A Web-Based Gamification Program to Improve Nutrition Literacy in Families of 3- to 5-Year-Old Children: The Nutriscience Project.

OBJECTIVE: Assess the impact of a web-based gamification program on nutrition literacy of families and explore differences in impact by socioeconomic status. DESIGN: Quasi-experimental. SETTING: Thirty-seven kindergartens from Portugal. PARTICIPANTS: Eight hundred seventy-seven families. INTERVENTION: Web-based social network of participants' interactions, educational materials, apps and nutritional challenges, focused on fruit, vegetables, sugar, and salt. MAIN OUTCOME MEASURES: Parental nutrition literacy (self-reported survey - 4 dimensions: Nutrients, Food portions, Portuguese food wheel groups, Food labeling). ANALYSIS: General linear model - Repeated measures was used to analyze the effect on the nutrition literacy score. RESULTS: Families uploaded 1267 items (recipes, photographs of challenges) and educators uploaded 327 items (photographs, videos) onto the interactive platform. For the intervention group (n = 106), the final mean (SD) score of nutrition literacy was significantly higher than the baseline: 78.8% (15.6) vs 72.7% (16.2); P < .001, regardless of parental education and perceived income status. No significant differences in the scores of the control group (n = 83) were observed (final 67.8% [16.1] vs initial 66.4% [15.6]; P = .364). CONCLUSIONS AND IMPLICATIONS: Gamified digital interactive platform seems to be a useful, easily adapted educational tool for the healthy eating learning process. Future implementations of the program will benefit from longer time intervention and assessment of the eating habits of families before and after intervention.

Food Insecurity in Older Adults: Results From the Epidemiology of Chronic Diseases Cohort Study 3.

Introduction: The public health problem of food insecurity also affects the elderly population. This study aimed to estimate the prevalence of household food insecurity and its associations with chronic disease and health-related quality of life characteristics in individuals ≥65 years of age living in the community in Portugal. Methods: The data were collected from the Epidemiology of Chronic Diseases Cohort Study 3 (EpiDoC3)-Promoting Food Security Study (2015-2016), which was the third evaluation wave of the EpiDoC and represented the Portuguese adult population. Food insecurity was assessed using a psychometric scale adapted from the Brazilian Food Insecurity Scale. The data on sociodemographic variables, chronic disease, and management of chronic disease were self-reported. Health-related quality of life were assessed using the European Quality of Life Survey (version validated for the Portuguese population). Logistic regression models were used to determine crude and adjusted odds ratios (for age group, gender, region, and education). The dependent variable was the perceived level of food security. Results: Among older adults, 23% were living in a food-insecure household. The odds of living in a food-insecure household were higher for individuals in the 70-74 years age group (odds ratio (OR) = 1.405, 95% confidence interval (CI) 1.392-1.417), females (OR = 1.545, 95% CI 1.534-1.556), those with less education (OR = 3.355, 95% CI 3.306-3.404), low income (OR = 4,150, 95% CI 4.091-4.210), and those reporting it was very difficult to live with the current income (OR = 16.665, 95% CI 16.482-16.851). The odds of having a chronic disease were also greater among individuals living in food-insecure households: diabetes mellitus (OR = 1.832, 95% CI 1.818-1.846), pulmonary diseases (OR = 1.628, 95% CI 1.606-1.651), cardiac disease (OR = 1.329, 95% CI 1.319-1.340), obesity (OR = 1.493, 95% CI 1.477-1.508), those who reduced their frequency of medical visits (OR = 4.381, 95% CI 4.334-4.428), and who stopped taking medication due to economic difficulties (OR = 5.477, 95% CI 5.422-5.532). Older adults in food-insecure households had lower health-related quality of life (OR = 0.212, 95% CI 0.210-0.214). Conclusions: Our findings indicated that food insecurity was significantly associated with economic factors, higher values for prevalence of chronic diseases, poor management of chronic diseases, and decreased health-related quality of life in older adults living in the community.

[Prevalence of overweight and obesity, and their relation to high blood pressure and central adiposity in students]. / Prevalencia de sobrepeso, obesidad y su relación con hipertensión arterial y centralización del tejido adiposo en escolares.

