6 genetic variants (rs1800795[-174G>C], rs1800796[-572G>C], rs2069827[-1426G>T], rs2069840[-1753C>G]) in psoriasis susceptibility and its influence in EAT and coronary artery calcification (CAC) in severe psoriasis patients.
- Influence of TNF-α gene polymorphisms in coronary artery calcification in psoriasis patientsPublication . Torres, T.; Bettencourt, N.; Ferreira, J.; Carvalho, C.; Mendonca, D.; Pinho-Costa, P.; Vasconcelos, C.; Selores, M.; Silva, B.Psoriasis is a systemic inflammatory disorder associated with numerous medical comorbidities and increased risk of cardiovascular disease (CVD. Psoriasis’ systemic inflammation may play an important role in the accelerated atherosclerosis observed in these patients2 as inflammatory processes play a key role in atherogenesis. Psoriasis and atherosclerosis share some pathological features including endothelial dysfunction, alteration in angiogenesis and some inflammatory pathways. TNF-a is a potent pro-inflammatory cytokine that has been implicated in psoriasis and atherosclerosis pathogenesis and its synthesis is tightly regulated at gene transcription level. TNF-a gene promoter region contains several single-nucleotide polymorphisms (SNP) that influence TNF-a production. Several TNF-a gene polymorphisms have been associated with psoriasis and CVD. A recent meta-analysis suggested that TNF-a rs1800629(308G/A) polymorphism was associated with decreased risk of psoriasis, whereas TNF-a rs361525(238G/A) was associated with increased risk. Regarding TNF-a rs1799964 (1031T/C) polymorphism, existing data are limited and contradictory.8 Since psoriasis morbidity and mortality are strongly linked to accelerated atherosclerosis, determining the genetic contribution for cardiovascular morbidity in psoriasis patients becomes an issue of major importance. The aim of this study was to evaluate the contribution of TNF-a rs361525(238G/A), TNF-a rs1800629(308G/A) and TNFa rs1799964(1031T/C) gene polymorphisms to coronary artery calcification (CAC) in severe psoriasis patients.
- Integrating health on air quality assessment--review report on health risks of two major European outdoor air pollutants: PM and NO₂Publication . Costa, S.; Ferreira, J.; Silveira, C.; Costa, C.; Lopes, D.; Relvas, H.; Borrego, C.; Roebeling, P.; Miranda, A.I.; Teixeira, João PauloQuantifying the impact of air pollution on the public’s health has become an increasingly critical component in policy discussion. Recent data indicate that more than 70% of the world population lives in cities. Several studies reported that current levels of air pollutants in urban areas are associated with adverse health risks, namely, cardiovascular diseases and lung cancer. IARC recently classified outdoor air pollution and related particulate matter (PM) as carcinogenic to humans. Despite the air quality improvements observed over the last few years, there is still continued widespread exceedance within Europe, particularly regarding PM and nitrogen oxides (NOx). The European Air Quality Directive 2008/50/EC requires Member States to design appropriate air quality plans for zones where air quality does not comply with established limit values. However, in most cases, air quality is only quantified using a combination of monitored and modeled data and no health impact assessment is carried out. An integrated approach combining the effects of several emission abatement measures on air quality, impacts on human health, and associated implementation costs enables an effective cost–benefit analysis and an added value to the decision-making process. Hence, this review describes the basic steps and tools for integrating health into air quality assessment (health indicators, exposure-response functions). In addition, consideration is given to two major outdoor pollutants: PM and NO2. A summary of the health metrics used to assess the health impact of PM and NO2 and recent epidemiologic data are also described. Over the years, air pollutants have been related to a wide range of adverse health effects usually expressed in several mortality and morbidity endpoints (Figure 1). A growing body of epidemiological and clinical evidence led to a heightened concern regarding the potential effects of outdoor air pollution on cardiovascular system, particularly in relation to heart disease, myocardial infarction, and stroke (Brook et al., 2004; Cheng et al., 2009). Moreover, an increased risk of lung cancer associated with exposure
- Nutritional evaluation of branded bakery and pastry products available in the Portuguese marketPublication . Albuquerque, T.G.; Ferreira, J.; Silva, M.A.; Costa, H.S.Branded bakery and pastry products are greatly appreciated by the population, especially by the youngest ones. However, these products are often considered poor from a nutritional quality point of view because they are a source of fat, saturated fat, sugar, and salt. A high intake of these foods is considered a major risk factor for the development of non-communicable chronic diseases, such as obesity, diabetes, hypertension, cancer, among others. This study aimed to develop a branded food database for bakery and pastry products, to assess the current situation on nutritional quality and to define further needs in terms of reformulation. Between January and March of 2023, a branded food database with data for 1062 products was developed by compiling the existing information on the websites of major supermarket chains available in Portugal and websites of manufacturers and retailers. The collected information was analysed regarding: i) evaluation of nutritional adequacy; ii) application of traffic light system; and iii) application of Nutri-score. After data cleaning and checking the absence of nutrition declaration, 966 foods were evaluated. Salt was above 0.3 g/100 g in 88.7% of the products and sugars were higher than 5 g/100 g in 79.1% of the products, which are goals of the Integrated Strategy for the Promotion of Healthy Eating, in Portugal. In the traffic light label analysis, the following percentages of foods are marked with red, meaning a high content: 53.5% for fat, 56.8% for saturated fatty acids, 53.9% for sugars and 9.4% for salt. According to Nutri-Score, 34.6% of the products are classified as “E” and 36.7% as “D”, indicating the poorest nutritional foods. It is of utmost importance to follow up this study and include other categories of foods. Moreover, strategies for the reformulation of bakery and pastry products to promote public health are still needed.
