Schistosomiasis and soil-transmitted helminthiasis preventive chemotherapy: Adverse events in children from 2 to 15 years in Bengo province, Angola.

Preventive chemotherapy campaigns with praziquantel and albendazole are being implemented in Angola, as a high priority public health intervention. However, there are no published data regarding adverse events associated with these medications. In this context, we analysed adverse events due to co-administration of praziquantel and albendazole in endemic areas of schistosomiasis and soil-transmitted helminths in Bengo, Angola. In the context of a targeted drug administration, between December 2012 and September 2013, we conducted two surveys after co-administrating single oral doses of praziquantel and albendazole tablets to children 2 to 15 years of age. About 24 hours after each treatment, participants answered a questionnaire about adverse events. At baseline, 605 children (55.0% male; mean age: 9.7 years) were treated; 460 were interviewed and 257 (55.9%) reported at least one adverse event, 62.3% (160/257) of children being infected with schistosoma haematobium. After six months of treatment, among 339 children surveyed, 184 (54.3%) reported adverse events, with 49.5% (91/184) of infected children. Adverse events were most common in preschool-aged children, with no significant difference between genders. The most frequent adverse events in the two surveys were abdominal pain (18.5%, 25.7%), headache (20.9%, 23.0%) and dizziness (15.7%, 19.8%). Children aged 12 to 15 years (adjusted OR = 0.40, p = 0.040) and those with mixed infection (adjusted OR = 0.04, p = 0.011) had lower odds of adverse events. After the second treatment, those with heavy infection (adjusted OR = 2.72, p = 0.018) and aged 9-11 years (adjusted OR = 2.01, p = 0.049) had significantly fewer adverse events. About 2.0% of children experienced severe adverse events. This study adds evidence that preventive chemotherapy for schistosomiasis and soil-transmitted helminths control is safe, but cases of adverse events are expected. Standardized methodologies to discriminate drug-related adverse events from the clinical manifestations of the infections are needed.

Very low prevalence of iron deficiency among young French children: A national cross-sectional hospital-based survey.

Although iron deficiency (ID) is considered the most frequent micronutrient deficiency in industrialized countries and is associated with impaired neurodevelopment when occurring in early years, accurate recent estimations of its prevalence are lacking. Our objective was to estimate ID prevalence and associated sociodemographic markers in young children in France. The Saturn-Inf national cross-sectional hospital-based survey recruited 3,831 French children <6 years old between 2008 and 2009 to assess lead poisoning prevalence and to establish a biobank. This secondary analysis measured serum ferritinemia (SF) in sera kept frozen at -80 °C for children with sufficient serum aliquots and C-reactive protein <10 mg/L. For the 657 participating children (17% of the Saturn-Inf study), the median age was 3.9 years (interquartile range: 2.2-5.1); 52% were boys. The median SF was 44 µg/L (interquartile range: 28-71). ID prevalence was 2.8% (95% confidence interval [1.7, 4.7]) and 3.2% (95% confidence interval [2.0, 5.1]) with an SF threshold of 10 and 12 µg/L, respectively. Low SF was significantly associated (p < .05) with mother being a migrant (32 vs. 45 µg/L for a mother born in France) or unemployed (37 vs. 50 µg/L for a mother employed). In this first national cross-sectional hospital-based study in France, ID prevalence was much lower than that in other French and European studies performed in underprivileged populations but close to the lowest values observed in other population-based studies in Europe.

Relationship between dietary vitamin D and serum 25-hydroxyvitamin D levels in Portuguese adolescents.

