Percorrer por autor "Gaspar, Marta"
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- Abordagem da obesidade infantil através do Objetivo de Desenvolvimento Sustentável 3 – Saúde e Bem-Estar : a contribuição do Centro Colaborativo da OMS para Nutrição e Obesidade InfantilPublication . Rito, Ana; Gaspar, Marta; Alvito, Paula; Bento, Alexandra; Santos, Cristina AbreuA obesidade infantil constitui um dos maiores desafios de saúde pública do século XXI e representa uma ameaça significativa para o cumprimento do Objetivo de Desenvolvimento Sustentável 3 (ODS 3) – Saúde e Bem-Estar, definido pela Agenda 2030 das Nações Unidas. Este artigo analisa criticamente a relação entre a obesidade infantil e o ODS3, com especial enfoque no papel desempenhado pelo Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA), enquanto Centro Colaborativo da Organização Mundial da Saúde (OMS) para Nutrição e Obesidade Infantil (CCOMS). Foi realizada uma revisão da literatura científica publicada entre 2020 e 2025, tendo sido identificadas 379 publicações das quais 19 artigos científicos sujeitos a arbitragem por pares foram incluídos na análise final. Seis estudos forneceram evidência direta sobre a relação entre obesidade infantil e o ODS 3, com particular ênfase na meta 3.4, evidenciando a obesidade infantil como fator determinante nas doenças não transmissíveis sublinhando a relevância de dados epidemiológicos e reforçando a necessidade de estratégias intersetoriais e prevenção e promoção da saúde. Os resultados destacaram ainda a escassez de literatura abrangente que articule soluções sustentáveis para a obesidade infantil em consonância com as metas do ODS 3. O CCOMS enquanto centro de vigilância nutricional infantil (com destaque para o estudo “Childhood Obesity Surveillance Initiative” (COSI) da OMS Europa), pelo seu apoio técnico e ação multissetorial e participação ativa na investigação e inovação científica, tem vindo a reforçar substancialmente o progresso em direção às metas do ODS 3. Em Portugal, os dados recentes do COSI revelam prevalências preocupantes de excesso de peso (31,9%) e obesidade (13,5%) em crianças, confirmando a urgência de medidas eficazes. Conclui-se que enfrentar a obesidade infantil é crucial para reduzir desigualdades em saúde e avançar no cumprimento do ODS 3, exigindo colaboração internacional e nacional, políticas públicas integradas e intervenções baseadas em evidência científica.
- Combate à desnutrição e à obesidadePublication . Rito, Ana Isabel; Gaspar, MartaA obesidade e a desnutrição não são realidades opostas – ambas fazem parte do espetro de malnutrição e podem coexistir no mesmo indivíduo, família ou comunidade/população Apesar de este ser um desafio, é também uma oportunidade para investir em estratégias integradas e medidas mais custo-efetivas que atuem simultaneamente no combate à desnutrição e à obesidade. São exemplos destas medidas o incentivo ao aleitamento materno, apoio nutricional na gravidez, promoção de uma alimentação complementar adequada, implementação de políticas alimentares e programas nas escolas e regulamentação do marketing alimentar. O combate à desnutrição e à obesidade em todas as fases do ciclo de vida deve ser um compromisso contínuo, público e multissetorial.
