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- Exercise training is associated with improved levels of C-reactive protein and adiponectin in ZDF (type 2) diabetic rats.Publication . Teixeira de Lemos, Edite; Reis, Flávio; Baptista, Sofi a; Pinto, Rui; Sepodes, Bruno; Vala, Helena; Rocha-Pereira, P.; Silva, Alice Santos; Teixeira, FredericoChronic low-grade systemic infl ammation is a feature of such chronic diseases as cardiovascular disease and type 2 diabetes (T2D). There is evidence that regular exercise is effective as a treatment in these situations. This study intended to assess the levels of two infl ammatory mediators, C-reactive protein (CRP) and adiponectin, in Zucker Diabetic Fatty (ZDF, fa/fa) rats, an experimental model of T2D, and to determine whether exercise-induced changes in insulin resistance could be explained by modifi cations in these infl ammation markers. Material/Methods: Male ZDF (Gmi fa/fa) rats and their littermates (Gmi +/+), aged 8 weeks, were randomly assigned in two groups: an exercise trained and a sedentary one. Swimming was conducted 1 h/day 3 days/week for 12 weeks. The rats were sacrifi ced 48 h after the last round of exercise. Rats had their body weight, insulin, adiponectin, CRP, as well as glucose, total cholesterol, triglycerides, MDA, and SOD measured and HOMA-IR calculated before and after the 12-week swimming training. Results: In the ZDF (fa/fa) rats underwent swimming exercise, all the metabolic abnormalities were totally or partially prevented ( p<0.001), namely the hyperglycemic, hyperinsulinemic, and dyslipidemic pattern observed in their sedentary counterparts. Furthermore, even without body weight change, a plasma adiponectin increase (28.0%) and a CRP decrease (12.7%) were also observed. Conclusions: A 12-week thrice-weekly swimming training was associated with improved measures of chronic in- fl ammation markers as measured by adiponectin and CRP. Moreover, improvements in insulin sensitivity resulting from swimming exercise appeared to be related to changes in these infl ammatory mediators.
- Exploring Lifestyle Factors and Treatment Adherence among Older Adults with Hypertension Attending a Mobile Health Unit (MHU) in a Rural Area of Central PortugalPublication . Pinto, Cátia; Margarida Correia Balula Chaves, Cláudia; Duarte, João; Raposo, António; Zandonadi, Renata Puppin; Monteiro, Sara; Teixeira-Lemos, EditeThis cross-sectional and analytical study aimed to characterize a sample of hypertensive older adults attending a Mobile Health Unit (MHU) in a rural area of central Portugal according to their lifestyle and to analyze the impact of lifestyles on treatment adherence. The sample comprised 235 Portuguese hypertense patients, mainly females (63.8%) with a mean age of 75 years (±8.14 years) and low level of education. The data collection was carried out through a questionnaire consisting of sociodemographic questions, dietary variables, an Alcohol Dependence Questionnaire, an International Physical Activity Questionnaire (Short Version), a Nutrition Health Determination Questionnaire, a Self-Care with Hypertension Scale, and an Adherence to Treatments Measurement Scale. Only 34.5% of the hypertensive patients have controlled blood pressure values (28.2% men and 38% women). However, more than half (56.2%) of the hypertensive patients are classified as adherent to therapeutic measures. The hypertensive individuals, who present higher levels of adherence to the treatment, do not present alcohol dependence, are frequent consumers of aromatic herbs, sporadically consume salt, present good nutritional health, and practice moderate physical activity. The predictor variables for treatment adherence are the self-care dimensions general dietary (p = 0.001), specific dietary (p = 0.034), physical activity (p = 0.031), and antihypertensive medication intake (p < 0.001). Hypertensive patients with healthier lifestyles present better levels of treatment adherence. Therefore, promoting physical activity and healthy dietary practices is necessary to improve treatment adherence and increase antihypertensive treatment’s effectiveness.
