Trends in ultra-processed food availability and its association with diet-related non-communicable disease health indicators in the Portuguese population.

Broad variations in dietary and physical activity patterns are part of nutritional transition concept. An additional nutritional transition has as main characteristic the change of consumption of processed foods for ultra-processed foods (UPF). This study aims to evaluate trends of UPF availability in Portuguese population and its association with diet-related non-communicable diseases (NCD) health indicators. This ecological study used data from the Household Budget Surveys conducted by the National Statistics Institute each 5 years within a national representative sample of households. The percentage of UPF was calculated based on the total daily amount of food and beverages available per capita (in grams). Data from the years 1990, 1995, 2000 and 2005 were used, which were retrieved from DAFNE-Anemos Software. NCD age-standardised mortality, prevalence and incidence were obtained from the Global Burden of Disease database, for the years 2000, 2005, 2010 and 2015. Between 1990 and 2005, the UPF availability increased from 3·9 % to 13·8 %. Over the years, almost all food and beverages categories increased the UPF availability contribution, mainly noticeable for milk, sugar, cereal and meat products. Positive correlations were observed between UPF availability and digestive diseases both in prevalence (r = 0·062; P = 0·037) and incidence (r = 0·005; P = 0·010) measures. Neoplasms incidence also showed positive correlation with UPF availability (r = 0·002; P = 0·012). Trends in UPF availability in Portugal increased exponentially. At the same time, there is a trend towards a decrease in unprocessed and processed food availability. The Portuguese population should be made aware of the health risks resulting from excessive consumption of UPF.

Adolescents' Perceptions About Healthy and Sustainable Diets: A Qualitative School-Based Study in Portugal.

In this qualitative study, we explored Portuguese adolescents' perceptions of diet, sustainability, and health through six focus group discussions (FGDs). Fifty-five adolescents (10-18 years) participated. FGDs focused on sustainability in food choices and its health impact, with our primary interest in their perceptions. Results showed a limited comprehension of "sustainable/sustainability," especially among younger participants. Those aware of sustainability recognized its diverse aspects, including health, economic, and ecological domains. Some adolescents recognized the link between health and sustainability in their diets, emphasizing the need for food literacy. These findings emphasize the importance of public health and sustainable policies among Portuguese adolescents.

Ultra-processed food consumption deteriorates the profile of micronutrients consumed by Portuguese adults and elderly: the UPPER project.

PURPOSE: This study aims to describe micronutrient intake according to food processing degree and to investigate the association between the dietary share of ultra-processed foods and micronutrient inadequacies in a representative sample of Portuguese adult and elderly individuals. METHODS: Cross-sectional data from the National Food, Nutrition and Physical Activity Survey (2015/2016) were used. Food consumption data were collected through two 24-h food recalls, and food items were classified according to the NOVA system. Linear regression models were used to assess the association between the micronutrient density and the quintiles of ultra-processed food consumption-crude and adjusted. Negative Binomial regressions were performed to measure the prevalence ratio of micronutrient inadequacy according to ultra-processed food quintiles. RESULTS: For adults, all evaluated vitamins had significantly lower content in the fraction of ultra-processed foods compared to unprocessed or minimally processed foods, except vitamin B2. For the elderly, out of ten evaluated vitamins, seven presented significantly less content in ultra-processed foods compared to non-processed ones. The higher energy contribution of ultra-processed foods in adults was associated with a lower density of vitamins and minerals. This association was not observed in the elderly. For adults, compared with the first quintile of ultra-processed food consumption, the fifth quintile was positively associated with inadequate intakes of vitamin B6 (PR 1.51), vitamin C (PR 1.32), folate (PR 1.14), magnesium (PR 1.21), zinc (PR 1.33), and potassium (PR 1.19). CONCLUSION: Our results corroborate the importance of public health actions that promote a reduction in the consumption of ultra-processed foods.

Human health risk-benefit assessment of fish and other seafood: a scoping review.

Fish and other seafood are important sources of nutrients, but they are also sources of chemical contaminants that may cause adverse health effects. This article aimed to identify existing risk-benefit assessments (RBA) of fish, shellfish, and other seafood, compare methodologies, discuss differences and commonalities in findings, and identify limitations and ways forward for future studies. We conducted a scoping review of the scientific literature of studies in all languages published from 2000 through April 2019. We identified 106 RBA of fish and other seafood across Europe, Asia, North America, Africa, and at the global level. Studies were heterogeneous in terms of types of fish and other seafood considered, beneficial and adverse compounds assessed, and overall methodology. Collected data showed that a diet consisting of a variety of lean and fatty fish and other seafood is recommended for the overall population and that women of childbearing age and children should limit the consumption of fish and other seafood types that have a high likelihood of contamination. Our review emphasizes the need for evidence-based, up-to-date, and harmonized approaches in RBA in general.

