Diet quality in elderly Portuguese households.

OBJECTIVE: To identify diet quality time trends in Portuguese elderly households and the association of diet quality with sociodemographic characteristics. DESIGN: Set of four cross-sectional studies. SETTING: Portuguese population. SUBJECTS: Nationally representative samples from Household Budget Surveys (1989-1990, 1994-1995, 2000-2001 and 2005-2006 versions). Households with members aged ≥ 65 years were categorized as solitary elderly female, solitary elderly male, or elderly couple (composed of one elderly female and one elderly male) and compared with adult households with the same composition. METHODS: Diet quality was assessed through a revised version of the Healthy Diet Indicator (HDIr). Univariate and multiple backward linear regression models were used to study the association with sociodemographic characteristics. RESULTS: Mean values of dietary index were low and the proportion of elderly households with low diet quality (HDIr≤4) was high (between 47.4% and 68.4%). However, the frequency of HDIr inadequacy for adult household was even higher (P<0.05). In general, adjusted coefficients for survey year, educational level of the household head, and eating out expenses were inversely associated with HDIr; whilst semi-urban and rural location of the households predicted higher HDIr values. Exceptions were found in elderly male households where the educational level of the household head was positively associated with HDIr values. CONCLUSIONS: Overall, diet quality was low and decreased over time but lonely elderly female and elderly couple households had higher values of HDIr. Adherence to a healthier diet was associated with lower educational level of the household head and location of the household in less urbanized areas.

Markers of metabolic syndrome in obese children before and after 1-year lifestyle intervention program.

PURPOSE: Excess weight may be related to the development of adverse cardiometabolic risk factors in children. The aim of this study was to evaluate the effect of a lifestyle intervention program (nutrition and exercise counseling) on anthropometric parameters and metabolic syndrome (MS) components in Portuguese overweight/obese children. METHODS: A total of 83 overweight/obese children aged 7-9 years were assigned to a 1-year individual or group-based treatment (GT); 61 children (z-score BMI (zBMI): 1.93 ± 0.28; 27 boys and 34 girls) completed the program. Anthropometric and biochemical parameters were assessed at baseline, at 6 months and at 1 year. RESULTS: The overweight/obese children, compared to normal-weight ones, presented significantly higher blood pressure, total-cholesterol, total-cholesterol/high density lipoprotein cholesterol (HDL) ratio, triglycerides, Apolipoprotein B and C-reactive protein levels, while HDL and Apolipoprotein A-I were significantly lower. At baseline, the prevalence of MS was 16.4% in overweight/obese and 0% in normal-weight children. The number of components of MS was significantly higher in children with higher zBMI. Lifestyle intervention led to a significant improvement in zBMI, waist circumference/height ratio, HDL, triglycerides, Apolipoprotein A-I, and Apolipoprotein B levels. The prevalence of MS decreased to 14.8%. The GT intervention seems to be more successful, with a significant decrease in zBMI and an increase in HDL and a lower drop-out rate. CONCLUSIONS: Overweight/obese children have multiple risk factors associated with the MS. Lifestyle intervention, both individual and group-based treatment, led to an improvement in the degree of overweight/obesity and in MS components.

Regional, demographic and national influences on attitudes and beliefs with regard to physical activity, body weight and health in a nationally representative sample in the European Union.

INTRODUCTION: Although the benefits of physical activity regarding body-weight gain and health in general are now widely accepted, physical activity levels remain low among citizens in the western world. This could be attributed to certain attitudes and beliefs about physical activity. Identifying and understanding these parameters would be the first step in an attempt to increase the levels of physical activity in populations generally characterized as having a sedentary lifestyle. OBJECTIVE: The aim of the present study was to identify the attitudes and beliefs regarding physical activity, body weight and health in a nationally representative sample in the EU and in particular to explore the demographic and national (cultural) influences on attitudes towards physical activity. DESIGN: In each member state of the EU, approximately 1000 adults aged 15 years and over, were selected to complete an interviewer-assisted face-to-face questionnaire. Overall, a sample of 15,239 individuals in the EU participated in the study. Subject selection was quota-controlled to ensure samples in each country were nationally representative. RESULTS: On a European level wide variations were observed regarding the levels, beliefs and attitudes towards physical activity. More positive beliefs were observed among Finns, while less positive beliefs were observed among southern Europeans. A similar pattern was observed for attitudes, with the Portuguese having the highest percentage feeling that they do not need to be more physically active than they already are. However, most southern Europeans felt that a campaign would encourage them to become more active than they already are. On a demographic level, the youngest, more educated and most physically active subjects had more positive attitudes and beliefs towards physical activity and the health benefits derived from it; while for the overweight, beliefs and attitudes toward physical activity were related primarily to the benefits related to weight control. CONCLUSIONS: Lower levels of physical activity, an unwillingness to become active among non-participants and confusion regarding the weight gain benefits and general health benefits of exercise were reported more frequently among southern Europeans and older and less educated subjects. The Finns scored highest in all these parameters, possibly due to the programmes implemented and the beliefs and behaviour changes observed in this country during the last few years. The actions taken in Finland and their benefits could be employed appropriately in the other European states.

Physical activity levels and body weight in a nationally representative sample in the European Union.

OBJECTIVES: The main objectives of this pan-European study were: (1) to identify different types of physical activity and the time devoted to them, (2) to assess physical activity/inactivity at work and in leisure time, and (3) to determine self-reported body weight and height. DESIGN AND SUBJECTS: In each member state of the EU, approximately 1000 adults, aged 15 years or more, were selected to participate in an interview-assisted face-to-face questionnaire on physical activity and body weight. In each country, sample selection was quota-controlled to ensure national representativeness. Overall, 15,239 subjects in the EU completed the study. RESULTS: On average in the EU, nearly three-quarters of the population participate in some kind of activity. In general, the highest proportions of participants were found in the Nordic countries and the lowest in the southern ones. At the European level, the five most common activities include walking, gardening, cycling, keep fit and swimming. Higher participation rates were found among men, younger subjects and those with a higher level of education. The majority of Europeans fall within the normal body mass index (BMI) range but more than one-third are overweight (31%) or obese (10%) and 11% have a BMI below 20. CONCLUSIONS: Several risk groups related to physical activity emerge from this survey: women, those with a lower level of education, older subjects, the overweight/obese and the underweight. Programmes to promote physical activity need to be tailored to the different groups identified in each country/region in order to increase adherence of non-participants and for the maintenance of those already engaged in activities.

Perceived benefits and barriers to physical activity in a nationally representative sample in the European Union.

OBJECTIVE: To examine the attitudes of consumers, in particular their perceived benefits and barriers to physical activity from all EU member states, and having a measure of prevailing levels of activity, inactivity and self-reported body weight and body shape. DESIGN: Cross-sectional survey using an interview-assisted face-to-face questionnaire. SETTING: The survey was conducted between March and April 1997 in the 15 member states of the EU. SUBJECTS: Overall, 15,239 EU subjects, classified according to sex, age (six levels) and highest level of education attained (primary, secondary or tertiary), completed the survey. Sample selection of subjects in each EU member state was quota-controlled to ensure they were nationally representative. RESULTS: The most important motivation for people to participate in physical activity is to maintain good health (42%), to release tension (30%) and to get fit (30%). The importance of the health argument is highest in older persons and in subjects with a primary education level. Only 13% of the EU population (16% of women, 10% of men) perceived losing weight as a benefit of physical exercise. The most important barriers to increase physical activity are work or study commitments (28%) and the subjects' belief that they are not 'the sporty type' (25%). There is considerable between-country variation in the answering pattern within the EU.