Laboratório de Nutrição (LN)
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Missão
O Laboratório de Nutrição (LN), no enquadramento da missão da Faculdade de Medicina da Universidade de Lisboa (FMUL), desenvolve a sua actividade em três eixos: Ensino, Investigação e Apoio à Comunidade.
O Laboratório de Nutrição assenta a sua missão nos eixos estratégicos da missão da FMUL, com foco na formação de nutricionistas, o ensino e a investigação da Nutrição e das ciências essenciais à promoção da saúde, prevenção, diagnóstico, tratamento e reabilitação da doença, através da criação, transmissão e difusão de ciência, tecnologia e cultura, no respeito pela liberdade intelectual e pela ética, reconhecimento do mérito e sentido de serviço à comunidade com ligação directa com a alimentação e nutrição.
Mission
Nutrition Laboratory, as part of Lisbon School of Medicina mission (FMUL) and as a structural unit of FMUL, develops its activity in three priority areas: Teaching, Research and Community Support.
Nutrition Laboratory bases its mission on the strategic guidelines of FMUL's mission, focusing on training nutritionists, teaching and researching Nutrition and the sciences essential to health promotion, prevention, diagnosis, treatment and rehabilitation of the disease. the creation, transmission and diffusion of science, technology and culture, respecting intellectual freedom and ethics, recognition of merit and sense of service to the community with a direct link to food and nutrition.
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Laboratório de Nutrição (LN)
Faculdade de Medicina da Universidade de LisboaEdifício Egas Moniz, ala C, piso 2
Av. Prof. Egas Moniz,
1649-028 Lisboa
Portugal
https://www.medicina.ulisboa.pt/laboratorio-de-nutricao
lab.nutricao@medicina.ulisboa.ptTelefone: + 351 217 999 465
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- Qual o perfil nutricional e de estilos de vida do doente oncológico? Estudo transversalPublication . Rolão, Andreia; Monteiro Grillo, Isabel; Camilo, Maria; Ravasco, PaulaBackground: Cancer aetiology is multifactorial and risk factors include: obesity, central adiposity, sedentarism, excessive or deficient intake of foods and/or nutrients with pro-carcinogenic effects vs protective ones. Objectives: To evaluate the pattern of nutritional status, life styles, physical activity and diet in a cohort of cancer patients. Methods: This pilot cross-sectional study was conducted in 64 patients referred for radiotherapy at the Radiotherapy Department of the University Hospital of Santa Maria (CHLN). Evaluations were: waist circumference associated with potential cardio-metabolic risk, body composition by Tetrapolar Bioimpedance Analysis (XITRON®), Body Mass Index, dietary intake pattern with a short food frequency questionnaire, physical activity with Jackson questionnaire. Results: The most frequent diagnosis were breast and colorectal cancers; 53% of patients were overweight/obese, and there was a significant correlation between this nutritional pattern and weight gain in comparison with usual weight (p<0.005). There were 78% of patients with a waist circumference above the maximum cut-off limit, indicating moderate/ high cardio-metabolic risk, and most were female patients (87%). The great majority of patients (61%) had excessive fat mass highly above the maximum recommended cut-off value, especially male patients (74%). The dietary pattern was poor in vegetables (55%) and excessive in meat and simple carbohydrates (78%); physical activity was low with a high prevalence of sedentarism. Conclusions: This population presented excessive body weight, excessive fat mass, high cardio-metabolic risk, sedentarism and an unbalanced diet poor in protective foods/nutrients. This population's life styles and nutritional pattern, may be considered of risk in oncology disease. The elevated and growing incidence of cancer in Portugal, reinforces the need for further research in order to identify nutritional factors involved in the etiology/evolution and probably prognosis of cancer.
- Diet, microbiota, and gut permeability : the unknown triad in rheumatoid arthritisPublication . Guerreiro, Catarina Sousa; Calado, Ângelo; Sousa, Joana; Fonseca, João EuricoGrowing experimental and clinical evidence suggests that a chronic inflammatory response induced by gut dysbiosis can critically contribute to the development of rheumatic diseases, including rheumatoid arthritis (RA). Of interest, an adherence to a Mediterranean diet has been linked to a reduction in mortality and morbidity in patients with inflammatory diseases. Diet and intestinal microbiota are modifying factors that may influence intestinal barrier strength, functional integrity, and permeability regulation. Intestinal microbiota may play a crucial role in RA pathogenesis, but up to now no solid data has clarified a mechanistic relationship between gut microbiota and the development of RA. Nonetheless, microbiota composition in subjects with RA differs from that of controls and this altered microbiome can be partially restored after prescribing disease modifying antirheumatic drugs. High levels of Prevotella copri and similar species are correlated with low levels of microbiota previously associated with immune regulating properties. In addition, some nutrients can alter intestinal permeability and thereby influence the immune response without a known impact on the microbiota. However, critical questions remain to be elucidated, such as the way microbiome fluctuates in relation to diet, and how disease activity may be influenced by changes in diet, microbiota or diet-intestinal microbiota equilibrium.