OBJECTIVE: To understand the relationship between vitamin D intake and serum 25-hydroxyvitamin D (25(OH)D) levels in a sample of Portuguese adolescents. DESIGN: Cross-sectional evaluation carried out in the 2003/2004 school year. Vitamin D intake was assessed by an FFQ and 25(OH)D was measured in a fasting blood sample. SETTING: Public and private schools in Porto, Portugal. SUBJECTS: Adolescents aged 13 years (n 521) enrolled at school (EPITeen cohort). RESULTS: Both mean (sd) intake and serum 25(OH)D level were far below the recommended, 4·47 (2·49) µg/d and 16·5 (5·7) ng/ml, respectively. A significant difference in serum level was found according to season, with lower values in winter than summer (14·8 (4·6) v. 17·3 (5·9) ng/ml, P<0·001). Vitamin D intake was weakly correlated with serum 25(OH)D (r=0·056, P=0·203). CONCLUSIONS: Dietary vitamin D and serum 25(OH)D levels were positively but weakly correlated and the error was higher among those with higher serum 25(OH)D concentration. Our results support the need for strategies that promote increase of the most important food sources of vitamin D to reduce the high prevalence of low vitamin D status.

Fish and seafood consumption during pregnancy and the risk of asthma and allergic rhinitis in childhood: a pooled analysis of 18 European and US birth cohorts.

Background: It has been suggested that prenatal exposure to n-3 long-chain fatty acids protects against asthma and other allergy-related diseases later in childhood. The extent to which fish intake in pregnancy protects against child asthma and rhinitis symptoms remains unclear. We aimed to assess whether fish and seafood consumption in pregnancy is associated with childhood wheeze, asthma and allergic rhinitis. Methods: We pooled individual data from 60 774 mother-child pairs participating in 18 European and US birth cohort studies. Information on wheeze, asthma and allergic rhinitis prevalence was collected using validated questionnaires. The time periods of interest were: infancy (0-2 years), preschool age (3-4 years), and school age (5-8 years). We used multivariable generalized models to assess associations of fish and seafood (other than fish) consumption during pregnancy with child respiratory outcomes in cohort-specific analyses, with subsequent random-effects meta-analyses. Results: The median fish consumption during pregnancy ranged from 0.44 times/week in The Netherlands to 4.46 times/week in Spain. Maternal fish intake during pregnancy was not associated with offspring wheeze symptoms in any age group nor with the risk of child asthma [adjusted meta-analysis relative risk (RR) per 1-time/week = 1.01, 95% confidence interval 0.97-1.05)] and allergic rhinitis at school age (RR = 1.01, 0.99-1.03). These results were consistently found in further analyses by type of fish and seafood consumption and in sensitivity analyses. Conclusion: We found no evidence supporting a protective association of fish and seafood consumption during pregnancy with offspring symptoms of wheeze, asthma and allergic rhinitis from infancy to mid childhood.

Family structure and use of prenatal care.

This cross-sectional study intended to assess the use of prenatal care according to the family structure in a population with free universal access to prenatal care. In 2005-2006, the Portuguese birth cohort was assembled by the recruitment of puerperae at public maternity wards in Porto, Portugal. In the current analysis, 7,211 were included. Data on socio-demographic characteristics, obstetric history, and prenatal care were self-reported. Single mothers were considered as those whose household composition did not include a partner at delivery. Approximately 6% of the puerperae were single mothers. These women were more likely to have an unplanned pregnancy (OR = 6.30; 95%CI: 4.94-8.04), an inadequate prenatal care (OR = 2.30; 95%CI: 1.32-4.02), and to miss the ultrasound and the intake of folic acid supplements during the first trimester of pregnancy (OR = 1.71; 95%CI: 1.30-2.27; and OR = 1.67; 95%CI: 1.32-2.13, respectively). The adequacy and use of prenatal care was less frequent in single mothers. Educational interventions should reinforce the use and early initiation of prenatal care.