Quantitative risk-benefit assessment of Portuguese fish and other seafood species consumption scenarios.

Portugal has high fish/seafood consumption, which may have both risks and benefits. This study aims to quantify the net health impact of hypothetical scenarios of fish/seafood consumption in the Portuguese population using a risk-benefit assessment methodology. Consumption data from the National Food, Nutrition and Physical Activity Survey 2015-2016 (n 5811) were used to estimate the mean exposure to methylmercury and EPA + DHA in the current and the alternative scenarios considered. Alternative scenarios (alt) were modelled using probabilistic approaches to reflect substitutions from the current consumption in the type of fish/seafood (alt1: excluding predatory fishes; alt2: including only methylmercury low-level fishes) or in the frequency of weekly fish/seafood consumption (alt3 to alt6: 1, 3, 5 or 7 times a week, replacing fish/seafood meals with meat or others). The overall health impact of these scenarios was quantified using disability-adjusted life years (DALY). In the Portuguese population, about 11 450 DALY could be prevented each year if the fish/seafood consumption increased to a daily basis. However, such a scenario would result in 1398 extra DALY considering the consumption by pregnant women and the respective risk on fetal neurodevelopment. Our findings support a recommendation to increase fish/seafood consumption up to 7 times/week. However, for pregnant women and children, special considerations must be proposed to avoid potential risks on fetal neurodevelopment due to methylmercury exposure.

Cysteine-Assisted Click-Chemistry for Proximity-Driven, Site-Specific Acetylation of Histones.

Post-translational modifications of histones are essential in the regulation of chromatin structure and function. Among these modifications, lysine acetylation is one of the most established. Earlier studies relied on the use of chromatin containing heterogeneous mixtures of histones acetylated at multiple sites. Differentiating the individual contribution of single acetylation events towards chromatin regulation is thus of great relevance. However, it is difficult to access homogeneous samples of histones, with a single acetylation, in sufficient quantities for such studies. By engineering histone H3 with a cysteine in proximity of the lysine of interest, we demonstrate that conjugation with maleimide-DBCO followed by a strain-promoted alkyne-azide cycloaddition reaction results in the acetylation of a single lysine in a controlled, site-specific manner. The chemical precision offered by our click-to-acetylate approach will facilitate access to and the study of acetylated histones.

Consumption of ultra-processed foods and non-communicable disease-related nutrient profile in Portuguese adults and elderly (2015-2016): the UPPER project.

This study aims to investigate the dietary share of ultra-processed foods and its association with the non-communicable disease (NCD)-related nutrient profile of adult and elderly populations in Portugal. Cross-sectional data from the National Food, Nutrition and Physical Activity Survey (2015-2016) of the Portuguese population were analysed. Dietary intake was assessed by two non-consecutive 24-h recalls, and food items were classified according to the NOVA system. We estimated the percentage of dietary energy provided by each of the NOVA food groups and assessed the NCD-related nutrient profile of the overall diet across quintiles of ultra-processed food consumption. Weighted t tests, besides crude and adjusted linear and Poisson regressions, were performed. Ultra-processed foods contributed to around 24 and 16 % of daily energy intake for adults and elderly, respectively. In both groups, as the consumption of ultra-processed foods increased, the dietary content of free sugars, total fats and saturated fats increased, while the dietary content of protein decreased. In adults, total energy intake, dietary energy density and content of carbohydrates also increased as the consumption of ultra-processed foods increased, while the dietary content of fibre, Na and K decreased. The prevalence of those exceeding the upper limits recommended for free sugars and saturated fats increased by 544 and 153 % in adults and 619 and 60 % in elderly, when comparing the lowest with the highest quintile of ultra-processed food consumption. Such a scenario demands for effective strategies addressing food processing in the Portuguese population to improve their diet quality and prevention against diet-related NCD.

Are older adults with excessive sodium intake at increased risk of hypohydration?

