Trends in food availability in Portugal in 1966-2003: Comparison with other Mediterranean countries

Background: Dietary intake has changed considerably in South European countries, but whether those changes were similar between countries is currently unknown. Aim of the study: To assess the trends in food availability in Portugal and four other Mediterranean countries from 1966 to 2003. Methods: Food and Agricultural Organization food balance sheets from Portugal, France, Italy, Greece and Spain. Trends were assessed by linear regression. Results: The per capita availability of calories has increased in Portugal, France, Greece, Italy and Spain in the past 40 years. Portugal presented the most rapid growth with an annual increase of 28.5 ± 2.2 kcal (slope ± standard error), or +1000 kcal overall. In animal products, Portugal had an annual increase of 20.7 ± 0.9 kcal, much higher than the other four countries. Conversely, the availabilities of vegetable and fruit only showed a slight growth of 1.0 ± 0.1 kcal/year and 2.5 ± 0.4 kcal/year, respectively, thus increasing the ration of animal to vegetable products. Olive oil availability increased in all countries with the notable exception of Portugal, where a significant decrease was noted. Wine supply decreased in all five countries; in contrast, beer supply started to take up more alcohol share. Percentage of total calories from fat increased from nearly 25% to almost 35% in Portugal during the study period, mainly at the expenses of calories from carbohydrates, whereas the share of protein showed just a slight increase. Furthermore, fat and protein were increasingly provided by animal products. Conclusions: Portugal is gradually moving away from the traditional Mediterranean diet to a more Westernized diet as well as France, Greece, Italy and Spain. Noticeably, the trends of diet transition were observed relatively faster in Portugal than in the other four Mediterranean countrie

Prevalence of overweight and obesity among migrants in Switzerland: association with country of origin

Abstract Objective Migrants tend to present higher overweight and obesity levels, but whether this relationship applies to all nationalities has seldom been studied. The present study aimed to assess the prevalence of overweight and obesity according to nationality in adults. Design Cross-sectional population-based samples. Setting Five-year nationwide interview surveys (Swiss Health Surveys - SHS) from 1992 to 2007 (n 63 766) and a local examination survey (CoLaus Study in Lausanne 2004-2006, n 6743). Subjects Participants were separated into Swiss, French, German, Italian, Portuguese, Spanish nationals, those from the former Republic of Yugoslavia and from other European and other countries. Results Compared with Swiss nationals, German and French nationals presented a lower prevalence of overweight and obesity, whereas nationals from Italy, Spain, Portugal and the former Republic of Yugoslavia presented higher levels. Adjusting the SHS data for age, gender, education, smoking, leisure-time physical activity and survey year, a lower risk for overweight and obesity was found for German (OR = 0·80, 95 % CI 0·70, 0·92) and French (OR = 0·74, 95 % CI 0·61, 0·89) nationals, whereas higher risks were found for participants from Italy (OR = 1·45, 95 % CI 1·33, 1·58), Spain (OR = 1·36, 95 % CI 1·15, 1·61), Portugal (OR = 1·25, 95 % CI 1·06, 1·47) and the former Republic of Yugoslavia (OR = 1·98, 95 % CI 1·69, 2·32). Similar findings were observed in the CoLaus Study for Italian (OR = 1·63, 95 % CI 1·29, 2·06), Spanish (OR = 1·54, 95 % CI 1·17, 2·04) and Portuguese (OR = 1·49, 95 % CI 1·16, 1·91) participants and for those from the former Republic of Yugoslavia (OR = 5·34, 95 % CI 3·00, 9·50). Conclusions Overweight and obesity are unevenly distributed among migrants in Switzerland. Migrants from Southern Europe and from the former Republic of Yugoslavia present higher prevalence rates. This suggests that preventive messages should be tailored to these specific population

The prevalence and management of cardiovascular risk factors in immigrant groups in Switzerland

Objectives: To compare the prevalence and management of cardiovascular risk factors (CVRFs) between immigrant groups and Swiss nationals. Methods: The Swiss Health Surveys (SHS, N=49,245) and CoLaus study (N=6,710) were used. Immigrant groups from France, Germany, Italy, Portugal, Spain, former Yugoslavia, other European and other countries were defined. Results: Immigrants from Italy, France, Portugal, Spain and former Yugoslavia presented a higher prevalence of smoking than Swiss nationals. Immigrants reported less hypertension than Swiss nationals, but the differences were reduced when blood pressure measurements were used. The prevalence of dyslipidaemia was similar between immigrants and Swiss nationals in the SHS. When eligibility for statin treatment was assessed, immigrants from Italy were more frequently eligible than Swiss nationals. Immigrants from former Yugoslavia presented a lower prevalence of diabetes in the SHS, but a higher prevalence in the CoLaus study. Most differences between immigrant groups and Swiss nationals disappeared after adjusting for age, leisure-time physical activity, being overweight/obesity and education. Conclusions: Most CVRFs are unevenly distributed among immigrant groups in Switzerland, but these differences are due to disparities in age, leisure-time physical activity, being overweight/obesity and educatio

