Browsing by Author "Santos, Osvaldo"
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- Association between general self-efficacy and eating habits among adolescentsPublication . Cardoso, Susana; Nunes, Carla; Santos, Osvaldo; Loureiro, IsabelIntroduction: Food choices are the result of several factors. Individual predispositions and resiliency are responsible for regulating against alternative food challenges. Bandura (1982) describes self-efficacy as a sense of self-esteem, feelings of adequacy, efficiency and competence to tackle the problems. Self-efficacy also underlies the choices and effort spent in activities or accomplishments. Objectives: To investigate associations between self-efficacy and eating habits. Methods: This is a cross-sectional survey, with data collected through self-administered questionnaires. Two schools participated in the survey (convenience sample). For each school, students were invited to participate, reaching a sample size of 358 students, aged 14 to 18. Students were asked to complete the Eating Habits Scale (EHA) as well as the General Self-efficacy Questionnaire (GSQ), (EHA/GSQ: 0-200/ 15-105), both validated for Portugal. Results: Significant positive correlation (r=.26; p<.001) was found between eating behaviors and self-efficacy (EHA: 86-172; mean =137.4; GSQ: 29-105; mean= 78). The correlation was stronger for the self-efficacy’s component of resistance to adversity (.32), followed by the initiative and persistence (.18) and by social effectiveness (.16). A higher coefficient of correlation was found among boys (.34) than among girls (.25), among overall scores of GSQ and scores of EHA. Conclusions: Higher self-efficacy may be associated with appropriate eating behaviors in adolescents. Control and resistance perception may play an important role, motivating youngsters to adopt healthy lifestyles. Thus, promoting self-efficacy can boost up healthy eating habits. Moreover, it may be appropriate to adopt health promotion strategies differentiated by gender.
- Association between living setting and malnutrition among older adults: The PEN-3S studyPublication . Madeira, Teresa; Peixoto-Plácido, Catarina; Sousa-Santos, Nuno; Santos, Osvaldo; Costa, Joana; Alarcão, Violeta; Nicola, Paulo Jorge; Severo, Milton; Lopes, Carla; Clara, João GorjãoObjectives: Malnutrition is frequent among older adults, especially those living in nursing homes, but the association between residential setting and nutritional status is controversial. The aim of this study was to examine the association between living setting (nursing home versus community) and malnutrition while adjusting for demographic, socioeconomic, health-related, and psychosocial factors. Methods: This cross-sectional study included a randomly selected representative sample of Portuguese adults ≥65 y of age. Interviewers collected data regarding demographic and socioeconomic characteristics, nutritional status, physical activity, energy intake, cognitive function, self-reported general health, functional status, symptoms of depression, and loneliness. Logistic regression models were used to estimate the association between residential setting and malnutrition. Results: Participants were 1186 nursing home residents (72.8% women, 49.2% ≥85 y of age) and 1120 community dwellers (49% women, 21.3% ≥85 y of age). Following Mini Nutritional Assessment (MNA®) criteria, 29.6% of nursing home residents and 14.1% of community dwellers were at risk of malnutrition, whereas 2.3% and 0.3%, respectively, were malnourished. The living setting was not significantly associated with malnutrition after adjusting for functional status, symptoms of depression, and feelings of loneliness (odds ratio, 1.03; 95% confidence interval, 0.67–1.58). Conclusions: Risk of malnutrition and malnutrition are more prevalent among nursing home residents than community dwellers. Physical (functional status) and mental health (symptoms of depression and loneliness) seems more relevant to nutritional status than residential setting by itself. These findings should be taken into account when designing public health policies to tackle malnutrition among older adults.
- Eating attitudes and risk of eating disorders in adolescents: role of the thinness stereotypePublication . Cardoso, Susana; Santos, Osvaldo; Nunes, Carla; Loureiro, IsabelIntroduction: In societies where thinness is seen as a sign of ideal beauty, there is a significant social pressure for teenagers to follow this model. Such cultural stereotypes can create risky situations in what eating behaviors are concerned. Those risky situations are associated with attitudes connected with fear of gaining weight and with low self-esteem. Objective: To identify risky eating attitudes in adolescents and to characterize associations between eating attitudes (promoting risk of developing an eating disorder), sex and age. Methods: 358 adolescents (convenience sample) of two secondary schools (aged 14-18 years) were asked to complete the EAT-25 (eating attitudes test) (range from 0 to 75; cutoff=19). Results: We found 4, 5% of increased-risk cases (boys: scores between 20 and 25; girls: scores between 19 and 35). No statistically significant differences were found between overall score of EAT-25 and age. Girls have higher (p<.001) scores (mean=7.04; SD=4.48) than boys (mean=4.78; SD=7.15), and higher prevalence of increased-risk cases. This difference between sexes results mainly from factor “Drive for thinness” (p<.001). Conclusions: A relevant percentage of adolescents revealed attitudes that put them in a spectrum of increased risk for eating disorders (more prevalent in girls). Desire to be thin is the most relevant attitudinal dimension. Health education interventions oriented to set objective and healthy standards of body image and to promote overall self-esteem building among adolescents are strategic to avoid the eventual development of eating disorders.