- Determinantes socioeconómicos, comportamentos de consumo e preocupação com o desperdício alimentar: perspetivas do programa Escola Missão Continente 2023/2024Publication . Filipe, Clara de Sousa; Marjineanu, Sandra; Martins, Maria de Fátima; Gaspar, Marta; Rito, AnaIntrodução: O desperdício alimentar é um dos desafios globais mais prementes, com implicações ambientais, sociais e económicas, estando frequentemente associado a fatores socioeconómicos, influenciando os comportamentos dos consumidores. Objetivo: Avaliar a relação entre fatores socioeconómicos (nível de escolaridade, ocupação profissional e o rendimento familiar percecionado), e os comportamentos de consumo de famílias portuguesas com a preocupação com o desperdício alimentar. Metodologia: Foi realizado um estudo observacional transversal, no âmbito do programa Escola Missão Continente-CEIDSS (EMC). O nível de escolaridade (“baixa” e “elevada”), rendimento familiar percecionado, que reflete a capacidade da família gerir o orçamento mensal (“baixo” e “elevado”) e ocupação profissional (“empregado” e “não empregado”) foram recolhidos através de um questionário aos Encarregados de Educação (EE) de crianças participantes no programa EMC no ano letivo 2023/2024. Foram ainda avaliadas a preocupação com o desperdício alimentar e os comportamentos de consumo das famílias, tais como planear as compras e as refeições, elaborar uma lista de compras, adquirir produtos da região/locais, e da época, procurar a origem do produto e prestar atenção aos prazos de validade (categorizadas em comportamento “pouco frequente” e “muito frequente”). Foi utilizado o Teste estatístico Qui-Quadrado de Pearson, com significado estatístico quando p<0,05, Resultados: Participaram no estudo 563 EE. Verificou-se uma associação significativa entre o rendimento familiar percecionado e a preocupação com o desperdício alimentar dos EE (p<0,001). A preocupação com o desperdício alimentar mostrou uma associação significativa com os comportamentos relativos ao consumo: “planear as compras e as refeições” (p<0,001); “elaborar lista de compras” (p<0,001); “adquirir produtos da região/locais” (p=0,024) “e da época” (p<0,001); “procurar origem do produto”(p=0,015) e “prestar atenção aos prazos de validade” (p<0,001). Conclusão: Este estudo sublinha a importância de implementar programas de nutrição de base comunitária que sensibilizem sobre o desperdício alimentar, designadamente dirigidos a famílias mais vulneráveis e de menor condição socioeconómica.
- Family wealth inequalities in Portuguese children's health-related quality of life according to weight status - findings from COSI/WHO Europe studyPublication . Rito, Ana Isabel; Martins, Maria de Fátima; Gaspar, Marta; Bento, Alexandra; Abreu Santos, CristinaIntrodution: Health-Related Quality of Life (HRQoL) is a multidimensional concept encompassing aspects of quality of life that directly or indirectly relate to health, such as physical, psychological, and social well-being. The interplay between socioeconomic factors, like family earnings and weight status impacts children’s HRQoL, highlighting the importance of addressing these factors to promote health equity from an early age. Methods: This observational cross-sectional study analyzed data from the 6th WHO European Childhood Obesity Surveillance Initiative, the COVID study in Portugal, targeting primary school-age children. BMI was calculated using WHO reference growth charts for children, and data on children's HRQoL and family perceived wealth was obtained through a family form, reporting data during the COVID-19 pandemic (March 2020-June 2022). HRQoL was assessed using the KIDSCREEN-10 parent report, with Rasch scores calculated and transformed into T-scores. Higher values indicate higher levels of HRQoL. Family perceived wealth reflects how easily a family meets monthly expenses using their earnings. It is categorized as “low” (combining the answers “we have trouble meeting the end of the month with our earnings” and “we barely meet the end of the month with our earnings”), “medium” (“we meet the end of the month with their own earnings without serious problems”), and “high” (“we easily met the end of the month with their own earnings”). Results: Among the 3279 children analysed, 12.0% were classified as having obesity, with a higher proportion of boys (51.8%) than girls (48.2%). After adjusting for sex and age, the linear regression coefficients showed that family perceived wealth was positively associated with HRQoL in both groups (without obesity: medium compared with low 2.548, 95% CI: 1.398;3.699, p<0.001 and high compared with low perceived health 4.240, 95% CI: 2.953;5.527, p<0.001; with obesity: medium compared with low 3.671, 95% CI: 0.810;6.532, p=0.012 and high compared with low perceived health 3.850, 95% CI: 0.516;7.184, p=0.024). General linear regression also showed that family perceived wealth demonstrates a clear gradient effect in both groups. The differences in age and sex-adjusted mean scores between the lowest and the medium and higher perceived wealth levels were statistically significant for HRQoL scores (47.64 for high, p<0.001, 45.93 for medium, p=0.003, and 43.38, p<0.001, for low in children without obesity; 48.04, 47.85, and 44.19 respectively in children with obesity, with p=0.038 for the lowest category). Conclusion: Findings suggest that family perceived family wealth significantly influences children's HRQoL, regardless of BMI. The relationships between this factor and HRQoL emphasize the need for multifaceted interventions that address both family socioeconomic circumstances and weight status to improve children's health and well-being.
