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- Determinantes das escolhas alimentares infantis em restaurantes de fast-foodPublication . Rocha, Ada; Viegas, Cláudia; Peixoto, CláudiaNos últimos anos, verificou-se uma alteração no ritmo de vida da população, que se traduziu numa mudança dos hábitos de consumo, com um aumento do consumo de refeições fora de casa, incluindo pelas crianças. Na maioria das vezes, os locais escolhidos para realizar as refeições são os restaurantes de fast-food. Geralmente as refeições preparadas neste tipo de restaurantes, incluindo as refeições infantis, têm uma qualidade nutricional muito baixa. O comportamento das crianças em relação às suas escolhas alimentares, é afetado por vários determinantes de consumo, pelo que o principal objetivo deste estudo foi identificar os determinantes das escolhas alimentares infantis em restaurantes de fast-food. De forma a atingir este objetivo, foi elaborado um questionário, disponibilizado online dirigido a pais de crianças com idades compreendidas entre os 6 e os 12 anos. Observou-se que para as crianças, os fatores determinantes na escolha do restaurante de fast-food e da refeição consumida, foram, por ordem de importância: a oferta de um brinquedo colecionável/promocional, as opções disponíveis e o sabor agradável da refeição. Para os pais, os fatores mais relevantes no momento da escolha do restaurante de fast-food e da refeição infantil consumida, foram a conveniência do local, o preço acessível, o sabor agradável e as preocupações com a saúde, respetivamente. Os resultados deste estudo evidenciam a necessidade de reformular e desenvolver refeições infantis equilibradas sem comprometer a palatabilidade, associando a estas opções equilibradas a oferta de brindes colecionáveis.
- Development of a tool to assess the compliance of cafeteria menus with the Mediterranean DietPublication . Silva, S. S.; Rocha, A.; Ferreira, L.; Neto, Beatriz; Dikmen, D.; Filipec, S. Vidacek; Satalic, Z.; Viegas, CláudiaBackground: The Mediterranean diet (MD) has been considered one of the healthiest dietary patterns, and an excellent model of sustainability. Higher Education food services present an excellent scenario to encourage students healthy eating habits and modulate food choices. The purpose of this work was to develop an index to evaluate MD compliance with cafeteria menus. Methods: Three major axes were considered: MD key points, existing indexes on individual adherence to the MD, and existing indexes on menu assessment. The index includes four levels: (I) assesses the availability (IA), variety, and frequency (IB) of food; (II) evaluates the menu's nutritional quality; (III) assesses the menu's quality through information provided in the dishes' technical specifications and (IV) allows a more detailed evaluation through on-site visits and documentation consultation. The components receive a score between - 2 and 3, according to the given answers. The final score may vary between - 33.5 and 41.5 points depending on the degree of compliance with the MD key points. The index was applied to 60 menus from different contexts using complete assessments of each menu, performed independently by 3 researchers, using the same pre-prepared Microsoft Excel® spreadsheet. Inter-rater reliability was assessed using Cohen's Kappa and internal consistency with Cronbach's alpha. Results: Assessment for level I) returned a Cohen's Kappa coefficient of 0.92 (p < 0.05) and a Cronbach's alpha coefficient of 0.88. Dimension I is mostly influenced by subdimension IB (r = 0,97). The availability of non-starchy vegetables and fresh fruits has a stronger correlation with IA (availability of foods), and the higher availability of fish, pulses, and fruit has a strong positive correlation with IB (variety and frequency of foods). Conclusion: Researchers believe that the index is a useful tool to assess compliance of menus to the MD and help identify the key points that need to be addressed and improved in cafeterias.
- Focus on food instead of nutrients improves consumers’ understanding of meals’ nutrition qualityPublication . Viegas, Cláudia; Lamy, E.; Prada, M.; Rocha, AdaBackground: Nowadays, most of the information directed to consumers focuses on nutrients, ignoring the impact of the interactions between different foods, origin, or degree of processing. The methodologies currently applied have led consumers to confuse foods with nutrients, meat, and fish are often referred to as “proteins”, and grains and potatoes are referred to as “carbohydrates, forgetting that these foods are sources of other nutrients, such as fat, proteins, or fiber. Furthermore, its efficacy is compromised by the difficulties of reading labels among consumers. Objectives: This study aimed to evaluate the understanding of food and nutritional information presented in menus to consumers, comparing the nutrient-focused approach (Nutrition Declaration) and the new food-focused approach (infographic - based on the Portuguese food Guide, from previous research). Methods: 4 different meals were created, 2 balanced and complete in terms of food and nutrient content and 2 unbalanced and incomplete. A questionnaire was applied, evaluating the understanding of the balance and healthiness of the meals, using the two approaches (nutrient-focused and food-focused). The order of presentation of the approaches and the meals was randomized for all participants. The questionnaire was distributed online through snowball sampling. Results: 221 individuals participated, mostly female (67%), aged 25 to 54 years old. Evaluation of meals (“how balanced” and “how to complete” the meal is) using the Nutrition Declaration did not allow to distinguish the quality of meals (Mb ¼ 3,8; Mc¼4,0), in opposite the Infographic returned significant differences between M1/M2 (Mb ¼ 4,3; Mc¼4,4) and M3/M4 (Mb ¼ 2,5; Mc¼2,6) (p < 0.01) allowing consumers to perceive differences between meals. The percentage of consumers that responded “I don’t know” to these questions decreased using the food-focused tool (13% vs 2%). Conclusions: The food-focused approach allows for a better understanding of meals’ nutritional balance.