BACKGROUND: Sodium intake is expected to affect water needs, although compensation mechanisms may not work efficiently particularly in older adults. The aim of this cross-sectional study was to quantify the association between sodium excretion and hydration status in a representative sample of Portuguese older adults. METHODS: A cluster sampling approach was used, representing Portuguese older adults (≥65 years) according to sex, education level and region. From a sample size of 1500 participants, 1318 were eligible for the present analysis. A 24-h urine sample was collected, and volume, osmolality, creatinine and sodium were quantified. Free water reserve (FWR) was used to assess hydration status. Excessive sodium intake was defined as above 2000 mg day-1 as recommended by the World Health Organization. A multivariable binary logistic regression model was used to estimate the association between FWR and sodium excretion. Odds ratios (OR) and respective 95% confidence intervals (95% CI) were calculated. RESULTS: Excessive sodium excretion was observed in 80.0% of women and 91.5% of men, whereas hypohydration affected 10.9% of women and 23.6% of men. After adjusting for confounders, excessive sodium excretion was associated with an increased risk of hypohydration among men (OR = 2.75; 95% CI = 1.06-7.15). CONCLUSIONS: These results stress the positive association between excessive sodium intake and hypohydration in men and highlight the need for implementing strategies regarding the reduction of salt consumption and the promotion of water intake.

Prediction equations for estimating body weight in older adults.

BACKGROUND: Assessing body weight in older adults may be challenging. Hence, the present study aimed to develop and cross-validate updated and reproducible equations to estimate body weight in a large sample of older adults, namely among the older-old. METHODS: In total, 1456 individuals aged ≥ 65 years, from the Nutrition UP 65 study, were included in the present analysis. The participants were randomly assigned to one of two sub-samples: development (n = 991) and validation samples (n = 465). Prediction equations using height, mid-upper arm circumference (MUAC), waist circumference (WC), calf circumference (CC) and triceps skinfold thickness (TST) were generated for the development sample using multiple regression analysis and then validated using the validation sample. RESULTS: The model with five predictor variables generated the following equations: females 65-79 years: -114.682 + 0.522 × height (cm) + 0.620 × MUAC (cm) + 0.517 × WC (cm) + 0.893 × CC (cm) + 0.111 × TST (mm) (adjusted r2  = 0.883, standard error of the estimate (SEE) = 4.4); females ≥ 80 years: -110.806 + 0.494 × height (cm) + 0.637 × MUAC (cm) + 0.500 × WC (cm) + 0.986 × CC (cm) + 0.021 × TST (mm) (adjusted r2  = 0.890, SEE = 3.9); males 65-79 years: -114.875 + 0.558 × height (cm) + 0.073 × MUAC (cm) + 0.671 × WC (cm) + 0.717 × CC (cm) + 0.182 × TST(mm) (adjusted r2  = 0.820, SEE=5.0); and males ≥ 80 years: -128.789 + 0.546 × height (cm) + 0.202 × MUAC (cm) + 0.612 × WC (cm) + 1.236 × CC (cm) + 0.093 × TST (mm) (adjusted r2  = 0.906, SEE = 3.5). CONCLUSIONS: Body weight can be estimated with good accuracy in older adults using these sex- and age-specific equations generated from regression models using three to five anthropometric predictor variables.

Current knowledge and future perspectives of the use of seaweeds for livestock production and meat quality: a systematic review.

The effects of dietary macroalgae, or seaweeds, on growth performance and meat quality of livestock animal species are here reviewed. Macroalgae are classified into Phaeophyceae (brown algae), Rhodophyceae (red algae) and Chlorophyceae (green algae). The most common macroalga genera used as livestock feedstuffs are: Ascophyllum, Laminaria and Undaria for brown algae; Ulva, Codium and Cladophora for green algae; and Pyropia, Chondrus and Palmaria for red algae. Macroalgae are rich in many nutrients, including bioactive compounds, such as soluble polysaccharides, with some species being good sources of n-3 and n-6 polyunsaturated fatty acids. To date, the incorporation of macroalgae in livestock animal diets was shown to improve growth and meat quality, depending on the alga species, dietary level and animal growth stage. Generally, Ascophyllum nodosum can increase average daily gain (ADG) in ruminant and pig mostly due to its prebiotic activity in animal's gut. A. nodosum also enhances marbling score, colour uniformity and redness, and can decrease saturated fatty acids in ruminant meats. Laminaria sp., mainly Laminaria digitata, increases ADG and feed efficiency, and improves the antioxidant potential of pork. Ulva sp., and its mixture with Codium sp., was shown to improve poultry growth at up to 10% feed. Therefore, seaweeds are promising sustainable alternatives to corn and soybean as feed ingredients, thus attenuating the current competition among food-feed-biofuel industries. In addition, macroalgae can hinder eutrophication and participate in bioremediation. However, some challenges need to be overcome, such as the development of large-scale and cost-effective algae production methods and the improvement of algae digestibility by monogastric animals. The dietary inclusion of Carbohydrate-Active enZymes (CAZymes) could allow for the degradation of recalcitrant macroalga cell walls, with an increase of nutrients bioavailability. Overall, the use of macroalgae as feedstuffs is a promising strategy for the development of a more sustainable livestock production.