- Serão as bolachas de arroz ou de milho, numa perspetiva de saúde pública, uma opção alimentar no lanche escolar saudável?Publication . Albuquerque, T.G.; Bento, A.; Silva, M.A.; Ferreira, J.; Costa, H.S.A prática dos hábitos alimentares saudáveis deve ser promovida, constituindo um alicerce essencial para a promoção da saúde pública. A escola constitui um local privilegiado para promover hábitos alimentares saudáveis e para melhorar o nível de literacia. Os lanches escolares são muitas vezes preparados pelas famílias das crianças, e por vezes apresentam uma qualidade nutricional pobre, sendo constituídos por alimentos de elevada densidade energética, ricos em sal, açúcar e gordura saturada. De acordo com a Direção-Geral da Saúde, um lanche saudável deve incluir leite e/ou derivados, fruta e cereais ou derivados. O objetivo deste trabalho foi avaliar a informação nutricional de bolachas de arroz ou milho com cobertura (BCC) e sem cobertura (BSC), e estimar o potencial impacto na saúde pública. Em 2023, foi desenvolvida uma base de dados através da consulta de websites de hipermercados e/ou produtores de bolachas de arroz ou milho. Nesta base de dados foi incluída, por exemplo, informação relativa aos ingredientes e declaração nutricional. Foi realizada uma análise detalhada da informação recolhida, considerando as orientações existentes, como a Estratégia Integrada para a Promoção da Alimentação Saudável (EIPAS), o descodificador de rótulos, o Nutri-Score e o Guia para lanches escolares saudáveis. Foram incluídos 65 tipos de bolachas (42 BSC e 23 BCC). 83% das BSC não cumprem a meta definida pela EIPAS para o sal (0,3 g/100 g) e 91% das BCC não cumprem a meta definida pela EIPAS para o açúcar (5 g/100 g). Após aplicação do descodificador de rótulos, verificou-se que para as BSC 17% são classificadas como tendo níveis altos de sal (>1,5 g/100 g). Nas BCC, 100%, 74% e 61%, têm níveis altos de ácidos gordos saturados (>5 g/100 g), de açúcares (>22,5 g/100 g) e de gordura (>17,5 g/100 g), respetivamente. O Nutri-Score permite classificar 69% das BSC em “A” ou “B” (melhor qualidade nutricional) e 100 % das BCC em “D” ou “E” (pior qualidade nutricional). O Guia para lanches escolares saudáveis, inclui uma lista de alimentos a privilegiar, a incluir de vez em quando e a evitar, de forma a tornar os lanches mais saudáveis e evitar a monotonia. Esta classificação, para o grupo dos cereais e derivados, baseia-se em critérios nutricionais para gordura, ácidos gordos saturados, ácidos gordos trans, açúcar, sal e fibra. Apesar das BSC poderem ser uma opção a privilegiar no lanche escolar saudável, verifica-se que apenas 26% cumprem o critério para o teor de fibra (>3 g/100 g) e que 29% e 21% não cumprem o critério para o sal (<1 g/100 g) e para a gordura (≤8 g/100 g), respetivamente. Este trabalho suporta a necessidade de continuarem a ser desenvolvidas estratégias baseadas na saúde em todas as políticas, com o envolvimento de todos os que possam contribuir para uma oferta alimentar mais saudável. Identifica-se ainda como primordial a necessidade de continuar a trabalhar na reformulação destes produtos alimentares, e de promover e motivar a literacia interpretativa da informação nutricional para pais e educadores.
- Towards a Global Perspective of Environmental Health: Defining the Research Grounds of an Institute of Environmental HealthPublication . Virgolino, A.; Antunes, F.; Santos, O.; Costa, A.; Gaspar de Matos, M.; Bárbara, C.; Bicho, M.; Caneiras, C.; Sabino, Raquel; Núncio, Sofia; Matos, O.; Santos, R. R.; Costa, J.; Alarcão, V.; Gaspar, T.; Ferreira, J.; Carneiro, A. V.Environmental health is at the intersection between health and the environment. However, it still has a recent (and narrow) history as a scientific area, mainly addressing human biomonitoring and toxicological issues. Only recently additional environmental ‘layers’, other than the traditional chemical, biological and physical environmental determinants, have been considered. This broader perspective of environmental health also encompasses digital, psychosocial, political, socioeconomic and cultural determinants, all of them relevant when considering human health from a planetary health paradigm. This reflects the progressive adoption of a systemic perspective regarding the impact of gains for human health and well-being towards a sustainable environment. It also implies a multi-method and participatory approach to understand the intertwined relationship between environmental changes and human health. In this paper, the broader approach to environmental health is discussed in order to ‘set the stage’ for introducing the Institute of Environmental Health (ISAMB)oftheLisbonSchoolofMedicine,Portugal. Eachoftheresearchgroupsandlabsthatcompose ISAMB are presented, as well as their main lines of research. Present and planned contributions of ISAMB to advance knowledge on environmental health and for promoting human health gains in an environmentally sustainable way are also discussed.