Percorrer por autor "Rito, A."
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- Commercial baby foods available in the Portuguese marketplace and the application of Nutrient Profile Models – the compliance assessmentPublication . Santos, Mariana; Assunção, R.; Matias, F.; Castanheira, I.; Rito, A.; Loureiro, I.Background: Scientific evidence suggests that nutritional and metabolic exposure during critical periods of early human development (“the first 1000 days”) may have a long-term effect on health in adulthood. An investment in nutrition at the earliest possible stage, providing appropriate complementary feeding, is critical to ensuring growth and development and to prevent noncommunicable diseases (NCDs). Food and drinks high in fats, free sugars and salt are being marketed for consumption by young children and represent a particular concern. Aim: This study aims to determine the compliance of complementary foods (CACF) for infants and young children sold in the Portuguese marketplace according to the WHO draft Nutrient Profile model (NPM) for infants and young children between 6 and 36 months (1). Methods: A sample of 128 complementary foods (CACFs) for infants and young children was collected. Using nutritional food label information, a database was created. The products were divided into four food categories: dry, powdered and instant cereals, dry finger foods and snacks, meals with chunky pieces and soft–wet spoonable, ready-to-eat foods. Packaging information was used to determine sodium, fat and sugar content per 100 g product and percentage energy from total sugar by food category. Results: Twenty-eight products (22%) comply with all the criteria established in the NPM. All the evaluated dry, powdered and instant cereals, dry finger foods and snacks and meals with chunky pieces (n =55) comply with the recommendations proposed for total fat (≤4.5 g/100 kcal). Analysis of the energy contribution from total sugars reveals that 9 % (n=5) of dry finger foods and snacks comply with the proposed criteria of < 15% total energy from total sugars. For the 73 soft–wet spoonable, ready-to-eat foods assessed, 74 % (n=54) comply with the sodium thresholds of 50 mg/100 kcal, 64 % (n=47) had a content ≥ 60 Kcal/100 g product and 74 % (n=54) contained over 20% of energy derived from sugar. Conclusions: The commercial baby foods available in the Portuguese marketplace are characterised by products with high proportion of calories derived from sugar, promoting an environment that encourages development of sweet-taste preferences and adverse health outcomes resultant from the overconsumption of sugar in early life. This study provide policy-makers with data to design evidence-based nutrition policies supporting food product reformulation, to provide healthier options and preventing and controlling NCDs. Main Messages: There is an urgent need for updated regulations to support and guide product reformulation. A nutrient profile model for CACFs will establishes compositional thresholds and provides guidance on product-labelling and promotion
- 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
- Eat Mediterranean: um programa para reduzir desigualdades nutricionais em refeições escolaresPublication . Santos, Mariana; Dinis, Ana; Rito, A.Enquadramento do Projeto “Eat Mediterranean”: Intervenção comunitária para redução das desigualdades nutricionais em meio escolar de promoção da Dieta Mediterrânica; Pretendeu: - Constituir um modelo ecológico comunitário - Melhorar oferta alimentar - Reduzir desvios do Estado Nutricional nos alunos - Capacitar Comunidade Educativa e Profissionais de Saúde e Educação para a Dieta Mediterrânica; Estratégia de intervenção da OMS, priorizando o meio escolar, assente em rede de parcerias - saúde/educação/municípios; Alinhado com Programas Nacionais Promoção Alimentação Saudável e Saúde Escolar.
- Economics of Chronic Diseases Protocol: Cost-effectiveness modelling and the future burden of non-communicable disease in EuropePublication . Divajeva, D.; Marsh, T.; Logstrup, S.; Kestens, M.; Vemer, P.; Kriaucioniene, V.; Peresson, S.; O’Kelly, S.; Rito, A.; Webber, L.Background: The majority of chronic disease is caused by risk factors which are mostly preventable. Effective interventions to reduce these risks are known and proven to be applicable to a variety of settings. Chronic disease is generally developed long before the fatal outcome, meaning that a lot of people spend a number of years in poor health. Effective prevention measures can prolong lives of individuals and significantly improve their quality of life. However, the methods to measure cost-effectiveness are a subject to much debate. The Economics of Chronic Diseases project aims to establish the best possible methods of measuring cost-effectiveness as well as develop micro-simulation models apt at projecting future burden of chronic diseases, their costs and potential savings after implementation of cost-effective interventions. Method: This research project will involve eight European countries: Bulgaria, Finland, Greece, Lithuania, The Netherlands, Poland, Portugal and the United Kingdom (UK). A literature review will be conducted to identify scientific articles which critically review the methods of cost-effectiveness. Contact will be made health economists to inform and enrich this review. This evidence will be used as a springboard for discussion at a meeting with key European stakeholders and experts with the aim of reaching a consensus on recommendations for cost-effectiveness methodology. Epidemiological data for coronary heart disease, chronic kidney disease, type 2 diabetes and chronic obstructive pulmonary disease will be collected along with data on time trends in three major risk factors related to these diseases, specifically tobacco consumption, blood pressure and body mass index. Economic and epidemiological micro-simulation models will be developed to asses the future distributions of risks, disease outcomes, healthcare costs and the cost-effectiveness of interventions to reduce the burden of chronic diseases in Europe. Discussion: This work will help to establish the best methods of measuring cost-effectiveness of health interventions as well as test a variety of scenarios to reduce the risk factors associated with selected chronic diseases. The modelling projections could be used to inform decisions and policies that will implement the best course of action to curb the rising incidence of chronic diseases.
