Browsing by Author "Mota, Jorge"
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- Cancer Survivor Study (CASUS) on colorectal patients: longitudinal study on physical activity, fitness, nutrition, and its influences on quality of life, disease recurrence, and survivalPublication . Soares-Miranda, Luísa; Abreu, Sandra; Silva, Marco; Peixoto, Armando; Ramalho, Rosa; Correia da Silva, Pedro; Costa, Carla; Teixeira, João Paulo; Gonçalves, Carla; Moreira, Pedro; Mota, Jorge; Macedo, GuilhermePurpose: Evidence suggests that being physically active in combination with a healthy diet contributes to diminish colorectalcancerrisk.However,ifthisistruefor colorectalcancer primary prevention, the same is not clear for its recurrence after colorectal cancer treatments. Data on cancer survival are scarce, and there is a need for greater attention on these survivors’ lifestyle behavior. This manuscript describes rationale and design of the Cancer Survival Study (CASUS) on colorectalpatients,alongitudinalobservationalstudywiththe aim of investigating how physical activity, physical fitness, and dietary intakeare related with their quality of life, disease recurrence, and survival. Methods: The CASUS on colorectal patients is a longitudinal cohort study on colorectal survivors, aged 18 years or older, recruited 6,12,and 24 months after surgery.Upon recruitment, patients fill in a battery of questionnaires about physical activity, dietary intake, and quality of life, donate blood samples,do physical fitness tests, and use an accelerometer during 7 days. Repeated analyses will be performed to assess changes over time in physical activity, physical fitness, dietary intake, and other factors in relation t recurrence and survival. Conclusions: Results will contribute to highlight the role of physical activity, physical fitness, and nutrition in the quality of life of colorectal cancer survivors, recurrence, and survival. This study will provide important information for policy makers on the potential benefits of future physical activity and nutritional interventions, which are inexpensive, as a way to improve general health of colorectal cancer survivors.
- Inquérito Alimentar Nacional e de Atividade Física, IAN-AF 2015-2016: relatório de resultadosPublication . Lopes, Carla; Torres, Duarte; Oliveira, Andreia; Severo, Milton; Alarcão, Violeta; Guiomar, Sofia; Mota, Jorge; Teixeira, Pedro; Rodrigues, Sara; Lobato, Liliane; Magalhães, Vânia; Correia, Daniela; Carvalho, Catarina; Pizarro, Andreia; Marques, Adilson; Vilela, Sofia; Oliveira, Luísa; Nicola, Paulo; Soares, Simão; Ramos, ElisabeteEste relatório foi realizado com informação recolhida no âmbito do Inquérito Alimentar Nacional e de Atividade Física (IAN-AF 2015-2016), desenvolvido por um Consórcio que tem como Promotor a Universidade do Porto. O IAN-AF recebeu financiamento do Espaço Económico Europeu concedido pela Islândia, Liechtenstein e Noruega através do Programa EEA Grants - Iniciativas de Saúde Pública, área dos Sistemas de Informação em Saúde (PT06 - 000088SI3). O IAN-AF teve o apoio institucional da Direção-Geral da Saúde, da Administração Central do Sistema de Saúde, das Administrações Regionais de Saúde, das Secretarias Regionais de Saúde dos Açores e da Madeira e da Autoridade Europeia para a Segurança dos Alimentos.
- Inquérito Alimentar Nacional e de Atividade Física, IAN-AF 2015-2016: relatório metodológicoPublication . Lopes, Carla; Torres, Duarte; Oliveira, Andreia; Severo, Milton; Alarcão, Violeta; Guiomar, Sofia; Mota, Jorge; Teixeira, Pedro; Ramos, Elisabete; Rodrigues, Sara; Vilela, Sofia; Oliveira, Luísa; Nicola, Paulo; Soares, Simão; Frost Andersen, Lene; Consórcio IAN-AFO Inquérito Alimentar Nacional e de Atividade Física (IAN-AF) 2015-2016 teve como objetivo primário recolher informação de representatividade nacional e regional (dos 3 meses aos 84 anos de idade) sobre o consumo alimentar (incluindo a ingestão e suplementação nutricionais, a segurança dos alimentos e a insegurança alimentar) e sobre a atividade física (incluindo os comportamentos sedentários, as atividades desportivas/de lazer e as escolhas ativas na rotina diária) e a sua relação com determinantes em saúde, nomeadamente os socioeconómicos. O projeto foi desenvolvido por um Consórcio, envolvendo investigadores da Universidade do Porto (Promotor), da Universidade de Lisboa, do Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA), da Universidade de Oslo e da empresa SilicoLife. Os participantes foram selecionados aleatoriamente por um processo de amostragem bietápica, a partir do Registo Nacional de Utentes do Serviço Nacional de Saúde: i) seleção aleatória de Unidades Funcionais de Saúde em cada Unidade Territorial para Fins Estatísticos (NUTS II), ponderada para o número de inscritos; ii) seleção aleatória de indivíduos registados em cada Unidade Funcional de Saúde, com um número fixo de elementos por sexo e grupo etário. Avaliaram-se 6553 participantes através de uma entrevista presencial e destes, 5811 completaram as duas entrevistas previstas, intervaladas no tempo entre 8 a 15 dias e distribuídas ao longo de 12 meses (outubro de 2015 a setembro de 2016), incluindo as quatro estações do ano e todos os dias da semana, de forma a ajustar para a variabilidade intra-individual e para a sazonalidade dos comportamentos alimentares e de atividade física. A metodologia utilizada incluiu ferramentas e protocolos harmonizados no contexto Europeu, de acordo com o definido no inquérito pan-Europeu EU-MENU, promovido pela Autoridade Europeia para a Segurança dos Alimentos (EFSA), integrados numa plataforma eletrónica assistida por computador, especificamente desenvolvida (Plataforma “You eAT&Move”). O Módulo “You” permite a recolha de informação sociodemográfica, de saúde geral, de antropometria, de propensão alimentar e de insegurança alimentar. Os parâmetros antropométricos (peso, estatura, perímetros do braço, cintura e anca) foram objetivamente medidos de acordo com procedimentos padronizados. A insegurança alimentar foi avaliada através de uma adaptação do questionário desenvolvido por Cornell/Radimer (1990), que fornece estimativas a nível nacional de insegurança alimentar, para as famílias, com e sem menores de 18 anos, recolhendo informação sobre quatro dimensões subjacentes à experiência de insegurança alimentar: disponibilidade, acesso, utilização e estabilidade/resiliência. O módulo “eAT24” permite a recolha de informação alimentar através de dois questionários às 24 horas anteriores (ou diários alimentares de dois dias nas crianças com idade <10 anos), sincronizada com dados de composição nutricional dos alimentos e receitas da Tabela da Composição de Alimentos Portuguesa (INSA), adaptada. A quantificação de porções alimentares incluiu um manual fotográfico especificamente desenvolvido para o efeito (1006 fotos de alimentos e receitas e 11 fotos de medidas caseiras). A classificação e descrição dos alimentos foram realizadas com base no sistema FoodEx2. Esta informação permite caracterizar as dimensões de consumo alimentar e nutricional e de segurança dos alimentos. O módulo “Move” permite a recolha de informação de atividade física e inclui os sub-módulos International Physical Activity Questionnaire (IPAQ), Activity Choice Index (ACI) (≥ 15 anos) e diários de atividade física de 4 dias (2 dias consecutivos e 2 dias de fim de semana) em crianças e adolescentes (6-14 anos), sincronizados com os dados de equivalentes metabólicos associados aos diferentes tipos de atividades. Esta informação permite caracterizar as dimensões de comportamentos sedentários, atividades desportivas e escolhas ativas na rotina diária. A criação de evidência nacional, desagregada por áreas geográficas, para diferentes grupos populacionais (crianças, adolescentes, adultos, idosos), constitui uma base descritiva essencial para o planeamento em saúde. O conhecimento produzido pelo IAN-AF 2015- 2016 permite dar resposta a prioridades estratégicas em saúde, nacionais e internacionais, e constitui uma base sólida para o desenvolvimento de políticas de educação alimentar e de atividade física, bem como de políticas de segurança alimentar, em Portugal e na União Europeia.
- Medication use in older patients and age-blind approach: narrative literature review (insufficient evidence on the efficacy and safety of drugs in older age, frequent use of PIMs and polypharmacy, and underuse of highly beneficial nonpharmacological strategies)Publication . Fialová, Daniela; Laffon, Blanca; Marinkovic, Valentina; Tasic, Ljiljana; Doro, Peter; Sóos, Gyongyver; Mota, Jorge; Dogan, Soner; Jovana, Brkic; Teixeira, João Paulo; Valdiglesias, Vanessa; Costa, Solange; EUROAGEISM H2020 project and WG1b group “Healthy clinical strategies for healthy aging” of the EU COST Action IS 1402Introduction: The importance of rational drug therapy is increasing with the aging of the population. Since one of the main reasons for inappropriate drug prescribing is also the “age-blind” approach, which results in ageist practices, this narrative literature review focuses on the description of the main barriers related to insufficient individualization of drug regimens associated with such age-blind approaches. Methodology: A narrative literature review using the PubMed, WoS, Embase, and Scopus databases was conducted by the EU COST Action IS1402. Experts in different scientific fields from six countries (the Czech Republic, Spain, Portugal, Hungary, Serbia, and Turkey) worked in four specific areas: (1) underrepresentation of older adults in clinical trials and clinical and ethical consequences; (2) insufficient consideration of age-related changes and geriatric frailty in the evaluation of the therapeutic value of drugs; (3) frequent prescribing of potentially inappropriate medications (PIMs); and (4) frequent underuse of highly beneficial nonpharmacological strategies (e.g., exercise). Results: Older patients are underrepresented in clinical trials. Therefore, rigorous observational geriatric research is needed in order to obtain evidence on the real efficacy and safety of frequently used drugs, and e.g. developed geriatric scales and frailty indexes for claims databases should help to stimulate such research. The use of PIMs, unfortunately, is still highly prevalent in Europe: 22.6% in community-dwelling older patients and 49.0% in institutionalized older adults. Specific tests to detect the majority of age-related pharmacological changes are usually not available in everyday clinical practice, which limits the estimation of drug risks and possibilities to individualize drug therapy in geriatric patients before drug prescription. Moreover, the role of some nonpharmacological strategies is highly underestimated in older adults in contrast to frequent use of polypharmacy. Among nonpharmacological strategies, particularly physical exercise was highly effective in reducing functional decline, frailty, and the risk of falls in the majority of clinical studies. Conclusion: Several regulatory and clinical barriers contribute to insufficient knowledge on the therapeutic value of drugs in older patients, age-blind approach, and inappropriate prescribing. New clinical and observational research is needed, including data on comprehensive geriatric assessment and frailty, to document the real efficacy and safety of frequently used medications.