Family structure and use of prenatal care / Estrutura familiar e uso de cuidados pré-natais / Estructura familiar y utilización de servicios de cuidados prenatales

This cross-sectional study intended to assess the use of prenatal care according to the family structure in a population with free universal access to prenatal care. In 2005-2006, the Portuguese birth cohort was assembled by the recruitment of puerperae at public maternity wards in Porto, Portugal. In the current analysis, 7,211 were included. Data on socio-demographic characteristics, obstetric history, and prenatal care were self-reported. Single mothers were considered as those whose household composition did not include a partner at delivery. Approximately 6% of the puerperae were single mothers. These women were more likely to have an unplanned pregnancy (OR = 6.30; 95%CI: 4.94-8.04), an inadequate prenatal care (OR = 2.30; 95%CI: 1.32-4.02), and to miss the ultrasound and the intake of folic acid supplements during the first trimester of pregnancy (OR = 1.71; 95%CI: 1.30-2.27; and OR = 1.67; 95%CI: 1.32-2.13, respectively). The adequacy and use of prenatal care was less frequent in single mothers. Educational interventions should reinforce the use and early initiation of prenatal care.

Este estudo transversal pretende avaliar a utilização dos cuidados pré-natais segundo a estrutura familiar, numa população com acesso universal e gratuito a estes cuidados. Em 2005-2006, puérperas foram recrutadas em maternidades públicas do Porto, Portugal, na coorte de nascimento portuguesa. Nesta análise, foram incluídas 7.211 mulheres. Dados sobre as características sociodemográficas, antecedentes obstétricos e cuidados pré-natais foram reportados. Definiram-se como mães monoparentais todas aquelas que não viviam em casal na altura do parto. Cerca de 6% eram mães monoparentais. Essas mulheres eram mais propensas a ter uma gravidez não planejada (OR = 6,30; IC95%: 4,94-8,04), cuidados pré-natais inadequados (OR = 2,30; IC95%: 1,32-4,02) e a não realizar uma ecografia e iniciar a ingestão de ácido fólico durante o primeiro trimestre da gravidez (OR = 1,71; IC95%: 1,30-2,27; e OR = 1,67; IC95%: 1,32-2,13, respectivamente). A adequação e utilização de cuidados pré-natais foram menos frequentes em mães monoparentais. As intervenções educativas devem reforçar o uso e início precoce dos cuidados pré-natais.

Este estudio transversal pretende evaluar la utilización de la atención prenatal, de acuerdo con la estructura familiar, en una población con acceso universal y gratuito a la atención prenatal. En 2005-2006, se seleccionaron puérperas en maternidades públicas de Porto, Portugal en una cohorte de nacimientos portuguesa. En el análisis, se incluyeron 7.211. Se informaron sobre datos como: características sociodemográficas, historia obstétrica y atención prenatal. Las madres monoparentales son las que no tenían un compañero en el momento del parto. Aproximadamente un 6% eran madres monoparentales. Estas tenían más probabilidades de tener un embarazo no planificado (OR = 6,30; IC95%: 4,94-8,04), atención prenatal inadecuada (OR = 2,30; IC95%: 1,32-4,02), y perder la ecografía y la ingesta de ácido fólico durante el primer trimestre del embarazo (OR = 1,71; IC95% 1,30-2,27; y OR = 1,67; IC95%: 1,32-2,13; respectivamente). La adecuación y el uso de la atención prenatal fueron menos frecuentes en las madres monoparentales. Las intervenciones educativas deben promover el uso y el inicio temprano de la atención prenatal.

Determinants of weight changes during the first 96 hours of life in full-term newborns.