Dichloro Butenediamides as Irreversible Site-Selective Protein Conjugation Reagent.

We describe maleic-acid derivatives as robust cysteine-selective reagents for protein labelling with comparable kinetics and superior stability relative to maleimides. Diamide and amido-ester derivatives proved to be efficient protein-labelling species with a common mechanism in which a spontaneous cyclization occurs upon addition to cysteine. Introduction of chlorine atoms in their structures triggers ring hydrolysis or further conjugation with adjacent residues, which results in conjugates that are completely resistant to retro-Michael reactions in the presence of biological thiols and human plasma. By controlling the microenvironment of the reactive site, we can control selectivity towards the hydrolytic pathway, forming homogeneous conjugates. The method is applicable to several scaffolds and enables conjugation of different payloads. The synthetic accessibility of these reagents and the mild conditions required for fast and complete conjugation together with the superior stability of the conjugates make this strategy an important alternative to maleimides in bioconjugation.

Information Sources on Healthy Eating Among Community Living Older Adults.

Information about nutrition and health are important to empower older adults on what their food choice is concerned. The present research aims to study the perceived need and preferences regarding sources of information about healthy eating among older adults and to relate them with sociodemographic characteristics. A sample of 602 older adults (≥65 years old) living in the community (Vila Nova de Gaia, Portugal) was assessed by trained nutritionists using a structured questionnaire developed within the Pronutrisenior project. Most participants (87.5%) are concerned about healthy eating, and 69.3% would like to receive more information about the subject, mainly as audiovisual material (49.8%). Women prefer to receive information through practical cooking sessions and audiovisual material. Highly educated individuals prefer leaflets with text as well as audiovisual material, while more independent individuals prefer a wide range of media, such as booklets with pictures, informational posters, and food education and practical cooking sessions. Those with an adequate social support network prefer booklets with text. Age was not related to these preferences. These results can inform stakeholders about the most effective means of transmitting information on food and nutrition to older adults and are therefore useful in tailoring community and clinical interventions.

Handgrip Strength and Its Association With Hydration Status and Urinary Sodium-to-Potassium Ratio in Older Adults.

Objective: Older adults present higher risk of functional disability detected by handgrip strength and an increased risk of poor health conditions, such as dehydration and low values of the sodium-to-potassium (Na/K) ratio. This study aimed to quantify the association of hydration status and Na/K ratio with handgrip strength, based on the urinary excretion of older adults.Methods: A cross-sectional study was conducted in 735 older adults ≥ 65 years old. Handgrip strength was measured with a Jamar Dynamometer and low values were defined according to body mass index and to sex-specific cutoff points. The hydration status was evaluated based on free water reserve. Sodium and potassium intake were evaluated after converting 24-hour urinary sodium and potassium excretion, respectively. A logistic regression model was used to estimate the probability of presenting low handgrip strength, according to risk of hypohydration and to quartiles of Na/K, stratified by sex and adjusted for potential confounders.Results: The adjusted odds ratio (OR) for presenting low handgrip strength was higher in women at risk of hypohydration, but this association was not found in men. Both women and men with the highest values of Na/K ratio presented higher adjusted OR for low handgrip strength (OR in women was 2.03; 95% confidence interval [CI]: 1.12-3.68, and in men was 2.19; 95% CI: 1.11-4.29).Conclusions: The risk of hypohydration was directly associated with low handgrip strength in older women. In older adults, higher values of urinary Na/K ratio were also directly associated with low handgrip strength.

The implications of following dietary advice regarding fish consumption frequency and meal size for the benefit (EPA + DHA and Se) versus risk (MeHg) assessment.

