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- Development of a new computer program to assess food consumption in Portuguese school-age children: a qualitative approach for identifying food itemsPublication . Carvalho, Maria Ana; Santos, Osvaldo; Rito, Ana Isabel; Pereira Miguel, JoséIntroduction: Food and nutrition are important determinants of non-communicable diseases such as childhood obesity. Understanding how to prevent this major public health problem remains a research question and the design of potentially effective interventions is hampered by the general lack of good-quality data. There is no validated method available to assess food and nutrition intake in school age Portuguese children. A new engaging method for assessing food and nutrition intake of school age Portuguese children (7-10 years old) is currently being developed, based on a self-administered computerized 24-Hour Recall questionnaire. The purpose of this study was to select and identify questionnaire food items through a qualitative approach. Methods: 21 Focus Group were conducted in seven primary schools from the seven geographic regions of Portugal. The focus group were homogeneous for age (7 years, n=70; 8 years, n= 61; 9 years; n=73) and area of residence but heterogeneous for sex, social-economic and nutritional status. Children participated in focus group after parent’s written informed consent and school authorization. The focus group were moderated by Nutritionists and/or Psychologists. Topics for discussion were: (a) food consumption on the previous day; (b) problems regarding to the reporting consumption on the previous day; (c) comprehension of some food items; (d) food preferences. Focus group were audio-recorded and transcribed. The content analysis followed a thematic coding process. Results: Main meals, such as breakfast, lunch and dinner were generally easier to remember than secondary meals such as snacks. Children tended to underreport the consumption of candies (either due to social desirability or to recall bias) and seem to remind better the consumption of this type of foods when there was a recall link between previous-day activities and food exposure/consumption. Overall, 4172 food items were identified and grouped into the following groups: 1) Grains (1147), 2) Diary (631), 3) Meat/seafood/eggs (578), 4) Drinks (451), 5) Vegetables (383), 6) Fruits (308), 7) Fats (150), 8) Beans and peas (25) and 9) Others (499). Regarding to drinks, 61.4% of the items correspond to soft drinks. Conclusion: This study proved the utility of the focus group methodology to obtain qualitative data about dietary intakes of children in the immediate past (24 hours). The identified items included both items that were part of previous checklists from other countries and many new items that are local-context specific. This pool of items will be used for building up the self-administered computerized 24-Hour Recall questionnaire.
- Family wealth inequalities in Portuguese children's health-related quality of life according to weight status - findings from COSI/WHO Europe studyPublication . Rito, Ana Isabel; Martins, Maria de Fátima; Gaspar, Marta; Bento, Alexandra; Abreu Santos, CristinaIntrodution: Health-Related Quality of Life (HRQoL) is a multidimensional concept encompassing aspects of quality of life that directly or indirectly relate to health, such as physical, psychological, and social well-being. The interplay between socioeconomic factors, like family earnings and weight status impacts children’s HRQoL, highlighting the importance of addressing these factors to promote health equity from an early age. Methods: This observational cross-sectional study analyzed data from the 6th WHO European Childhood Obesity Surveillance Initiative, the COVID study in Portugal, targeting primary school-age children. BMI was calculated using WHO reference growth charts for children, and data on children's HRQoL and family perceived wealth was obtained through a family form, reporting data during the COVID-19 pandemic (March 2020-June 2022). HRQoL was assessed using the KIDSCREEN-10 parent report, with Rasch scores calculated and transformed into T-scores. Higher values indicate higher levels of HRQoL. Family perceived wealth reflects how easily a family meets monthly expenses using their earnings. It is categorized as “low” (combining the answers “we have trouble meeting the end of the month with our earnings” and “we barely meet the end of the month with our earnings”), “medium” (“we meet the end of the month with their own earnings without serious problems”), and “high” (“we easily met the end of the month with their own earnings”). Results: Among the 3279 children analysed, 12.0% were classified as having obesity, with a higher proportion of boys (51.8%) than girls (48.2%). After adjusting for sex and age, the linear regression coefficients showed that family perceived wealth was positively associated with HRQoL in both groups (without obesity: medium compared with low 2.548, 95% CI: 1.398;3.699, p<0.001 and high compared with low perceived health 4.240, 95% CI: 2.953;5.527, p<0.001; with obesity: medium compared with low 3.671, 95% CI: 0.810;6.532, p=0.012 and high compared with low perceived health 3.850, 95% CI: 0.516;7.184, p=0.024). General linear regression also showed that family perceived wealth demonstrates a clear gradient effect in both groups. The differences in age and sex-adjusted mean scores between the lowest and the medium and higher perceived wealth levels were statistically significant for HRQoL scores (47.64 for high, p<0.001, 45.93 for medium, p=0.003, and 43.38, p<0.001, for low in children without obesity; 48.04, 47.85, and 44.19 respectively in children with obesity, with p=0.038 for the lowest category). Conclusion: Findings suggest that family perceived family wealth significantly influences children's HRQoL, regardless of BMI. The relationships between this factor and HRQoL emphasize the need for multifaceted interventions that address both family socioeconomic circumstances and weight status to improve children's health and well-being.
- Nanomaterials safety assessment: contribution from the Portuguese National Institute of Health (INSA) researchPublication . Albuquerque, José MariaThe National Health Institute Doutor Ricardo Jorge (INSA) is a public organization of the Portuguese Ministry of Health, which develops a triple role as State Laboratory in the health sector, National Reference Laboratory and National Health Observatory. All operative units composing the departments develop multidisciplinary programs in problem areas of Public Health, namely performing R&D, health monitoring, training, laboratory external quality assessment and general health services. INSA has been successful in leading and being partner of national and transnational research projects and initiatives in the nanosafety field.
- The development and validation of a novel computer program to assess food and nutrition intake in Portuguese schoolchildrenPublication . Carvalho, Maria Ana; Pereira Miguel, José; Rito, Ana IsabelIntroduction: Food and nutrition are important determinants of non-communicable diseases such as childhood obesity which is a public health priority. Understanding how to prevent it remains a research question. However the design of potentially effective interventions is hampered by the general lack of good-quality data available. There is no validated methodology available to assess food and nutrition intake in school age Portuguese children. The purpose of this study is to develop and validate, for the first time in Portugal, a novel engaging method of assessing food and nutrition intake of school age Portuguese children. Methods: A self-administered computerized 24-Hour Recall questionnaire will be designed to 7-10 years-old Portuguese children. The research will have the following chronological developmental phases: 1) Questionnaire food items selection and psychometric tests (reliability and validity tests) and 2) Pilot study (two days of dietary intake will be evaluated because one administration of the 24-Hour Recall is of little use in estimating children’s usual energy and nutritional intake). Results (expected): Developmental of a novel, valid and engaging method of assessing food and nutrition intake, set within a user-friendly interface and the collection of valid information about food and nutritional intake of school age Portuguese children. Conclusion: The design and implementation of this study will be an essential prerequisite for monitoring the nutritional status of school age Portuguese children as well as will lead to perform several epidemiological researches on the links between diet and health, which help develop sound public health policy, direct and design health programs.