Browsing by Author "Moreira, Pedro"
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- Alergia Alimentar na RestauraçãoPublication . Pádua, Inês; Barros, Renata; Moreira, Pedro; Moreira, André; Graça, Pedro; Carrelhas, HelenaO Manual de Alergia Alimentar para a Restauração foi criado com o objetivo de informar, educar e ajudar os setores da restauração, hotelaria e turismo a lidar com a alergia alimentar e com as novas disposições previstas no regulamento 1169/2011 da União Europeia. O presente manual inclui assim componentes educacionais e práticas na abordagem à alergia alimentar na restauração, não tendo caráter vinculativo ou legal, nem substituindo a abordagem médica ou nutricional no diagnóstico e tratamento da doença. A informação disponível relativamente à presença de alergénios nos alimentos processados e preparações culinárias é exemplificativa, permitindo a adaptação ao desenvolvimento de novos géneros alimentícios e receitas culinárias. Todos os contributos e informações adicionais poderão assim ser remetidos para o Centro de Competências de Alergia Alimentar da Universidade do Porto, de forma a contribuir para a melhoria contínua do manual e dos serviços prestados pela restauração aos clientes com alergia alimentar.
- An anti-inflammatory and low fermentable oligo, di, and monosaccharides and polyols diet improved patient reported outcomes in fibromyalgia : a randomized controlled trialPublication . Silva, Ana Rita; Bernardo, Alexandra; Mesquita, Maria Fernanda de; Vaz-Patto, José; Moreira, Pedro; Silva, Maria Leonor; Patrícia, PadrãoBackground: Fibromyalgia (FM) has been associated with dysbiosis and low-grade inflammation. Studies have reported that diet influences clinical features in FM. Objective: To evaluate the effect of an anti-inflammatory and low fermentable oligo, di, and monosaccharides and polyols (FODMAP) diet on clinical outcomes of patients with FM. Methods: This two arms Randomized Controlled Trial (NCT04007705) included 46 female patients with FM. The intervention group (n = 22) adopted an anti-inflammatory diet for 3 months, excluding gluten, dairy, added sugar, and ultra-processed foods, along with a low FODMAPs diet in the first month. The control group (n = 24) followed general healthy eating recommendations. Both diets were applied by a certified dietitian. Before and after the intervention, participants were assessed regarding pain, fatigue, gastrointestinal symptoms, quality of sleep, and quality of life, through the Revised Fibromyalgia Impact Questionnaire (FIQR), Visual Analogue Pain Scale (VAS), Visual Analog Scale from gastrointestinal symptoms (VAS GI), Brief Pain Inventory (BPI), Pittsburg Sleep Quality Index (PSQI), Fatigue Severity Survey (FSS), and The Short Form Health Survey (SF-36). A blood sample was collected and high-sensitive C-Reactive Protein and Erythrocyte Sedimentation Rate were quantified. Paired Samples t-test/Wilcoxon and independent samples t-test/Mann−Whitney were used to compare variables between groups. Results: After intervention, there was an improvement in intervention group scores of FIQR (p = 0.001), VAS (p = 0.002), BPI (p = 0.011), FSS (p = 0.042), VAS_GI (p = 0.002), PSQI (p = 0.048), and SF36 (p = 0.045) compared to control group. Inflammatory biomarkers (hs-CRP, ESR) did not change in both groups. The intervention was beneficial in the intervention group, regardless of age, disease duration, body mass index variation, and body fat change between baseline and post-intervention. Conclusion: An anti-inflammatory and low-FODMAP diet improved clinical features in patients with FM and may be useful as a complement to pharmacological therapy.