- Determinants influencing distance learning at health technology higher education institutions in PortugalPublication . Teresa Ribeiro, Ricardo; Cunha, Gilda; Silva, Carina; Medeiros, Nuno; Viegas, Cláudia; Borges-Ferro, A; Poças, Ilda Maria; Raposo, Hélder António; Eiras, MargaridaIntroducing distance learning within higher education institutions (HEIs) is a key societal issue, especially in the health sector, due to its in vivo learning nature. Public policies play an important role in these digital environments. This study aims to identify the determinants influencing national public policies that foster digital learning transformation in Health HEIs in Portugal. A prospective survey, using the structural analysis of Godet’s method, is conducted, and data are gathered from different health sector stakeholders. Despite the efforts to increase digital literacy and funding for digital learning in HEIs, a weak strategy and implementation of a national plan for distance learning in Health HEIs are still prevalent. The driver to success is grounded on national and international cooperation between health professionals, hospitals, and HEIs through transferability processes of innovative practices.
- KIMEHS – Proposal of an index for qualitative evaluation of children’s menus: a pilot studyPublication . Rocha, Ada; Viegas, CláudiaConsidering the importance of the food environments for health promotion, and the lack of simple, easy-to-use, low-cost measures of the quality of meals, the authors developed a qualitative menu index (KIMEHS-Kids' Menu Healthy Score), tailored to children's menu evaluation. Development of the tool was based on the Mediterranean food pattern. It includes 18 components, divided into seven main groups that reflect key aspects of menu quality, including protein source, side dishes, vegetables, dessert and beverages, and also allergens and nutritional information. The index was analysed for content and construct validity, as well as inter-rater reliability, and was applied to a sample of menus from restaurants in shopping centres in the Lisbon region. Possible index point ranges from -17 to 17, with a higher score indicating greater compliance with the recommendations. A value of 5.5 is obtained if all KIMEHS items are available, considering healthy and non-healthy options. The inter-rater reliability was assessed and values above 0.80 were obtained for Alpha Cronbach, as well as agreement % rate >75%. Agreement percentage is above 75% for all the components. Evaluated restaurants scored from -14 to 7, with an average KIMEHS of -6.15. Only four restaurants scored positive values, ranging from 0.25 to 7. KIMEHS was considered to be an adequate index to evaluate children's menus, from the menu information displayed on restaurant websites and/or on restaurant displays or table menus. It is a simple, low-cost tool that may be used as a reference for health professionals as an objective measure to evaluate the food environment. Stakeholders could also be involved in their own assessment to help educate consumers about healthy food choices, strengthening the efforts to promote an adequate food pattern and health, contributing to the fight against obesity.
