Clean-label products: Factors affecting liking and acceptability by Portuguese older adults.

Consumers are preferring more "natural" foods, made of "healthier" and "familiar" components - the "clean-label" trend. As the population ages, understanding the older adult consumer segment becomes increasingly important. This study aims to identify the factors influencing the acceptability and liking of clean-label products in older adults living in the community. A convenience sample of 100 older adults was used for this cross-sectional study. Socio-demographic data, health status, independence level, lifestyle characteristics, nutritional status, and food and nutrient intake data were collected. The acceptability and liking for clean-label products comprised two parts: Sensory analysis with overall liking evaluation of three pairs of products, using a 9-point hedonic scale and free comments; Willingness to eat and preference assessment of nine pairs of products using the Food Action scale and a simple preference test. The participants were 80% female with a mean age of 75 years old. The overall liking for clean-label versions of cookies and mayonnaise was lower than for traditional versions. However, participants were more willing to eat the clean-label versions of products, particularly ham and yogurt. Most of the participants would prefer buying the clean-label version of all nine pairs of products, especially for ham, loaf bread, sausages, and yogurt. In sum, older adults living in the community exhibit a lower liking but, a greater willingness to eat and a higher preference for buying clean-label products. Older adults who favor clean-label products have higher levels of education and are reported to have a more adequate diet.

The Portuguese mediterranean diet wheel: development considerations.

Scientific evidence has been reporting the health and environmental benefits of the Mediterranean diet. However, countries of the Mediterranean region, Portugal included, are gradually abandoning this traditional food pattern. The aim of the present work was to develop the Portuguese Mediterranean diet wheel. Three main steps were followed: (1) establishment of the most relevant Mediterranean diet and lifestyle principles to improve this pattern among the Portuguese population; (2) converting those principles into a captivating and easy to understand tool and (3) obtaining experts' opinion. By a matter of consistency, the preservation and transmission of the Mediterranean heritage was represented through an upgrade of the current Portuguese food wheel guide. This complementary tool highlights the Mediterranean diet enlarged character that encompasses a healthy lifestyle and reinforces sociocultural and environmental features. It was launched at the end of 2016 and was nationally disseminated with the support of the Portuguese Health Directorate. Initially it was presented in a poster format image that was subsequently spread in different communication formats. This newly developed Mediterranean food guide is a complementary educational tool that will support health and education professionals in the never ending mission of promoting healthy food choices.

General and abdominal adiposity in a representative sample of Portuguese adults: dependency of measures and socio-demographic factors' influence.

The aims of this study were: (i) to estimate the dependency between BMI and waist:height ratio (WHtR) as measures of general and abdominal adiposity, and (ii) to evaluate the influence of socio-demographic factors on both measures and on their dependency in risk classification. Data from a cross-sectional study conducted in 2009 among a representative sample of 3529 Portuguese adults were used. Height, weight and waist were measured and socio-demographic data (sex, age, education level, occupational status, marital status, region of residence) were obtained. Using logistic regression, crude and adjusted OR for high general (BMI≥25·0 kg/m²) and abdominal (WHtR≥0·5) adiposity, and for incompatible classification between them, were calculated. Above half (50·8%) of the respondents had high BMI and 42·1% had high WHtR, and the rates were higher in men than in women. There was an inverse association between education level and both adiposity measures. The lowest prevalence of high general and abdominal adiposity was observed in students and singles, whereas the highest was found in retired, widowed and respondents from Azores, Madeira and Alentejo. Nearly a quarter of respondents (24·0%) were incompatibly classified by BMI and WHtR, with higher prevalence in men than in women and in low- than in high-educated people. Future surveys should focus on developing at least sex-specific cut-offs for both measures. Implementation of effective strategies for preventing and reducing high adiposity levels in Portugal should be directed primarily to men, older, low-educated individuals, as well as those living in the islands and poor regions of the country.

System of planning and evaluation of school meals.

