Obesity markers in patients with drug allergy and body fat as a predictor.

BACKGROUND: Obesity is a chronic low-grade inflammation state associated with several diseases. OBJECTIVE: To investigate a potential link between drug allergy and obesity, exploring whether the association depends on the type (immediate vs nonimmediate) or the severity of the reaction. METHODS: Anthropometric measurements, bioimpedance, and biochemical analysis, including serum adipokines, were performed in 90 consecutive adult patients studied for suspected drug allergy. Logistic regression models were developed to identify predictors of drug allergy. RESULTS: A total of 84 patients completed the diagnostic workup (78.6% women; mean age 39.58 ± 13.3 years). Drug allergy was confirmed in 39 patients and excluded in 45 (controls). Regarding body mass index, 42.2% had normal weight and 55.3% were overweight/obese. A total of 58% of women and 41% of men fulfilled the criteria for central obesity. Patients with drug allergy exhibited considerably higher body mass index, waist and hip circumferences, waist-hip ratio, fat mass, body fat percentage (BFP), trunk fat mass, leptin levels, and leptin-adiponectin ratio than controls. Similar results were obtained in the subgroup with immediate reactions, compared with the nonimmediate or unknown reactions. The higher the BFP and the number of reactions, the greater the odds of drug allergy (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.01-1.14 and OR, 2.82; 95% CI, 1.31-6.10, respectively). An immediate reaction was also a predictor of drug allergy (OR, 3.81; 95% CI, 1.30-11.14, P = .02), compared with nonimmediate or unknown reactions. In patients with drug allergy, BFP was a predictor of having an immediate reaction (OR, 1.12; 95% CI, 1.02-1.24, P = .02). CONCLUSION: Our study illustrates, for the first time, evidence of a link between obesity and drug allergy, particularly immediate reactions. The BFP emerged as a potential predictor of drug allergy.

Eating behaviour among nutrition students and social desirability as a confounder.

INTRODUCTION: The study of eating behaviour should consider the presence of potential sources of bias, including social desirability. This is particularly relevant among students of Nutrition Sciences, since they have a higher risk of eating disorders. OBJECTIVE: To analyse the effect of social desirability in the assessment of eating behaviour dimensions among nutrition students. METHODS: In this cross-sectional study, we analysed data from 149 students of Nutrition Sciences. Participants completed a questionnaire assessing social desirability and eating behaviour dimensions (emotional, external and binge eating, flexible and rigid control, and eating self-efficacy). RESULTS: Among males, social desirability had a negative association with binge eating, while among women it had a negative association with emotional, external and binge eating and a positive association with eating self-efficacy. In both subsamples, social desirability showed no significant association with any of the two types of dietary restraint (rigid and flexible control). DISCUSSION: Overall, the association between social desirability and eating behaviour dimensions among students of Nutrition Sciences occurs in the same direction as found in students from other areas. However, alongside these similarities, there is a stronger association between social desirability and binge eating among male students of Nutrition Sciences. We hypothesize that this may be related with the different knowledge of students from different areas, and the way they perceive and face the treatment of eating disorders. CONCLUSION: Our study shows that social desirability should be considered while assessing eating behaviour among nutrition students, particularly when studying external eating, binge eating and eating self-efficacy. Moreover, when tailoring interventions to reduce the possible effects of eating behaviour on nutritionists and dieticians' practice, we should consider the influence of social desirability.

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.

Eating behaviour among undergraduate students. Comparing nutrition students with other courses.

Our main aim was to compare eating behaviour between Portuguese undergraduate nutrition students and students attending other courses. Several eating behaviour dimensions were compared between 154 nutrition students and 263 students from other areas. Emotional and external eating were assessed by the Dutch Eating Behavior Questionnaire, dietary restraint was measured using the flexible and rigid control of eating behaviour subscales, binge eating was measured using the Binge Eating Scale, and eating self-efficacy using the General Eating Self-Efficacy Scale. Higher levels of flexible and rigid control were found in nutrition students from both sexes when compared to students from other courses. Female nutrition students also presented higher binge eating levels than their colleagues from other courses. To our knowledge no other work has previously assessed all eating behaviour dimensions considered in the current study among nutrition students. Besides the results by themselves, the data obtained from this study provide several clues to further studies to be developed regarding the still rarely approached issue of eating behaviour among nutrition students.