INTRODUCTION: Obesity is associated with a broad spectrum of cardiometabolic diseases that are also present in childhood. Objective. To estimate the prevalence of overweight and obesity in six- to nine- year old children and analyze their relation to high blood pressure (HBP) and central adiposity. METHODS: Cross-sectional study in 1st to 3rd graders. Weight, height, waist circumference and blood pressure were assessed. We calculated Body Mass Index, and estimated the prevalence of overweight and obesity. Statistical analysis was performed using the Epi Info 6.04 software. Statistical significance: p < 0.05. RESULTS: The general prevalence of overweight and obesity was 17.9% and 16.7%, respectively. Overweight was significantly higher in boys than in girls (p = 0.035); 9.4% of the population had high blood pressure, with no significant gender differences (9.1% and 9.7%). Prevalence of high blood pressure in overweight and obese children was 10.9% and 25%, respectively (p = 0,001). Waist circumference above the 80th percentile was 16.6% in overweight and 26.5% in obese children. The body mass index/waist circumference correlation coefficient was 0.79. CONCLUSION: This study shows a high prevalence of overweight and a positive association between body mass index or high blood pressure and central adiposity. Preventive measures to control overweight are imperative in the City of Santa Teresita.

Prevalencia de sobrepeso, obesidad y su relación con hipertensión arterial y centralización del tejido adiposo en escolares / Prevalence of overweight and obesity, and their relation to high blood pressure and central adiposity in students

Introducción. La obesidad ha sido vinculada a un gran espectro de alteraciones cardiometabólicasque se expresan también en la infancia.Objetivo. Estimar prevalencia de sobrepeso y obesidad en niños de 6-9 años. Analizar su relación con hipertensión arterial y centralizaciónadiposa.Métodos. Estudio de corte en escolares de 1er a 3er grado. Se evaluó peso, talla, circunferencia de cintura y tensión arterial. Se calculó el índice demasa corporal y se estimó la prevalencia de sobrepesoy obesidad. El procesamiento estadísticose realizó con Epi info versión 6.04. Significación estadística: p <0,05.Resultados. La prevalencia general de sobrepeso y obesidad fue de 17,9 por ciento y 16,7 por ciento, respectivamente. Los varones mostraron significativamente más sobrepeso que las niñas (p= 0,035). El 9,4 por ciento de la población presentó hipertensión, sin diferencias significativas de género (9,1 por ciento y 9,7 por ciento). La prevalenciande hipertensión en niños con sobrepeso ynobesidad fue de 10,9 por ciento y 25 por ciento, respectivamente (p= 0,001). La circunferencia de cintura superioral percentilo 80 fue de 16,6 por ciento en niños con sobrepeso y de 26,5 por ciento en los niños con obesidad. El coeficiente de correlación índice de masa corporal/circunferencia de cintura fue de 0,79.Conclusión. El estudio muestra una alta prevalencia de sobrepeso y una asociación positivaentre índice de masa corporal, hipertensión y centralización adiposa. Implementar medidas para controlar el sobrepeso constituye una prioridaden la Ciudad de Santa Teresita.

Introduction. Obesity is associated with a broad spectrum of cardiometabolic diseases that are also present in childhood. Objective. To estimate the prevalence of overweight and obesity in six- to nine- year old children and analyze their relation to high bloodpressure (HBP) and central adiposity.Methods. Cross-sectional study in 1st to 3rd graders. Weight, height, waist circumference and blood pressure were assessed. We calculated Body Mass Index, and estimated the prevalenceof overweight and obesity. Statistical analysis was performed using the Epi Info 6.04 software. Statistical significance: p <0.05. Results. The general prevalence of overweight and obesity was 17.9% and 16.7%, respectively. Overweight was significantly higher in boys than in girls (p= 0.035); 9.4% of the population had high blood pressure, with no significant gender differences (9.1% and 9.7%). Prevalence of high blood pressure in overweight and obese children was 10.9% and 25%, respectively(p= 0,001). Waist circumference above the 80th percentile was 16.6% in overweight and 26.5% in obese children. The body mass index/waistcircumference correlation coefficient was 0.79. Conclusion. This study shows a high prevalence of overweight and a positive association between body mass index or high blood pressure and central adiposity. Preventive measures to control overweight are imperative in the City of Santa Teresita.

[Study of cellular inflammatory response with bronchoalveolar lavage in allergic asthma, aspirin asthma and in extrinsic infiltrating alveolitis]. / Estudio de la respuesta inflamatoria celular a través del lavado bronco alveolar en asma alérgica, por aspirina y en las alveolitis alérgica extrínseca.