- Escolhas alimentares e e de atividade física dos adolescentes: sexo, atitudes alimentares e perceção de autoeficácia geralPublication . Cardoso, Susana; Nunes, Carla; Santos, Osvaldo; Loureiro, IsabelAs escolhas alimentares e de atividade física influenciam de forma relevante o estado de saúde. Importa compreender melhor os fatores e as interações entre os mesmos que contribuem para estas escolhas, nomeadamente no período da adolescência. Pretende‐se assim identificar determinantes da adoção de comportamentos alimentares e de padrões de atividade física e caracterizar a associação entre a perceção de autoeficácia e os hábitos alimentares e de atividade física em adolescentes portugueses. Realizou‐se um estudo transversal, sobre uma amostra de conveniência de adolescentes (14 ‐ 18 anos). Foram autoadministradas as escalas EHA (escala de hábitos alimentares), IPAQ (questionário internacional de atividade física), TAA‐25 (teste de atitudes alimentares) e GSQ (escala de autoeficácia geral). Os dados foram tratados com recurso ao software IBM SPSS, v.22.0. As raparigas tendem a assumir comportamentos alimentares mais saudáveis (t=3,84; p<,0001) mas apresentam maior risco de distúrbio do comportamento alimentar (t=3,54; p<,0001), este associado à motivação para a magreza (t=5,98; p<,0001). Os rapazes praticam mais atividade física (ᵡ2 (2)=28,2; p<,001) e apresentam maior perceção de autoeficácia geral (t=2,45; p<,015). O modelo de regressão multinomial melhor ajustado integra sexo e autoeficácia geral. A resistência à adversidade é a subdimensão que apresenta menor diferença entre sexos mas maior associação quer com os hábitos alimentares (rP=,32; p<,0001), quer com o padrão de atividade física (rP= ,235; p<,001). Vários estudos revelam que fatores fisiológicos e ideais de beleza podem explicar risco acrescido de desenvolvimento de patologia do comportamento alimentar, por parte das raparigas. A perceção de boa autoeficácia geral será protetora das escolhas alimentares inadequadas, mais frequentes entre os rapazes do que entre as raparigas. As diferenças entre os sexos poderão justificar intervenções diferenciadas no âmbito da educação para a saúde, com especial foco em dimensões como a autoimagem e a autoestima.
- Escolhas e hábitos alimentares em adolescentes: associação com padrões alimentares do agregado familiarPublication . Cardoso, Susana; Nunes, Carla; Santos, Osvaldo; Loureiro, IsabelIntrodução: São múltiplos os fatores que condicionam as escolhas alimentares. Nas idades infanto‐juvenis, os pais desempenham um papel importante na construção de preferências alimentares. Tal influência é especialmente relevante na infância, mas parece prolongar‐se através do período da adolescência. Objetivo: O principal objetivo do estudo foi caracterizar a associação entre hábitos alimentares do agregado familiar e escolhas alimentares dos adolescentes. Método: Trata‐se de um estudo com abordagem mista, quantitativa e qualitativa. Numa primeira etapa, a recolha de dados (quantitativos) foi feita através da Escala de Hábitos Alimentares (EHA), autopreenchida por uma amostra de adolescentes a frequentar o ensino secundário (10.°‐12.° ano) em 2 escolas do distrito de Coimbra. Desta forma, foi possível caracterizar os adolescentes quanto à adequação de hábitos alimentares. De seguida, para a componente qualitativa do estudo, foram identificados e selecionados os adolescentes com pontuações mais elevadas na escala EHA (i. e., com hábitos mais adequados) e os adolescentes com pontuações mais baixas nesta escala (i. e., com hábitos alimentares menos adequados). Estes adolescentes foram entrevistados relativamente às suas preferências alimentares, nomeadamente quanto à escolha alimentar em vários contextos (em casa, na escola e fora de casa), hábitos do agregado familiar e razões conducentes às opções efetuadas. Foram questionados ainda quanto ao risco de saúde (i. e., perceções de risco) associado aos hábitos alimentares, decisão perante o impulso de comer e situações associadas e, por último, acerca de intenções de mudança de hábitos. Foi feita uma análise de conteúdo de natureza temática, com codificação linha‐a‐linha segundo o método de Charmaz e codificação axial (com recurso ao software MaxQDA). Resultados: Participaram 358 adolescentes, dos 14 aos 18 anos (média = 15,78; desvio‐padrão = 1,05; 46,9% rapazes). A média da pontuação obtida nos itens da EHA (escala tipo Likert 1‐5) foi de 3,434 (desvio‐padrão = 0,346), variando entre 2,15‐4,3. A pontuação total resultante da soma dos itens variou entre 86‐172 (numa escala entre 0‐200), com uma média de 137,4 pontos (desvio‐padrão = 13,85). Não foram encontrados hábitos alimentares significativamente diferentes entre grupos etários ou estratos socioeconómicos, sendo as raparigas a assumir escolhas alimentares mais adequadas. O grupo de adolescentes com hábitos adequados (média EHA entre 3,75‐4,3; pontuação total EHA entre 150‐172) integra 11 alunos; o grupo com hábitos desadequados (média EHA entre 2,65‐3,125; pontuação total EHA entre 106‐125) integra 17 alunos. Os adolescentes com hábitos alimentares mais adequados descrevem o estilo parental como sendo