Browsing by Issue Date, starting with "2023-11-21"
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- Anthropometric Indices and Cardiovascular Risk: A Cross-Sectional Study in PortugalPublication . Santos, Maria; Sousa-Uva, Mafalda; Namorado, Sónia; Gonçalves, Teresa; Matias Dias, Carlos; Gaio, VâniaIntroduction: The relationship between abdominal obesity and cardiovascular risk is well established. The objective of this study was to determine the best anthropometric index to assess cardiovascular risk in the Portuguese population aged 40-69 years. Materials and methods: Data from the 1st National Health Examination Survey 2015 were used. The analyzed anthropometric indices included Body Mass Index (BMI), Waist Circumference (WC), Waist-to-Height Ratio (WHtR), Waist-to-Hip Ratio (WHR), and A Body Shape Index (ABSI). The subsample consisted of 2780 individuals who met the inclusion criteria: aged 40-69 years, not pregnant, available information on sex, age, smoking status, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, and anthropometric measures (weight, height, WC, hip circumference). Individuals receiving cancer treatment were not included in the study. Those with a previous diagnosis of acute myocardial infarction, stroke, diabetes, chronic kidney disease, or undergoing medication therapy for these conditions were excluded from the analysis due to their already high or very high cardiovascular risk, being the use of SCORE2 inappropriate. The area under the curve (AUC) of the receiver operating characteristic (ROC) was calculated, stratified by sex, to determine the best index for assessing cardiovascular risk. Results: In females, WHR exhibited the highest discriminatory power with an AUC of 0.67 (95% CI: 0.63 to 0.71), closely followed by WHtR with an AUC of 0.66 (95% CI: 0.61 to 0.70) and ABSI with an AUC of 0.65 (95% CI: 0.60 to 0.70). In males, WHtR displayed the highest discriminatory power with an AUC of 0.64 (95% CI: 0.59 to 0.68), closely followed by WHR with an AUC of 0.63 (95% CI: 0.58 to 0.67), and WC had an AUC of 0.62 (95% CI: 0.57 to 0.67). Discussion: Previous research has produced diverse findings regarding the choice of anthropometric indices, with variations across genders. In the present study the AUC values for the analyzed indices encountered for both genders had overlapping confidence intervals, indicating no statistically significant difference in predictive power. Conclusion: In women, the best index was WHR, and in men it was WHtR. However, due to a lack of statistical significance, it was not possible to determine which index had the best predictive ability. Nevertheless, this doesn't invalidate the previously well-established link between abdominal obesity and cardiovascular risk. Cardiovascular disease has a multifactorial etiology, and attempting to find only one variable that predicts the risk of a cardiovascular event can be overly simplistic and limiting.
- 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.
- Vigilância do vírus sincicial respiratório em crianças menores de 2 anos em Portugal, 2022/23Publication . Guiomar, Raquel; Verdasca, Nuno; Melo, Aryse; Gomes, Licínia; Henriques, Camila; Dias, Daniela; Lança, Miguel; Torres, Ana Rita; Pernadas, Bernardo; Gaio, Vânia; Rodrigues, Ana PaulaO vírus sincicial respiratório (Respiratory Syncytial Virus - RSV) é um dos principais agentes etiológicos de infeções respiratórias do trato respiratório inferior, com elevado impacto na morbilidade e mortalidade em crianças menores de 5 anos. É por isso considerado um problema de saúde pública pela Organização Mundial de Saúde, com prioridade na vigilância e prevenção. Este trabalho pretende descrever e caraterizar os casos de infeção por RSV identificados no sistema de vigilância VigiRSV durante a época 2022/23.
- Prevalence of abdominal obesity in the Portuguese populationPublication . Santos, Maria; Sousa-Uva, Mafalda; Namorado, Sónia; Gonçalves, Teresa; Matias Dias, Carlos; Gaio, VâniaIntroduction: Overweight and obesity cause 1.2 million deaths annually and contribute to 7% of Years Lived with Disability in the World Health Organization (WHO) European Region, increasing the risk of cardiovascular diseases, diabetes, and various cancers. This study aimed to estimate and characterize the prevalence of abdominal obesity (AO) in the Portuguese population aged 25-74 years in 2015, using different anthropometric measures as a proxy of AO: waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and a body shape index (ABSI). Materials and methods: Data from the 1st National Health Examination Survey (INSEF) in 2015 were used. The subsample consisted of 4812 individuals who met the inclusion criteria: age 25-74 years, absence of pregnancy and available data on anthropometric measurements (weight, height, WC, hip circumference). Individuals undergoing cancer treatment were excluded from the analysis. The prevalence of abdominal obesity was stratified by sex, age group, marital status, education level, occupational activity, degree of urbanization, health region, and income quintile. Results: In Portugal, in 2015, the prevalence of abdominal obesity according to each considered anthropometric measure was 40.3% (95% CI: 38.0 - 42.5), 43.6% (95% CI: 40.1 - 47.0), 65.2% (95% CI: 62.8 - 67.5) and 75.5% (95% CI: 74.1 - 76.9) when considering WC, ABSI, WHR and WHtR, respectively. The prevalence was higher in women for WC and ABSI, while it was higher in men for WHR and WHtR. The most affected individuals had 60-74 years old. Regarding education, the highest prevalence was observed among individuals with no formal education or only primary education. In terms of occupation, the prevalence was higher among individuals engaged in low-skilled occupations (e.g., farmers, industrial workers, and construction workers). These findings remain consistent, regardless of the index under consideration. Discussion: In 2015, INSEF reported 38.9% of Portuguese adults had overweight, and 28.7% were obese. According to the WHO European Regional Obesity Report 2022, Portugal had a 57.5% prevalence of overweight and 20.8% of obesity in 2016. Within the WHO European Region, 58.7% of adults were overweight, and 23.3% were obese. The high prevalence of abdominal obesity in Portugal is a significant public health concern and is in line with European Region obesity trends. To determine the most accurate anthropometric index for assessing abdominal obesity, further research using imaging methods like computed tomography and nuclear magnetic resonance would be essential among the INSEF 2015 participants, as no gold standard index currently exists. Conclusion: The prevalence of abdominal obesity ranged from 40.3% for WC to 75.5% for WHtR. Nonetheless, irrespective of the index employed, the prevalence remains significantly elevated. The prevalence of abdominal obesity was higher in older age groups, individuals with lower education levels, and those engaged in less skilled occupations. Early identification of abdominal obesity in Primary Healthcare is essential for the most susceptible groups, as well as providing nutritional support, mainly for individuals in socioeconomic vulnerability.