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Purpose Appetitive behaviours have been associated with body mass index (BMI). However, existing data were largely derived from cross-sectional studies and cannot provide insight into the direction of associations. We aimed to explore the bidirectionality of these associations in school-age children. Methods Participants are from the Generation XXI birth cohort, assessed at both 7 and 10 years of age ( n  = 4264; twins excluded). The Children’s Eating Behaviour Questionnaire (CEBQ) was used to measure appetitive behaviours (8 subscales). Anthropometrics were measured and WHO BMI z -score was calculated. Cross-lagged analyses were performed to compare the magnitude and direction of the associations (behaviours at 7 years to BMI z -score at 10 years and the reverse) (covariates: child’s sex, physical exercise, maternal age and education; plus BMI z -score at age 7 or, in the reverse direction, the subscale score). Results In cross-lagged analyses, appetitive behaviours at 10 years of age (apart from emotional undereating) were shown to be reactive to the child BMI z -score at 7 years of age. Only slowness in eating was significantly related to subsequent BMI. However, the strongest association was from the child BMI z -score to the behaviour ( β standardized  = − 0.028 compared with β standardized  = − 0.103, likelihood ratio test p  < 0.001). Conclusions BMI at age 7 was related to appetitive behaviours at 10 years of age, rather than the reverse. This suggests that children with a higher BMI in middle childhood are at increased risk of developing an avid appetite over time.

Background/objectives The objective of this study was to evaluate the performance of a short food frequency questionnaire (FFQ) to assess dietary intake at 4 and 7 years of age, against 3d food diaries (FD) and serum biomarkers, using two methods to convert the FFQ to daily intake in grams and nutrients (standard and z -score method). Subjects/methods The present analysis comprises data from 2482 4-year-old children and 3511 7-year-old children, from the birth cohort Generation XXI (Porto, Portugal). To estimate daily consumption from the FFQ, the frequency response was multiplied by a standard mean portion (standard method) or adjusted with data from the FD ( z -score method). The dietary intake obtained from the FFQ was compared with the FD and serum biomarkers, using Intra-Class Correlation Coefficients (ICC), de-attenuated Pearson’s correlation coefficients and Bland Altman analysis. Results In general, the mean daily food intake estimated by the z -score method had a higher agreement with the FD, than the standard method. The highest ICC was obtained for “vegetable soup” (ICC = 0.536), using the z -score method, compared to an ICC of 0.373 using the standard method. Significant correlation coefficients were observed for all nutrients; the average of correlation coefficients was 0.39 at 4 years and 0.42 at 7 years of age. For the majority of nutrients, the correlation between mean and mean difference was lower using the z -score method, in comparison with the standard method. Conclusions The results suggest that the FFQ is a reasonably good instrument to estimate dietary intake in children. Moreover, adjusting the FFQ portion size, by using a z -score method, seems to increase the accuracy of dietary data in children.

Objective:To assess total sugar (TS), added sugar (AS) and free sugar (FS) intakes, dietary sources, adherence to recommendations and determinants of consumption, in a Portuguese national sample.Design:Cross-sectional study. Dietary assessment was obtained by two food diaries in children aged <10 years and two non-consecutive 24 h recalls for other age groups. TS, AS and FS intakes were estimated by using SPADE software. TS content in food was estimated at the ingredient level. AS content in food was assessed through a systematic methodology and FS was based on the WHO definition.Setting:National Food, Nutrition and Physical Activity Survey (IAN-AF 2015-2016), Portugal.Participants:Representative sample from the Portuguese population, aged from 3 months to 84 years (n 5811).Results:Mean daily intake and contribution to total energy intake (E%) were 84·3 g/d (18·5 E%) for TS, 32·1 g/d (6·8 E%) for AS and 35·3 g/d (7·5 E%) for FS. Of the population, 76 % adhered to the FS recommendation (FS < 10 E%). The lowest adherence was in children (51·6 %) and adolescents (51·3 %). The main dietary source of TS was fruit across all ages, except in adolescents which was soft drinks. In children, the main dietary sources of FS were yoghurts and sweets, soft drinks in adolescents and table sugar in adults/elderly. FS intake was lower in children with more educated parents and in adults who practised physical activity regularly, and higher among smokers.Conclusions:Interventions ought to be planned towards decreasing intakes of added and free sugars considering population-specific characteristics. (c) The Authors 2019.