BACKGROUND: Newborn weight loss (NWL) in the first 3 days of life is around 6 percent of birthweight (BW). We aim to describe the determinants of an excessive and insufficient NWL in the first 96 hours of life. METHODS: A sample of 1,288 full-term singletons without congenital abnormality belonging to Generation XXI birth cohort was selected. Newborns were recruited in 2005-2006 at all public units providing obstetrical and neonatal care in Porto, Portugal. Information was collected by face-to-face interview and additionally abstracted from clinical records. Anthropometrics were obtained by trained examiners and newborn weight change (NWC) was estimated as (weight-BW)/BW × 100. We categorized NWL as excessive (below 10th percentile of the sample distribution of NWC: ≤-9.4% of BW), normal (between 10th and 90th percentiles: -9.3 to -4.2%) and insufficient (above 90th percentile: ≥ -4.1%). Adjusted odds ratios (OR) and 95 percent confidence intervals (CI) were calculated using multinomial regression models. RESULTS: Excessive NWL was positively associated with maternal age ≥40 years (OR = 3.32, 95%CI 1.19-9.25), maternal education (OR = 1.04, 95% CI 1.00-1.09), cesarean delivery (OR = 2.42, 95% CI 1.12-5.23), and phototherapy-treated jaundice (OR = 1.69, 95% CI 1.00-2.87). Insufficient NWL was positively associated with low BW (OR = 2.68, 95% CI 1.13-6.33), and formula/mixed feeding (OR = 1.74, 95% CI 1.13-2.66). CONCLUSION: Excessive NWL was positively associated with maternal age and education, cesarean delivery, and phototherapy-treated jaundice. Insufficient NWL reflected child's feeding. As breastfed newborns did not lose weight excessively, but newborns with formula/mixed feeding had insufficient NWL, our study supports that breastfeeding provides excellent nutrition during this period.

Caffeine intake reduces sleep duration in adolescents.

In our study, we hypothesized that higher caffeine intake would be associated with lower sleep duration among 13-year-old adolescents. In addition, we aimed to identify food sources of caffeine intake in this sample. Eligible participants were adolescents who were born in 1990 and attended school in Porto, Portugal, in 2003/2004. Self-administered questionnaires were used, and diet was evaluated using a food frequency questionnaire. From the 2160 eligible participants, only 1522 with valid information regarding their diet were included in this study. In our sample, the median intake of caffeine was 23.1 mg/d, with soft drinks being the major source. Ice tea presented the highest median (25th-75th percentiles) contribution (33.1% [14.0-52.1]), followed by cola (21.1% [6.4-37.6]). Regarding cocoa products, chocolate bars presented a median contribution of 5.1% (1.0-14.0), and snacks containing chocolate had a contribution of 3.0% (0.5-7.2). Coffee and tea presented a negligible contribution. Adolescents who reported less sleep duration and those who spent more time watching TV during the weekend had a significantly higher caffeine intake. Overall, boys had higher intakes of caffeine from soft drinks, and private school attendees, those who had parents with more education, who reported less television viewing time and had lower body mass index presented higher intakes of caffeine from chocolate. Considering sleeping more than 9.5 hours as a reference class, for each increase of 10 mg/d in caffeine intake, we found that the odds ratio of sleeping 8.5 hours or less was 1.12 (95% confidence interval, 1.06-1.19). Our results support the hypothesis that caffeine intake was inversely associated with sleep duration in adolescents.

Caffeine intake is associated with a lower risk of cognitive decline: a cohort study from Portugal.

Alzheimer's disease has emerged in recent decades as a major health problem and the role of lifestyles in the modulation of risk has been increasingly recognized. Recent epidemiological studies suggest a protective effect for caffeine intake in dementia. We aimed to quantify the association between caffeine dietary intake and cognitive decline, in a cohort of adults living in Porto. A cohort of 648 subjects aged > or =65 years was recruited between 1999-2003. Follow-up evaluation (2005-2008) was carried out on 58.2% of the eligible participants and 10.9% were deceased. Caffeine exposure in the year preceding baseline evaluation was assessed with a validated food frequency questionnaire. Cognitive evaluation consisted of baseline and follow-up Mini-Mental State Examination (MMSE). Cognitive decline was defined by a decrease > or =2 points in the MMSE score between evaluations. Relative risk (RR) and 95% confidence interval (95%CI) estimates adjusted for age, education, smoking, alcohol drinking, body mass index, hypertension, and diabetes were computed using Poisson regression. Caffeine intake (> 62 mg/day [3rd third] vs. < 22 mg/day [1st third]) was associated with a lower risk of cognitive decline in women (RR=0.49, 95%CI 0.24-0.97), but not significantly in men (RR=0.65, 95%CI 0.27-1.54). Our study confirms the negative association between caffeine and cognitive decline in women.