- Fatores percecionados pelos encarregados de educação sobre o pequeno-almoço de crianças do 1º ciclo EB - programa MUN-SI Oeiras 2023/2024Publication . Alves, Carolina; Martins, Maria de Fátima; Gaspar, Marta; Rito, AnaIntrodução: O Programa MUN-SI desenvolve-se anualmente no Município de Oeiras em crianças do 3º e 4º ano de escolaridade do 1º ciclo do Ensino Básico, com o objetivo de promover atitudes e comportamentos mais saudáveis, ao nível dos hábitos alimentares. O consumo regular do pequeno-almoço (PA) tem sido associado à manutenção de um peso saudável, redução do risco de doenças cardiovasculares e benefícios cognitivos para as crianças. Apesar da maioria das crianças portuguesas consumirem esta refeição diariamente, existe ainda uma percentagem relevante de crianças que não o fazem. Objetivos: Analisar os fatores percecionados pelos Encarregados de Educação (EE) sobre o PA das crianças participantes no programa MUN-SI Oeiras 2023/2024 (MUNSI-O). Métodos: Estudo observacional transversal dirigido aos EE de crianças inscritas no MUNSI-O. As variáveis relacionadas sobre a importância, frequência e barreiras para a toma de PA pelas crianças, foram recolhidas através de um Questionário Família. Foram analisadas medidas de dispersão, frequências absolutas (n) e relativas (%). Resultados: Participaram no estudo 78 EE. Todos consideraram o consumo do PA importante para os seus educandos. A maioria dos EE (65,4%) oferece PA todos os dias aos seus educandos, enquanto 16,7% referiram nunca oferecer. As principais barreiras identificadas para a oferta do PA foram a falta de apetite das crianças pela manhã (15,4%) e falta de tempo dos EE (6,4%). A maioria dos inquiridos (76,9%), referiu não sentir nenhuma barreira e nenhum dos EE mencionou o seu próprio hábito de não tomar o PA como um impedimento para oferecer esta refeição às suas crianças. Conclusões: Os resultados deste estudo evidenciam a necessidade de desenvolver e implementar medidas abrangentes que promovam e facilitem o consumo do PA pelas crianças. A implementação de programas contínuos e abrangentes de nutrição comunitária nas escolas, como o MUN-SI, podem contribuir para a melhoria dos hábitos alimentares das crianças.