- The influence of salt reduction with encapsulated oleoresins on the quality of mayonnaise, mustard, and ketchupPublication . Serrano, Carmo; Sapata, Margarida; Castelo-Branco, Diogo; Tasso, Ana; Marques, António; Viegas, Cláudia; Figueira, Diogo; Komora, NortonIntroduction: Mayonnaise, mustard, and ketchup are table sauces enjoyed worldwide, adding flavor and texture to many dishes. However, these products often contain high sodium content, which contributes to health issues such as high blood pressure and cardiovascular disease. To address these concerns, reducing salt content in the sauces has become a significant goal for both manufacturers and consumers. Objectives: This study investigates the effects of three formulations of microencapsulated (ME) oleoresins (F1, F2, and F3), derived from aromatic plants and spices, on the mineral content, physical-chemical properties, color, and sensory profiles of mayonnaise, mustard, and ketchup. Results: The addition of ME ingredients resulted in significant reductions in salt content across all sauces, with reductions up to 50% in mayonnaise, 45% in mustard, and 52% in ketchup, aligning with EU sodium guidelines and allowing for a "reduced Na/NaCl content" nutrition claim. Potassium levels in mustard and ketchup were sufficient to support health claims related to blood pressure maintenance, while chloride content was reduced in ME formulations, better aligning with dietary reference values. Physical-chemical analysis revealed that ME ingredients had minimal impact on parameters like pH, lipid oxidation, and viscosity, although significant differences were observed in specific areas, such as the consistency of ketchup and chloride content in mustard and ketchup. The use of inulin, as a carrier agent, helped maintain the sauces' rheological properties. Mustard showed the most similarity to the control in terms of physical-chemical parameters. Color analysis indicated minimal changes in mayonnaise, moderate changes in mustard, and significant differences in ketchup, particularly with the ME-F3 formulation, where the light-yellow ME ingredients had a pronounced effect on the darker sauce. Despite these differences, the sensory analysis demonstrated that the overall sensory profiles of the ME formulations were similar to the like control for all sauces. Mayonnaise showed the closest resemblance, while mustard had slightly lower scores in flavor and saltiness. Ketchup followed the same trend as mayonnaise, with no significant sensory differences compared to the control. Conclusion: These findings suggest that ME ingredients can be effectively used in condiment reformulation to achieve significant salt reduction without compromising sensory qualities, while also supporting health-related claims. By incorporating ME-based salt reduction strategies and exploring low-sodium alternatives, consumers can continue to enjoy their favorite sauces while minimizing sodium intake. Embracing these changes not only benefits personal health but also aligns with the industry's commitment to offering more nutritious options.
- Examining the relationship between sugar content, packaging features, and food claims of breakfast cerealsPublication . Prada, Marília; Saraiva, Magda; Viegas, Cláudia; Cavalheiro, Bernardo; Garrido, MargaridaExcessive free-sugar intake has become highly prevalent in numerous countries, and Portugal is not the exception. One product category that contributes to the daily intake of free sugars is breakfast cereals. In the current work, we identified 289 exemplars from two major retailers in Portugal and collected information on their nutritional profile (e.g., sugar, salt, fiber per 100 g), price, packaging features, type of food claims present (e.g., statements about the composition, sensory features, the origin of the product), and ingredients list. Overall, the sugar content of breakfast cereals was high (Mean = 19.9 g), and less than 10% of the products complied with the current national guidelines (i.e., 5 g of sugar per 100 g of product). Sugar (or other sugar sources) was listed in the top three ingredients for over 85% of the products. On average, each product included about four claims (Mean = 3.9), and sugar content was lower when the claims were related to the product composition. Critically, the sugar content was particularly high for children-oriented products (Mean = 26.4 g). Correlation analysis showed that breakfast cereals with higher sugar content also were cheaper and had lower quantities of fiber, proteins, and salt. Our findings suggest the need to implement strategies to reduce sugar in this product category (e.g., incentivize manufacturers to reformulate products). Also, our results may inform strategies aimed at promoting consumers' awareness about the sugar content in breakfast cereals and other processed foods, facilitating healthier decision-making.
- Assessment of food and cooking skills: validation of a Portuguese version of a tool and characterisation of food and cooking skills in young adultsPublication . Costa, Vânia; Borrego, Rute; Mateus, Cátia; Carolino, Elisabete; Viegas, CláudiaABSTRACT - Introduction: Food and cooking skills (FCSks) is defined as a complex, interrelated, and person-centered set of skills, necessary to provide and prepare safe, nutritious, and culturally acceptable meals for all members of the household. Recent studies have associated higher FCSk with healthier eating habits and better health. This study aimed to validate a Portuguese version of a tool to assess and describe FCSk in young adults. Methods: A cross-sectional study used an online anonymous questionnaire that was disseminated to students from three Portuguese Higher Education Institutes. The questionnaire validation included Cronbach alpha and confirmatory factor analysis (CFA). The Mann-Whitney test was used for evaluating sample differences and Pearson correlation for association among variables. Results: Internal consistency reliability was 0.89 for cooking skills (CSks) and 0.87 for food skills (FSks). A moderate positive correlation was found between CSks and FSks confidence (r = 0.658, p < 0.01). CFA presented a good adjustment model for most of the fit indices, indicating the adequacy of the questionnaire. The CSks score was 74.1 ± 21.2 (moderate) and the food Skills was 94.2 ± 20.8 (high). Cook pulses, steaming food, and planning meals ahead scored the lowest value while boiling or simmering food, chopping, peeling vegetables, and reading the best-before date scored the highest value. No difference was found among sex (pCSk = 0.576; pFSk = 0.158), age (pCSk = 0.566; pFSk = 0.130), body mass index classes (pCSk = 0.903; pFSk = 0.320), or course (pCSk = 0.169; pFSk = 0.126). The greatest interest in gastronomy and frequency of meal preparation is associated with higher FCSk (p < 0.05). Conclusion: This research validated a Portuguese version of a tool to assess FCSk among young adults. Internal consistency reliability was adequate. Confirmatory factor analysis returned good psychometric properties for the questionnaire. Authors identified lower FCSk competencies in cooking pulses and vegetables, which are healthy and sustainable foods. This may compromise the adoption of healthy eating behaviors, so promoting FCSk in young adults may pose a strategy for nutrition and public health in reducing diet-related diseases. This tool may be used to identify opportunities for intervention in public health nutrition.
