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- Food Choice, Nutrition, and Public HealthPublication . Santos, Mariana; Assunção, RicardoMaintaining a healthy diet throughout life helps prevent all forms of malnutrition, thereby reducing the risk of non-communicable diseases (NCDs) and related conditions . Dietary habits, lifestyle choices, and social factors significantly influence our health. Recently, we have seen shifts in food consumption patterns driven by various factors. These include the increased availability of processed foods, rapid urbanization, and changing lifestyles. The types, amounts, and frequency of consumed foods and beverages define dietary patterns, which have been evolving in recent decades due to the emergence of new or adapted eating habits. Common examples of dietary patterns include the ‘Western dietary pattern’ and the ‘Mediterranean dietary pattern’. Other significant patterns are the ‘prudent dietary pattern’, which emphasizes a high intake of vegetables, fruits, legumes, whole grains, fish, and seafood, and the ‘vegetarian/plant-based dietary pattern’, which entirely omits meat and animal products. Understanding the individual motives that drive certain food choices is crucial for changing consumption habits, promoting healthier behaviors, and fostering sustainability. This Editorial introduces the Special Issue “Food Choice, Nutrition, and Public Health” and highlights key topics on this subject.
- Surveying genetic markers of antibiotic resistance and genomic background in Chlamydia trachomatis: insights from a multiplex NGS-based approach in clinical strains from PortugalPublication . Lodhia, Zohra; da Silva, Jorge Costa; Correia, Cristina; Cordeiro, Dora; João, Inês; Carreira, Teresa; Schäfer, Sandra; Aliyeva, Elzara; Portugal, Clara; Monge, Isabel; Gonçalves, Elsa; Matos, Susana; Dias, Ana Paula; Côrte-Real, Rita; Carpinteiro, Dina; Duarte, Sílvia; Vieira, Luís; Gomes, João Paulo; Borges, Vítor; Borrego, Maria JoséObjectives: To survey genetic markers of potential antimicrobial resistance (AMR) to macrolides and fluoroquinolones among Chlamydia trachomatis–positive samples from the collection of the Portuguese National Reference Laboratory for Sexually Transmitted Infections (STIs), and explore a multiplex PCR approach coupled with NGS to provide complementary information regarding a strain’s genomic backbone. Methods: A total of 502 C. trachomatis–positive samples, mostly anorectal exudates, were subjected to PCR and sequencing of five targets, including loci potentially driving AMR (23S rRNA, gyrA and parC) and loci potentially informative about a strain’s genomic backbone with emphasis on differentiation of lymphogranuloma venereum (LGV)/non-LGV and L2/L2b (a 9 bp insertion in pmpH, a 74 bp insertion upstream from CT105 and the polymorphic CT442). Results: No samples evidenced 23S rRNA mutations recognizably linked to macrolide resistance. Three samples harboured the Ser83Ile mutation in GyrA putatively driving fluoroquinolone resistance: two recombinant L2-L2b/D-Da (0.4%) and one L2 (0.2%). The screened regions in pmpH, upstream CT105 and CT442 were fully concordant with LGV/non-LGV differentiation. As expected, the pmpH L2b-specific genetic trait locus was detected in all L2b and recombinant L2-L2b/D-Da ompA genotypes, but also in 96.0% of L2 specimens, which also likely possess an L2b genomic backbone. The insertion upstream from CT105 exhibited full LGV specificity, constituting a promising target for the development of rapid LGV diagnostic assays. Conclusions: This study contributes to enhancing the knowledge of C. trachomatis molecular epidemiology, suggesting that the known genetic determinants of AMR are not disseminated in clinical C. trachomatis strains, and presents an exploratory approach that can be suitable for LGV/non-LGV and L2/L2b genomic background differentiation.
- Aligning Present and Future Agrifood Systems: Integrating Sustainability and Health for Better ChoicesPublication . Assunção, Ricardo; Bento, AlexandraThe transition to sustainable food systems is essential to address global challenges such as climate change, biodiversity loss and public health crises. Current food production and consumption patterns contribute to environmental degradation, while dietary choices strongly influence health outcomes and planetary sustainability. Supporting dietary decisions with robust scientific evidence is therefore essential for meaningful and informed change. This work aims to discuss the intersection of food system transitions, dietary health impacts and sustainability, highlighting the importance of a comprehensive evidence-based approach to guide decisions at individual and systemic levels. By integrating methodologies such as Risk-Benefit Assessment (RBA) and Life Cycle Sustainability Assessment (LCSA), this study provides an approach to evaluating foods, dietary patterns and food choices. RBA considers risks (e.g. food contaminants) and benefits (e.g. beneficial nutrients), while LCSA assesses the environmental, social and economic dimensions of food production and consumption. Inspired by the ALTERNATIVA project , the integration of these two perspectives, complemented by additional tools such as Multi-Criteria Decision Analysis (MCDA), will be explored and synthesised. The combination of these methodologies enables a dual-angle approach that quantifies health outcomes alongside sustainability metrics, providing a framework for balancing dietary health benefits with sustainable food systems. This approach not only informs recommendations for healthier and more sustainable diets but also supports policymakers and stakeholders in developing strategies for food system transformation. By bridging gaps between food system actors and aligning public health goals with environmental sustainability, this evidence-based framework promotes a holistic vision for the agri-food sector and empowers consumers and stakeholders to make better choices that benefit both humans and the planet.