- Nutritional support in cirrhotic patients with sarcopeniaPublication . Vasques, João; Guerreiro, Catarina Sousa; Sousa, Joana; Pinto, Mariana; Cortez-Pinto, HelenaSarcopenia has been linked to oncologic and chronic diseases such as liver cirrhosis. In fact, sarcopenia is present in 25-70% of patients with liver cirrhosis. Furthermore, sarcopenia is an independent predictor of poor prognosis in many diseases. Currently cirrhotic patients are recommended to adopt a high protein diet (1.5 g/kg/day) with 30-40 kcal/kg/day and several meals throughout the day, being late evening snack intake with at least 50 g of carbohydrates of special importance. Despite the growing interest in the impact of sarcopenia in cirrhotic patients, there are still gaps in knowledge in the appropriate diagnostic criteria for this syndrome, the role of gut microbiota, as well as the most appropriate nutritional therapy.
- Alcohol-related liver disease is rarely detected at early stages compared with liver diseases of other etiologies worldwidePublication . Shah, Neil D.; Ventura-Cots, Meritxell; Abraldes, Juan G.; Alboraie, Mohamed; Alfadhli, Ahmad; Argemi, Josepmaria; Badia-Aranda, Ester; Arús-Soler, Enrique; Barritt, A. Sidney; Bessone, Fernando; Biryukova, Marina; Carrilho, Flair J.; Fernández, Marlen Castellanos; Dorta Guiridi, Zaily; El Kassas, Mohamed; Eng-Kiong, Teo; Queiroz Farias, Alberto; George, Jacob; Gui, Wenfang; Thurairajah, Prem H.; Hsiang, John Chen; Husić-Selimovic, Azra; Isakov, Vasily; Karoney, Mercy; Kim, Won; Kluwe, Johannes; Kochhar, Rakesh; Dhaka, Narendra; Marques Da Costa, Pedro; Nabeshima Pharm, Mariana A.; Ono, Suzane K.; Reis, Daniela; Rodil, Agustina; Domech, Caridad Ruenes; Sáez-Royuela, Federico; Scheurich, Christoph; Siow, Way; Sivac-Burina, Nadja; Dos Santos Traquino, Edna Solange; Some, Fatma; Spreckic, Sanjin; Tan, Shiyun; Vorobioff, Julio; Wandera, Andrew; Wu, Pengbo; Yacoub, Mohamed; Yang, Ling; Yu, Yuanjie; Zahiragic, Nerma; Zhang, Chaoqun; Cortez-Pinto, Helena; Bataller, RamonBackground & aims: Despite recent advances in treatment of viral hepatitis, liver-related mortality is high, possibly owing to the large burden of advanced alcohol-related liver disease (ALD). We investigated whether patients with ALD are initially seen at later stages of disease development than patients with hepatitis C virus (HCV) infection or other etiologies. Methods: We performed a cross-sectional study of 3453 consecutive patients with either early or advanced liver disease (1699 patients with early and 1754 with advanced liver disease) seen at 17 tertiary care liver or gastrointestinal units worldwide, from August 2015 through March 2017. We collected anthropometric, etiology, and clinical information, as well as and model for end-stage liver disease scores. We used unconditional logistic regression to estimate the odds ratios for evaluation at late stages of the disease progression. Results: Of the patients analyzed, 81% had 1 etiology of liver disease and 17% had 2 etiologies of liver disease. Of patients seen at early stages for a single etiology, 31% had HCV infection, 21% had hepatitis B virus infection, and 17% had nonalcoholic fatty liver disease, whereas only 3.8% had ALD. In contrast, 29% of patients seen for advanced disease had ALD. Patients with ALD were more likely to be seen at specialized centers, with advanced-stage disease, compared with patients with HCV-associated liver disease (odds ratio, 14.1; 95% CI, 10.5-18.9; P < .001). Of patients with 2 etiologies of liver disease, excess alcohol use was associated with 50% of cases. These patients had significantly more visits to health care providers, with more advanced disease, compared with patients without excess alcohol use. The mean model for end-stage liver disease score for patients with advanced ALD (score, 16) was higher than for patients with advanced liver disease not associated with excess alcohol use (score, 13) (P < .01). Conclusions: In a cross-sectional analysis of patients with liver disease worldwide, we found that patients with ALD are seen with more advanced-stage disease than patients with HCV-associated liver disease. Of patients with 2 etiologies of liver disease, excess alcohol use was associated with 50% of cases. Early detection and referral programs are needed for patients with ALD worldwide.
