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- Sitting time and associated factors among Portuguese older adults: results from Nutrition UP 65Publication . Sousa, Ana Sofia; Mendes, Joana; Guerra, Rita S.; Padrão, Patrícia; Moreira, Pedro; Santos, Alejandro; Borges, Nuno; Afonso, Cláudia; Martins, Cátia; Ferro, Graça; Amaral, Teresa F.Older adults are particularly susceptible to sedentary behaviours. Sitting time has been increasingly referred to as a potentially modifiable risk factor in the prevention of chronic diseases. Identifying factors associated with sitting time, particularly those that are modifiable, will allow for more effective public health strategies. This study aimed to describe sitting time among Portuguese older adults and to evaluate associated factors. A cross-sectional study including 1423 older adults ≥ 65 years old was conducted. Sitting time was assessed with the International Physical Activity Questionnaire. Socio-demographic, health, anthropometric and functional variables were collected. Bivariate and multivariate linear regression models were conducted to study the association between these variables and sitting time. The median of sitting time was 300 min/day (interquartile range = 240 min/day), which is equal to 5 h/day. The following factors were directly associated with longer sitting time: being male, age ≥ 80 years, living in Central or Southern Portugal, being retired from work, as well as presenting low physical activity, obesity or longer time to walk 4.6 metres. On the other hand, being married, having higher education and higher household income were inversely associated with longer sitting time. It can be concluded that Portuguese older adults spend a considerable amount of time sitting per day. Potentially modifiable risk factors associated with longer sitting time in this population were related to nutritional status and functional ability.
- Handgrip strength percentiles for Portuguese older adults: use and validity for undernutrition screening in hospitalized older adultsPublication . Carvalho, Vítor; Sousa, Ana S.; Amaral, Teresa F.; Guerra, Rita S.
- Nutrition up 65 educational strategies: health professionals qualification coursePublication . Sousa, Ana S.; Guerra, Rita. S; Álvares, Luísa; Valdiviesso, Rui; Padrão, Patrícia; Borges, Nuno; Santos, Alejandro; Afonso, Cláudia; Martins, Cátia; Ferro, Graça; Moreira, Pedro; Amaral, Teresa F.INTRODUCTION: Nutrition knowledge among health professionals has a major impact on older adults’ healthcare. However, there is a lack of specialized education offer in this area. Within the Nutrition UP 65 Project, a health professional’s qualification nutrition course was created and implemented from April 2015 to April 2017. We aim to describe this process here. METHODOLOGY: At Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, a course of twenty-seven hours was created by six professors. The course comprises eight hours of direct contact and nineteen hours of individual study and was accredited by the University of Porto and credited with one European Credit Transfer System (ECTS). Educational materials and presentations for each session were produced including posters and flyers. A final test was developed to evaluate attendee’s knowledge. Approximately 10% of national health units were identified, randomly selected in each country regional area (NUTS II – “Nomenclatura Comum das Unidades Territoriais para Fins Estatísticos”) and invited to participate. RESULTS: Thirty-five course editions were carried out by twenty-three Porto University accredited instructors for 784 professionals from 241 different health units. Concerning the knowledge evaluation, a 99% approval rate was achieved and the average mark score was of 16.8 out of 20. Course satisfaction survey revealed that 45.7% of the participants classified the course as “good” and 41.1% as “very good”. CONCLUSIONS: The overall balance of this branch of the Nutrition UP 65 project is very positive. The results on health professional’s adherence demonstrate that the interest in this area of nutrition care is high and that this nutrition course is a good opportunity to expand access to specialized education. This highlights the need for further initiatives promoting educational sessions targeting nutrition topics. These course sessions must be acknowledged as a starting point to a new approach in older adult’s nutrition knowledge in Portugal.