- European guidelines for the management of tuberculosis screening procedures in migrants: A systematic reviewPublication . Pinheiro, Marina; Valente, Carolina; Cruz, Margarida; Nascimento Moreira, David; Aguiar, Ana; Duarte, RaquelBackground: This systematic review assesses the current available evidence across the WHO European region on the effectiveness and cost-effectiveness of the different approaches used for TB screening and also explores the facilitators and barriers that migrants face during screening programmes. Methods: We conducted an extensive, comprehensive, and systematic literature search across multiple databases, including MEDLINE, Cochrane, Scopus, and ISI Web of Knowledge, without any restrictions on publication date or language. In addition, we reviewed grey literature and reports. The data were meticulously analysed with a focus on screening of TB active disease and infection effectiveness indicators, and cost-effectiveness economic analyses as a primary objective and the comprehension of barriers and facilitators of screening as a secondary objective. Findings: Our review included 43 studies covering over 8 million migrants from 11 countries. The findings demonstrate that while screening uptake was high, coverage varied, and completion rates for preventive treatments were low. Economic analyses supported the high cost-effectiveness of the screening programmes, particularly when integrating both active TB and TBI screening strategies. Interpretation: This review underscores the cost-effectiveness and public health importance of TB screening in migrant populations within Europe. However, the disparities in screening practices highlight the urgent need for standardisation at the European level.
- Harnessing Black Soldier Fly Larvae for Sustainable Food Waste Valorisation and Pathogen BioremediationPublication . Oliveira, Joana; Ligeiro, Carolina; Fantatto, Rafaela; Souza, Clarice; Grilo, Miguel L.; Carvalho, Carina; Trindade, Alexandre; Murta, Daniel; Assunção, RicardoFood waste is a pressing challenge for public health and environmental sustainability, with an estimated 59 million tonnes generated annually in the European Union. This substantial waste compromises the resilience of agrifood systems, intensifies food insecurity, and hampers efforts toward achieving a circular economy [2]. The insect Black soldier fly larvae (BSFL) present a promising and innovative approach to addressing these issues by efficiently converting organic waste into valuable outputs, such as high-protein animal feed and fertilisers. Despite the industrial valorisation of agricultural by-products, BSFL’s potential to fully utilise food waste remains subject to some legal restrictions. This study, conducted in collaboration with Ingredient Odyssey SA – EntoGreen, investigated the suitability of food waste as a substrate for BSFL production and assessed the larvae's bioremediation potential for reducing foodborne pathogens. An industrial-scale trial was performed over 14 days, using 114 test units with food waste-based substrates and 144 control units with Gainesville Diet, a standard insect feed. Two tonnes of food waste sourced from restaurants in Santarém, Portugal, were collected and prepared by removing physical contaminants such as plastic, cutlery, and cans. The food waste was then mixed with wheat bran, and its moisture was adjusted to 70% to create an optimal substrate. Measurements, including larval weight and substrate temperature, were taken every other day, while microbiological analyses followed ISO standards to detect pathogens and enumerate microorganisms. Results showed that food waste substrate significantly enhanced larval growth and bioconversion rates while bioremediating pathogens, including Bacillus cereus, Vibrio spp., and Salmonella spp. These results highlight the potential of BSFL to transform food waste into valuable resources while mitigating microbial risks, demonstrating a scalable and sustainable solution for food waste valorisation and contributing to a circular economy.
- Familial Hypercholesterolemia (FH): 25 Years Of Findings In The Portuguese FH StudyPublication . Miranda, Beatriz; Medeiros, Ana Margarida; Alves, Ana Catarina; Bourbon, MafaldaFamilial Hypercholesterolemia (FH) is a hereditary condition characterized by elevated LDL-C levels, which leads to increased risk of atherosclerosis and cardiovascular events. FH presents an estimated frequency of 1/300 and is expected to affect almost 33,000 Portuguese individuals. Therefore, this work summarizes the advances achieved in 25 years of diagnosis and investigation within the Portuguese FH Study (EPHF). A lipid profile and genetic diagnosis were performed for 1291 referred index cases fulfilling FH clinical criteria (523 children, 768 adults) and 2288 relatives. In 2017, a Next Generation Sequencing panel including FH genes (LDLR, APOB, PCSK9) and FH phenocopy genes (LDLRAP1, APOE, LIPA, ABCG5, ABCG8) was implemented. In approximately 40% (n=464) of the EPHF cohort, a genetic cause of FH was identified: 451 index cases with heterozygous FH (HeFH) and 13 with homozygous FH (HoFH). The majority of pathogenic variants were found in the LDLR gene (93%), compared with APOB (5%) and PCSK9 (2%) genes. Cascade screening allowed the identification of FH in 624 relatives (622 HeFH and 2 HoFH). Among adults with FH, 20% present cardiovascular disease (CVD) and 17% have premature CVD. Variants of uncertain significance in FH genes were identified in 63 index cases. Within 60% of the EPHF cohort (group of index cases where the genetic cause of hypercholesterolemia was not identified), 35% present hyper-Lp(a). Other monogenic causes of dyslipidemia were discovered during genetic analysis: 4 cases with lysosomal lipase deficiency (LIPA gene) and 4 cases with sitosterolemia (ABCG5 and/or ABCG8 genes). The genetic identification of FH corresponds to 3% of the expected number of individuals affected in Portugal. Nevertheless, other rare lipid metabolism disorders were identified. To overcome FH underdiagnosis in Portugal and to promote early diagnosis and treatment to prevent CDV complications, a cost-effective screening chip array is under development.
