Mediterranean Diet conceptual model and future trends of its use in Portugal.

The aim of this study was to present a new model for the Mediterranean Diet definition and to identify the major trends for the use of the Mediterranean Diet concept by 2028, in Portugal. A Delphi panel was implemented with 28 experts with solid knowledge and understanding of the Mediterranean Diet concept. The first round evaluated the degree of expert self-knowledge, which also contributed to the final questionnaire building. It was answered in 2 successive rounds with 21 statements, divided into 2 dimensions: Mediterranean Diet concept and use. A Mediterranean Diet model definition was produced with 73.8% of agreement. Culture, education, environment, health, food industry/distribution and tourism were identified as the future trends of Mediterranean Diet use areas. The model presented can be used as a pedagogical tool. For the first time, it was possible to explore the future trends of Mediterranean Diet use, which can help with the initiatives to safeguard the Mediterranean Diet concept.

Mediterranean food pattern vs. Mediterranean diet: a necessary approach?

"Food pattern" and "diet" sometimes are referred with the same meaning. "Food pattern" can be defined by a priori and a posteriori approaches and refers to the characterisation of foods and frequency of consumption within a population combining with various characteristics. "Diet" may be represented as an individual way of life and considers the food consumption and others like culture, history, society, economy, sustainability, culinary activities, conviviality, physical activity and rest. Mediterranean diet fits on these two concepts. The question is if we are measuring Mediterranean diet as a whole, or whether we are only measuring one of its parts, neglecting the rest of components. Can this compromise the way we monitor its adherence and evolution, with the possibility of losing the perception of certain aspects? How can we preserve and promote the concept if we do not monitor all the pieces of the puzzle?

Bidirectional association between parental child-feeding practices and body mass index at 4 and 7 y of age.

BACKGROUND: Evidence of the association between parental child-feeding practices and the child's body mass index (BMI) is controversial, and bidirectional effects have been poorly studied. OBJECTIVE: We aimed to examine bidirectional associations between parental child-feeding practices and BMI at 4 and 7 y of age. DESIGN: This study included 3708 singleton children from the Generation XXI birth cohort with data on parental child-feeding practices and BMI at 4 and 7 y old. Feeding practices were assessed through a self-administered questionnaire by combining the Child Feeding Questionnaire and the Overt/Covert Control scale and then adapting it to Portuguese preschool children. Weight and height were measured according to standardized procedures, and age- and sex-specific BMI z scores were computed based on the WHO Growth References. Linear regression models were used to estimate the bidirectional associations between each practice and BMI z score. Crosslagged analyses were performed to compare the directions of those associations (the mean score of each practice and BMI z score at both ages were standardized to enable effect size comparisons). RESULTS: After adjustments, pressure to eat and overt control at 4 y of age were associated with a lower BMI z score 3 y later (ß: -0.05; 95% CI: -0.08, -0.03 and ß: -0.05; 95% CI: -0.09, -0.01, respectively). Regarding the opposite direction of association, a higher BMI z score at 4 y of age was significantly associated with higher levels of restriction and covert control at 7 y of age (ß: 0.06; 95% CI: 0.03, 0.08 and ß: 0.06; 95% CI: 0.04, 0.08, respectively) and with lower levels of pressure to eat (ß: -0.17; 95% CI: -0.20, -0.15). The only bidirectional practice, pressure to eat, was more strongly influenced by the BMI z score than the reverse (ßstandardized: -0.17 compared with ßstandardized: -0.04; likelihood ratio test: P < 0.001). CONCLUSIONS: We found that parents both respond to and influence the child's weight; thus, this child-parent interaction should be considered in future research.

Combination and adaptation of two tools to assess parental feeding practices in pre-school children.

OBJECTIVE: To test a combined version of the Child Feeding Questionnaire and the expanded concept of parental control ("covert" and "overt") among Portuguese preschool children. METHODS: The final questionnaire comprised 38 items and 9 subscales. The translated questionnaire was self-administered to 854 mothers of 4 year-old children from the Generation XXI birth cohort. Maternal and children's weight and height and socio-demographic characteristics were measured. The global goodness of fit was evaluated by confirmatory factor analysis. Cronbach's alpha was used to measure the reliability of subscales. Construct validity was tested for different dimensions. RESULTS: A 9-factor model was obtained, after excluding five "restriction" items and 1 "overt control" item, with a global goodness of fit (CFI=0.961, TLI=0.973, RMSEA=0.057). Cronbach's alpha ranged from 0.684 to 0.889. Children's body mass index (BMI) was significantly and positively related with "perceived parental weight", "perceived child's weight" and "concern about child's weight", and inversely related with "pressure to eat", supporting the theoretical hypothesis. Maternal BMI was positively related with "perceived parental weight". CONCLUSIONS: Our study confirmed the usefulness of this questionnaire for Portuguese preschool children, and supports the need of reformulating the restriction dimension and keeping separately the overt and covert control dimensions.

Influence of dietary supplementation with dextrin or oligofructose on the hepatic redox balance in rats.

We assessed the impact of oligofructose (OFS) and dextrin (DEX) as diet supplements on hepatic redox state. Rats were fed either a 10% OFS or a 10% DEX supplemented diet for 9 wk. In the DEX diet group, the levels of hepatic protein carbonylation were decreased by 63%. Total glutathione and reduced glutathione (GSH) contents were reduced in the OFS and DEX diet groups by around 20%. DEX supplementation significantly reduced oxidized glutathione (GSSG) levels resulting in a 33% increase in the GSH/GSSG ratio. The activity of the hepatic antioxidant enzymes was not changed by either OFS or DEX supplementation. OFS supplementation caused a decrease in serum levels of triglycerides (36%), cholesterol (24%), HDL (16%) and LDL (17%). DEX supplementation only reduced triglycerides (32%) and urea (22%). Both diets increased serum levels of acetate by fivefold and propionate by twofold, but DEX diet decreased butyrate levels by 75%. Due to their different composition/structure these two dietary fibers affected metabolism in different ways. Diet supplementation with 10% DEX can potentially improve host health, by protecting the liver from protein carbonylation and by improving GSH/GSSG ratio and diet supplementation with 10% OFS can improve the lipid profile.