Gender heterogeneity in the association between lifestyles and non-fatal acute myocardial infarction.

OBJECTIVE: To evaluate the modification effect of sex in the association between lifestyles and acute myocardial infarction (AMI). DESIGN: Population-based case-control study. Trained interviewers collected information using a standard structured questionnaire. Associations were estimated using unconditional logistic regression. The effect modification by sex was evaluated in the regression models, testing interaction terms between lifestyles and sex. SETTING: Porto, Portugal. SUBJECTS: Portuguese Caucasian adults, aged > or =18 years. Cases were patients consecutively admitted with an incident AMI during 1999-2003 (n 918) and controls were a representative sample of non-institutionalized inhabitants of Porto with no evidence of previous clinical or silent infarction (n 2316). RESULTS: Cigarette smoking was positively associated with AMI in both men and women (smokers >15 cigarettes/d v. never smokers: OR = 9.11, 95% CI 4.83, 17.20 for women; OR = 3.92, 95% CI 2.75, 5.58 for men; interaction term P value = 0.001). A significant protective effect of moderate alcohol intake on AMI occurrence was found in women (0.1-15.0 g/d v. non-drinkers: OR = 0.48, 95% CI 0.31, 0.74), but not in men. Fruit and vegetable intake, vitamin and mineral supplement use and leisure-time physical activity practice were found to decrease AMI risk, with similar effects between sexes. CONCLUSIONS: A strong positive association between smoking and AMI was found in women. Also, a protective effect of moderate alcohol intake was only found among females. Fruit and vegetable intake, vitamin and mineral supplement use and leisure-time physical activity practice were found to decrease AMI risk in both sexes.

Dietary intake and nutritional adequacy prior to conception and during pregnancy: a follow-up study in the north of Portugal.

OBJECTIVE: To assess maternal diet and nutritional adequacy prior to conception and during pregnancy. DESIGN: Follow-up of a cohort of pregnant women with collection of questionnaire data throughout pregnancy and after delivery. SETTING: Antenatal clinics at two public hospitals in Porto, Portugal. SUBJECTS: Two hundred and forty-nine pregnant women who reported a gestational age below 13 weeks at the time they attended their first antenatal visit. RESULTS: Intakes of energy and macronutrients were within recommended levels for most women. Pregnancy was accompanied by increases in the dietary intake of vitamins A and E, riboflavin, folate, Ca and Mg, but declines in the intake of alcohol and caffeine. The micronutrients with higher inadequacy prevalences prior to pregnancy were vitamin E (83%), folate (58%) and Mg (19%). These three micronutrients, together with Fe, were also those with the highest inadequacy prevalences during pregnancy (91%, 88%, 73% and 21%, respectively, for folate, Fe, vitamin E and Mg). Ninety-seven per cent of the women reported taking supplements of folic acid during the first trimester, but the median gestational age at initiation was 6.5 (interquartile range 5, 9) weeks. Self-reported prevalences of Fe and Mg supplementation were high, and increased throughout pregnancy. CONCLUSION: The study identified low dietary intakes of vitamin E, folate and Mg both in the preconceptional period and during pregnancy, and low intake of Fe during pregnancy only. The low dietary intake of folate and the late initiation of supplementation indicate that current national guidelines are unlikely to be effective in preventing neural tube defects.

Adequacy of prenatal care as a major determinant of folic acid, iron, and vitamin intake during pregnancy.