Fish contain healthy nutrients, such as ω3 polyunsaturated fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which protect against cardiovascular disease, and selenium (Se), which reduces methylmercury (MeHg) toxicity. Fish are also a dietary source of MeHg. This requires an assessment of the benefits versus risks. A risk-benefit evaluation showed that blue shark regardless of the way it is cooked generated high probabilities of surpassing the MeHg tolerable weekly intake (TWI), >22%. In tuna, boiling and grilling led to higher MeHg risks than canning, 6-37% versus <7%. EPA + DHA contributed for the prevention of coronary disease. With exception of blue shark, Se neutralised MeHg toxicity. Higher MeHg risk was associated with blue shark and boiled and grilled tuna consumption. For tuna, however, high Se content after boiling and grilling may mitigate MeHg risk.

Risk of Suicidal Behavior With Use of Efavirenz: Results from the Strategic Timing of Antiretroviral Treatment Trial.

Background: Randomized trials have shown increased risk of suicidality associated with efavirenz (EFV). The START (Strategic Timing of Antiretroviral Treatment) trial randomized treatment-naive human immunodeficiency virus (HIV)-positive adults with high CD4 cell counts to immediate vs deferred antiretroviral therapy (ART). Methods: The initial ART regimen was selected prior to randomization (prespecified). We compared the incidence of suicidal and self-injurious behaviours (suicidal behavior) between the immediate vs deferred ART groups using proportional hazards models, separately for those with EFV and other prespecified regimens, by intention to treat, and after censoring participants in the deferred arm at ART initiation. Results: Of 4684 participants, 271 (5.8%) had a prior psychiatric diagnosis. EFV was prespecified for 3515 participants (75%), less often in those with psychiatric diagnoses (40%) than without (77%). While the overall intention-to-treat comparison showed no difference in suicidal behavior between arms (hazard ratio [HR], 1.07, P = .81), subgroup analyses suggest that initiation of EFV, but not other ART, is associated with increased risk of suicidal behavior. When censoring follow-up at ART initiation in the deferred group, the immediate vs deferred HR among those who were prespecified EFV was 3.31 (P = .03) and 1.04 (P = .93) among those with other prespecified ART; (P = .07 for interaction). In the immediate group, the risk was higher among those with prior psychiatric diagnoses, regardless of prespecified treatment group. Conclusions: Participants who used EFV in the immediate ART group had increased risk of suicidal behavior compared with ART-naive controls. Those with prior psychiatric diagnoses were at higher risk.

Dietary DHA, bioaccessibility, and neurobehavioral development in children.

Docosahexaenoic acid (DHA) is a key nutritional n-3 polyunsaturated fatty acid and needs to be supplied by the human diet. High levels of DHA intake appear to reduce the risk of depression, bipolar disorder, and mood disorders. On the basis of these connections between DHA and neurological health, this paper reviews what is currently known about DHA and children neurodevelopment as well as the benefits of DHA intake to prevention of autism and behavior disorders through a selective and representative revision of different papers ranging from pure observational studies to randomized controlled trials (RCTs). This review also highlights the issue of DHA bioaccessibility and its implications to the performance of studies. As main conclusions, it can be mentioned that high DHA intake may prevent autism disorder. However, more studies are required to strengthen the connection between autism and dietary DHA. Regarding behavioral disorders, the evidence is also contradictory, thereby raising the need of further studies. From all screened studies on autism, attention deficit/hyperactivity disorder, and other disorders, it can be concluded that study samples should be larger for greater statistical significance and RCTs should be more carefully designed.

Handgrip strength values of Portuguese older adults: a population based study.

BACKGROUND: Handgrip strength is used to identify sarcopenia and frailty phenotypes, being a potential predictor of mortality in older adults. However, uniformity is lacking in the reference values. This study aimed to describe handgrip strength values of older population aged ≥65 years in Portugal, considering the possible influence of anthropometric parameters. METHODS: A cross-sectional study was conducted in Portugal, among 1500 older adults aged ≥65 years old, according to "The Nutrition UP 65 Study Protocol". Demographic data were collected and cognitive performance, subjective general health, physical activity, anthropometric parameters and nutritional status were assessed and analysed. Handgrip strength data was obtained with a Jamar dynamometer. A Pubmed/Medline search was carried out to compare handgrip strength data between Portuguese older adults and other older populations. RESULTS: Handgrip strength was higher among men than among women (30.3 ± 9.2 Kgf vs 18 ± 5.4 Kgf, p < 0.001, respectively). In general, handgrip strength values of Portuguese older adults were lower than other older populations. In our sample, age, cognitive and nutritional status, self-reported sitting time and practice of physical activity were significantly correlated with handgrip strength in both sexes. Concerning anthropometric parameters, height was the most significantly correlated with handgrip strength (r = 0.34, p < 0.001, in women and r = 0.40, p < 0.001, in men). CONCLUSION: This study described, for the first time, handgrip strength values of Portuguese population aged ≥65 years, according to age and to sex-specific tertiles of height. The definition of handgrip strength reference values in this age group merits further reflection.

