Risk of Eating Disorders and Social Desirability among Higher Education Students: Comparison of Nutrition Students with Other Courses.

The transition to college is a period of higher risk of the development of eating disorders, with nutrition/dietetics students representing a group of particular vulnerability. Hence, it is interesting to assess eating disorders, taking into consideration potential sources of bias, including social desirability. Our aims were to compare the risk of eating disorders between students of nutrition/dietetics and those attending other courses and to study potential social desirability biases. A total of 799 higher education students (81.7% females) aged 18 to 27 years old completed a questionnaire assessing the risk of eating disorders (EAT-26) and social desirability (composite version of the Marlowe-Crowne Social Desirability Scale). The proportion of students with a high risk of eating disorders was higher among females (14.5% vs. 8.2%, p = 0.044). Nutrition/dietetics students did not differ from those attending other courses regarding the risk of eating disorders. The social desirability bias when assessing the risk of eating disorders was overall low (EAT-26 total score: r = -0.080, p = 0.024). Social desirability correlated negatively with the Diet (r = -0.129, p < 0.001) and Bulimia and food preoccupation subscales (r = -0.180, p < 0.001) and positively with Oral self-control (r = 0.139, p < 0.001).

Assessment of Intuitive Eating and Mindful Eating among Higher Education Students: A Systematic Review.

BACKGROUND: The role of mindful eating (ME) and intuitive eating (IE) in improving eating behavior, diet quality, and health is an area of increasing interest. OBJECTIVE: The objective of this review was to identify the instruments used to assess ME and IE among higher education students and outcomes related to these dimensions. METHODS: This review was carried out according to the PRISMA statement, through systematic searches in PubMed, Web of Science, PsycInfo, and Scopus. The inclusion criteria selected for higher education students, levels of ME and/or IE reported, and observational and clinical studies. The exclusion criteria selected against reviews, qualitative studies, and case studies. Quality was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist. RESULTS: A total of 516 initial records were identified, from which 75 were included. Cross-sectional studies were the most common research design (86.7%). Most studies were conducted with samples that were predominantly female (90.7%), White (76.0%), aged 18 to 22 years (88.4%), with BMI < 25 kg/m2 (83.0%), and in the United States (61.3%). The Intuitive Eating Scale (IES), the Mindful Eating Questionnaire (MEQ), and their different versions were the most used instruments. The outcomes most studies included were eating behavior and disorders (77.3%), anthropometric assessments (47.8%), mental health (42.0%), and body image (40.6%). Regarding the quality of studies, 34.7% of studies were assigned a positive, 1.3% a negative, and 64.0% a neutral rate. CONCLUSIONS: IES and MEQ were the most used instruments. RCT and cohort studies are scarce, and future research with a higher level of quality is needed, especially on the topics of food consumption, diet quality, and biochemical markers.

Nutritional Status among Portuguese and Turkish Older Adults Living in the Community: Relationships with Sociodemographic, Health and Anthropometric Characteristics.

Malnutrition is widespread among older adults, and its determinants may differ between countries. We compared Portuguese and Turkish non-institutionalized older adults regarding nutritional status, sociodemographic, health and anthropometric characteristics and studied the relationships between nutritional status and those characteristics. This cross-sectional study analyzed data from 430 Portuguese and 162 Turkish non-institutionalized older adults regarding sociodemographics, health conditions, the Mini-Nutritional Assessment (MNA-FF) and anthropometry. Turkish older adults were more likely to be malnourished or at risk of malnutrition and had lower average BMI but a higher calf circumference. A higher proportion of the Portuguese sample had tooth loss, diabetes, hypertension, oncologic diseases, kidney diseases, osteoarticular problems or eye problems, while less had anemia. A better nutritional status (higher MNA-FF score) was found among the Portuguese, males, people using dentures, those without tooth loss, hypertension, cardiovascular diseases, anemia or oncological diseases and was related to younger age, higher BMI and a higher calf circumference. Malnutrition and its risk were higher among older adults from Turkey, despite Portuguese older adults presenting a higher prevalence of chronic diseases. Being female, older age, tooth loss, hypertension, anemia, CVD or oncological disorders and having a lower BMI or CC were associated with higher rates of malnutrition among older adults from Portugal and Turkey.

Evolution of body composition of obese patients undergoing bariatric surgery.