This study aimed to quantify the association between adequacy of prenatal care and prevalence of folic acid, iron, and multivitamin intake during pregnancy. Data were obtained on socio-demographics, prenatal care, pregnancy complications, and use of vitamin/mineral supplements for 836 women, using a postpartum interview. Associations with the use of vitamin/mineral supplements were quantified with risk ratios (RR), computed by generalized binomial regression. A high proportion of women reported the use of folic acid (81.9%), iron (55.4%), and multivitamins (76.2%) as supplements during pregnancy. Use of supplements was independently associated with adequacy of prenatal care (adequate vs. inadequate: folic acid, RR = 2.28; 95%CI: 1.58-3.29; iron, RR = 1.99; 95%CI: 1.57-2.52, multivitamins, RR = 1.97; 95%CI: 1.54-2.51). Higher schooling was also associated with increased use of folic acid (RR = 1.42; 95%CI: 1.18-1.70), but not multivitamins (RR = 0.87; 95%CI: 0.77-0.98). Use of folic acid was less prevalent in single women (RR = 0.67; 95%CI: 0.48-0.95) and during unplanned pregnancies (RR = 0.81; 95%CI: 0.71-0.92). Adequacy of prenatal care is a major determinant of vitamin/mineral intake during pregnancy.

Adequacy of prenatal care as a major determinant of folic acid, iron, and vitamin intake during pregnancy

This study aimed to quantify the association between adequacy of prenatal care and prevalence of folic acid, iron, and multivitamin intake during pregnancy. Data were obtained on socio-demographics, prenatal care, pregnancy complications, and use of vitamin/mineral supplements for 836 women, using a postpartum interview. Associations with the use of vitamin/mineral supplements were quantified with risk ratios (RR), computed by generalized binomial regression. A high proportion of women reported the use of folic acid (81.9 percent), iron (55.4 percent), and multivitamins (76.2 percent) as supplements during pregnancy. Use of supplements was independently associated with adequacy of prenatal care (adequate vs. inadequate: folic acid, RR = 2.28; 95 percentCI: 1.58-3.29; iron, RR = 1.99; 95 percentCI: 1.57-2.52, multivitamins, RR = 1.97; 95 percentCI: 1.54-2.51). Higher schooling was also associated with increased use of folic acid (RR = 1.42; 95 percentCI: 1.18-1.70), but not multivitamins (RR = 0.87; 95 percentCI: 0.77-0.98). Use of folic acid was less prevalent in single women (RR = 0.67; 95 percentCI: 0.48-0.95) and during unplanned pregnancies (RR = 0.81; 95 percentCI: 0.71-0.92). Adequacy of prenatal care is a major determinant of vitamin/mineral intake during pregnancy.

Quantificar a associação entre a adequação dos cuidados pré-natais e a prevalência de utilização de ácido fólico, ferro e vitaminas durante a gravidez. Após o parto, 836 mulheres foram questionadas relativamente a características sócio-demográficas, utilização dos cuidados pré-natais, complicações durante a gravidez e utilização de suplementos vitamínicos/minerais. A associação entre as variáveis foi quantificada por meio de riscos relativos (RR) calculados por regressão binomial generalizada. Uma elevada proporção de mulheres reportou ter tomado ácido fólico (81,9 por cento), ferro (55,4 por cento) e multivitaminas (76,2 por cento) durante a gravidez. A utilização de suplementos esteve independentemente associada à adequação dos cuidados pré-natais (adequado vs. inadequado: ácido fólico, RR = 2,28; IC95 por cento: 1,58-3,29; ferro, RR = 1,99; IC95 por cento: 1,57-2,52; multivitaminas, RR = 1,97; IC95 por cento: 1,54-2,51). O elevado nível de escolaridade associou-se ao uso de ácido fólico (RR = 1,42; IC95 por cento: 1,18-1,70), mas não de multivitaminas (RR = 0,87; IC95 por cento: 0,77-0,98). A utilização de ácido fólico foi menos prevalente em mulheres que viviam sozinhas (RR = 0,67; IC95 por cento: 0,48-0,95) e cuja gravidez não foi planeada (RR = 0,81; IC95 por cento: 0,71-0,92). A adequação dos cuidados pré-natais é um determinante importante da utilização de vitaminas/minerais durante a gravidez.

