Browsing by Author "Rascôa, Carla"
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- Avaliação da intervenção qualitativa na composição nutricional de refeições escolares: programa Eat MediterraneanPublication . Santos, Mariana; Mendes, Sofia; Dinis, Ana; Rascôa, Carla; Rito, Ana IsabelO programa de intervenção comunitária Eat Mediterranean: a program for eliminating dietary inequality in schools (EM), promovido pela Administração Regional de Saúde de Lisboa e Vale do Tejo, teve como objetivo contribuir para a redução das desigualdades nutricionais em meio escolar, através da promoção da Dieta Mediterrânica enquanto estilo de vida saudável e com um padrão alimentar mediterrânico. O presente artigo refere-se à avaliação da composição nutricional das refeições escolares, antes e após intervenção deste programa, relativamente às recomendações nutricionais estabelecidas para a população em estudo. Na fase de diagnóstico as refeições avaliadas apresentaram um desvio negativo, para os teores de energia e hidratos de carbono para os grupos 6-10 e 16-21 anos (com e sem pão nas refeições), mantendo-se esta tendência para as outras faixas etárias, particularmente para as refeições sem pão. Em contraste, com exceção da faixa etária dos 16-21, observaram-se desvios tendencialmente positivos para os teores de proteína, relativamente às recomendações nutricionais estabelecidas para a população em estudo. Os teores de sal apresentaram desvios diferentes para as diferentes faixas etárias, sendo estes superiores a 40% para a faixa etária dos 2-5, quando comparados com o valor da dose diária recomendada. Na fase pós-intervenção, conseguiram-se melhorias significativas nos teores de energia e hidratos de carbono para as faixas etárias dos 2-5 e 6-10 ano, nos valores de proteína manteve-se o desvio positivo e, no teor de sal, observou-se uma redução nos desvios obtidos para todas as faixas etárias. Quanto ao valor de gordura esteve sempre dentro dos intervalos de referência, na fase de diagnóstico e intervenção. O programa EM demonstrou ter um impacto positivo na qualidade nutricional das refeições escolares disponibilizadas, embora os aspetos relacionados com a redução do teor de sal, a oferta de quantidades adequadas de proteína e hidratos de carbono, bem como a porção servida à respetiva faixa etária, precisem de ser acompanhados, ajustados e reavaliados
- Improving breakfast patterns of portuguese children - an evaluation of ready-to-eat cereals according to the European nutrient profile modelPublication . Rito, Ana; Dinis, Ana; Rascôa, Carla; Martins, Inês; Santos, Mariana; Lima, João; Mendes, Sofia; Padrão, Joana; Seint Novais, CamilaBackground/objectives: Ready-to-eat cereal (RTEC) breakfasts have been increasing in Portugal, among children. Eat Mediterranean (EM), a Portuguese comprehensive community-based intervention, proposed to improve breakfast patterns of children and adolescents and to evaluate the healthiness of RTEC according to WHO/Europe nutrient profile model (Euro- NP). Subjects/methods: EM Program was developed during two scholar years (15/16 and 16/17) toward 2333 students (pre to secondary education). Data on breakfast was provided using a family record form. The intervention consisted of 257 educational sessions addressing the principles of Mediterranean Diet, and promoting a “healthy breakfast at home”. To check for compliance with Euro-NP, RTEC package food labels’ nutritional composition was used. Results: After intervention 92.9% of children/adolescents had breakfast daily with no report of breakfast skippers. RTECs were one of the most frequent (66.5%) breakfasts. Statistically significant improvements were showed for: daily qualitative and complete breakfast frequency (5.6%) and fruit (11.2%). Consumption of RTEC decreased 28%. According to Euro-NP, 84.6% of the RTECs were non-compliant, regarding sugar content. Children’s RTECs presented 5% more of energy and 26% more sugar than the “non-children’s” RTECs. Conclusion: EM strategy showed to be a successful program to improve patterns and quality of breakfast of the children and adolescents, reinforcing the importance of school-based nutritional programs in changing lifestyles. Nutrient profiling can be a useful tool to provide a selection of foods to be part of a healthy diet and can be used by policymakers to design policies to identify the foods to which marketing restrictions to children, will apply.
- Mediterranean Diet Index (KIDMED) adherence, socioeconomic determinants, and nutritional status of Portuguese children: the Eat Mediterranean ProgramPublication . Rito, Ana; Dinis, Ana; Rascôa, Carla; Maia, António; Mendes, Sofia; Stein-Novais, Camila; Lima, JoãoBackground: Despite its health benefits, adherence to the Mediterranean diet (MD) has been decreasing, particularly in young generations and in Mediterranean regions, including Portugal. Socioeconomic and lifestyle factors have been shown to influence children and adolescents’ eating habits. This study aimed to assess the association between socioeconomic factors and children’s nutritional status with the MD adherence using the Eat Mediterranean (EM) program. Methods: Participant’s BMI and adherence to the MD diet was assessed at baseline and after the intervention. Data regarding socioeconomic status and KIDMED Index were collected using a family record form. The intervention consisted of various educational sessions addressing the principles and promoting a Mediterranean dietary pattern in schools belonging to two municipalities in the central area of Portugal. A total of 1,772 participants (from preschool to secondary school) met the inclusion criteria for the study. Results: At the end of the program, the adherence to the MD diet improved significantly with participants increasing their adherence to an optimal diet by 17.6%. Daily intake of foods belonging to the MD diet also increased significantly, and the intake of high energy density foods decreased. Mother’s educational level and household income were significantly (p < 0.0001) associated with optimal MD adherence by participants, in both stages. Nutritional status was not associated with the KIDMED Index. Discussion: The EM program showed to be effective in increasing MD adherence in this study population since optimal MD adherence was reported in most participants at the end of the EM program. Household income and mother’s educational level were positively associated with the diet quality of the children and adolescents.
- Salt Reduction Strategies in Portuguese School Meals, from Pre-School to Secondary Education-The Eat Mediterranean ProgramPublication . Rito, Ana Isabel; Mendes, Sofia; Santos, Mariana; Goiana-da-Silva, Francisco; Cappuccio, Francesco Paolo; Whiting, Stephen; Dinis, Ana; Rascôa, Carla; Castanheira, Isabel; Darzi, Ara; Breda, JoãoHigh sodium (salt) consumption is associated with an increased risk of developing non-communicable diseases. However, in most European countries, Portugal included, sodium intake is still high. This study aimed to assess the sodium content of school meals before and after the Eat Mediterranean (EM) intervention-a community-based program to identify and correct nutritional deviations through the implementation of new school menus and through schools' food handlers training. EM (2015-2017) was developed in 25 schools (pre to secondary education) of two Portuguese Municipalities, reaching students aged 3-21 years old. Samples of the complete meals (soup + main course + bread) from all schools were collected, and nutritional quality and laboratory analysis were performed to determine their nutritional composition, including sodium content. Overall, there was a significant decrease (-23%) in the mean sodium content of the complete school meals, which was mainly achieved by the significant reduction of 34% of sodium content per serving portion of soup. In conclusion, EM had a positive effect on the improvement of the school meals' sodium content, among the participant schools. Furthermore, school setting might be ideal for nutrition literacy interventions among children, for flavors shaping, and for educating towards less salty food acceptance.