- Obesity and socioeconomic vulnerabilities: evidence from COSI Portugal supporting BETTER4U - a tailored approach to weight managementPublication . Rito, Ana; Martins, Maria de Fátima; Gaspar, Marta; Dedoussis, GeorgeIntroduction: Obesity remains a critical global health challenge, contributing to the rising prevalence of non-communicable diseases and imposing substantial burdens on public health systems worldwide. Understanding the determinants of obesity is essential for designing effective and inclusive interventions. The BETTER4U project (2023–2027) aims to develop and implement a personalized lifestyle intervention, by addressing the multifaceted determinants of adult obesity. Data such as those provided by the Childhood Obesity Surveillance Initiative (COSI) offer critical insights into these determinants, supporting the design of tailored interventions. Socioeconomic vulnerabilities, in particular, have been consistently identified as key determinants of obesity, requiring targeted strategies to address their impact. Methods: COSI, conducted by WHO, not only collects data on the nutritional status of children aged 6–8 years, but also gathers family-level information self-reported by parents, including parental nutritional status (calculated BMI, classified according to the WHO reference) and socioeconomic factors. This study utilized data from the 5th (2018/2019) and 6th (2021/2022) rounds of COSI in Portugal to perform a cross-sectional observational analysis exploring the association between adult obesity and vulnerability factors. Participants were categorized into groups based on sex (female vs. male) and the following socioeconomic variables: educational level (lower vs. higher education), perceived family wealth (experiencing financial difficulties vs. not experiencing financial difficulties), occupation (employed/student vs. unemployed/sick/disabled), and residential setting (urban vs. rural). The aim was to identify the determinants of adult obesity to support the design of BETTER4U’s personalized intervention strategies, which will be implemented in seven European countries, including Portugal. Results: Of the 9169 adults included in this analysis, 12.2% had obesity and 21.6% reported financial difficulties. A binary logistic regression was conducted, considering a significance level of p<0.05. After adjusting for confounding factors (age, sex, education level, occupation and residential setting), financial difficulties emerged as a significant predictor of obesity. Adults facing financial challenges were nearly twice as likely to have obesity compared to those without such difficulties (adjusted Odds Ratio [aOR]: 1.88, 95% Confidence Interval [CI]: 1.639–2.162; p<0.001). Conclusions: This analysis demonstrates the critical role of financial difficulties in shaping obesity outcomes among adults, emphasizing the need for inclusive, tailored interventions to address the needs of at-risk populations and providing a robust foundation for BETTER4U’s innovative and evidence-based strategies for weight management
- Portuguese Tax on sugar-sweetened beverages: children's consumption trends (COSI PORTUGAL 2019-2022) and social media advertisingPublication . Gaspar, Marta; Rito, AnaIntroduction: Reducing sugar consumption is a cost-effective strategy to combat childhood obesity. The World Health Organization (WHO) recommends fiscal policies, such as the increase of the price of sugar-sweetened beverages (SSBs) to reduce its intake. In Portugal, the SSB tax (2017 revised in 2019) led to declining sales and nutritional reformulation. The WHO´s Childhood Obesity Surveillance Initiative (COSI) Portugal provides data on SSB consumption trends among primary-school children, enabling policy evaluation. However, marketing remains a key driver of children's food choices, with SSBs heavily promoted on digital platforms. Aims: To analyze trends in children SSBs consumption, before and after the tax, and characterize SSB-related social media marketing content from the most advertised brands to children. Methodology: Data from COSI Portugal 2019 and 2022 (repeated cross-sectional design) were analyzed. Nationally representative samples of 6–8-year-old children completed a family questionnaire, reporting SSB consumption frequency. Additionally, using the WHO CLICK framework, the 21 most frequently advertised food and beverage brands to 3–16-year-old children sample were identified, and their Instagram posts (2022) were examined for SSB presence and compliance with the Portuguese Nutrient Profile Model (PT-NPM). Results: In 2019, 85.4% of children consumed SSBs, with 71.3% drinking up to 3 days/week (3dw) and 14.1% over 4 days/week (4+w). After the revised tax, in 2022, consumption slightly declined to 84.2% (69.1% 3dw and 15.1% 4+w). Regarding digital advertisements, 337 Instagram posts were analyzed, 106 contained foods/beverages classified under PT-NPM. Among them, 30 (28.3%) featured SSBs, yet only one met PT-NPM criteria. Conclusions: While the SSB tax implementation suggests a contribution to a reduction in consumption, intake remains high, in children. Additionally, SSBs continue to be marketed on digital platforms by brands exposed to children. These findings highlight the need for more comprehensive policy action including marketing regulations to protect children from exposure to SSB content.