- A Pilot Study on Dietary Choices at Universities: Vending Machines, Canteens, and Lunch from HomePublication . Oliveira, Leandro; BinMowyna, Mona N.; Alasqah, Ibrahim; Zandonadi, Renata Puppin; Teixeira-Lemos, Edite; Margarida Correia Balula Chaves, Cláudia; Alturki, Hmidan A.; Albaridi, Najla A.; Alribdi, Fatmah Fahad; Raposo, AntónioAbstract Commercial environments and food acquisition methods significantly shape dietary practices and impact health. This study assesses dietary choices among Portuguese university students regarding vending machines, canteens, and lunches from home. It also evaluates their use of the university canteen and their tendency to bring lunch from home. This pilot cross-sectional study used a self-administered electronic questionnaire, made available in early 2023. Participants were recruited through snowball sampling. The study included 137 students from Portuguese higher education institutions, mainly women (74.5%), pursuing degrees or integrated Master’s degrees (83.2%), primarily in health-related fields (55.5%). The median age was 21 years (20 to 23.5 years). About 70.0% regularly consumed food from vending machines, while approximately 60.0% brought lunch from home, avoiding the canteen. Factors such as convenience (48.5%), price (47.5%), product availability (40.6%), and taste (39.6%) mainly influenced vending machine choices. Monthly, chocolates, water, coffee, cookies, treats, and soft drinks were the most commonly acquired items, with coffee being the most frequent daily purchase. These findings provide insights for creating policies and initiatives to promote healthier and more accessible food options for students and strategies to encourage positive eating behaviors.
- Risk of Gluten Cross-Contamination Due to Food Handling Practices: A Mini-ReviewPublication . Damasceno, Renatta Pereira B.; Zandonadi, Renata Puppin; Mendes, Marcela; Cunha Junior, Luis Carlos; Raposo, António; Teixeira-Lemos, Edite; Margarida Correia Balula Chaves, Cláudia; Farage, PriscilaAbstract Celiac disease (CD) is an autoimmune disease triggered by the ingestion of gluten in genetically predisposed individuals, affecting 1.4% of the world population. CD induces an inflammatory reaction that compromises small intestine villi, leading to nutrient malabsorption, and gastro and extraintestinal manifestations. Although other treatment approaches are being studied, adherence to a gluten-free diet (GFD) is the only effective intervention to date. Despite this, about 50% of patients experience persistent inflammation, often associated with unintentional gluten ingestion through contaminated food. There are regulations for labeling gluten-free foods which specify a limit of 20 mg/kg (20 ppm). The risks of gluten cross-contamination above that level are present throughout the whole food production chain, emphasizing the need for caution. This review explores studies that tested different procedures regarding the shared production of gluten-containing and gluten-free food, including the use of shared equipment and utensils. A literature review covering PubMed, Scielo, Web of Science, VHL and Scopus identified five relevant studies. The results indicate that shared environments and equipment may not significantly increase gluten cross-contamination if appropriate protocols are followed. Simultaneous cooking of gluten-containing and gluten-free pizzas in shared ovens has demonstrated a low risk of contamination. In general, shared kitchen utensils and equipment (spoon, ladle, colander, knife, fryer, toaster) in controlled experiments did not lead to significant contamination of samples. On the other hand, cooking gluten-free and gluten-containing pasta in shared water resulted in gluten levels above the established limit of 20 ppm. However, rinsing the pasta under running water for a few seconds was enough to reduce the gluten content of the samples to less than 20 ppm.