BACKGROUND & AIMS: Bariatric surgery is increasingly common in the fight against morbid obesity. However, after this intervention, it is not fully understood the evolution of weight loss and how body composition changes. The objective of this work is to study the evolution after surgery of weight and body composition of obese patients that underwent bariatric surgery. METHODS: In this retrospective and prospective study, we studied initially BMI and body composition of obese patients who attended nutritional appointments at Centro Hospitalar São João E.P.E. We collected personal data and anthropometric measurements between the pre-surgery appointment up to 60 months after surgery. RESULTS: The sample consisted of 793 patients, of which 86.5% were female and 13.5% were male, with a mean age of 43 years (SD = 10.5 years) and mean height of 1.62 m (SD = 0.079 m). Patients undergoing gastric band, sleeve gastrectomy and gastric bypass had, respectively, an initial BMI reduction of 6.3 kg/m2, 13.2 kg/m2 and 15.4 kg/m2 and an initial fat mass% reduction of 4.4%, 14.3% and 17.3%. On the other hand, they had an initial increase of 3.2%, 10.8% and 12.4% of water%, 1.4%, 3.9% and 4.6% of fat and water-free mass%, and 1.9%, 7.3% and 8.9% of skeletal muscle mass%, respectively. BMI and fat mass% on average had a large decrease in the first 12 months, increasing slightly from 24 months onwards. The opposite behaviour was observed for water%, fat and water-free mass% and skeletal muscle mass%. CONCLUSIONS: Bariatric surgery initially allows a substantial decrease in BMI as well as beneficial changes in the overall body composition of the individuals. Gastric bypass was the method that caused the most changes, followed by sleeve gastrectomy and, finally, gastric band. On average, after 24 months of follow-up, and for all surgical procedures studied, we observed a reversion in BMI and body composition values, showing the difficulties in maintaining weight and fat loss.

Metabolic Control in Patients With Phenylketonuria Pre- and Post-Sapropterin Loading Test

Abstract In Portugal, tetrahydrobiopterin (BH4)-responsive patients with phenylketonuria (PKU) are identified using a loading test (LT). Phenylalanine/natural protein (Phe/NP) intake is increased to elevate blood Phe prior to the LT. In a longitudinal retrospective study, the impact of Phe/NP titration post-LT in 58 patients (19.6 + 8.2 years) with PKU during 4 study periods (SPs) was examined. In SP1 (2010-2013), patients were diet treated only; in SP2 (2014), the Phe/NP titration was followed by the LT in SP3 (2015). In SP4 (2016), patients received diet treatment only (n » 49) or BH4 þdiet (n » 9). The median percentage blood Phe within the target range was higher in SP1 versus SP4 (64 [28-85] vs 45 [0-66]; P < .001). Our results suggest that transient Phe/NP titration, associated with a deliberate increase in NP, may adversely affect metabolic control. Controlled studies are necessary to examine the longer term impact of temporary increased NP with BH4 LT in non-BH4-responsive patients.

Providing Personalised Nutrition: Consumers' Trust and Preferences Regarding Sources of Information, Service Providers and Regulators, and Communication Channels.

BACKGROUND/AIMS: Personalised nutrition has potential to revolutionise dietary health promotion if accepted by the general public. We studied trust and preferences regarding personalised nutrition services, how they influence intention to adopt these services, and cultural and social differences therein. METHODS: A total of 9,381 participants were quota-sampled to be representative of each of 9 EU countries (Germany, Greece, Ireland, Poland, Portugal, Spain, the Netherlands, the UK, and Norway) and surveyed by a questionnaire assessing their intention to adopt personalised nutrition, trust in service regulators and information sources, and preferences for service providers and information channels. RESULTS: Trust and preferences significantly predicted intention to adopt personalised nutrition. Higher trust in the local department of health care was associated with lower intention to adopt personalised nutrition. General practitioners were the most trusted of service regulators, except in Portugal, where consumer organisations and universities were most trusted. In all countries, family doctors were the most trusted information providers. Trust in the National Health Service as service regulator and information source showed high variability across countries. Despite its highest variability across countries, personal meeting was the preferred communication channel, except in Spain, where an automated internet service was preferred. General practitioners were the preferred service providers, except in Poland, where dietitians and nutritionists were preferred. The preference for dietitians and nutritionists as service providers highly varied across countries. CONCLUSION: These results may assist in informing local initiatives to encourage acceptance and adoption of country-specific tailored personalised nutrition services, therefore benefiting individual and public health.

Prevalence of Alcohol Abuse Before and After Bariatric Surgery Associated With Nutritional and Lifestyle Factors: A Study Involving a Portuguese Population.