OBJECTIVE: To develop a software to plan and evaluate school meals according to the main national and international standards for foods and nutrition. DESIGN: Development of software. SETTING: Public schools, Portugal. SUBJECTS: School meals for students. RESULTS: The System of Planning and Evaluation of School Meals (SPARE) is a software that allows the planning of school meals in an effective and organized way, according to the main national and international standards for food and nutrition. The regular use of this tool enables the evaluation, monitoring and verification towards continuous improvement of the quality of school meals. CONCLUSIONS: The SPARE software aims to promote healthy eating by focusing on the planning and production of safe and adequate meals in the school environment. This software can be adapted to different age groups and to different contexts, attending to specific nutritional and food standards.

Does eating family meals and having the television on during dinner correlate with overweight? A sub-study of the PRO GREENS project, looking at children from nine European countries.

OBJECTIVE: Family meals have been negatively associated with overweight in children, while television (TV) viewing during meals has been associated with a poorer diet. The aim of the present study was to assess the association of eating family breakfast and dinner, and having a TV on during dinner, with overweight in nine European countries and whether these associations differed between Northern and Southern & Eastern Europe. DESIGN: Cross-sectional data. Schoolchildren reported family meals and TV viewing. BMI was based on parental reports on height and weight of their children. Cut-off points for overweight by the International Obesity Task Force were used. Logistic regressions were performed adjusted by age, gender and parental education. SETTING: Schools in Northern European (Sweden, the Netherlands, Iceland, Germany and Finland) and Southern & Eastern European (Portugal, Greece, Bulgaria and Slovenia) countries, participating in the PRO GREENS project. SUBJECTS: Children aged 10-12 years in (n 6316). RESULTS: In the sample, 21 % of the children were overweight, from 35 % in Greece to 10 % in the Netherlands. Only a few associations were found between family meals and TV viewing during dinner with overweight in the nine countries. Northern European children, compared with other regions, were significantly more likely to be overweight if they had fewer family breakfasts and more often viewed TV during dinner. CONCLUSIONS: The associations between family meals and TV viewing during dinner with overweight were few and showed significance only in Northern Europe. Differences in foods consumed during family meals and in health-related lifestyles between Northern and Southern & Eastern Europe may explain these discrepancies.

Fruit and vegetables: intake and sociodemographic determinants among Portuguese mothers.

BACKGROUND: Fruit and vegetable intake is crucial in health promotion and disease prevention. Inadequate intake is found among adult populations worldwide. AIMS: To assess fruit and vegetable intake among Portuguese mothers and to examine its association with sociodemographic determinants. METHODS: A national cross-sectional survey was performed in Portugal as part of the Pro Children study. Data from self-administrated precoded 24-hour recall and food frequency questionnaires answered by 1,853 mothers of 11- to 13-year-old children were analyzed. Descriptive analysis of the data was followed by logistic regression to assess associations between daily fruit and vegetable intake and sociodemographic determinants. RESULTS: The mean fruit and vegetable intake was 221.2 and 170.0 g/day, respectively. Only 46% of the mothers met the WHO recommendations (≥400 g fruit and vegetables/day). Daily fruit intake was significantly higher among mothers who live with a spouse/partner, and who belong to a higher social class. For vegetables, daily intake was significantly higher among mothers with a higher education and social class. CONCLUSIONS: This study shows that the mean intake of fruit and vegetables among Portuguese mothers is far below international recommendations. Effective strategies to promote fruit and vegetable intake are needed, especially for mothers belonging to lower social classes and educational levels.

Body Composition, Nutritional Intake Assessment, and Perceptions about Diet for Health and Performance: An Exploratory Study for Senior Futsal Players.