- Relationship between children's dietary habits, screen time and overweight - Escola Missão Continente (EMC) programPublication . Gonçalves, Margarida; Martins, Maria de Fátima; Gaspar, Marta; Sousa, Bruno; Pêgo, Cíntia; Rossoni, Carina; Rito, AnaIntroduction: The prevalence of childhood overweight has been increasing in Portugal. This may be linked to poor dietary habits, sedentary behavior, and excessive screen time, key modifiable risk factors for childhood overweight. Aims: This study evaluated the relationship between dietary habits, screen time and the prevalence of overweight in children participating in Escola Missão Continente study (EMC) on the impact of a school-based nutrition education program for first to fourth-grade children (2021- 2025). Methodology: This cross-sectional study used data from EMC’s first year (2021-22). Children's weight and height were collected and classified as having overweight or not having overweight using WHO Growth Charts (5–19 years). Children´s dietary habits and screen time was assessed through a family questionnaire and food frequency responses were categorized as “healthy” or “less healthy.” “Less healthy” behaviors included not eating fresh fruit or vegetables daily and consuming ultra-processed foods (e.g., salty snacks) more than three days per week. Screen time was classified as “<2h/day” or “≥2h/day.” Results: The sample included 521 children (6-7 years old), with a 27.8% overweight prevalence. Chi-Square and Fisher tests (p<0.05) showed that children with ≥2h/day screen time had less healthy behavior regarding the consumption of salty snacks (7.3%) compared to those who spend less time on screens (2.4%, p=0.023). Additionally, children who spend more time on screens tend to have less healthy behavior regarding vegetable consumption (50.0%, p=0.010). Children with overweight showed a lower consumption of healthy fresh fruit (24.5% vs. 75.5%) and vegetable (23.1% vs. 76.9%) (p=0.002). Conclusion: There is a significant relationship between screen time, dietary habits, and overweight in primary school children. Increased screen time may relate to poorer dietary habits, while a diet rich in fruit and vegetables may lower overweight risk. These findings support future research and school-based nutrition interventions.
- Understanding the intergenerational impact of obesity in Portugal: data from COSI to support BETTER4U – an innovative European projectPublication . Rito, Ana; Gaspar, Marta; Martins, Maria de Fátima; Dedoussis, GeorgeIntroduction: Both childhood and adult obesity have been rising worldwide, as a global health challenge, with parental obesity identified as a key determinant of childhood obesity through genetic predisposition and shared obesogenic environments. This intergenerational link underscores the potential of interventions targeting adult obesity to disrupt the family cycle of obesity, such as the BETTER4U project (2023–2027), a personalized lifestyle intervention that aims to reduce obesity prevalence in adults, using artificial intelligence and evidence-based strategies. In this context, the WHO Childhood Obesity Surveillance Initiative (COSI) provides critical data on the nutritional status of children across Europe, including valuable insights into parental factors. These data form a vital foundation for interventions like BETTER4U, guiding their design and focus. Methods: COSI systematically collects comparable data every 2–3 years on the nutritional status of children aged 6 to 9 years across Europe. This data includes anthropometric measurements of children (weight and height), which are classified using the WHO Growth Reference Charts (5–19 years). Additionally, information on family and parental characteristics is gathered through self-reported data, including parental nutritional status (calculated BMI, classified according to the WHO reference) and socioeconomic factors. For this analysis, a cross-sectional observational study was carried out based on data from the 6th round of COSI (2021/2022) in Portugal to explore the association between parental and childhood obesity. The aim was to support the potential of the BETTER4U project, which involves 7 countries, including Portugal, to address obesity not only at the individual level but also within families by disrupting intergenerational patterns of obesity. Results: The sample included 4215 children and their parents. The prevalence of obesity was 12.9% among children and 13.7% among parents. A binary logistic regression was performed, considering a significance level of p<0.05. After adjusting for potential confounding factors, including sex and age of both children and parents, parental education level, and perceived family wealth, parental obesity was found to be significantly associated with childhood obesity. Children with parents with obesity were 2.65 times more likely to have obesity than children of parents without obesity (adjusted Odds Ratio [aOR]: 2.65; 95% Confidence Interval [CI]: 2.133–3.292; p<0.001). Conclusions: Parental obesity is a critical determinant of childhood obesity, underlining the importance of targeting parental factors in health interventions. By focusing on adult obesity, the BETTER4U project has the potential to not only reduce obesity prevalence in adults but also create positive effects within families.