BACKGROUND: It has been hypothesized that the metabolism of alcohol is altered following bariatric surgery. However, few studies have evaluated preoperative and postoperative alcohol use. The aims of the study were to characterize alcohol use in the preoperative period and 2 years postoperatively as well as to identify factors associated. METHODS: A study was conducted using data from the electronic charts of patients submitted to laparoscopic adjustable gastric banding (LAGB) and Roux-en-Y gastric bypass (RYGB) surgery in the city of Porto, Portugal. Associations with the following variables were analyzed: age, marital status, schooling, alcohol use, body mass index, binge eating disorder, and lifestyle habits. RESULTS: Among the 659 patients, 42.0 % completed the 2 years of follow-up. A total of 90.2 % were women; 67.4 % underwent LAGB, and 32.6 % underwent RYGB. The frequency of alcohol use was 24.2 % in the preoperative period and 9.4 % in the postoperative period (p = 0.000). Daily alcohol intake was two drinks in the preoperative period and 1.8 drinks in the postoperative period. Significant associations were found between postoperative alcohol use and the male gender (p = 0.001), age ≥ 45 years (p = 0.018), and preoperative BMI <40 kg/m(2) (p = 0.028). No significant associations were found with the surgical technique. No previous nondrinkers became drinkers, and no patients increased the quantity or frequency of alcohol intake in the postoperative period. CONCLUSIONS: The prevalence of alcohol use in the sample was low. Moreover, a lower prevalence rate was found in the postoperative period, independently of surgical technique, clinical factors, and percentage of weight loss.

Eating behavior in Portuguese higher education students: the effect of social desirability.

OBJECTIVES: The aim of this study was to relate social desirability with eating behavior dimensions among higher education students in Portugal, and to assess the effect of social desirability on the association between pairs of eating behavior dimensions. METHODS: Data from 266 higher education students (62.8% women) aged between 18 and 27 y were evaluated. Social desirability and several eating behavior dimensions (emotional and external eating, flexible and rigid restraint, binge eating, and eating self-efficacy) were assessed. RESULTS: In both women and men, social desirability showed negative associations with emotional, external, and binge eating, and positive associations with eating self-efficacy. For the majority of the correlations, the control for social desirability led to a decrease in the strength of the association: Social desirability showed a greater effect on the associations between external and binge eating, external eating and eating self-efficacy, binge eating and eating self-efficacy, and emotional and external eating. CONCLUSION: This study demonstrated that social desirability should be considered when assessing the dimensions of eating behavior, namely eating self-efficacy and dimensions related to overeating.

Eating behaviour patterns and BMI in Portuguese higher education students.

Our aim was to determine prototypical patterns of eating behaviour among Portuguese higher education students, and to relate these patterns with BMI. Data from 280 higher education students (63.2% females) aged between 18 and 27 years were analysed. Several eating behaviour dimensions (emotional and external eating, flexible and rigid restraint, binge eating, and eating self-efficacy) were assessed, and eating styles were derived through cluster analysis. BMI for current, desired and maximum self-reported weights and the differences between desired and current BMI and between maximum and current BMI were calculated. Women scored higher in emotional eating and restraint, whereas men showed higher eating self-efficacy. Men had higher current, desired and maximum BMI. Cluster analysis showed three eating styles in both male and female subsamples: "Overeating", "High self-efficacy" and "High restraint". High self-efficacy women showed lower BMI values than the others, and restrictive women had higher lost BMI. High self-efficacy men showed lower desired BMI than overeaters, and lower maximum and lost BMI than highly restrictive ones. Restrictive women and men differ on important eating behaviour features, which may be the cause of differences in the associations with BMI. Eating self-efficacy seems to be a central variable influencing the relationships between other eating behaviour dimensions and BMI.

Metabolic syndrome, adipokines and ghrelin in overweight and obese schoolchildren: results of a 1-year lifestyle intervention programme.

The aim of this study was to evaluate the effect of a lifestyle intervention programme (nutrition and exercise counselling) on metabolic syndrome (MS) components, adipokines (leptin, adiponectin) and ghrelin levels in overweight children. A total of 61 overweight children aged 7-9 years (≥ 85th body mass index (BMI) percentile; 27 boys/34 girls) were randomly assigned and completed a 1-year individual (IT) or group-based treatment (GT). Anthropometric and biochemical parameters were assessed at baseline, at 6 months and at 1 year. Twenty-two normal weight children (<85th BMI percentile; 7-9 years old; 13 boys/nine girls) were also evaluated at baseline. Insulin resistance (IR) was determined by the homeostasis model assessment of IR (HOMA-IR). Overweight children presented significantly higher blood pressure, triglycerides, apolipoprotein B, insulin, HOMA-IR, leptin, C-reactive protein and homocysteine levels, while apolipoprotein A-I was significantly lower. At baseline, MS was present in ten overweight children, of which only five maintained it at 1 year. Leptin and ghrelin levels were associated with IR and MS components. MS was predicted by apolipoprotein A-I, insulin and pre-puberty. The lifestyle intervention led to a significant improvement in standard deviation score of BMI, waist circumference/height ratio and lipid profile. Changes in insulin, HOMA-IR, leptin and adiponectin were not significant. Ghrelin behaved differently between IT and GT. The GT intervention seems to be more successful, with a decrease in BMI Z-score and an improvement of metabolic parameters. In conclusion, overweight children have multiple risk factors associated with MS. A lifestyle intervention programme seems to be an effective mean for reducing obesity and MS components and improving adipokines concentrations.