mais interventivo do que o descrito pelos adolescentes com hábitos menos adequados. Esta influência, por parte dos pais, é operacionalizada de formas diversas: através de estilo autoritativo, através dos exemplos comportamentais (por parte dos pais) e/ou através de negociação ou controlo da disponibilidade alimentar em casa. Da análise de conteúdo também se infere que os pais/familiares dos adolescentes com baixa pontuação na EHA tendem a ter hábitos alimentares pouco saudáveis. É frequente o registo de sensações de bem‐estar associado ao padrão alimentar, por parte dos alunos com hábitos mais adequados; nos adolescentes com hábitos menos adequados foram registadas ações de acomodação aos hábitos, sem desenvolvimento de uma postura ativa de remediação como, por exemplo, iniciativa para mudar os hábitos, mesmo que pontualmente. Os resultados deste estudo apontam para a necessidade de as intervenções de educação alimentar entre jovens apostarem no desenvolvimento de comportamentos alimentares adequados ao nível de todo o agregado familiar, em complemento a intervenções educativas dirigidas apenas aos jovens.
- Functional health literacy: psychometric properties of the newest vital sign for Portuguese adolescents (NVS-PTeen)Publication . Santos, Osvaldo; Stefanovska-Petkovska, Miodraga; Virgolino, Ana; Miranda, Ana Cristina; Costa, Joana; Fernandes, Elisabete; Cardoso, Susana; Carneiro, António VazSelf-management of health requires skills to obtain, process, understand, and use healthrelated information. Assessment of adolescents’ functional health literacy requires valid, reliable,and low-burden tools. The main objective of this study was to adapt and study the psychometric properties of the Newest Vital Sign for the Portuguese adolescents’ population (NVS-PTeen). Classic psychometric indicators of reliability and validity were combined with item response theory (IRT) analyses in a cross-sectional survey, complemented with a 3-month test-retest assessment. The NVSPTeen was self-administered to students enrolled in grades 8 to 12 (12 to 17 years old) in a school setting. Overall, 386 students (191 girls) from 16 classes of the same school participated in the study (mean age = 14.5; SD = 1.5). Internal reliability of the NVS-PTeen was = 0.60. The NVS-PTeen total score was positively and significantly correlated with Portuguese (r = 0.28) and mathematics scores (r = 0.31), school years (r = 0.31), and age (r = 0.19). Similar to the original scale (for the U.S.), the NVSPTeen is composed of two dimensions, reading-related literacy and numeracy. Temporal reliability is adequate, though with a learning effect. IRT analyses revealed differences in difficulty and discriminative capacity among items, all with adequate outfit and infit values. Results showed that the NVS-PTeen is valid and reliable, sensible to inter-individual educational differences, and adequate for regular screening of functional health literacy in adolescents.
- Geriatric Assessment of the Portuguese Population Aged 65 and Over Living in the Community: The PEN-3S StudyPublication . Madeira, Teresa; Peixoto-Plácido, Catarina; Sousa Santos, Nuno; Santos, Osvaldo; Alarcão, Violeta; Nicola, Paulo Jorge; Lopes, Carla; Clara, João GorjãoIntroduction: As populations live longer, they also aim to live better. A crucial step for this is to improve the understanding about older adults' physical and psychological health. Therefore, the aim of the present study was to characterise the Portuguese population over-65 regarding nutritional status, cognitive function, functional status, symptoms of depression, and loneliness, by sex and age groups. Material and Methods: Cross-sectional study including a nationally representative sample of community-dwelling adults aged 65 and over. Trained interviewers collected data face-to-face on demographic and socioeconomic characteristics, health status, nutritional status, cognitive function, functional status for activities of daily living, symptoms of depression, and loneliness feelings. Complex sample procedures were used in the statistical analysis. Results: Overall, 1120 community-dwellers (49.0% women, 21.3% aged ≥ 85) participated in the study. The estimated prevalence of risk of malnutrition was 16.4% (95% confidence interval: 13.3 - 19.9), while 17.7% (95% confidence interval: 12.8 - 23.9) were cognitively impaired, and 28.5% (95% confidence interval: 23.7 - 33.8) presented limitations to perform daily living activities. Moreover, 23.5% (95% confidence interval: 19.7 - 27.7) presented symptoms of depression and 13.6% (95% confidence interval: 10.6 - 17.1) reported loneliness feelings. These conditions were more prevalent among women, and generally more frequent in the oldest individuals (≥ 85). Discussion: Risk of malnutrition, cognitive impairment, functional limitations, depression and loneliness were moderately frequent, which may justify screening and preventive actions at a community level. Conclusion: This study contributed to a national characterisation of the health of older adults, that may inform policies and interventions targeted at the needs of the Portuguese aging population.