The asthmatic inflammatory responses present different type of cells involved in this process, such as: Lymphocytes and Eosinophils. In experienced hands the bronchoalveolar lavage (BAL) is a well-tolerated and valuable tool for investigation of basic mechanisms in asthma and other immunological respiratory diseases. The purpose of this work was to study the different cells involved in asthmatic inflammatory responses in allergic and aspirin sensitivity patients and compared with Extrinsic Allergic Alveolitis patients (EAA) by BAL procedure. We studied 27 asthmatic patients. This group was divided by etiological conditions in: allergic asthmatic patients (a) (n: 19), (9 male and 10 female) demonstrated by reversible fall of FEV 1 (3) 20% and 2 or more positive skin test for common aeroallergens. The aspirin asthmatic patients (b) (n: 8) (5 male and 3 female) demonstrated by progressive challenge with aspirin and fall of FEV 1 (3) 20%. The third group with compatible symptoms and signs of EAA, demonstrated by lung biopsy, (n: 9) (8 male and 1 female) (c). We determined in all patients: Total IgE serum level by ELISA test. BAL was performed by standard procedure in all patients. The cells count were performed in BAL and were separated in Eosinophils, T lymphocytes defined by monoclonal anti CD 3 antibody, Lymphocytes CD 4 and CD 8 by monoclonal anti CD 4 and CD 8 antibodies respectively. The B lymphocytes defined by surface immunoglobulin isotypes IgG, IgM, IgA and IgE. The IgE level was in (a) 630 +/- 350 kU/L, in (b) it was 85 +/- 62 kU/L and in EAA (c) 55 +/- 23 kU/L, p < .0005. Eosinophil percentage in (a) was 25 +/- 13% of cells, in (b) was 28 +/- 15% of cells, NS, and 0 in (c), p < .0005. Lymphocytes T level was 43 +/- 15% of cells in (a), it was 32 +/- 15% of cells in (b) and it was 54 +/- 19% of cells in (c), NS. Lymphocytes CD 4 (+) level was 30 +/- 10% of cells in (a), it was 24 +/- 11% of cells in (b) and it was 8 +/- 6% of cells in (c), p < .005. Lymphocytes CD8 level was 8 +/- 6% of cells in (a), it was 7 +/- 4% of cells in (b) and it was 44 +/- 15% of cells in EAA (c), p < .005. Lymphocytes B level was 8 +/- 4% cells in (a), it was 2.9 +/- 2.5% cells in (b) and it was 3 +/- 2.7% of cells in (c), p < .025. The features described here suggest the importance of the Eosinophils and CD 4 +/- Lymphocytes in asthmatic response of allergic asthmatic patients as well as in aspirin sensitivity asthmatic patients. The LBA cellular profile of E.AA patients presented eosinophilia and CE8+ Lymphocite predominance when compared with both asthmatic cellular profile.

Estudio de la respuesta inflamatoria celular através del lavado bronco alveolar en asma alérgica, por aspirina y en las alveolitis alérgica extrínseca / Bronchoalveolar lavage in the study of inflammatory cellular response in: allergic asthma, aspirin asthma, and extrinsic allergic alveolitis