Association between serum 25-hidroxyvitamin D concentrations and ultraviolet index in Portuguese older adults: a cross-sectional study.

BACKGROUND: The older population is a risk group for hypovitaminosis D. The Ultraviolet Index (UVI) can be an indicator of potential for cutaneous synthesis of vitamin D but physiological and other environmental factors also influence vitamin D synthesis and status. Knowledge about vitamin D status in Portuguese older adults is limited. This study aims to explore the association between Ultraviolet Index and serum 25-hidroxyvitamin D3 [25(OH)D] levels accounting for other potential influential factors. METHODS: A cross-sectional study was conducted between December 2015 and June 2016, in 1497 Portuguese older adults (≥ 65 years) within Nutrition UP 65 project. For each participant, serum 25(OH)D was determined and the mean UVI (mUVI) in the respective residence district was calculated for the previous 30 days. Stepwise linear regression analyses were conducted for the following periods of blood collection: between December and June, December and March and April and June. Standardized regression coefficients (Sß) and 95% confidence intervals were calculated. RESULTS: The median 25(OH)D concentration was 35.9 nmol/L. The UVI was independently and positively associated with 25(OH)D in the models for December-June (Sß = 0.244, 95% CI: 0.198; 0.291, P < 0.001) and April-June (Sß = 0.295, 95% CI: 0.299; 0.362, P < 0.001) and independently and negatively associated in December-March period (Sß = -0.149, 95% CI: -0.211; -0.087, P < 0.001). CONCLUSIONS: In this sample with high vitamin D deficiency frequency, the UVI was a predictor of 25(OH)D levels but the direction of the association varied according to the blood collection period. Our results suggest that accounting for the time of year in future research regarding vitamin status and related public health recommendations may be relevant.

Tocopherols in Seafood and Aquaculture Products.

Fish products contain various nutritionally beneficial components, namely, ω3-polyunsaturated fatty acids (ω3-PUFA), minerals, and vitamins. Particularly, tocopherols (α-, ß-, γ-, and δ-tocopherol) can be provided by seafood and aquaculture products. Hence, this review shows the various aspects of tocopherols in seafood and aquaculture products. For tocopherol determination in these products, HPLC methods coupled with diode array detection in the UV area of the spectrum or fluorescence detection have been shown as sensitive and accurate. These newest methods have helped in understanding tocopherols fate upon ingestion by seafood organisms. Tocopherols pass through the intestinal mucosa mainly by the same passive diffusion mechanism as fats. After absorption, the transport mechanism is thought to consist of two loops. The first loop is dietary, including chylomicrons and fatty acids bound to carrier protein, transporting lipids mainly to the liver. The other is the transport from the liver to tissues and storage sites. Moreover, tocopherol levels in fish organisms correlate with diet levels, being adjusted in fish body depending on diet concentration. For farmed fish species, insufficient levels of tocopherols in the diet can lead to poor growth performance or to nutritional disease. The tocopherol quantity needed as a feed supplement depends on various factors, such as the vitamer mixture, the lipid level and source, the method of diet preparation, and the feed storage conditions. Other ingredients in diet may be of great importance, it has been proposed that α-tocopherol may behave as a prooxidant synergist at higher concentrations when prooxidants such as transition metals are present. However, the antioxidant action of tocopherols outweighs this prooxidant effect, provided that adequate conditions are used. In fact, muscle-based foods containing higher levels of tocopherol show, for instance, higher lipid stability. Besides, tocopherols are important not only from the nutritional point of view but also from the physiological one, since they are involved in many metabolic processes in the human organism. Moreover, synergistic interactions with selenium and ascorbic acid have been reported. It deserves attention that there is evidence tocopherols taken with food can prevent heart disease, while no such evidence was found for α-tocopherol as supplement. From this perspective, eating fish is advisable, since, for instance, a 100 g serving of salmon may provide nearly 14% of recommended dietary allowance.