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  • Low adherence to mediterranean diet in Portugal: pregnant women nutrition in Portugal and its repercussions
    Publication . Pereira-da-Silva, Luís; Pinto, Elisabete
    Introduction: Portuguese population is drifting away from the Mediterranean diet-like pattern. In this context, the current nutritional status of women of childbearing age and of pregnant Portuguese women and their growing fetuses is critically reviewed. Material and Methods: A narrative critical review was performed on recent published high quality studies assessing diet and nutritional status of women of childbearing age and pregnant women and its influence on the nutritional status of their offspring. Results: Data from five multinational ecological studies that included Portugal, two national official surveys on food availability, seven national studies on the diet and nutritional status of women of childbearing age and pregnant women, and five national studies on the effect of nutritional maternal factors on their growing fetuses were selected and analyzed. The prevalence of overweight/obesity has dramatically increased in Portuguese women of childbearing age and pregnant women, associated with the described trend of low adherence to Mediterranean diet. Variations in energy and macronutrients intakes during pregnancy seem to have no significantly impact on the nutritional status of growing fetuses. On contrary, pre-pregnancy overweight/obesity has been associated with increased offspring adiposity at birth, and an excessive gestational weight gain may be associated with offspring’s overweight status in childhood. Factors potentially contributing to low adherence to the Mediterranean diet, deserving further investigation, include European Union agriculture policies that have implemented the production of non-Mediterranean food groups at low cost, and insufficient financial capacity to afford foods of quality reported by Portuguese population. Conclusion: Retrieving traditional Mediterranean dietary habits should be incorporated into strategies for prevention and treatment of overweight/obesity in Portugal, especially in women of childbearing age.
  • CoFI - Consensus on infant formulas: the opinion of portuguese experts on their composition and indications
    Publication . Rego, Carla; Pereira-da-Silva, Luis; Ferreira, Ricardo
    Introduction: Breastfeeding has unique health benefits. Exclusive breastfeeding is recommended during the first six months of life and should be maintained during complementary feeding. Alternatively, infant formulas, which are designed to mimic human breastmilk to promote similar metabolic and growth profiles, can be used. This study aimed to assess the opinion of Portuguese paediatricians with expertise in nutrition on the composition, benefits and indications of commercialised infant formulas.Material and Methods: A survey based on the Delphi method with application of a questionnaire developed by a scientific committee was issued to a panel of paediatricians with expertise in nutrition. An initial questionnaire that included 65 items covering 11 areas was administered in two rounds.Results: Twenty-one experts participated, and the final response rate was 87.5%. The panel was in agreement in 68.3% of the enquired items, namely that infant formulas should be used only when breastfeeding is not possible. Notwithstanding, the opinion of the panel was heterogeneous on a number of issues, particularly those related to the advantages and indications of ‘special’ or modified infant formulas (partially hydrolysed formulas and anti-colic, anti-constipation and anti-regurgitation formulas) and of young child formulas (‘growing-up formulas’). Discussion: A wide consensus was recorded on the nutritional quality, food safety and indications attributed to commercialized infant formulas.Conclusion: The opinion of Portuguese experts was consensual in most of the enquired topics. The absence of consensus was mostly related to issues that remain under debate in the literature and lack robust scientific evidence.