RCIPL
Repositório Institucional do Politécnico de Lisboa
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The association between Mediterranean diet: related health literacy, cooking skills and Mediterranean diet adherence in the Spanish population
Publication . Casucci, Maria Giulia; Muñoz-Martínez, Júlia; Caneda-Ferrón, Begoña; Salinas-Roca, Blanca; Orta-Ramirez, Alicia; Vidal, Eulàlia; Rodríguez-Monforte, Míriam; Costa, Inês M.; Costa, Vânia; Renzi, Sofia; Carrillo-Álvarez, Elena
Background/Objectives: Even with solid proof of its benefits for cardiovascular health and metabolism, adherence to the Mediterranean Diet (MD) in Spain has noticeably declined in recent years. The socioeconomic changes occurring in recent decades have prompted shifts in cooking habits and in how food is socially experienced, particularly among children and adolescents. The MD is more than just food: it is a cultural tradition and a lifestyle, rich in food and cooking skills, and food wisdom passed down over generations. When these practices fade, it affects both health and the environment, making them vital components in strengthening support for food knowledge, cooking abilities, and a healthier lifestyle. Considering these shifting dietary patterns and the growing need for targeted educational strategies, the present study aimed to investigate the association between cooking skills, MD-related health literacy, and adherence to the Mediterranean Diet across different developmental stages: childhood, adolescence, and adulthood in a sample of the Spanish population. Additionally, a secondary objective was to identify potential critical windows for intervention based on the strength of these associations. Methods: This cross-sectional study included 832 Spanish participants grouped by age: children and early adolescents (n = 408), older adolescents (n = 136), and adults (n = 288). Cooking skills were assessed using CooC11 for children and FCSk for older groups. Adults also completed Lit_MEDiet to assess MD-related health literacy. Adherence was measured with KIDMED (children/adolescents) and MEDAS (adults). Spearman correlations and standardized linear regressions were used. All statistical tests were two-sided, and statistical significance was set at p < 0.05. Results: In children, no significant association was found between cooking skills (CooC11) and KIDMED scores (β = 0.008; p = 0.875). Among adolescents, a strong positive association emerged between FCSk and KIDMED (β = 0.313; p < 0.001; ρ = 0.371), indicating a large, standardized effect and suggesting that this stage is particularly sensitive to food skills. In adults (18+), both food and cooking skills (FCSk) (β = 0.189; p = 0.001) and MD-related health literacy (Lit_MEDiet) (β = 0.187; p = 0.004) were moderately associated with MEDAS scores. Conclusions: These findings suggest that mid-adolescence could represent a favourable developmental window where food skills may hold potential to influence positive dietary behaviours. Regarding adults, the results indicate that combining practical and educational components appears to beneficial for dietary quality. Overall, this study supports the relevance of age-tailored public health strategies to potentially enhance long-term adherence to the Mediterranean Diet.
Characterization of Th2 serum immune response in acute appendicitis
Publication . Carvalho, Nuno; Almeida, Jani-Sofia; Carolino, Elisabete; Lopes, Francisco; Henriques, Susana; Vaz, João; Coelho, Hélder; Santos, Paulo Rodrigues; Rosa, Manuel Santos; Moita, Luís; Luz, Carlos; Costa, Paulo Matos
Acute Appendicitis (AA) is the commonest abdominal digestive surgical emergency, but its etiology is not clarified. Based on histologic observations, an allergic cause has been proposed. In a type I hypersensitivity allergic reaction, there is a Th2 immune response characterized by Th2 cells, eosinophils, basophils, IgE, IL-4, IL-5, and IL-13 serum elevation. Recent studies showed a local appendicular endoluminal and parietal Th2 immune response in acute phlegmonous appendicitis. We performed a prospective single-center study where we evaluated the Th2 blood immune response in 38 patients with acute phlegmonous appendicitis, 27 patients with acute gangrenous appendicitis, and 18 patients with the clinical picture of AA, who underwent appendectomy but had negative histology for AA (negative appendectomy group). Higher levels of basophils were found in phlegmonous appendicitis (p = 0.03), and higher levels of eosinophils were found in the control group (p = 0.003). Effector memory CD4 T cells re-expressing CD45RA were higher in gangrenous (p = 0.020) and central memory CD4 T cells in phlegmonous appendicitis (p = 0.004). The number of Th2 circulating cells was higher in gangrenous appendicitis (p = 0.037), while Th1 circulating cells were higher in phlegmonous appendicitis (p = 0.028). IL-4 blood concentrations were elevated in acute gangrenous appendicitis (p = 0.029). No significant differences were found in the levels of IgE, IL-5, or IL-13 in any of the groups. Thus, a Th2 response was not detected in patients’ serum with phlegmonous appendicitis. Serum levels of IgE, IL-5, and IL-13 were not different among patients with acute phlegmonous appendicitis, acute gangrenous appendicitis, and the negative appendectomy group. These findings are in contrast to our previous work in which we evaluated the Th2 response at the local level, at the appendicular luminal aspect and appendicular wall, in phlegmonous appendicitis and control groups, and we unequivocally showed a Th2 response in phlegmonous appendicitis. Thus, in patients with phlegmonous appendicitis, the local Th2 response is not reflected in the serum levels of immune cells and cytokines.