[Normative data for quantitative ultrasound measurement of the calcaneus in a Portuguese population]. / Valores de referência para uma população urbana Portuguesa da avaliação quantitativa por ultrasons do calcâneo.

BACKGROUND: Quantitative ultrasound (QUS) measurement of the calcaneus is a safe and reliable method for evaluating skeletal status. Although central bone densitometry (DXA) measurement is the gold-standard to classify osteopenic and osteoporotic patients, QUS can give supplementary information and its use is expanding. Up to now there are no published normative data for QUS measurements in the Portuguese population. OBJECTIVES: The aims of this study were to determine normative QUS data in the Sahara Clinical Sonometer (Hologic) for the Portuguese population. METHODS: Cross-sectional evaluation of consecutive subjects selected as part of the EpiPorto study, Portugal. Calcaneus QUS (Sahara Clinical Sonometer, Hologic) parameters were obtained: Broadband Ultrasound Attenuation (BUA), Speed of Sound (SOS), Quantitative Ultrasound Index (QUI) and Estimated Bone Mineral Density (EBMD) were determined for men and women, stratified by their age group. RESULTS: 1,482 consecutive subjects (1,010 females and 472 males), aged from 18 to 92 years. Higher levels of QUS parameters were found in the lower age group and, for both gender, progressive decrease with age were reported. Men showed higher values as compared to women in all parameters and differences between them increased with age. Differences were significant for BUA after the age of 39 and for SOS after the age of 59. Short-term in vivo precision was 5.5% for BUA and 0.4% for SOS, while in vitro precision was 3.23% for BUA and 0.15% for SOS. DISCUSSION: Our data are comparable to other Southern European data and represent the first QUS normative data for the Portuguese population.

Coffee and gastric cancer: systematic review and meta-analysis.

We systematically reviewed the literature on the association between coffee consumption and gastric cancer and performed a meta-analysis of the results. Published cohort and case-control studies were identified in PubMed and reference lists. Random effects meta-analysis was used to pool effects from 23 studies, and heterogeneity was explored by stratification and meta-regression. The odds ratio (OR) for the overall association between coffee and gastric cancer (highest vs. lowest category of exposure) was 0.97 (95%CI: 0.86-1.09), similar for cohort (OR = 1.02; 95%CI: 0.76-1.37) and case-control studies (population-based: OR = 0.90; 95%CI: 0.70-1.15; hospital-based: OR = 0.97; 95%CI: 0.83-1.13). The OR was 1.26 (95%CI: 1.02-1.57) when considering five studies conducted in the USA, 0.97 (95%CI: 0.82-1.14) for the five Japanese studies, 0.98 (95%CI: 0.81-1.17) for the six studies from Europe, and 0.64 (95%CI: 0.47-0.86) for the two studies from South America. In this meta-analysis we found no adverse effect of coffee associated with gastric cancer. Knowledge on the level of exposure to different coffee constituents may provide a deeper understanding of this reassuring result and the real role of coffee on cancer risk.