Despite the potential effectiveness of bariatric surgery in promoting weight loss, a considerable proportion of patients still face the challenge of achieving optimal post-surgery outcomes. The timing of eating, in addition to the content of what is eaten, as well as chronotype and social jetlag (a marker of circadian misalignment), have been implicated in weight regulation. However, the current understanding of these chrono-related behaviours in individuals undergoing bariatric surgery is still scarce. Thus, this study aims to evaluate the role of chrono-nutrition, chronotype, and circadian misalignment in the weight-loss trajectory among individuals living with severe obesity who underwent bariatric surgery. The ChronoWise project is a prospective single-centre cohort study designed to follow patients experiencing bariatric surgery at the Santo António Local Health Unit (ULSSA), Porto, Portugal. Participants will be recruited and evaluated at pre-surgery and followed-up over 3 and 6 months after surgery. The baseline evaluation will be conducted face-to-face during the hospital stay and by telephone or video call on the subsequent evaluations, following standard procedures. Data collection includes sociodemographics, food intake, chrono-nutrition behaviours, sleep time behaviour, sleep quality, screen time, physical activity and exercise behaviours, anthropometric measurements, and biochemical parameters. The 'Munich Chronotype Questionnaire' will be used to assess chronotype and social jet lag. Chrono-nutrition dimensions will be measured by the 'Chrononutrition Profile-Questionnaire' in all evaluations. Weight and height will be self-reported and retrieved from medical registries. trajectories of weight-loss will be obtained. This study will add important evidence on the role of chrono-nutrition, chronotype and social jetlag profile in weight-loss outcomes after bariatric surgery. Identifying novel approaches to change the paradigm of post-surgical weight management towards a tailored treatment aligned with circadian rhythm may be useful to strengthen the existing treatments and improve patients' response to bariatric surgery.

The assessment of food consumption data using harmonized methodologies at the European level is fundamental to support the development of public policies. Portugal is one of the countries with the most outdated information on individual food consumption. The objective of this study was to describe the design and methodology of the National Food, Nutrition and Physical Activity Survey, 2015-2016, developed to collect national and regional data on dietary habits, physical activity (PA), and nutritional status, in a representative sample of the Portuguese general population (3 months-84 years). Participants were selected by multistage sampling, using the National Heath Registry as the sampling frame. Data collection, during 12 months, was harmonized according to European guidelines (EU-MENU, European Food Safety Authority [EFSA]). Computer-assisted personal interviewing (CAPI) was performed on a specific electronic platform synchronized with nutritional composition data and considering the FoodEx2 classification system. Dietary assessment was performed using 24-hour recalls (two nonconsecutive, 8-15 days apart) or food diaries in the case of children aged <10 years, complemented with a food propensity questionnaire; PA data (International Physical Activity Questionnaire [IPAQ], the Activity Choice Index [ACI], and 4-days PA diaries); sociodemographic data, and other health-related data were also collected. A sample of 6553 individuals completed the first interview, and 5811 participants completed two dietary assessments. The participation rate among eligible individuals was 33.38% (6553/19,635), considering the first interview, and 29.60% (5811/19,635) for the participants with two completed interviews (about 40% in children and adolescents and 20% in elderly individuals). Results of the survey will be disseminated in national and international scientific journals during 2018-2019. The survey will assist policy planning and management of national and European health programs on the improvement of nutritional status and risk assessment related to food hazards, and the enhancement of PA. The infrastructures and data driven from this Survey are a solid basis to the development of a future national surveillance system on diet, PA, and other health behaviors reproducible over time.