- Nutritional and Contaminant Analysis of Foods Ingested by Vegetarian Consumers: Total Diet Study ApproachPublication . Ventura, Marta; Gueifão, Sandra; Rego, Andreia; Delgado, Inês; Coelho, InêsDietary habits have changed over the years, with the popularity of vegetarian and vegan diets increasing [1]. Total Diet Studies (TDS) are a public health tool for assessing dietary exposure to contaminants and beneficial substances in foods [2]. This study aimed to determine the profile of micronutrients and inorganic contaminants in the Portuguese population's most commonly consumed plant-based foods. The sampling plan followed the TDS methodology, and a total of five main food groups were analysed: grains and grain-based products (n=48); milk and dairy products (n=60); products for non-standard diets, food imitates and food supplements (n=72); pulses, dried fruits, oilseeds and spices (n=132); and vegetables and vegetable products (n=12). The 324 individual samples collected were analysed as 27 pooled samples. Each sample was analysed by Inductively Coupled Plasma Mass Spectrometry for thirteen elements: arsenic, cadmium, chromium, cobalt, copper, iodine, lead, lithium, manganese, molybdenum, selenium, strontium, and zinc. The analytical results were obtained under quality assurance conditions supported by the requirements described in NP ISO/IEC 17025:2017. The results of this study indicated that some food samples from the group of pulses, dried fruits, oilseeds and spices had the highest content of manganese, zinc, molybdenum and selenium. On the other hand, products for non-standard diets and dairy products had the highest content of copper and iodine, respectively. The arsenic, cadmium, and lead levels were below the limit of quantification for the majority of samples analysed. The results demonstrated that while the consumption of 100 g of foods, like chia seeds, textured soy protein, and Brazil nuts, significantly exceeds the Dietary Reference Value for essential elements like copper, manganese, molybdenum, and selenium, others, particularly within dairy products, fall short of these nutritional benchmarks. This study revealed that the levels of inorganic contaminants (arsenic, cadmium and lead) in the analysed samples are safe for the Portuguese population.
- From waste to value: Antioxidant and antimicrobial properties of fresh and dried cardoon leaf extractsPublication . Barbosa, Cássia H.; Andrade, Mariana A.; Duarte, Maria Paula; Mateus, Ana Rita; Tomé, Sidney; Vilarinho, Fernanda; Fernando, Ana Luísa; Sanches Silva, AnaCynara cardunculus L. (cardoon) is a resilient perennial crop that is highly productive under extremely challenging conditions. Even though its flowers are used in the cheese-making process, its bioactive-rich leaves are largely discarded [1]. This study assessed the antioxidant and antimicrobial potentials of fresh and dried cultivated cardoon leaves (var. altilis DC) using ethanolic and methanolic extracts as well as the effects of oven-drying with forced air circulation on the bioactive profile. Dried leaf extracts showed better antioxidant activity than fresh leaf extracts, despite having a greater polyphenol profile. A total of 16 compounds were identified, and luteolin, apigenin, and chlorogenic acid were the most prevalent. The highest antioxidant activity was presented by dried leaf extracts for both the methanolic (EC50 = 0.8 mg/mL, AAC = 279.67) and ethanolic (EC50 = 2.1 mg/mL, AAC = 448.06) solvents. Gram-positive bacteria were more sensitive to ethanolic and methanolic extracts than Gram-negative bacteria. With lower minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values (125–2000 μg/mL) across most of the tested bacteria, the dried leaf ethanolic extract showed greater antimicrobial activity. Although Aspergillus fumigatus was only mildly inhibited, dried leaf extracts demonstrated superior antimicrobial effectiveness compared to fresh leaf extracts. These studies demonstrate the potential benefits of using dried cardoon leaves in the food, cosmetic, and pharmaceutical industries because of the bioactive components they have. These findings encourage sustainable production and consumption, which align with the goals of the United National Sustainable Development Goal 12, as well as the principles of circular economy. Cardoon leaves can be further transformed into relevant products in the current industrial world while simultaneously ensuring economic and environmental sustainability.