- National Food, Nutrition and Physical Activity Survey of the Portuguese general populationPublication . Lopes, Carla; Torres, Duarte; Oliveira, Andreia; Severo, Milton; Guiomar, Sofia; Alarcão, Violeta; Vilela, Sofia; Ramos, Elisabete; Rodrigues, Sara; Oliveira, Luísa; Nicola, Paulo; Mota, Jorge; Teixeira, Pedro; Soares, SimãoThe National Food, Nutrition and Physical Activity Survey of the Portuguese general population aimed to collect nationwide and regional data on dietary intake and physical activity, and their relation with health determinants, namely socioeconomic factors. Results from this project were obtained from a representative sample of the Portuguese population, aged between three months to 84 years of age, selected from the National Heath Registry, by multistage sampling (a sample size of 5068 individuals was estimated and 5811 participants with two dietary assessments were achieved). To accomplish the EFSA requirements, a minimum, of 260 individuals in each age group (130 by sex) was planned. Two face-to-face interviews were conducted at a health care centre or participant’s home. Dietary intake was obtained by two non-consecutive days of food diaries for children (<10 years old) and two non-consecutive 24-hours recalls for the older age groups, with a time interval between 8 and 15 days, complemented with a Food Propensity Questionnaire. An electronic platform based on a client-server architecture was used to manage the field work and to assist the data collection. The Electronic Assessment Tool for 24-hours recall (eAT24) allowed the collection of dietary data by an Automated Multiple-Pass Method for 24-hours. This interview-based dietary assessment instrument allowed obtaining a very detailed description and quantification of foods, recipes, and food supplements consumed in the course of the preceding day, and it had several adaptations, described in detail in this report. The survey outcomes support solid evidence-based information covering all age groups of the population, using harmonized methodologies at the European level, and will contribute to develop a national infrastructure for monitoring progress of specific targets supporting national and European policies and future interventions on diet, physical activity and food safety.
- National Food, Nutrition, and Physical Activity Survey of the Portuguese General Population (2015-2016): Protocol for Design and DevelopmentPublication . Lopes, Carla; Torres, Duarte; Oliveira, Andreia; Severo, Milton; Guiomar, Sofia; Alarcão, Violeta; Ramos, Elisabete; Rodrigues, Sara; Vilela, Sofia; Oliveira, Luísa; Mota, Jorge; Teixeira, Pedro J; Nicola, Paulo J; Soares, Simão; Andersen, Lene Frost; IAN-AF ConsortiumBACKGROUND: The assessment of food consumption data using harmonized methodologies at the European level is fundamental to support the development of public policies. Portugal is one of the countries with the most outdated information on individual foodconsumption. OBJECTIVE: The objective of this study was to describe the design and methodology of the National Food, Nutrition and Physical ActivitySurvey, 2015-2016, developed to collect national and regional data on dietary habits, physical activity (PA), and nutritional status, in a representative sample of the Portuguese general population (3 months-84 years). METHODS: Participants were selected by multistage sampling, using the National Heath Registry as the sampling frame. Data collection, during 12 months, was harmonized according to European guidelines (EU-MENU, European Food Safety Authority [EFSA]). Computer-assisted personal interviewing (CAPI) was performed on a specific electronic platform synchronized with nutritional composition data and considering the FoodEx2 classification system. Dietary assessment was performed using 24-hour recalls (two nonconsecutive, 8-15 days apart) or food diaries in the case of children aged <10 years, complemented with a food propensity questionnaire; PA data (International Physical Activity Questionnaire [IPAQ], the Activity Choice Index [ACI], and 4-days PA diaries); sociodemographic data, and other health-related data were also collected. RESULTS: A sample of 6553 individuals completed the first interview, and 5811 participants completed two dietary assessments. The participation rate among eligible individuals was 33.38% (6553/19,635), considering the first interview, and 29.60% (5811/19,635) for the participants with two completed interviews (about 40% in children and adolescents and 20% in elderly individuals). Results of the survey will be disseminated in national and international scientific journals during 2018-2019. CONCLUSIONS: The survey will assist policy planning and management of national and European health programs on the improvement of nutritional status and risk assessment related to food hazards, and the enhancement of PA. The infrastructures and data driven from this Survey are a solid basis to the development of a future national surveillance system on diet, PA, and other health behaviors reproducible over time.