Determinants of Nutritional Risk among Community-Dwelling Older Adults with Social Support.

BACKGROUND: It is well established that older adults are at risk for malnutrition due to several social and non-social determinants, namely physiological, psychosocial, dietary and environmental determinants. The progression to malnutrition is often insidious and undetected. Thus, nutritional assessment should consider a complex web of factors that can impact nutritional status (NS). The primary objective of this study was to assess the NS of older adults attending senior centres (SCs) and to identify its predictors. METHODS: This cross-sectional study enrolled a sample of community-dwelling older adults in Lisbon. NS was assessed using Mini Nutritional Assessment (MNA®). Malnutrition or malnutrition risk (recategorised into a single group) was predicted using binary logistic regression models, considering those participants classified as having a normal NS as the reference group. Data were collected through face-to-face interviews and anthropometric indices were measured according to Isak procedures. RESULTS: A sample of 337 older adults, with an average age of 78.4 years old (range 66-99), mostly women (n = 210; 62.3%), were enrolled. Older adults at risk of malnutrition accounted for 40.7% of the sample. Being older (OR = 1.045, CI 95% [1.003-1.089], p = 0.037), having a worse perception of health status (OR = 3.395, CI 95% [1.182-9.746], p = 0.023), having or having had depression (OR = 5.138, CI 95% [2.869-9.201], p < 0.001), and not having or having had respiratory tract problems (OR = 0.477, CI 95% [0.246-0.925], p = 0.028) were independent predictors of malnutrition or malnutrition risk. An intermediate time of SC attendance was associated with a lower probability of malnutrition or risk (OR = 0.367, CI 95% [0.191-0.705], p = 0.003). CONCLUSIONS: NS among older adults has a multifactorial aetiology, with a strongly social component and is related to health circumstances. Further research is needed to timely identify and understand nutritional risk among this population.

Dietary parameters in patients with drug allergy: Assessing dietary inflammatory index.

BACKGROUND: Research on the increasing incidence of allergic diseases evidenced the role of diet as a potential key factor. Diet can modulate the low-grade systemic inflammation related to obesity and several diseases. There are no published data on drug allergy. AIM: To investigate a potential association between diet, including dietary inflammatory index (DII), and drug allergy. Also, to evaluate correlations between diet and obesity, inflammatory and metabolic parameters in patients with drug allergy. METHODS: Ninety consecutive patients studied for suspected drug allergy were evaluated in terms of dietary parameters, anthropometric measurements, bioimpedance and biochemical analysis. DII was calculated based on information collected from a food frequency questionnaire. RESULTS: After diagnostic work-up, 39 patients had confirmed drug allergy and 45 excluded, representing the study group and the control group, respectively. The majority (79%) were female, with mean age of 39.58±13.3 years. The 84 subjects revealed an anti-inflammatory diet pattern. No significative difference was found in DII scores between drug allergic patients and controls (-3.37±0.95 vs -3.39±0.86, p = 0.985). However, the patients with drug allergy revealed higher obesity and inflammatory parameters. A significative negative correlation was found between DII and adiponectin levels, in the control group (r = -0.311, p = 0.040). In the patient group, a significative positive correlation was observed between DII and triglycerides (r = 0.359, p = 0.032). No other correlations were found between DII and the assessed parameters. Patients with drug allergy presented a significative higher intake of mono-unsaturated fatty-acids comparing to controls (19.8±3.7 vs 17.8 ± 4.0, p = 0.021). No other statistically significant differences were achieved in dietary parameters, between patients and controls. CONCLUSION: The population assessed in this study revealed an anti-inflammatory diet profile. Although we have found in a previous work that the same patients with drug allergy revealed higher obesity and inflammatory parameters, the DII did not allow to distinguish between patients with drug allergy or controls. The DII scores correlated with triglycerides levels in the drug allergy patients and inversely with adiponectin levels in the control group. Larger studies are needed to clarify the potential role of the diet in drug allergy and its outcomes.

Attitudes toward genetic testing and personalised nutrition in a representative sample of European consumers.