- Assessing quality of life in severe obesity: development and psychometric properties of the ORWELL-RPublication . Camolas, José; Ferreira, André; Mannucci, Edoardo; Mascarenhas, Mário; Carvalho, Manuel; Moreira, Pedro; Carmo, Isabel do; Santos, OsvaldoPURPOSE: Several health-related quality-of-life (HRQoL) dimensions are affected by obesity. Our goal was to characterize the psychometric properties of the ORWELL-R, a new obesity-related quality-of-life instrument for assessing the "individual experience of overweightness". METHODS: This psychometric assessment included two different samples: one multicenter clinical sample, used for assessing internal consistency, construct validity and temporal reliability; and a community sample (collected through a cross-sectional mailing survey design), used for additional construct validity assessment and model fit confirmation. RESULTS: Overall, 946 persons participated (188 from the clinical sample; 758 from community sample). An alpha coefficient of 0.925 (clinical sample) and 0.934 (community sample) was found. Three subscales were identified (53.2 % of variance): Body environment experience (alpha = 0.875), Illness perception and distress (alpha = 0.864), Physical symptoms (alpha = 0.674). Adequate test-retest reliability has been confirmed (ICC: 0.78 for the overall score). ORWELL-R scores were worse in the clinical sample. Worst HRQoL, as measured by higher ORWELL-R scores, was associated with BMI increases. ORWELL-R scores were associated with IWQOL-Lite and lower scores in happiness. CONCLUSIONS: ORWELL-R shows good internal consistency and adequate test-retest reliability. Good construct validity was also observed (for convergent and discriminant validity) and confirmed through confirmatory factor analysis (in both clinical and community samples). Presented data sustain ORWELL-R as a reliable and useful instrument to assess obesity-related QoL, in both research and clinical contexts.
- Association between sodium excretion and hydration status by Free Water Reserve: a cross-sectional analysis in adolescentsPublication . Gonçalves, Carla; Abreu, Sandra; Padrão, Patrícia; Pinho, Olívia; Graça, Pedro; Breda, João; Santos, Rute; Moreira, PedroBackground: Excessive sodium intake is excreted through urine and could affect hydration status. This study aims to describe hydration status in adolescents and to assess the association between hydration status by free water reserve (FWR) and urinary sodium excretion. Methods: Two hundred participants (118 girls), aged 13–18 years completed the study. Median urinary sodium excretion was measured in one 24-hour collection and was used as a proxy for sodium intake. FWR (measured urine volume minus the obligatory urine volume) was used for characterization of hydration status, and linear regression models were used to evaluate the association between urinary sodium excretion and FWR, adjusted for water and energy intake in boys and carbohydrate, fiber, and water intake in girls. Results: The participants median urinary sodium excretion was 3645.5 mg/d for boys and 2702.5 mg/d for girls (p < 0.001). Median FWR was positive in both sex groups; however, 40.2 % of boys and 31.4 % of girls (p = 0.195) were at risk of hypo-hydration status. Linear regression models showed that urinary sodium excretion was a significant predictor of FWR for both sexes (Crude Model β = 0.114, p = 0.003 for boys and β = 0.160, p < 0.001 for girls; Adjusted Model β = 0.120, p = 0.002 for boys and β = 0.142, p < 0.001 for girls). Conclusions: Nearly one third of subjects were at risk of hypo-hydration. Higher sodium excretion was associated with a better hydration status obtained by FWR. However, as the majority of subjects consume sodium above recommendations, preventive measures to promote better hydration status should focus in increasing the level of total water intake.
- INDIVIDUO: intervenção nutricional direcionada aos estilos de vida em indivíduos com obesidadePublication . Camolas, José; Santos, Osvaldo; Mascarenhas, Mário; Moreira, Pedro; Carmo, Isabel doO paradigma terapêutico em obesidade força os profissionais de saúde a decisões clínicas partilhadas com o doente. A adoção de novos padrões alimentares depende de múltiplas mudanças comportamentais propostas pelos profissionais de saúde, que podem ter impacto negativo na qualidade de vida dos doentes, dificultando a sua manutenção. Este artigo apresenta o modelo de intervenção nutricional INDIVIDUO. Trata-se de uma intervenção estruturada, que integra recomendações nutricionais baseadas na evidência com estratégias relacionais promotoras de mudança comportamental sustentável. Apresenta-se também o protocolo do primeiro ensaio clínico controlado, que visa avaliar a efetividade desta intervenção. Sendo direcionada a candidatos a cirurgia da obesidade, em contexto de consulta multidisciplinar, espera-se que a intervenção seja promotora e/ou catalisadora de mudanças comportamentais sustentáveis, conducentes a melhorias clínicas significativas, a nível do peso corporal, controlo metabólico e qualidade de vida relacionada com a saúde.