- Consumer Knowledge about Dietary Relevance of Fruits and Vegetables: A Study Involving Participants from Portugal and FrancePublication . Le Turc, Nolwenn; Silva, Ana Jaquelina; Florença, Sofia De Guiné E; Raposo, António; C. Goncalves, J.; Lima, Maria João; Teixeira de Lemos, Edite; Guiné, RaquelFruits and vegetables are recommended as low-calorie foods that contribute to the proper intake of necessary micronutrients, macronutrients, and bioactive compounds with health benefits. However, the recommendations for the dietary intake of these foods fail to be attained in most European countries. For this reason, promoting more knowledge about the health effects of fruits and vegetables is essential to decrease the incidence of chronic diseases. This study was conducted to investigate the knowledge of the health benefits of fruits and vegetables among the population of Portugal and France. The present work involved a questionnaire survey of 639 participants (257 from Portugal and 382 from France). The results revealed that most participants were young females (68.9%) with good education (76%) and an average weight range. They consumed a varied diet (57%) but had body dissatisfaction (63.2%). The respondents had good knowledge about the health effects of fruits and vegetables. However, the French population knew more about the theme than the Portuguese. Portuguese individuals were more likely to have incomplete information. Gender and education significantly influenced knowledge levels, with females and highly educated individuals demonstrating greater understanding. Dissatisfaction with body weight drives individuals to seek nutrition information. This investigation enhances our comprehension of the factors that affect knowledge of vegetable and fruit consumption among young adults in Portugal and France. Moreover, it highlights the importance of implementing focused educational programs to enhance nutrition literacy, particularly for less-aware demographic groups. Going forward, a more in-depth analysis of these factors could assist in creating more efficient strategies to encourage healthier dietary habits and improve nutrition literacy among these communities.
- Effect of Cynara cardunculus L. var. altilis (DC) in inflammatory bowel diseasePublication . Mateus, Vanessa; Estarreja, João; Silva, Inês Filipa Janeiro; Barracosa, Paulo; Teixeira de Lemos, Edite; Pinto, RuiCynara cardunculus L. var. altilis (DC) is a plant generally associated as an ingredient in the Mediterranean diet. The polyphenols present in this plant provide pharmacological and nutritional properties. C. cardunculus L. has been used throughout animal studies, which demonstrated an anti-inflammatory effect. Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract. Since there is not a known cure, the research of new possible pharmacological approaches is essential. This study aims to evaluate the effect of an aqueous extract of C. cardunculus L. dry leaves in a 2,4,6-Trinitrobenzenesulfonic acid (TNBS)-induced colitis model. Methods: CD-1 mice with TNBS-induced colitis received an intraperitoneal (IP) administration of C. cardunculus L. once per day for 4 days. Results: The C. cardunculus L. demonstrated a beneficial effect in this experimental model of IBD with anti-inflammatory action through the reduction of tumor necrosis factor (TNF)-α levels. It also demonstrated a beneficial influence on the extra-intestinal manifestations related to IBD, with the absence of significant side effects of its use. Conclusions: The extract of C. cardunculus L. dry leaves can become an interesting tool for new possible pharmacological approaches in the management of IBD.
- Enhancing life with celiac disease: unveiling effective tools for assessing health-related quality of lifePublication . Falcomer, Ana Luísa; de Lima, Bernardo Romão; Farage, Priscila; Fabris, Samantha; Ritter, Ruth; Raposo, António; Teixeira-Lemos, Edite; Margarida Correia Balula Chaves, Cláudia; Zandonadi, Renata PuppinAbstract Celiac disease (CD) is an autoimmune chronic enteropathy provoked by gluten ingestion in genetically predisposed individuals. Considering it´s only safe treatment is a lifelong gluten-free diet, the burden of living with the disease becomes evident, as well as the need to assess CD health-related quality of life (HRQOL). This review aims to identify and analyze the instruments used to evaluate the HRQOL of adults with CD. This integrative review using a systematic approach was designed to achieve high scientific standards. Accordingly, the search strategy was developed and executed as recommended by the guideline of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Detailed individual searches were developed to Pubmed, Science Direct, Scopus, Web of Science, and Google Scholar. After careful analysis of the papers, 43 studies were included, in which seven instruments were identified: Celiac Disease Questionnaire (CDQ) (n=21), Celiac Disease Specific Quality of Life Instrument (CD-QOL) (n=17), Celiac Disease Assessment Questionnaire (CDAQ) (n=4), CeliacQ-7 (n=1), CeliacQ-27 (n=1), Black and Orfila´s self-developed instrument (n=1) and the Coeliac Disease Quality of Life Questionnaire (CDQL) (n=1). The CDQ and CD-QOL were the two most applied instruments. Since the first focuses on the physical and mental symptoms related to the disease and the second focuses on the emotional repercussions of adhering to the GFD treatment for life (dysphoria), the CDQ application is an interesting option for countries that struggle with public policies for CD patients and patients with active CD. The CD-QOL could be used for countries with strict regulations for CD and gluten-free products and populations in remission. When comparing results among different populations, it is preferable to utilize culturally validated instruments, which have been applied across multiple countries, providing greater comparability between study findings.