- Hazard and mode of action of disinfection by-products (DBPs) in water for human consumption : evidences and research prioritiesPublication . Chaves, Raquel S.; Guerreiro, Catarina Sousa; Cardoso, Vítor V.; Benoliel, Maria J.; Santos, Miguel M.Disinfection of water system is an essential strategy to protect human health from pathogens and prevent their regrowth during water distribution, but the reaction of disinfectant agents with organic matter can lead to the formation of disinfection by-products (DBPs). Given their widespread occurrence, potential human health impacts and (eco)toxicity associated with exposure to DBPs are of particular interest due to their potential carcinogenicity and vary non-carcinogenic effects, such as endocrine disruption. Understanding the public health implications of this emerging issue is crucial for societies and decision-makers, supporting more effective water safety plans. Here, we review the recent literature on the effects of DBPs presented in drinking water and treated swimming pools water, focusing particularly in unregulated compounds and the putative underlying mode of action, linking the available data with adverse health outcomes. Overall, the majority of studies highlight the limited knowledge in the understanding of the underlying mode of action of DBPs. Yet, available evidences indicate that different signaling pathways seem to be involved in the adverse outcomes associated with distinct DBPs classes. The main knowledge gaps in this field are also identified, and future research priorities discussed.
- Terão os adolescentes portugueses uma alimentação adequada? Resultados do estudo HBSC de 2018Publication . Peralta, Miguel; Marques, Adilson; Gaspar, Susana; Sousa, Joana; Diniz, José Alves; Matos, Margarida Gaspar deThe aim of this study was to characterize the eating habits and body image perceptions of Portuguese young people. A total of 6997 Portuguese young people (51.7% girls) attending the 6th, 8th and 10th grades participated in the study, integrated in the Health Behaviour in School aged Children. Young people were asked about their weight, height, eating habits and body image perception. About 70% of the adolescents presented normal/healthy weight. More girls than boys considered their waist “large” and that their body “fat”. Approximately 45% and 33% of the adolescents reported daily consumption of fruits and vegetables respectively. Consumption of sweets and soft drinks showed an increasing tendency between the 6th and 10th grades and girls reported consuming these foods every day, more than once a day, less frequently than boys. Excessive consumption of sugar together with the scarce consumption of fruits and vegetables reveals frailties in the diet of Portuguese young.
- Irritable bowel syndrome : how can symptoms and quality of life be improved with diet?Publication . Guerreiro, Margarida; Guerreiro, Catarina Sousa; Cravo, MaríliaPurpose of review: This article aims to review the current scientific evidence of dietary approaches to control the symptoms of irritable bowel syndrome (IBS). Recent findings: In the last decade, there was an important evolution in the study of the low fermentable oligo, di, mono-saccharides and polyols (FODMAP) diet (LFD). Current scientific evidence suggests a significant efficacy in the overall control of symptoms. LFD seems to be effective in improving quality of life. Recent studies suggest that LFD is effective and nutritionally well tolerated also in the long term, and longer adherence may contribute to greater effectiveness in improving depression. There is insufficient scientific evidence for the recommendation of gluten exclusion in IBS therapy, and some authors still suggest that the efficacy of this approach results from the limited ingestion of fructans. There is a promising efficacy of pre, pro, and symbiotic supplements, but there is no consensus on the most appropriate and effective strains in each case. Summary: Given the poor evidence and the pathophysiological variability of IBS, the interest of each therapeutic option should be always evaluated individually. Nevertheless, LFD is currently the dietary approach with a higher degree of scientific evidence.
