Browsing by Author "Rodrigues, Ana M."
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- Dietary Patterns Characterized by High Meat Consumption Are Associated with Other Unhealthy Life Styles and Depression SymptomsPublication . Gregório, Maria João; Rodrigues, Ana M.; Eusébio, Mónica; Sousa, Rute Dinis; Dias, Sara; André, Beate; Grønning, Kjersti; Coelho, Pedro S.; Mendes, Jorge M.; Graça, Pedro; Espnes, Geir A.; Branco, Jaime C.; Canhão, HelenaObjective: We aimed to identify dietary patterns (DPs) of Portuguese adults, to assess their socioeconomic, demographic, lifestyle determinants, and to identify their impact on health. Design: EpiDoC 2 study included 10,153 Portuguese adults from the EpiDoC Cohort, a population-based study. In this study, trained research assistants using computer assisted telephone interview collected socioeconomic, demographic, dietary, lifestyles, and health information from March 2013 to July 2015. Cluster analysis was performed, based on questions regarding the number of meals, weekly frequency of soup con sumption, vegetables, fruit, meat, fish, dairy products, and daily water intake. Factors associated with DP were identified through logistic regression models. results: Two DPs were identified: the “meat dietary pattern” and the “fruit & vegetables dietary pattern.” After multivariable adjustment, women (OR = 0.52; p < 0.001), older adults (OR = 0.97; p < 0.001), and individuals with more years of education (OR = 0.96; p = 0.025) were less likely to adopt the “meat dietary pattern,” while individuals in a situation of job insecurity/unemployment (OR = 1.49; p = 0.013), Azores island residents (OR = 1.40; p = 0.026), current smoking (OR = 1.58; p = 0.001), daily alcohol intake (OR = 1.46; p = 0.023), and physically inactive (OR = 1.86; p < 0.001) were positively and significantly associated with “meat dietary pattern.” Moreover, individuals with depres sion symptoms (OR = 1.50; p = 0.018) and the ones who did lower number of medical appointments in the previous year (OR = 0.98; p = 0.025) were less likely to report this DP. conclusion: Our results suggest that unhealthy DPs (meat DP) are part of a lifestyle behavior that includes physical inactivity, smoking habits, and alcohol consumption. Moreover, depression symptoms are also associated with unhealthy DPs.
- Disease mapping models for data with weak spatial dependence or spatial discontinuitiesPublication . Baptista, Helena; Congdon, Peter; Mendes, Jorge M.; Rodrigues, Ana M.; Canhão, Helena; Dias, Sara SimõesRecent advances in the spatial epidemiology literature have extended traditional approaches by including determinant disease factors that allow for non-local smoothing and/or non-spatial smoothing. In this article, two of those approaches are compared and are further extended to areas of high interest from the public health perspective. These are a conditionally specified Gaussian random field model, using a similaritybased non-spatial weight matrix to facilitate non-spatial smoothing in Bayesian disease mapping; and a spatially adaptive conditional autoregressive prior model.
- Food Insecurity Is Associated with Low Adherence to the Mediterranean Diet and Adverse Health Conditions in Portuguese AdultsPublication . Gregório, Maria João; Rodrigues, Ana M.; Graça, Pedro; Sousa, Rute Dinis de; Dias, Sara; Branco, Jaime C.; Canhão, HelenaBackground: Food insecurity is a limited or uncertain access to the adequate food and is a significant public health problem. We aimed to assess determinants of food insecurity and the corresponding health impact in Portugal, a southern European country that faced a severe economic crisis. Methods: Data were derived from the Epidemiology of Chronic Diseases Cohort Study (EpiDoC), a population-based cohort of 10,661 individuals that were representative of the Portuguese adult population and followed since 2011. A cross-sectional analysis of the third wave of evaluation (EpiDoC 3) was performed between 2015 and 2016. Food insecurity was assessed with the household food insecurity psychometric scale. Socioeconomic, demographic, lifestyle, adherence to Mediterranean diet (MD), self-reported non-communicable disease, health-related quality of life (HRQoL) (EQ-5D-3L), physical function (HAQ score), and health resource consumption information was also collected. Results: The estimated proportion of food insecurity was 19.3% among a total of 5,653 participants. Food insecure households had low adherence to the MD (OR = 0.44; 95% IC 0.31-0.62). In addition, diabetes (OR = 1.69; 95% IC 1.20-2.40), rheumatic disease (OR = 1.67; 95% IC 1.07-2.60), and depression symptoms (OR = 1.50; 95% IC 1.09-2.06) were independently associated with food insecurity. On average, food insecure households had a lower HRQoL (OR = 0.18; 95% IC 0.11-0.31) and a higher disability (OR = 2.59; 95% IC 2.04-3.29). A significantly higher proportion of food insecure households reported being hospitalized (OR = 1.57; 95% IC 1.18-2.07) and had more public hospital medical appointments (OR = 1.48; 95% IC 1.12-1.94) in the previous 12 months. Conclusion: We found that food insecurity is highly prevalent in Portugal. Food insecurity was associated with low adherence to the MD, non-communicable chronic diseases, lower quality of life, and higher health resource consumption. Therefore, this study provides valuable insight into the relationship between food security and the diet and health of the population during an economic crisis.