- Health-related quality of life among celiacs in Portugal: a comparison between general and specific questionnairesPublication . Margarida Correia Balula Chaves, Cláudia; Zandonadi, Renata Puppin; Raposo, António; Nakano, Eduardo Yoshio; Ramos, Fernando; Farage, Priscila; Teixeira-Lemos, EditeObjective: This study aimed to compare the 36-Item Short Form Survey Instrument version 2 (SF-36-v2) (generic) and Celiac Disease Questionnaire (CDQ) (specific) questionnaires used to evaluate the quality of life (QoL) in celiac Portuguese adult individuals. Methods: This cross-sectional study used non-probabilistic sampling based on Portuguese celiac patients who accessed the online survey in 2022. The online data collection used a self-reported instrument composed of three parts: (i) socioeconomic, health, and gluten-free diet (GFD) adherence questions; (ii) SF-36 v2 - Portuguese version (generic questionnaire) and (iii) Celiac Disease Questionnaire (CDQ) (specific questionnaire). Results: A total of 234 individuals who accessed the survey completed the questionnaire. Seven of the eight SF-36 domains positively correlated to the specific questionnaire CDQ. The "General Health" domain (domain 4) showed a negative correlation with the CDQ. Differences in content between the two instruments might be able to explain this finding since the CDQ explores issues regarding the specificities of celiac disease (CD) and the lifelong GFD burden. About half of the sample from this study displayed poor diet adherence, it is possible that the SF-36 could not reflect the impact of CD treatment - the complete elimination of gluten from the diet - on patients' health. Therefore, this issue should be carefully evaluated in future research. Conclusion: Specific validated questionnaires for CD individuals, such as the CDQ, contemplate social, economic, and clinical variables that permeate the patient's life context. Therefore, these instruments may be more suitable for evaluating QoL in this public. However, using a general questionnaire such as the SF-36 would be indicated for comparing QOL between celiac patients and the general population or even between CD and other disease individuals. In this case, we recommend assessing GFD compliance for control parallelly.
- From Validation to Assessment of e-Health Literacy: A Study among Higher Education Students in PortugalPublication . Oliveira, Leandro; Zandonadi, Renata Puppin; Nakano, Eduardo Yoshio; Almutairi, Sulaiman; Alzghaibi, Haitham; Lima, M. J. Reis; Teixeira-Lemos, Edite; Saraiva, Ariana; Raposo, AntónioDespite their familiarity with technology, higher education students often lack the critical skills needed to assess the credibility of online health information, potentially impacting their health decisions and well-being. This study aims to validate and assess the e-Health Literacy Scale among those in Portuguese higher education. In addition, this study focused on measuring their e-health literacy levels and investigating how these skills relate to different sociodemographic variables. This cross-sectional study was conducted in two phases. Initially, the test–retest reliability and reproducibility of measured e-health literacy were assessed with a convenience sample of 20 participants. Subsequently, the e-health scale was applied to a group of 245 Portuguese higher education students. The research took place from January 2023 to April 2024. The scale exhibited robust internal consistency and reproducibility. Male gender consistently correlates with higher levels of e-health literacy. Students demonstrate good levels of e-health literacy (24/40), reflecting their ability to effectively navigate and utilize health information online. By integrating strategies to further enhance this literacy into university health programs, students can develop essential skills necessary for making informed decisions about their health. This proactive approach not only empowers students to access reliable health resources but also fosters a culture of health literacy that can positively impact their well-being both during their academic journey and beyond graduation.
- Exploring prebiotic properties and its probiotic potential of new formulations of soy milk-derived beveragesPublication . Rana, Ananya; Taneja, Neetu Kumra; Raposo, António; Alarifi, Sehad N.; Teixeira-Lemos, Edite; Lima, M. J. Reis; C. Goncalves, J.; Dhewa, Tejpal