- INDIVIDUO: Results from a patient-centered lifestyle intervention for obesity surgery candidatesPublication . Camolas, José; Santos, Osvaldo; Moreira, Pedro; Carmo, Isabel doPreoperative nutritional counseling provides an opportunity to ameliorate patients' clinical condition and build-up adequate habits and perception of competence. Study aimed to evaluate: (a) the effect of INDIVIDUO on weight and metabolic control; (b) the impact of INDIVIDUO on psychosocial variables associated with successful weight-control.
- Potassium urinary excretion and dietary intake: a cross-sectional analysis in 8–10 year-old childrenPublication . Oliveira, Ana Catarina; Padrão, Patrícia; Moreira, André; Graça, Pedro; Breda, João; Moreira, Pedro; et alBackground: Data from studies assessing the intake of potassium, and the concomitant sodium-to-potassium ratio are limited. The aim of this study was to evaluate potassium and sodium-to-potassium ratio intake in 8–10 year-old children. Methods: A cross-sectional survey was carried out from January to June 2014 and data from 163 children (81 boys) were included. Potassium intake was estimated by 24-h urine collection and coefficient of creatinine was used to validate completeness of urine collections. Urinary sodium and sodium-to-potassium ratio were also analysed. A 24-h dietary recall was used to provide information on dietary sources of potassium. Height and weight were measured according to international standards. Results: The mean urinary potassium excretion was 1701 ± 594 mg/day in boys, and 1682 ± 541 mg/day in girls (p = 0.835); 8.0 % of children met the WHO recommendations for potassium intake. The mean sodium excretion was 2935 ± 1075 mg/day in boys and 2381 ± 1045 mg/day in girls (p <0.001) and urinary sodium-to-potassium ratio was 3.2 ± 1.4 in boys, and 2.5 ± 1.1 in girls (p = 0.002). The mean fruit and vegetable intake was 353.1 ± 232.5 g/day in boys, and 290.8 ± 213.1 g/day in girls (p = 0.101). Conclusions: This study reported a low compliance of potassium intake recommendations in 8–10 year-old children. Health promotion interventions are needed in order to broaden public awareness of potassium inadequacy and to increase potassium intake.
- Promovendo mudanças comportamentais sustentáveis no controlo do peso corporalPublication . Camolas, José; Santos, Osvaldo; Moreira, Pedro; Carmo, Isabel doA obesidade assume atualmente uma importância óbvia, expressa pelos esforços de investigação, de saúde pública e clínicos, a nível mundial. Se a evidência produzida aponta para algumas direções de sucesso terapêutico, a efetividade destas a médio ou longo prazo tende a ser pouco satisfatória. A literatura não é inequívoca em áreas nucleares da intervenção nutricional para tratamento da obesidade, como sejam a magnitude da restrição energética, a proporção dos macronutrientes, o fracionamento alimentar, entre outros. O mesmo acontece na área da recomendação de atividade física. Proliferam assim as formas de intervenção e importa portanto fazer um exercício de integração da evidência científica e clínica. Este artigo consiste numa revisão narrativa de questões centrais para a prática da intervenção em obesidade, nomeadamente no que toca às ações que, no seu conjunto, visam a redução e/ou controlo do peso corporal e seus benefícios. Salienta-se o papel do profissional de saúde como promotor de hábitos que favorecem o controlo do peso corporal, numa perspetiva que integra o saber científico do profissional com a disponibilidade e capacidade para a mudança do doente.