Negative consumer opinion poses a potential barrier to the application of nutrigenomic intervention. The present study has aimed to determine attitudes toward genetic testing and personalised nutrition among the European public. An omnibus opinion survey of a representative sample aged 14-55+ years (n 5967) took place in France, Italy, Great Britain, Portugal, Poland and Germany during June 2005 as part of the Lipgene project. A majority of respondents (66 %) reported that they would be willing to undergo genetic testing and 27 % to follow a personalised diet. Individuals who indicated a willingness to have a genetic test for the personalising of their diets were more likely to report a history of high blood cholesterol levels, central obesity and/or high levels of stress than those who would have a test only for general interest. Those who indicated that they would not have a genetic test were more likely to be male and less likely to report having central obesity. Individuals with a history of high blood cholesterol were less likely than those who did not to worry if intervention foods contained GM ingredients. Individuals who were aware that they had health problems associated with the metabolic syndrome appeared particularly favourable toward nutrigenomic intervention. These findings are encouraging for the future application of personalised nutrition provided that policies are put in place to address public concern about how genetic information is used and held.

[Prevalence of the metabolic syndrome: comparison between ATPIII and IDF criteria in a feminine population with severe obesity]. / Prevalência da sindrome metabólica: comparação entre os critérios ATPIII e IDF numa população feminina com obesidade.

INTRODUCTION: The metabolic syndrome (MS) consists of the conjoint presence of risk factors for coronary. Several study groups have developed diagnostic criteria for MS, standing out those from the "Adult Treatment Panel III" (ATPIII), due to their wide utilization. Recently, the International Diabetes Federation (IDF) developed new diagnostic criteria for MS. OBJECTIVES: To evaluate the prevalence of MS in a group of women with severe obesity. To evaluate the prevalence of each one of the diagnostic criteria for MS. To compare the results obtained with the utilization of the ATPIII and the IDF criteria. To relate the results with the patients' age and Body Mass Index (BMI). SAMPLE AND METHODS: We evaluated 128 women (mean age = 38 years, sd = 11) with BMI equal to or higher than 35.0 kg/m2 (mean BMI = 46.5 kg/m2, sd = 6.5) on anthropometric measures (weight, height and waist circumference), analytically (fasting serum levels of triglycerides, HDL cholesterol and glucose), being also registered the values of systolic and diastolic blood pressure and age. RESULTS: The prevalence of MS in our sample following the ATPIII and the IDF criteria was, respectively, of 66.4% e 70.3%. The most frequently filled in criteria are those referring to waist circumference (ATPIII: 99.2%; IDF: 100%), blood pressure (77.3%) and HDL cholesterol (69.5%). Older patients and those with higher BMI fill in more criteria, being the diagnostic of MS associated to higher mean age and BMI. CONCLUSION: The prevalence of MS in women with severe obesity is high, being similar when the ATPIII or the IDF diagnostic criteria are used.

[Circadian energy intake evaluation of a group of office workers in Porto]. / Avaliação da ingestão energética circadiana: num grupo de trabalhadores da segurança social do Porto.

The importance of food in health promotion and disease prevention is well known. The aims of our study were to evaluate the daily energy intake of an adult group; to study the association of a 24 hour recall (R24h) and a Food Frequency Questionnaire (FFQ); to analyse energy intake variation with obesity and to verify if our sample had an ingestion according to DRI's. We studied a convenience sample of Portuguese adult population of 154 office workers (121 women), with a mean of ages of 44.2 +/- 12.1 years. We used a self administered FFQ and a R24h to evaluate food habits. Middle number of meals was 4.8 +/- 1.0 meals (breakfast, lunch and dinner were the most frequent). Middle daily ingestion was 1908 +/- 559 kcal. Men had a superior energy intake at all meals, except at afternoon snack and supper. We did not find any relation between BMI and food intake, BMI is only related with age. We compared our sample ingestion with DRI's and verified that vitamins B1, B2, B12, B6, C, niacin, Fe and P, were totally reached, and the inverse was obtained in Zn, folate, vitamin D and E, pantothenic acid and biotin. We conclude that our sample ingestion of protein is higher than the recommended, carbohydrates is less consume than the recommended and only recommendations of fat and alcohol consumption were in agreement with WHO recommendations.