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- Avaliação e Promoção da qualidade alimentar e nutricional de refeições escolares portuguesas - Programa Eat MediterraneanPublication . Rito, Ana; Dinis, Ana; Rascoa, Carla; Rodrigues, Susana; Stein-Novais, Camila; Mendes, Sofia; Maia, António; Luis, Sonia; Luciano, RicardoIntrodução: O Programa Eat Mediterranean: A Program for Eliminating Dietary Inequalities in Schools foi desenvolvido através de uma abordagem abrangente a nível individual e comunitário, centrada no ambiente escolar. A escola constitui um ambiente privilegiado para educação para a saúde, promoção de estilos de vida saudáveis e equidade social, assumindo igualmente a responsabilidade de assegurar uma oferta alimentar nutricionalmente equilibrada. Objetivos: Avaliar o impacto do programa Eat Mediterranean na qualidade nutricional da oferta alimentar nos refeitórios escolares em 3 Agrupamentos de Escolas dos municípios de Santarém e Alpiarça. Metodologia: Foram avaliadas qualitativamente, através da ferramenta Sistema de Planeamento e Avaliação de Refeições Escolares (SPARE), todas as ementas escolares (n=386) do ano letivo 2015/16 das escolas do ensino pré-escolar e 1.º ciclo do ensino básico (responsabilidade municipal); 2.º e 3.º ciclos do ensino básico e ensino secundário (responsabilidade da Direção-Geral dos Estabelecimentos de Ensino) e de uma escola de 2.º e 3.º ciclos com confeção própria (responsabilidade da Escola), num total de 25 escolas. Foram elaboradas novas ementas de acordo com os critérios SPARE, as quais foram implementadas, em 2016/17, nas escolas da responsabilidade dos Municípios e na escola com confeção própria. Resultados: Após a intervenção do Eat Mediterranean, a pontuação global SPARE das ementas da escola com confeção própria passou de 37% para 86,4%; nas escolas da responsabilidade dos Municípios de Santarém e Alpiarça, as pontuações globais SPARE passaram de 76,7% e 53,6%, respetivamente, para 88,2% e 100%, após a intervenção. Dos critérios SPARE não cumpridos na avaliação inicial e que passaram a estar cumpridos nas novas ementas implementadas destacam-se os associados à oferta de hortícolas, leguminosas, pescado e carnes brancas. Conclusões: O Eat Mediterranean demonstrou ter um impacto favorável na qualidade das refeições oferecidas nas escolas em estudo. As escolas devem assumir um papel determinante na promoção de estilos de vida saudáveis onde se incluem os princípios da Dieta Mediterrânica, assumindo-a de forma coerente através de uma oferta alimentar equilibrada e saudável, atuando no ambiente social e económico das populações mais desfavorecidas.
- 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.
- Evaluation of Portuguese Community Health Projects and initiatives within the European and National Healthy Cities NetworkPublication . Rito, Ana; Cardoso, Rafael; Portugal, Inês; Baleia, Joana; Bica, MargaridaIntroduction: Following the World Health Organization European Healthy Cities Network, the Portuguese Healthy Cities Network was formally created by municipalities equally committed to promote equity, health and quality of life through local action. Objectives: To evaluate the health promotion strategies and initiatives implemented at municipality level in the Portuguese Healthy Cities Network and to confirm if these were in line with the requirements of the Health 2020 policy integrated on Phase VI of European Healthy Cities Network (2014-2018). Methodology: An exploratory-descriptive methodological design was used and a semi-structured questionnaire, developed by the World Health Organization Regional Office for Europe, was applied to the 29 municipalities of the Portuguese Healthy Cities Network (2013) invited to participate. 22 (75.8%) healthy cities met the criteria and were included. Results: Programmes on promotion of physical activity were the most frequently implemented across the Portuguese Healthy Cities Network (81.8%). All municipalities (100%) reported that children (>5 years) were the main targeted group of Portuguese Healthy Cities Network initiatives, followed by elderly (95.5%), adolescents (86.4%) and adults (86.4%). Low levels (27% – 32%) of initiatives that engaged other stakeholders, were reported as well as there was lack of research projects related to health matters and established partnerships by the scientific community. Overall, there was a perception of a positive impact of the Portuguese Healthy Cities Network programmes as 50% of the municipalities reported a remarkable improvement in health and quality of life of the population. Conclusions: Although life-course initiatives addressing the major burden of diseases were implemented, a more comprehensive approach is needed to follow Health 2020 principles. Development and reinforcement of the Portuguese Healthy Cities Network programmes is still a challenge. It should cover different population groups in order to tackle social inequalities and it also demands new partnerships, new forms of communication, as well as monitoring and evaluation mechanisms in place.