This study aims to assess the body composition and nutritional intake of senior male futsal players from the II Futsal Division-Azores Series and explore their individual viewpoints regarding the benefits and barriers of healthy eating and performance. Two groups were identified: those who only completed the sociodemographic questionnaire and the anthropometric data (Group 1, n = 48), and those who additionally had their food intake assessed using three 24-h dietary recalls and were interviewed (Group 2, n = 20). Although most of the players have a healthy body composition, those from Group 2 had a significantly higher Body Mass Index, showing that they are under "pre-obesity", and have a higher percentage of body fat compared to the players from Group 1. Findings from the nutritional intake assessment revealed that players from Group 2 met dietary recommendations for protein, but not for energy and carbohydrate, and they slightly exceeded recommendations for fat. Findings from the interviews revealed that most of these players reported low levels of satisfaction with their sport performance, explained by their deviation from a healthy eating practice in their daily lives. They recognized the need to alter their diets, identifying food items that should be taken and avoided.

Association between parenting styles and own fruit and vegetable consumption among Portuguese mothers of school children.

The aim of the present study was to evaluate the association between parenting styles and own fruit and vegetable consumption among Portuguese mothers of school children. A cross-sectional study was performed in Portugal as part of the Pro Children cross-sectional European survey. Portuguese mothers (n 1601) of 11-13-year-old school children were included in the present study. A self-administered questionnaire was developed to assess fruit and vegetable consumption as well as the parenting styles. Fruit and vegetable consumption was assessed by a validated FFQ. Parenting styles based on two dimensions - strictness and involvement - were classified into authoritative, authoritarian, indulgent and neglectful. The higher mean intakes of fruit, vegetables and total fruit and vegetables were observed for mothers classified as indulgent, whereas the lower mean intakes were observed for mothers classified as neglectful. Differences in intake among parenting styles were significant for fruit, vegetables and total fruit and vegetables. When partial correlations were calculated between the two dimensions, strictness and involvement (controlled one for the other), and intakes, only involvement was positively associated with fruit, vegetables and total fruit and vegetable intake. Findings from the present study show that fruit and vegetable consumption of Portuguese mothers of school children seems to be related to their own parenting styles, especially with the dimension involvement. Future interventions to promote fruit and vegetable intake should take into account these variables.

An extended version of the MNA-SF increases sensitivity in identifying malnutrition among community living older adults. Results from the PRONUTRISENIOR project.

BACKGROUND & AIMS: The Mini Nutritional Assessment (MNA) is the most used tool to assess malnutrition and/or its risk among older adults. Its Screening section was proposed as a short form (MNA-SF) but studies comparing the two forms present controversial results. Our main aims were to study the agreement between MNA-SF and its full form (MNA-FF) among Portuguese older adults living in the community and to develop a more sensible version of the MNA-SF. MATERIAL AND METHODS: This cross-sectional study used a convenience sample of 456 older adults (54.2% females) aged 65-92 years (mean = 73; SD = 6). Data analyzed included: nutritional status (MNA), social support (Fillenbaum's Social Network Index), level of independency in daily activities (Lawton e Brody's scale) and eating-related quality of life. Both MNA-FF and MNA-SF classify participants as malnourished, at risk of malnutrition or with normal nutrition status. Anthropometric assessments (weight, height, arm and calf perimeters) were carried out and BMI was computed. RESULTS: The agreement between the two classifications is 82.7%, but Cohen's k shows a weak agreement (weighted Cohen's k = 0.497; p < 0,001), and the sensitivity of the MNA-SF to detect malnutrition or its risk (as assessed by the MNA-FF) was 42.6% (despite a specificity of 98.8%). Participants classified as normal using the MNA-SF despite at risk using the MNA-FF present lower scores in two items from the Assessment section (number of full meals eaten daily and amount of fluid consumed per day). These were included in MNA-SF to obtain an extended short-version (MNA-SF8). The difference between the ROC curves for MNA-SF and MNA-SF8 justifies the preferential use of the MNA-SF8 with an estimated cut-off of 14 points, which showed high sensitivity (91.8%) and specificity (79.9%). CONCLUSIONS: The addition of two items to the MNA-SF provides a more sensible tool to detect the risk of malnutrition among older adults. General eating-related questions seem relevant to assess malnutrition in this age group.