La respuesta inflamatoria asmática presenta diferentes tipos de células involucradas en este proceso, tales como: linfocitos, eosinófilos. En manos experimentadas el lavado broncoalveolar (LBA) es un procedimento bien tolerado y con gran valor como herramienta para la investigación de los mecanismos básicos en asma y otras enfermedades respiratorias de origen inmunológico. El próposito de este trabajo fue estudiar las diversas células involucradas en la repuesta inflamatoria asmática de pacientes alérgicos, o sensibles a aspirina y compararlos con aqéllos que padecen alveolitis alérgica extrínseca por medio del LBA. Hemos estudiados 27 pacientes asmáticos. Divididos por su etiología en 19 alérgico (a) (9 de sexo masculino y 10 femeninos), demostrado por la caída del VEF 1 >= al 20 de tipo reversible y dos o más pruebas cutáneas positivas para aéro-alérgenos, comunes de la región; 8 sensibles a aspirina (b) (4 masculinos y 4 femeninos) demostrado por desafío progresivo con aspirina y caída del VEF >= al 20. Ambos grupos de asmáticos se compararon con 9 pacientes que padecían Aveolitis Alérgica Extrínsica (8 masculinos y 1 feminino) demostrado por biopsia pulmonar (c). Se determinó en todo los pacientes, niveles de IgE sérica total. LAB en todos los pacientes según el procedimiento estándar. La células se contaron en el LBA y separadas en Eosinofilos, linfocitos T totales por anti CD 3, linfocitos B por antiinmunoglobulinas de superficie G,M,A,E,, Linfocitos CD 4 +, Linfocitos T CD 8 + po antimonoclonales respectivamente. Los niveles de IgE fueron para (a) 630+/-350KU/l.p<.0005. Los porcentajes de eosinofilos fueron para (a) 25 +- 13, para (b) 28 +- 15, NS y para (c) 0. P<.0005. Los nivele de linfocitos T fueron para (a) 43 +- 14, para (b) 32 +- 15 y para (c) 54 +- 19 (NS). Los linfocitos CD 4 fueron 30 +- 10 para (a), 24 +- 11 para (b) y 8+-6 para (c) p<.005. Los linfocitos CD 8 +, fueron en (a), 8 +- , en (b) 7 +-4 en (c) 44 +- 15, p<.005. Los linfocitos B fueron 8 +- 4 en (a), 2.9+-2.5 en (b) y 3 +- 2 en, p<.025. Los hallazgos descritos aquí sugieren fuertemente la importancia de los linfocitos CD 4 + y eosinófilos en el asma en general tanto para las formas alérgicas como para las inducidas pro aspirina. Los pacientes con alveolitis alérgica extrínseca tienen otro claro perfil celular representado por la presencia dominante de CD8+

Importancia del núcleo bencilpenicilina y las cadenas laterales de los beta-lactámicos: demostración por pruebas cutáneas y RAST en pacientes alérgicos a penicilina / Importance of the benzylpenicillin nucleus and the side chain of the beta-lactams: demonstration by skin tests and RAST in penicillin allergic patients

Se estudiaron 30 pacientes con reacciones alérgicas a Beta - Lactámicos claramente demostrados por las manifestaciones clínicas. El objetivo de este trabajo fue determinar la importancia del núcleo Beta - Lactámico y las cadenas laterales en la inducción de IgE específica para BPO, Ax y AMP por medio de las pruebas cutáneas y el RAST para estos determinantes. Este grupo se dividió previamente por historia clínica en: 1 - Acelerados (n:19); 2-Inmediatos (n:11). Las pruebas del Prick se realizaron con BPO-PL, Ax-PL, Amp-PL, MDM de BP, MDM de Ax y MDM de Amp. Presentando en el grupo acelerado: 2 (+) a BPO, 4(+) Ax/AMP, 13(+) a todos los reactivos (BPO-Ax - Amp - MDM BP/Ax/Amp). Los pacientes con reacción inmediata: 10 casos (+) a MDM-BP y 1 (+) MDM-Amp. Estos pacientes fueron estudiados con la técnica del RAST para BPO - PL, Ax-PL, Amp PL y PL. Se consideró como línea de corte positiva al nivel = a 1524 cpm, tomado de la curva estandar de Pharmacia. Los pacientes con reacción acelerada presentaron en 13/19 casos RAST (+) a BPO-PL, 1/19 (+) BPO- Ax/PL, 3/19(+) Ax-PL, 1/19(+) Am/PL y 1 negativo para todos los reactivos estudiados. Los pacientes con reación inmediata (n:11) en todos los casos fueron negativos para todos los reactivos estudiados. El grupo control (n:20) presentó en 1/20 casos positividad por Prick a Ax-PL y 19 casos negatividad total a todos los reactivos. Los RAST a todos los reactivos fueron negativos en todos los individuos estudiados. Estos resultados indican que la bensilpenicilina (BPO) es el más importante determinante y las cadenas laterales (Ax y Amp) son otros determinantes antigénicos en los Beta-Lactámicos, siendo cada uno de ellos inductores de un tipo de IgE específica y que raramente aparece una respuesta IgE a dos determinantes diferentes en un mismo sujeto. Las pruebas cutáneas son el método de elección para el estudio de alergia a penicilina ya que con el método in vitro se cubre un espectro menor de reactivos que los que producen reacción acelerada (MDM).