Previous physical activity interventions for children (5-12yrs) have aimed to change determinants associated with self-report physical activity behaviour (PAB) and/or sedentary behaviour (SB), however, the associations between these determinants and PAB/SB in different settings are uncertain. The present study aimed to identify modifiable determinants targeted in previous PAB/SB interventions for children. Intervention effects on the determinants and their associations with self-report PAB/SB were assessed across settings. Search of relevant interventions from pre-defined databases was conducted up to July 2023. Randomized and non-randomized controlled trials with modifiable determinants were included. Data extraction and risk of bias assessments were conducted by two independent researchers. Where data could be pooled, we performed Robust Bayesian meta-analyses. Heterogeneity, publication bias and certainty of evidence were assessed. Fifteen studies were deemed eligible to be included. Thirty-seven unique determinants within four settings were identified–school, family, school with family/home, and community with(out) other settings. Ninety-eight percent of determinants belonged to individual/interpersonal determinant categories. Narratively, intervention effects on student perception of teachers’ behaviour (school), self-management, perceived barriers, external motivation, exercise intention, parental modeling on SB (school with family/home) and MVPA expectations (community) were weak to strong, however, corresponding PAB/SB change was not evident. There were negligible effects for all other determinants and the corresponding PAB/SB. Meta-analyses on self-efficacy, attitude, subjective norm and parental practice and PAB/SB in two settings showed weak to strong evidence against intervention effect, while the effect on knowledge could not be determined. Similarly, publication bias and heterogeneity for most analyses could not be ascertained. We found no concrete evidence of association between the modifiable determinants and self-report PAB/SB in any settings. This is presumably due to intervention ineffectiveness. Design of future interventions should consider to follow the systems-based approach and identify determinants unique to the context of a setting, including policy and environmental determinants.

Self-directed behaviors (SDBs), such as scratching, self-grooming, and body shaking, have been widely used as indicators of anxiety and social stress in non-human primates. However, research focused on SDB outside the primate range is still in infancy. Expanding this topic to other species can support animal welfare assessments and enhance comparative social studies. This study investigates whether SDB levels can reflect the social stress experienced in Asian elephants ( Elephas maximus ). Using all-occurrences and focal sampling on four captive individuals, we compared post-conflict SDB levels in victims to their baseline levels. Furthermore, changes in group composition during the study allowed us to examine whether individual baseline SDBs varied with social stress, measured as victimization rates across settings. Finally, we assessed whether there was any relation between levels of SDBs and stereotypic behavior. Results showed an increase in SDB levels in the victims after aggression compared to baselines, especially for behaviors recorded as counts. An estimated 39.8% increase in expected SDB counts was associated with the post-conflict context (E = 0.335, p  = 0.024). The SDBs that differed more prominently were touch mouth, head shake, dust bathing, and trunk curled inwards ( p  < 0.05). Regarding baselines, two individuals increased their basal SDB levels when their rates as victims were the highest, although only one reached marginal significance. An individual who was never recorded as the recipient of aggression revealed remarkably low SDB levels. This study identified specific SDBs induced by social stress in Asian elephants and suggests SDB as a potential good indicator of their wellbeing.