- Healthiness of Portuguese Ready to Eat Breakfast Cereals using three international nutritional profile modelsPublication . Santos, Mariana; Matias, Filipa; Calhau, Maria Antónia; Rito, A.; Loureiro, IsabelIn Portugal according the most recent Health Behaviour in School-aged Children study (HBSC) 90% of the boys and 91% of the girls aged 11 eat breakfast every weekday. Breakfast Cereals and Children's Cereals are included in the group of foods that contribute to the consumption of 30.7% of simple sugars, representing more than 10% of the energy intake in 15.4% of the national population. The nutritional quality of readyto- eat breakfast cereals (RTECs) is variable and can be considered as highly processed and to have higher contents in sugar, mainly those marketed to children. Nutrient profiling according World Health Organization (WHO) definition “is the science of classifying or ranking foods according to their nutritional composition for reasons related to preventing disease and promoting health”. The objective of this study was to compare the healthiness of RTECs by three existing nutrient profiling models, the EU Pledge system, the WHO-Euro model, and the UK model (Ofcom). We selected nutrient profiling models that were applied for different purposes and target groups to enhance the reliability of the results. A Convenient sample was drawn and data was collecting from three food retail chains in the Lisbon region. A total of 39 samples RTECs were evaluated using three nutrient profiling models. Nutrient content of energy (Kcal), saturated fat (g), sugar (g) and sodium (mg)/salt (g). was analysed per 100g of each product. For total sugar content, 56.4% (n=22) and 15.4% (n=6) of RTECs met the criteria EU Pledge system and WHO-Euro model, respectively. For sodium and salt 97% (n=38) of RTECs met the criteria for EU Pledge system and WHO-Euro model. All the RTECs analysed had higher OFCOM cut-off scores (≥4). Nutrient profiling models seem to be an important tool in supporting public health policies particularly the ones to evaluate and improve nutritional quality of foods.
- Sodium and Potassium Intake from School MealsPublication . Santos, Mariana; Nascimento, Ana C.; Santiago, S; Calhau, M.A.; Rito, A.; Loureiro, IsabelIntroduction: Children consume more than one-third of their daily food intake in schools, suggesting that these environments are ideal places for intervening on poor dietary behaviours. School meals play an important role in children’s diet especially for elementary school children aged from 6 to 9 years, to support normal growth, as well as the acquisition of taste and food preferences. Methodology: The purpose of this study was to determine the contribution of school meals to the daily sodium (Na) and potassium (K) intake and to evaluate the molar sodium: potassium (Na:K) ratio for the school meals. In this study, 19 school meals were collected from nineteen primary schools, located in two different cities in the Lisbon district. Analyses were carried out in accordance with ISO standard 17025. Sodium and potassium levels were determined using an Inductively Couple Plasma Atomic Emission Spectrometry–ICP-OES. To calculate the average molar Na:K ratio, sodium and potassium in micrograms (mg) were converted to millimoles (mmol) using the following conversion: 23 mg Na = 1 mmol Na, 39 mg K = 1 mmol K. Results: The Na content of the samples analysed ranging from 155 to 293 mg/100g and the K content between 98-193 mg/100g. The molar Na:K ratio exceeded the recommend level of 1, the values were between 2.2-4.3 (mmol). The results indicate that most of the school-meals presented a large amount of Na, but a small amount of K. In addition, the Na:K ratio is likely to be higher and doesn´t meet the World Health Organisation (WHO) recommendation for a Na:K ratio of ≤1. Conclusions: These data enhance the importance of planning the school meals to achieve a reasonable amount of sodium and potassium accordingly to the recommendations for children population and to make informed decisions on appropriate nutrition actions to reduce potential risks for noncommunicable diseases.
- Teores de sódio e açúcar em alimentos, destinados a lactentes e crianças jovens, disponíveis no mercadoPublication . Santos, Mariana; Matias, Filipa; Calhau, M.A.; Rito, A.; Loureiro, IsabelA alimentação desde o momento da conceção, ao longo da gravidez e nos primeiros dias de vida é considerada uma janela de oportunidades para a aquisição de hábitos alimentares saudáveis que poderão manter-se pela vida fora. A OMS recomenda que a amamentação seja exclusiva até aos 6 meses de idade, oferecendo inúmeros benefícios para o bebé e para a mãe. A alimentação complementar é essencial na transição de uma dieta líquida (leite materno ou fórmulas para lactentes) para uma dieta onde os alimentos sólidos são integrados gradualmente. Este tipo de alimentação contém uma ampla gama de sabores e texturas, abrangendo diversas categorias de alimentos e assegurando o fornecimento adequado de energia, proteínas, micronutrientes, necessários ao crescimento da criança. As crianças são um grupo vulnerável de consumidores que estão especialmente expostos aos meios modernos de marketing. Está provado que a publicidade influencia as preferências alimentares das crianças, como também os pedidos de compra e os padrões de consumo das crianças, pelo que há necessidade de desenvolver iniciativas que visem reduzir o impacto do marketing de alimentos com elevado teor em matéria gorda, sal e açúcar, para prevenir o excesso de peso e a obesidade infantil.
- 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.