Health-related quality of life in migrant preschool children

BACKGROUND: Minority groups have a lower health-related quality of life (HRQOL), but there is little information if this finding also applies to children. In this study, we compared HRQOL between young children with and without migrant parents. METHODS: Two cross-sectional studies of culturally diverse preschool populations in Switzerland: Ballabeina (40 preschools, 258 girls and 232 boys aged 4 to 6 years) and Youp'la Bouge (58 child care centers, 453 girls and 522 boys aged 2 to 4 years). Most children were born in Switzerland (Ballabeina: 92.3%; Youp'la Bouge: 93.7%). Number of migrant parents was considered as the main exposure. HRQOL was measured using the 23-item Pediatric Quality of Life Inventory. RESULTS: Children of migrant parents had a significantly lower HRQOL total score (mean +/- SD, Ballabeina: 84.2 +/- 9.1; 82.7 +/- 9.6 and 81.7 +/- 11.7 for children with none, one or two migrant parents, respectively; Youp'la Bouge: 83.8 +/- 8.6; 82.9 +/- 9.5; 80.7 +/- 11.7, all p > 0.05). Similar results were found in Ballabeina and Youp'la Bouge for social, school and physical functioning (all p > 0.05), but not for emotional functioning. The differences in HRQOL measures were partly mediated by children's place of birth, parental education, paternal occupational level, children's BMI, screen time and physical activity in one study (Ballabeina), but not in the other (Youp'la Bouge). CONCLUSION: In preschoolers, children of migrant parents have lower HRQOL than children of non-migrant parents. These differences are only partly mediated by other sociocultural characteristics or lifestyle behavior. These families may need assistance to prevent further inequalities

Prevalence of normal weight obesity in Switzerland: effect of various definitions

Background: Normal weight obesity (NWO) is defined as an excessive body fat associated with a normal body mass index (BMI <25kg/m2), but its prevalence in the general population is unknown. Aim of the study: To assess the prevalence of NWO in Switzerland according to different cut points used to define excess body fat. Methods: Cross-sectional study including 3,213 women and 2,912 men aged 35-75years. Body fat was assessed by bioelectrical impedance analysis and prevalence of NWO was assessed using four previously published definitions for excess body fat. Results: Percent body fat increased with age: in men, the values (mean±SD) were 20.2±5.4, 23.0±5.4, 26.3±5.2 and 28.2±4.6 for age groups 35-44, 45-54, 55-64 and 65-75years, respectively; the corresponding values for women were 29.9±7.8, 33.1±7.4, 36.7±7.5 and 39.6±6.9. In men, prevalence of NWO was <1% irrespective of the definition used. Conversely, in women, a 1- to 20-fold difference (from 1.4 to 27.8%) in NWO prevalence was found. The prevalence of NWO increased with age when age-independent cut points were used in women, but not in men. Conclusions: Prevalence of NWO is low in the general population and higher in women than in men. The prevalence is highly dependent on the criteria used to define excess body fat, namely in women. The use of gender- and age-specific cut points to define excess body fat is better than fixed or gender-specific only cut point

Determinants and burden of chronic kidney disease in the population-based CoLaus study: a cross-sectional analysis

Background Chronic kidney disease (CKD) represents an increasing health burden. We present the population-based prevalence of CKD and compare the CKD Epidemiology collaboration (CKD-EPI) and modification of diet in renal disease (MDRD) equations to estimate the glomerular filtration rate, using the revised CKD classification with three albuminuria classes. We also explore factors associated with CKD. Methods The Swiss population-based, cross-sectional CoLaus study conducted in Lausanne (2003-2006) included 2810 men and 3111 women aged 35-75. CKD prevalence was assessed using CKD-EPI and MDRD equations and albuminuria estimated by the albumin-to-creatinine ratio in spot morning urine. Multivariate logistic regression was used to analyse determinants of CKD. Results Prevalence [95% confidence interval (CI)] of all stages CKD was 10.0% (9.2-10.8%) with CKD-EPI and 13.8% (12.9-14.6%) with MDRD. Using the revised CKD classification, the prevalence of low-, medium-, high- and very high-risk groups was 90.0, 8.46, 1.18 and 0.35% with CKD-EPI, respectively. With MDRD, the corresponding values were 86.24, 11.86, 1.55 and 0.35%. Using the revised classification, CKD-EPI systematically reclassified people in a lower risk category than MDRD. Age and obesity were more strongly associated with CKD in men [odds ratio (95% CI): 2.23(1.95; 2.56) per 10 years and 3.05(2.08;4.47), respectively] than in women [1.46 (1.29; 1.65) and 1.78 (1.30;2.44), respectively]. Hypertension, type 2 diabetes, serum homocysteine and uric acid were positively independently associated with CKD in men and women. Conclusions One in 10 adults suffers from CKD in the population of Lausanne. CKD-EPI systematically reclassifies people in a lower CKD risk category than MDRD. Serum homocysteine and uric acid levels are associated with CKD independently of classical risk factors such as age, hypertension and diabete