Coffee and gastric cancer: systematic review and meta-analysis

Efetuamos uma revisão sistemática dos estudos publicados avaliando a associacão entre café e câncer de estômago. Identificamos estudos de coorte e caso-controle na PubMed e nas listas de referências. Foram obtidas estimativas conjuntas do risco por meta-análise de 23 estudos (método de efeitos aleatórios). A heterogeneidade foi explorada por estratificacão e meta-regressão. O odds ratio (OR) conjunto para a associacão entre café e câncer gástrico (categoria de exposicão mais elevada vs. mais baixa) foi de 0,97 (IC95 por cento: 0,86-1,09), semelhante para estudos de coorte (OR = 1,02; IC95 por cento: 0,76-1,37) e caso-controle (populacional: OR = 0,90; IC95 por cento: 0,70-1,15; hospitalar: OR = 0,97; IC95 por cento: 0,83-1,13). O OR foi de 1,26 (IC95 por cento: 1,02-1,57) para cinco estudos efetuados nos Estados Unidos, 0,97 (IC95 por cento: 0,82-1,14) para cinco estudos japoneses, 0,98 (IC95 por cento: 0,81-1,17) para cinco estudos europeus, e 0,64 (IC95 por cento: 0,47-0,86) para dois estudos sul-americanos. Nesta meta-análise não observamos efeito significativo do consumo de café na ocorrência de câncer gástrico. Contudo, o conhecimento dos níveis de exposicão a diferentes constituintes do café poderá permitir uma melhor compreensão deste resultado e o verdadeiro contributo do café para a ocorrência de câncer.

Coffee and myocardial infarction: heterogeneity of an association in Portuguese men.

BACKGROUND: Despite the amount of published studies on the subject, controversy still exists about the effect of coffee drinking on the occurrence of coronary heart disease. In general, epidemiological studies do not support the belief that it is a major risk factor. DESIGN: A community-based case-control study was conducted. METHODS: A random sample of men aged 40 years and over with no previous myocardial infarction was compared with patients with a first acute myocardial infarction (AMI). A structured questionnaire was used to collect information on sociodemographic characteristics, personal and family medical history and lifestyles. Dietary data were obtained by a food frequency questionnaire. Odds ratios were calculated by unconditional logistic regression. After exclusions, 290 cases and 364 controls were considered in the final analysis. RESULTS: Coffee drinking is a widespread habit in this population, and most individuals did not change their habit throughout life. Most participants reported the consumption of moderate amounts of coffee (< 25% drank more than four cups a day) and espresso was by far the most commonly used brewing. The crude odds ratio for having ever drunk coffee regularly was 0.5 (95% confidence interval 0.3-1.1). However, there was a significant effect-measure modification by family history of AMI (P = 0.02). CONCLUSIONS: The results suggest different susceptibility to coffee drinking, such that coffee drinking was positively although not significantly associated with an increased risk of AMI in men with a family history of AMI, whereas there was a significant inverse association with the occurrence of myocardial infarction among men with no family history of AMI.

Leisure-time versus full-day energy expenditure: a cross-sectional study of sedentarism in a Portuguese urban population.

BACKGROUND: Low physical activity is known to be a potential risk factor for cardiovascular disease. With high prevalence of cardiovascular diseases in the Portuguese urban population, little is known about how sedentary this population is and what factors are associated to sedentary lifestyles. This study's objective was to examine sedentary lifestyles and their determinants through a cross-sectional study. METHODS: 2134 adults (18 years and older) were interviewed using a standard questionnaire, comprising of social, behavioural and clinical information. Time spent in a variety of activities per day, including: work, household chores, sports, sedentary leisure time and sleep, were self-reported. Energy expenditure was estimated based on the related metabolic equivalent (MET) and time spent in each activity (min/day). Those with less than 10% of energy expenditure at a moderate intensity of 4 METs or higher were categorised as sedentary. The proportion of sedentary people and 95% Confidence Intervals (CI) were calculated, and the magnitude of associations, between sedentary lifestyles and the population characteristics, were computed as age-adjusted odds ratios using logistic regression. RESULTS: Sedentarism in both genders during leisure time is high at 84%, however in full day energy expenditure, which includes physical activity at work, sleeping hours and household chores, 79% of males and 86% of females are found to be sedentary. In leisure-time only, increased age is associated with higher odds of being sedentary in both genders, as well as in women with increased BMI. In comparison, in full-day energy expenditure, sedentarism is more likely to occur in those with higher levels of education and in white-collar workers. CONCLUSIONS: A high prevalence of sedentarism is found in the study participants when measuring leisure-time and full-day energy expenditure. The Portuguese population may therefore benefit from additional promotion of physical activity.