- Adesão à dieta mediterrânica em adolescentes do 2º ciclo: que fatores são influenciadores?Publication . Timóteo, Sara; Costa, Vânia; Viegas, Cláudia; Moreira, Ana Catarina; Mendes, LinoOs hábitos alimentares adquiridos na adolescência perduram para a vida adulta, determinando a saúde do indivíduo. A dieta mediterrânica representa um estilo de vida saudável. Contudo, tem-se verificado uma diminuição da adesão a este padrão alimentar. A adoção de hábitos alimentares ocidentalizados pelos estudantes portugueses pode ter repercussões no estado nutricional e na saúde atual e futura. Objetivos do estudo: Avaliar a adesão à dieta mediterrânica e estudar a relação com fatores socioeconómicos e com o estado nutricional.
- Alimentação individual e coletiva: nutrir pessoas, planear refeições e gerir serviçosPublication . Rocha, Ada; Damas, Carlos; Viegas, CláudiaImagine uma manga... Fruta exótica, suculenta e saborosa, rica em carotenos e vitamina C, disponível em qualquer supermercado a preço acessível, mas que viaja milhares de quilómetros, atravessando oceanos e continentes, para chegar à nossa mesa. A distância não torna esta manga mais interessante do ponto de vista alimentar, nem é sinónimo de que a globalização e facilidade nas trocas mundiais sejam fatores que contribuem para uma mesa mais rica. Uma dieta melhor e uma maior literacia alimentar não são determinadas (em regra) por informação em excesso e muitas vezes contraditória, pelo acesso a um leque muito diversificado de alimentos — como se a sua mera soma encerrasse em si vantagem —, ou pela disponibilidade destes alimentos ao longo de todo o ano. O admirável mundo novo e sedutor dos alimentos exóticos, de geografias que desafiam a curiosidade à mesa, ofusca muitas vezes o discernimento dos consumidores face ao produto local. Afasta-nos dele, das suas virtudes, da sua origem próxima, do ciclo de vida por que passa e de como o respeito pelo consumo local também é importante na promoção de uma alimentação equilibrada. Neste contexto, palavras que façam alusão a “saúde” e “bem-estar” ou expressões como “estilo de vida saudável” e “alimentação equilibrada e sustentável” poderão não passar de meros rótulos à boleia da dita globalização alimentar e apropriação insustentável de recursos planetários que sabemos finitos. Saúde e literacia à mesa precisam-se. É necessário recentrar o foco de abordagem: sem desprezo pelos nutrientes consumidos e sem desvalorizar o meio através do qual são veiculados — os alimentos. Há, pois, que procurar inverter o cenário que anteriormente sumariámos: (re)conciliar os consumidores com os alimentos que tecem o seu dia a dia; reativar a relação dos alimentos com o seu teor em nutrientes; e desenvolver uma cultura alimentar que aperfeiçoe as competências culinárias, como forma de tornar a dieta mais rica. Isto sem desmerecer uma realidade transversal à vida moderna, a do consumo de alimentos fora de casa, nos diferentes contextos da alimentação coletiva, como restaurantes, cantinas, refeitórios, entre outros. Uma vez mais, é preciso modelar a oferta alimentar nestes locais, orientando a criação de ementas que contemplem refeições mais saudáveis e sustentáveis. Com a presente obra, pretendemos levar ao leitor uma abordagem da nutrição numa perspetiva enriquecedora e esclarecedora dos alimentos, das suas características e de como deles podemos beneficiar individual e coletivamente. Este é um manual que se quer prático, com aplicação a contextos concretos, e em que são referidas porções de alimentos e valores nutricionais. Na primeira parte do livro, apresentamos os grupos alimentares e as recomendações nutricionais ao longo do ciclo de vida e explicamos como calcular as quantidades de alimentos para atingir essas recomendações. Na segunda parte, abordamos o planeamento de um serviço de refeições, das respetivas ementas e a sua adaptação aos diferentes contextos da restauração. Na terceira e última parte, são incluídos alguns aspetos legais a cumprir, nomeadamente no que diz respeito aos alergénios e à rotulagem da oferta alimentar. Não menos importante, exploramos ainda o tema da sustentabilidade, como garantia da sua autopreservação, mas também como exigência de responsabilidade social.