- Exploring the relationship between the Mediterranean diet and weight loss maintenance: the MedWeight studyPublication . Poulimeneas, Dimitrios; Anastasiou, Costas A.; Santos, Inês; Hill, James O.; Panagiotakos, Demosthenes B.; Yannakoulia, MaryWeight loss maintenance is crucial for obesity management, yet optimal dietary patterns for this period are not established. We aimed to explore the relationship between adherence to the Mediterranean diet and weight loss maintenance. Sample includes 565 adults (62 % women) of the MedWeight study. Eligible volunteers were those reporting intentional weight loss of ≥10 %, starting from a BMI ≥ 25 kg/m2, over 12 months prior to enrolment. Based on current weight, participants were characterised as maintainers (≤90 % maximum weight) or regainers (>95 % maximum weight). Socio-demographics and weight history were recorded. Dietary intake was assessed by two non-consecutive 24-h recalls within 10 d and analysed in energy, macronutrient and food group intakes. Adherence to the Mediterranean diet was assessed with the Mediterranean Diet Score (MedDietScore) (range 0-55, greater scores showing higher adherence). Protein intake was higher in maintainers than in regainers (P < 0·001). When MedDietScore quartiles were considered, a linear trend for weight loss maintenance was revealed (P < 0·05). After adjustment for basic demographic characteristics, being in the third or fourth quartile of the MedDietScore (v. first) was associated with 2·30 (95 % CI 1·29, 4·09) and 1·88 (95 % CI 1·10, 3·22) increased odds of maintenance. Regarding individual MedDietScore components, only fruit intake is associated with increased odds for maintenance (1·03 (95 % CI 1·01, 1·06)). The leave-one-out approach revealed that at least six MedDietScore components were essential for the observed relationship. Higher adherence to the Mediterranean diet was associated with 2-fold increased likelihood of weight loss maintenance. Future studies should replicate these findings in non-Mediterranean populations as well.
- Motivation and physical activity levels in bariatric patients involved in a self-determination theory-based physical activity programPublication . González-Cutre, David; Jiménez-Loaisa, Alejandro; Alcaraz-Ibáñez, Manuel; Romero-Elías, María; Santos, Inês; Beltrán-Carrillo, Vicente J.Objective: This study examines the associations between pre-to post-intervention changes in motivation and physical activity (PA) levels of bariatric patients involved in a 6-month postoperative PA program based on selfdetermination theory (SDT). We also explore the extent to which patients’ perception of autonomy support and basic psychological need satisfaction during the program were associated with changes in their motivation to exercise. Method: Forty patients were assigned to a motivational PA intervention (MPAI-G) or to a control group (CG). Both groups completed questionnaires assessing the variables of interest and wore GT3X accelerometers before surgery and after the program. Results: Thirty-two participants (78.1% female) completed all measures and were included in the present analyses. CG showed greater increases in integrated (d = 1.60, 95% CI [ 2.40, 0.81]) and identified regulation (d = 0.75, 95% CI [ 1.47, 0.03]) than MPAI-G. However, the MPAI-G experienced increases in introjected regulation (d = 1.95, 95% CI [1.11, 2.79]) and greater decreases in external regulation (d = 1.00, 95% CI [ 1.74, 0.27]) than CG, which were associated with decreases in sedentary activity and increases in light and total PA. Oppositely to the CG, amotivation decreased in the MPAI-G (d = 2.98, 95% CI [ 3.98, 1.97]) and it was related to increases in light and total PA. Changes in exercise motivation were associated with perceived autonomy support and basic psychological need satisfaction during the program. Conclusion: The SDT-based PA program gave rise to greater changes in controlled forms of motivation and amotivation than in autonomous motivation in post-bariatric surgery patients.
- Toxicological assessment of seven unregulated drinking water Disinfection By-products (DBPs) using the zebrafish embryo bioassayPublication . Chaves, Raquel S.; Guerreiro, Catarina Sousa; Cardoso, Vítor V.; Benoliel, Maria J.; Santos, Miguel M.Disinfection By-products (DBPs) are formed during the chemical treatment of water for human consumption, by the reaction of raw water with chemical agents used in the different steps of the process. Disinfection is one of the most important steps, inactivating pathogens and preventing their regrowth during water distribution. However, it is also involved in DBPs formation due to the use of disinfectant agents, such as chlorine, which reacts with dissolved precursors, such as pharmaceuticals, toxins, pesticides, among others. Given their widespread occurrence, potential human health and (eco) toxicological impacts are of particular interest due to their potential carcinogenicity and various non-carcinogenic effects, such as endocrine disruption. In this study, the developmental toxicity of chemically- different unregulated DBPs was evaluated using zebrafish embryo bioassay. Embryos were exposed to different concentrations of the target DBPs and multiple endpoints, including, mortality, morphological abnormalities and locomotor behavior were assessed at specific developmental stages (24, 48, 72 and 96 hpf). The different families of DBPs tested included nitrosamines, aldehydes, alcohols and ketones. The results show that the effects were compound dependent, with EC10 values varying between 0.04 mg/L (2-ethyl-1-hexanal) to 9.2 mg/L (hexachloroacetone). Globally, several of the tested unregulated DBPs displayed higher toxicity when compared with the available data for some already regulated, such as trihalomethanes (THMs), which highlights the importance of screening the toxicity of still untested and poorly characterized DBPs.