- Sodium and potassium urinary excretion and their ratio in the elderly: results from the Nutrition UP 65 studyPublication . Moreira, Pedro; Sousa, Ana Sofia; Guerra, Rita S.; Santos, Alejandro; Borges, Nuno; Afonso, Cláudia; Amaral, Teresa F.; Padrão, PatríciaBackground: We aimed to describe urinary sodium and potassium excretion and their ratio in a representative sample of Portuguese elderly population, according to sociodemographic characteristics and weight status. Methods: A cluster sampling approach was used, representing older Portuguese adults (≥65 years) according to age, sex, education level, and regional area within the Nutrition UP 65 study. This cross-sectional evaluation was conducted in 2015 and 2016. From a sample size of 1,500 participants, 1,318 were eligible for the present analysis, 57.3% were women, and 23.5% were aged ≥80 years. Sodium and potassium consumption was evaluated through one 24 h urinary excretion. Inadequate sodium intake was defined as ≥2,000 mg/day, inadequate potassium intake was considered as <3,510 mg/day, and inadequate sodium-to-potassium ratio was defined as >1, according to the World Health Organization cutoffs. Results: The proportion of the participants with an inadequate intake was 80.0% in women and 91.5% in men (sodium), 96.2% of women and 79.4% of men (potassium), and 98.4% of women and 99.1% of men (sodium- to-potassium ratio). Higher sodium adequacy was observed among the older elderly, unmarried, with lower household income, and underweight/normal weight. Higher potassium adequacy was observed in the younger elderly, married, and with higher income. Conclusion: The majority of the Portuguese elderly population was classified as having inadequate sodium, potassium, and sodium-to-potassium ratio urinary excretion. Therefore, strategies for reducing sodium and increasing potassium intake are priorities in the Portuguese elderly population.
- The Effect of β-Hydroxy-β-Methylbutyrate on Muscle Strength and Functional Outcomes in Older AdultsPublication . Mendes, Joana; Guerra, Rita S.; Sousa, Ana S.Nutritional intervention is increasingly being recognized as playing an important role in functional status. The supplementation with β‑hydroxy-β-methylbutyrate (HMB), which is a metabolite of an essential amino acid, may be an effective nutritional intervention to improve muscle strength and functionality in older adults. The aim of this narrative review was to present an updated overview of the effects of HMB supplementation in older adults, specifically on muscle strength and functional outcomes. A PubMed database search was performed and only randomized controlled trial studies were included. More than half of the 14 analyzed studies reported that HMB supplementation improved muscle strength and other functional outcomes. HMB supplementation has demonstrated some promising effects on muscle strength and functional outcomes in older adults with different conditions of health and physical activity.
- Anthropometric and Body Composition Changes After Bariatric Surgery—The Effect of Sex, Age, and Type of SurgeryPublication . Guerra, Rita Soares; Pinho-Reis, Cíntia; Sousa, Ana Sofia; Mendes, Joana; Silva, CláudiaThe rise in obesity and its associated health problems increases the need for therapeutic approaches such as bariatric surgery. Therefore, this study aims to explore the changes in the anthropometric and body composition characteristics of patients undergoing bariatric surgery. A retrospective longitudinal study was conducted in subjects ≥ 18 y who underwent bariatric surgery and attended one nutrition appointment before and after surgery. Information on their sex, age, weight, fat mass (kg and %), fat-free mass (kg and %), and skeletal muscle mass, obtained using bioelectrical impedance, and on their waist circumferences was collected. Their BMIs and skeletal muscle mass indexes were calculated. The differences in the anthropometric and body composition parameters between pre- and post-surgery were also calculated. The participants were grouped by sex, age groups (18–44 y and 45–69), and type of surgery (Roux-en-Y gastric bypass and gastric sleeve). The variables are presented as n (%) and as means (SDs) or medians (interquartile ranges). Student’s t-test and the Mann–Whitney test were employed (p < 0.05). The sample consisted of 57 subjects (aged 18–69 years; 75% women). Between the pre- and post-surgical periods (63 (42) days), their weight (mean: 103.0 (SD: 16.3) kg vs. 91.2 (14.2) kg, p < 0.001); BMIs (37.9 (4.2) kg/m2 vs. 33.6 (4.1) kg/m2, p < 0.001); waist circumferences (116.2 (12.4) cm vs. 105.7 (12.3) cm, p < 0.001); % fat mass (45.5 (6.0) vs. 41.0 (8.0), p < 0.001); skeletal muscle mass (32.8 (7.4) kg vs. 30.3 (6.5) kg, p < 0.001); and skeletal muscle mass indexes (12.0 (1.8) kg/m2 vs. 11.1 (1.7) kg/m2, p < 0.001) decreased; meanwhile, their % fat-free mass increased (54.7 (6.0) vs. 59.0 (8.0), p < 0.001). Most of these changes occurred regardless of sex, age, or type of surgery. Shortly after bariatric surgery, patients show a better nutritional status and body composition.