- Is olive oil good for you? A systematic review and meta-analysis on anti-inflammatory benefits from regular dietary intakePublication . Fernandes, João; Fialho, Mónica; Santos, Rodrigo; Peixoto-Plácido, Catarina; Madeira, Teresa; Sousa-Santos, Nuno; Virgolino, Ana; Santos, Osvaldo; Carneiro, António VazThe prevalence of non-communicable diseases is rapidly increasing, and evidence shows that diet and lifestyle are key areas of intervention to decrease their burden. Olive oil is considered one of the key nutritional components responsible for the benefits of the Mediterranean diet, which is characterized by the use of olive oil in meals as the main source of fat; a high consumption of water, fruits, nuts, vegetables, legumes, whole grains, spices, and herbs; a moderate consumption of dairy products (mainly cheese and yogurt), fish, poultry, and red wine; and a reduced consumption of red meat and processed foods. The aim of this review was to summarize evidence from randomized controlled trials on the effect of regular dietary intake of olive oil on three inflammatory markers: C-reactive protein, interleukin-6, and tumor necrosis factor-α. Reviewed RCTs reveal beneficial effects of olive oil by reducing levels of inflammation markers. Olive oil taken on a regular basis can be a good dietary fat alternative, especially to manage IL-6. However, further research is required to clarify the effects of olive oil consumption on inflammation, comparing to other fats. Moreover, olive oil daily dosage, different time-lenght intervention and follow-up periods should be taken into consideration.
- Nutritional counselling in adults promoting adherence to the Mediterranean diet as adjuvant in the treatment of major depressive disorder (INDEPT): a randomized open controlled trial study protocolPublication . Sousa-Santos, Nuno; Fialho, Mónica; Madeira, Teresa; Clara, Cátia; Veiga, Sofia; Martins, Raquel; Barros, Neuza; Santos, Gabriela; Santos, Osvaldo; Almeida, Carolina; Ganança, Licínia; Campos, Rui C.; Camolas, José; da Silva, Alda Pereira; Guarino, Maria Pedro Sucena; Heitor, Maria JoãoBackground Major Depressive Disorder (MDD) is a leading cause of disability worldwide. Approximately one-third of patients with MDD do not respond to treatment, and often exhibit elevated inflammation biomarkers, which are associated with worse prognosis. Previous research has linked healthier dietary patterns, such as the Mediterranean Diet (MedDiet), with a lower risk of MDD and symptoms of depression, potentially due to their anti-inflammatory properties. The aim of this study is to evaluate the effectiveness of a nutritional counselling intervention promoting MedDiet to alleviate symptoms of depression in adults recently diagnosed with MDD and presenting with elevated inflammation biomarkers. Methods This study is a randomized controlled trial (RCT) that will recruit adults from outpatient clinics, between the ages of 18 and 70 years who have been diagnosed with MDD and are currently receiving treatment with the first prescribed antidepressant, and who exhibit elevated inflammation biomarkers (interleukin-6 and/or C-reactive protein). The control group will receive treatment-as-usual (TAU) only. The primary outcome of the study will be the change in symptoms of depression, as measured by the Beck Depression Inventory 2 (BDI-II), after 12 weeks of intervention. Data analysis will follow an intention-to-treat approach. Secondary outcomes will include changes in inflammation biomarkers, quality of life, adherence to the MedDiet, and cost-effectiveness of nutritional counselling. All outcomes will be assessed at baseline, after the 12-week intervention, and at 6- and 12-months post-baseline. Discussion This study will be the first RCT to evaluate the effect of a nutritional intervention with anti-inflammatory properties, as an adjuvant in the treatment of MDD, in individuals diagnosed with MDD and elevated inflammation biomarkers. The results of this study may contribute to the development of more effective and personalized interventions for MDD patients with elevated inflammation biomarkers.