The comet assay as a tool in human biomonitoring exposure to volatile organic compounds: a systematic review and meta-analysis
Publication . Giovannelli, Lisa; Møller, Peter; Gajski, Goran; Stopper, Helga; Azqueta, Amaya; Bankoglu, Ezgi Eyluel; Haveric, Anja; Gerić, Marko; Collins, Andrew; Ladeira, Carina
Exposure to volatile organic compounds (VOCs) such as benzene, styrene, toluene, and formaldehyde is associated with genotoxicity and increased risk of cancer. In this systematic review and meta-analysis, we have assessed the effects of VOCs exposure on levels of DNA strand breaks in leukocytes, measured by the comet assay, in human biomonitoring studies. The literature search led to 57 studies included in the review. Of these, 50 studies met the criteria to be used in the meta-analysis. Using standardized mean difference and 95 % confidence interval (CI), the meta-analyses show increased levels of DNA strand breaks in subjects exposed to benzene (1.59, 95 % CI: 0.94, 2.24), styrene (0.87, 95 % CI: 0.23, 1.51), formaldehyde (0.39, 95 % CI: −0.15, 0.92) and other organic solvents (2.14, 95 % CI: 1.48, 2.81). Results originate mainly from studies on workers, with only a few studies on environmental benzene exposure. Subgroup analysis indicates that all studies combined from middle-income countries have a higher effect size (1.81, 95 % CI: 1.26, 2.36, n = 28) than studies from high-income countries (0.87, 95 % CI: 0.49, 1.24, n = 22). This difference between middle- and high-income countries may be due to differences in exposure levels or exposure assessment. However, this might not be the only reason, as sensitivity analysis indicates that effect sizes are at risk of comet assay measurement bias, as 78 % (39 out of 50 studies) and 60 % (30 studies) have not reported the use of assay controls and blinded analysis of samples, respectively. Relatively few studies have a high risk of bias due to an inadequate comet assay procedure description (14 %, 7 studies) and exposure misclassification (16 %, 8 studies). Limitations of the study were the differences in protocols, comet descriptors, exposure assessment, and control for confounding factors among the studies. In conclusion, this systematic review and meta-analysis show that exposure to VOCs – benzene, styrene, formaldehyde, and others – is associated with increased levels of DNA strand breaks in human leukocytes.
The comet assay as a tool in human biomonitoring exposure to combustion-derived air pollution: a systematic review and meta-analysis
Publication . Møller, Peter; Gajski, Goran; Gerić, Marko; Haveric, Anja; Stopper, Helga; Bankoglu, Ezgi Eyluel; Azqueta, Amaya; Giovannelli, Lisa; Collins, Andrew; Ladeira, Carina
Humans are exposed to environmental or occupational air pollution from combustion emissions in outdoor and indoor environments. Irrespective of the sources, combustion emissions are characterized by being a complex mixture of particles, volatile compounds and gases. The present systematic review summarizes results on DNA strand breaks measured by the comet assay in leukocytes, from studies on human exposure to traffic-related vehicle exhaust, biomass combustion and coke oven work environments. These exposures have in common the combustion of fuel, which generates particles and polycyclic aromatic hydrocarbons. Standardized mean differences (SMDs) have been calculated by random effects models. Meta-analyses show increased levels of DNA strand breaks in studies on traffic-related exhausts (SMD = 0.62, 95 % CI: 0.36, 0.89, n = 21), biomass combustion (1.73, 95 % CI: 0.72, 2.74, n = 10) and coke oven emission (0.84, 95 % CI: 0.30, 1.37, n = 10). Studies from high-income countries have reported much smaller differences in DNA strand break levels than have studies from middle-income countries. These differences may be attributed to higher exposures related to less strict emission control, and more susceptible populations in middle-income populations; unrecognized confounding despite efforts to match subjects on traditional confounders; or higher risk of comet assay measurement bias and exposure misclassification. In conclusion, this systematic review and meta-analysis show that exposure to combustion-derived air pollution, with clear exposure gradients in terms of particulate matter or polycyclic aromatic hydrocarbons, is associated with increased levels of DNA strand breaks in human leukocytes.
Involvement in Portuguese father-infant free play interactions at 3 and 9 months
Publication . Almeida, Rita; Barros, Luisa; Santos, Margarida; Beeghly, Marjorie; Fuertes, Marina
Objective. Although continuity and stability in parental sensitivity promote a sense of security and predictability for infants and are linked to a variety of positive child outcomes, research with fathers is relatively rare. The present Portuguese longitudinal study investigates mean group-level continuity (vs. discontinuity) and individual-order stability (vs. instability) of ratings of paternal sensitivity and other dimensions of father-infant interactive behavior with infants from 3 to 9 months. Design. Participants included 61 urban middle- to lower-middle-class Portuguese fathers and their healthy, term infants observed during free play at 3 and 9 months. Multiple dimensions of paternal and infant behavior were scored using Crittenden’s CARE-Index. Fathers also reported on their involvement in childcare activities using the Parents’ Responsibility Scale. Results. The magnitude of fathers’ average group-level sensitivity decreased from 3 to 9 months, but fathers’ ratings correlated over time, indicating individual-order stability. In a First-Difference Regression Model, increases in paternal involvement (play and primary caregiving) and infant cooperative behavior from 3 to 9 months predicted higher paternal sensitivity. Conclusions. Evidence for both group-level discontinuity and individual-order stability in fathers’ sensitivity and involvement was found at 3 to 9 months postpartum. Increases in paternal play and primary caregiving, along with cooperative infant behavior, predicted higher paternal sensitivity at 9 months, identifying modifiable targets for early support.