Background Although physical activity (PA) is associated with significant health benefits, only a small percentage of adolescents meet recommended PA levels. This systematic review with meta-analysis explored the modifiable determinants of adolescents’ device-based PA and/or sedentary behaviour (SB), evaluated in previous interventions and examined the associations between PA/SB and these determinants in settings. Methods A search was conducted on five electronic databases, including papers published from January 2010 to July 2023. Randomized Controlled Trials (RCTs) or Controlled Trials (CTs) measuring adolescents’ device-based PA/SB and their modifiable determinants at least at two time points: pre- and post-intervention were considered eligible. PA/SB and determinants were the main outcomes. Modifiable determinants were classified after data extraction adopting the social-ecological perspective. Robust Bayesian meta-analyses (RoBMA) were performed per each study setting. Outcomes identified in only one study were presented narratively. The risk of bias for each study and the certainty of the evidence for each meta-analysis were evaluated. The publication bias was also checked. PROSPERO ID: CRD42021282874. Results Fourteen RCTs (eight in school, three in school and family, and one in the family setting) and one CT (in the school setting) were included. Fifty-four modifiable determinants were identified and were combined into 33 broader determinants (21 individual–psychological, four individual–behavioural, seven interpersonal, and one institutional). RoBMAs revealed none or negligible pooled intervention effects on PA/SB or determinants in all settings. The certainty of the evidence of the impact of interventions on outcomes ranged from very low to low. Narratively, intervention effects in favour of the experimental group were detected in school setting for the determinants: knowledge of the environment for practicing PA, d  = 1.84, 95%CI (1.48, 2.20), behaviour change techniques, d  = 0.90, 95%CI (0.09, 1.70), choice provided, d  = 0.70, 95%CI (0.36, 1.03), but no corresponding effects on PA or SB were found. Conclusions Weak to minimal evidence regarding the associations between the identified modifiable determinants and adolescents’ device-based PA/SB in settings were found, probably due to intervention ineffectiveness. Well-designed and well-implemented multicomponent interventions should further explore the variety of modifiable determinants of adolescents’ PA/SB, including policy and environmental variables.

Hunting activity is usually seen as a factor capable of causing an intense stress response in wildlife that may lead to short but also long-term stress. In the Lousã Mountain, Portugal, the population of red deer (Cervus elaphus) is the target of intensive seasonal hunting. We collected and measured cortisol (and its metabolites) in three tissues types (blood, feces and hair) from red deer hunted during two hunting seasons to evaluate the stress levels at different time windows. We also assessed the immunological and physical condition of the animals. We predicted that the hunting activity would act as a stressor inducing increased short and long-term stress levels in the population. Results showed an increase in hair cortisol levels during the months of harvesting. Surprisingly, the tendency for plasma cortisol levels was to decrease during the hunting season, which could be interpreted as habituation to hunting activity, or due to the hunting duration. Contrary to our predictions, fecal cortisol metabolites did not show any clear patterns across the months. Overall, our results suggest an influence of hunting activities on the physiological stress in red deer. In addition, hair seems to be useful to measure physiological stress, although more studies are required to fully understand its suitability as an indicator of long-term stress. Methodologically, our approach highlights the importance of simultaneously using different methods to assess short and long-term effects in studies on physiological stress reactions.

The present study aimed to evaluate the association between the consumption of energy-dense foods at 2 years of age and the consumption of foods and diet quality at 4 years of age. The sample included 705 children evaluated at 2 and 4 years of age, as part of the population-based birth cohort Generation XXI (Porto, Portugal). Data on sociodemographic and lifestyle factors of both children and mothers were collected by face-to-face interviews. The weight and height of children were measured by trained professionals. Based on FFQ, four energy-dense food groups were defined: soft drinks; sweets; cakes; salty snacks. A healthy eating index was developed using the WHO dietary recommendations for children (2006) aged 4 years. The associations were evaluated through Poisson regression models. After adjustment for maternal age and education, child's carer, child's siblings and child's BMI, higher consumption of energy-dense foods at 2 years of age was found to be associated with higher consumption of the same foods 2 years later. An inverse association was found between the intake ( ≥ median) of soft drinks (incidence rate ratio (IRR) = 0·74, 95 % CI 0·58, 0·95), salty snacks (IRR = 0·80, 95 % CI 0·65, 1·00) and sweets (IRR = 0·73, 95 % CI 0·58, 0·91) at 2 years of age and the consumption of fruit and vegetables at 4 years of age ( ≥ 5 times/d). Weekly and daily consumption of energy-dense foods at 2 years of age was associated with a lower healthy eating score at 4 years of age (IRR = 0·75, 95 % CI 0·58, 0·96; IRR = 0·56, 95 % CI 0·41, 0·77, respectively). The consumption of energy-dense foods at young ages is negatively associated with the diet quality of children a few years later.