- Increased short-term risk of cardiovascular events in inflammatory rheumatic diseases: Results from a population-based cohortPublication . Da Silva Domingues, Vital; Rodrigues, Ana M.; Dias, Sara Simões; Delgado, Luís; Barkoudah, Ebrahim; Branco, J; Canhao, HCardiovascular diseases represent the frst cause of death globally. Infammatory rheumatic disease (IRMD) patients, due to their lifelong infammatory status, are at increased risk of developing premature cardiovascular disease. We aimed to assess the risk for cardiovascular events (CVE) in a population-based study. We followed 10,153 adults from the EpiDoC Cohort, a large Portuguese population-based prospective study (2011–2016). IRMD patients were identifed at baseline and followed during 5 years. CVE were defned as a composite of self-reported myocardial infarction or angina pectoris, arrhythmias, valvular disease, stroke or transient ischemic attack and peripheral artery disease. Statistical analysis was performed by utilizing multivariate logistic regression and goodness-of-ft and area under ROC curve. At baseline, IRMD patients had similar age as the non-IRMD participants (mean age 55 vs 53 years-old; 72.1% female); dyslipidaemia and sedentary lifestyle were more common (40.7% vs 31.4%, p=0.033; 87.3% vs 67%, p=0.016, respectively). During an average follow-up of 2.6 years, 26 CVE were reported among IRMD patients. IRMD patients had higher odd of CVE (OR 1.64, 95% CI 1.04–2.58; p=0.03), despite comparable mortality rates (1.7% vs 0.7%, p=0.806). A stepwise approach attained that gender, age, history of hypertension, body mass index, IRMD and follow-up time are the most important predictive variables of CVE (AUC 0.80). IRMD patients, at community level, have an increased short-term risk of major CVE when compared to non-IRMD, and that highlights the potential beneft of a systematic screening and more aggressive cardiovascular risk assessment and management of these patients.
- Prevalence of vitamin D deficiency and its predictors in the Portuguese population: a nationwide population-based studyPublication . Duarte, Catia; Carvalheiro, Helena; Rodrigues, Ana M.; Dias, Sara S.; Marques, Andréa; Santiago, Tânia; Canhão, Helena; Branco, Jaime Cunha; Silva, José António Pereira daSummary Vitamin D deficiency is prevalent worldwide, but its prevalence is unknown in adult Portuguese population. In Portugal, 66% of adults present Vitamin D insufficiency/deficiency. Winter, living in Azores, older age, and obesity were the most important risk factors. It highlights the need of strategies to prevent vitamin D deficiency in Portugal. Objective To estimate the prevalence and risk factors of vitamin D deficiency in the adult Portuguese population. Methods Adults (≥ 18 years old) from the EpiReumaPt Study (2011–2013) were included. Standardized questionnaires on sociodemographic and lifestyle features were obtained. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were evaluated using ADVIA Centaur VitD competitive immunoassay (Siemens Healthineers) in 2015–2017 as 25 (OH)D Level 0: ≤ 10 ng/mL; Level 1: 11–19 ng/mL; Level 2: 20–29 ng/mL, and Level 3: ≥ 30 ng/mL. Weighted multinomial regression analysis was conducted to evaluate the association between socio-demographic and lifestyle variables and vitamin D status. Results Based on weighted analysis, the estimated prevalence of levels of 25(OH)D ≤ 10, < 20, and < 30 ng/mL was 21.2, 66.6, and 96.4%, respectively. The strongest independent predictors of serum 25 (OH)D ≤ 10 ng/mL were living in the Azores archipelagos (OR 9.39; 95%CI 1.27–69.6) and having the blood sample collection in winter (OR 18.53; 95%CI 7.83–43.87) or spring (11.55; 95%CI 5.18–25.74). Other significant predictors included older age (OR 5.65, 95%CI 2.08–15.35), obesity (OR 2.61; 95%CI 1.35–5.08), current smoking (OR 2.33; 95%CI 1.23–4.43), and female gender (OR 1.9, 95%CI 1.1–3.28). Conversely, physical exercise (OR 0.48, 95%CI 0.28–0.81) and occasional alcohol intake (OR 0.48, 95%CI 0.29–0.81) were associated with a lower risk of 25(OH)D ≤ 10 ng/mL. Conclusion Vitamin D deficiency/insufficiency [25(OH)D < 20 ng/ml] is highly prevalent in Portugal, affecting > 60% of all Portuguese adults, with strong geographical and seasonal variation. This study highlights the need to critically assess the relevance of vitamin D deficiency as a public health problem and the urgent need for a wide and scientifically robust debate about the most appropriate interventions at the individual and societal levels.