The relationship between health self-perception, food consumption and nutritional status among Portuguese older adults.

In Portugal people aged 65 and above will be the populational group with the highest growth rate of the next decades. Healthy ageing constitutes a challenge as not only the number of years lived are essential, but also the quality of life becomes a priority. The aim of this study was to understand the relationship between health self-perception (HSP), food consumption and nutritional status among Portuguese older adults. Four hundred fifty-nine older adults (aged ≥ 65) were interviewed, almost half had a positive HSP. The most significant predictor of HSP was nutritional status, p = 0.005, but independence in shopping had the largest impact on how they compared to others, p < 0.001. Interventions need to focus on factors like nutritional status, independency on Activities of Daily Living, Satisfaction with Food-Related Life and utilize them to modify the negative HSP and attitudes towards ageing and health and maximize the positive aspects of old age.

Differences in prevalence of overweight and stunting in 11-year olds across Europe: The Pro Children Study.

OBJECTIVES: To assess country differences in prevalence of overweight, obesity, underweight and stunting in the Pro Children Survey. METHODS: A cross-sectional study conducted in a random sample of schools in nine European countries in 2003. The subjects were 8317 11-year-old children from Austria, Belgium, Denmark, Iceland, The Netherlands, Norway, Portugal, Spain and Sweden. Parents reported height and weight of the children, and BMI values were analysed using the US Centers of Disease Control and Prevention and the International Obesity Task Force reference populations. Continuous variables were compared with one-way analysis of variance (ANOVA) with Games-Howell post hoc tests. Categorical variables were analysed using chi-square tests. RESULTS: The prevalence of overweight + obesity varied between the countries from 8.6% to 30.6% and 5.9% to 26.5%, respectively, depending on the reference population, with the lowest prevalence in Dutch girls, the highest in Portuguese boys. Obesity prevalence varied from 1.1% (Dutch and Danish girls) to 10.7% (Portuguese boys) and from 0.3% (Dutch girls) to 6.2% (Portuguese boys), respectively. Portugal and Spain had the highest prevalence of overweight and obesity for both genders. The ranking of the countries according to overweight and obesity prevalence was roughly the same, independent of reference population. The prevalence of underweight varied from 2.3% (Swedish boys) to 12.3% (Belgian boys), using the American reference population. The proportion of stunted children was highest in Portugal, Spain and Belgium. CONCLUSIONS: The highest levels of overweight, obesity and stunting in the pro children material are found in Portugal and Spain.

Fruit and vegetable intake in a sample of 11-year-old children in 9 European countries: The Pro Children Cross-sectional Survey.

BACKGROUND/AIMS: An adequate fruit and vegetable intake provides essential nutrients and nutritive compounds and is considered an important part of a healthy lifestyle. No simple instrument has been available for the assessment of fruit and vegetable intake as well as its determinants in school-aged children applicable in different European countries. Within the Pro Children Project, such an instrument has been developed. This paper describes the cross-sectional survey in 11-year-olds in 9 countries. METHODS: The cross-sectional survey used nationally, and in 2 countries regionally, representative samples of schools and classes. The questionnaires, including a precoded 24-hour recall component and a food frequency part, were completed in the classroom. Data were treated using common syntax files for portion sizes and for merging of vegetable types into four subgroups. RESULTS: The results show that the fruit and vegetable intake in amounts and choice were highly diverse in the 9 participating countries. Vegetable intake was in general lower than fruit intake, boys consumed less fruit and vegetables than girls did. The highest total intake according to the 24-hour recall was found in Austria and Portugal, the lowest in Spain and Iceland. CONCLUSION: The fruit and vegetable intake in 11-year-old children was in all countries far from reaching population goals and food-based dietary guidelines on national and international levels.