- Sodium and potassium urinary excretion and dietary intake: a cross-sectional analysis in adolescentsPublication . Gonçalves, Carla; Abreu, Sandra; Padrão, Patrícia; Graça, Pedro; Breda, João; Moreira, Pedro; et alBackground: Hypertension is the leading cause for heart disease and stroke, for mortality and morbidity worldwide, and a high sodium-to-potassium intake ratio is considered a stronger risk factor for hypertension than sodium alone. Objective: This study aims to evaluate sodium and potassium urinary excretion, and assess the food sources of these nutrients in a sample of Portuguese adolescents. Design: A cross-sectional study with a sample of 250 Portuguese adolescents. Sodium and potassium excretion were measured by one 24-h urinary collection, and the coefficient of creatinine was used to validate completeness of urine collections. Dietary sources of sodium and potassium were assessed using a 24-h dietary recall. Results: Valid urine collections were provided by 200 adolescents (118 girls) with a median age of 14.0 in both sexes (p 0.295). Regarding sodium, the mean urinary excretion was 3,725 mg/day in boys and 3,062 mg/day in girls (pB0.01), and 9.8% of boys and 22% of girls met the World Health Organization (WHO) recommendations for sodium intake. Concerning potassium, the mean urinary excretion was 2,237 mg/day in boys and 1,904 mg/day in girls (pB0.01), and 6.1% of boys and 1.7% of girls met theWHOrecommendations for potassium intake. Major dietary sources for sodium intake were cereal and cereal products (41%), meat products (16%), and milk and milk products (11%); and for potassium intake, main sources were milk and milk products (21%), meat products (17%), and vegetables (15%). Conclusions: Adolescents had a high-sodium and low-potassium diet, well above the WHO recommendations. Health promotion interventions are needed in order to decrease sodium and increase potassium intake.
- A study protocol for a randomized controlled trial of an anti-inflammatory nutritional intervention in patients with fibromyalgiaPublication . Silva, Ana Rita; Bernardo, Alexandra; Mesquita, Maria Fernanda de; Patto, José Vaz; Moreira, Pedro; Silva, Maria Leonor; Padrão, PatríciaBackground: This study aims to analyze the effects of a potentially anti-inflammatory nutritional intervention in disease assessment parameters, inflammatory markers, and quality of life of fibromyalgia (FM) patients. Methods: A sample of 100 female patients diagnosed with FM, followed up at Portuguese Institute of Rheumatology (IPR) in Lisbon, is being randomly allocated in two groups. Patients in the intervention group are adopting an anti-inflammatory diet, characterized by the exemption of the intake of foods containing gluten, dairy, sugar, and ultra-processed foods, during 3 months. During the first month, a low fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) diet is implemented, along with the anti-inflammatory diet, followed by the reintroduction of all fruits and vegetables over a consecutive period of 2 months. Patients in the control group are adopting a diet based on general recommendations for healthy eating. The outcomes are pain, fatigue, quality of sleep, quality of life, gastrointestinal symptoms, and inflammation. Before and after the 3 months intervention, and also 1 month after beginning the intervention, the following questionnaires are applied: Revised Fibromyalgia Impact Questionnaire, visual analog pain scale, Brief Pain Inventory,visual analog scale from a list of common gastrointestinal and extraintestinal symptoms in FM, Short Form 36, Fatigue Severity Survey, and Pittsburg Sleep Quality Index. Ultra-sensitive serum C-reactive protein, eritrocyte sedimentation rate, and interleukin-8 are determined. Age, physical activity, anthropometric parameters, and body composition are being collected. Student’s t test will assess the association between the disease evaluation parameters, the inflammatory markers, and the dietary interventions. Discussion: The results of this study are expected to determine whether a change in patient nutrition helps to alleviate symptoms, which would optimize medical intervention.