- Trophic web structure and ecosystem attributes of a temperate coastal lagoonPublication . Bueno-Pardo, Juan; García-Seoane, Eva; Sousa, Ana I.; Coelho, João P.; Morgado, Mariana; Frankenbach, Silja; Ezequiel, João; Vaz, Nuno; Quintino, Victor; Rodrigues, Ana M.; Leandro, Sérgio; Luis, António; Serôdio, João; Cunha, Marina R.; Calado, António J.; Lillebø, Ana; Rebelo, José E.; Queiroga, HenriqueA high quality data collection has been carried out between 2004 and 2014 to develop the first trophic ECOPATH model for the functioning of the sub and intertidal zones of Ria de Aveiro. This schematic representation allows the characterization of the most important compartments of biomass and flows of energy representing the functioning of the ecosystem, and can be used in the fields of decision-making and management. The model considered 26 functional groups from primary producers to top-predators and two different fisheries (artisanal and leisure), and showed that Ria de Aveiro is a dynamic ecosystem dominated by a high biomass of primary producers, where the transference of energy among compartments is, to a large extent, accomplished through the detritus path. The model also provides several ecological indicators on the state of maturity of the ecosystem, showing that Ria de Aveiro is in an intermediate state of maturity with a relatively complex food web and resilience to environmental changes. As discussed, this state of maturity is probably determined by human action pervading the system to advance in the expectable ecological succession of a coastal lagoon. These aspects, together with indicators of elevated fishing pressure and predation within the system, underline the necessity of controlling illegal extraction activities and monitoring the biomass of the main functional groups of the system, especially top predators, in order to keep the functioning of the ecosystem of Ria de Aveiro in its current condition.
- Validation of the Telephone-Administered Version of the Mediterranean Diet Adherence Screener (MEDAS) QuestionnairePublication . Gregório, Maria João; Rodrigues, Ana M.; Salvador, Clara; Dias, Sara S.; Sousa, Rute D. de; Mendes, Jorge M.; Coelho, Pedro S.; Branco, Jaime C.; Lopes, Carla; Martínez-González, Miguel A.; Graça, Pedro; Canhão, HelenaA 14-Item Mediterranean Diet Adherence Screener (MEDAS) questionnaire was developed and validated in face-to-face interviews, but not via telephone. The aims of this study were to evaluate the validity and reliability of a telephone-administered version of the MEDAS as well as to validate the Portuguese version of the MEDAS questionnaire. A convenience community-based sample of adults (n = 224) participated in a three-stage survey. First, trained researchers administered MEDAS via a telephone. Second, the Portuguese version of Food Frequency Questionnaire (FFQ), and MEDAS were administered in a semi-structured face-to-face interview. Finally, MEDAS was again administered via telephone. The telephone-administered MEDAS questionnaire was compared with the face-to-face-version using several metrics. The telephone-administered MEDAS was significantly correlated with the face-to-face-administered MEDAS [r = 0.805, p < 0.001; interclass correlation coefficient (ICC) = 0.803, p < 0.001] and showed strong agreement (k = 0.60). The MEDAS scores that were obtained in the first and second telephone interviews were significantly correlated (r = 0.661, p < 0.001; ICC = 0.639, p < 0.001). The overall agreement between the Portuguese version of MEDAS and the FFQ-derived Mediterranean diet adherence score had a Cohen's k = 0.39. The telephone-administered version of MEDAS is a valid tool for assessing the adherence to the Mediterranean diet and acquiring data for large population-based studies.