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- Role of Eating Behavior and Stress in Maintenance of Dietary Changes During the PREVIEW InterventionPublication . Jalo, Elli; Fogelholm, Mikael; Westerterp-Plantenga, Margriet; Adam, Tanja C.; Drummen, Mathijs; Huttunen-Lenz, Maija; Kjølbæk, Louise; Martinez, José Alfredo; Handjieva-Darlenska, Teodora; Taylor, Moira A.; Brand-Miller, Jennie; Poppitt, Sally; Stratton, Gareth; Lam, Tony; Navas-Carretero, Santiago; Bogdanov, Georgi; Simpson, Liz; Muirhead, Roslyn; Silvestre, Marta P.; Swindell, Nils; Raben, Anne; Konttinen, Hanna; Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS); NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); ElsevierObjective: To examine whether eating behavior and perceived stress predict the maintenance of self-reported dietary change and adherence to dietary instructions during an intervention. Design: A secondary analysis of the behavior maintenance stage (6–36 months) of the 3-year PREVIEW intervention (PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World). Participants: Adults (n = 1,311) with overweight and prediabetes at preintervention baseline. Variables Measured: Eating behavior (Three-Factor Eating Questionnaire), stress (Perceived Stress Scale), and dietary intake (4-day food records on 4 occasions) were reported. Analysis: Associations between predictors and dietary outcomes were examined with linear mixed-effects models for repeated measurements. Results: Eating behaviors and stress at 6 months did not predict the subsequent change in dietary outcomes, but higher cognitive restraint predicted lower energy intake, and both higher disinhibition and hunger predicted higher energy intake during the following behavior maintenance stage. In addition, higher disinhibition predicted higher saturated fat intake and lower fiber intake, and higher hunger predicted lower fiber intake. Stress was not associated with energy intake or dietary quality. Eating behaviors and stress were not consistently associated with adherence to dietary instructions. Conclusions and Implications: Higher cognitive restraint predicted lower energy intake (food quantity), but disinhibition and hunger were also associated with dietary quality.
- Perspetivas de peritos sobre fatores estratégicos para a gestão e prevenção da insuficiência cardíaca em PortugalPublication . Caldeira, Daniel; Brito, Dulce; Aguiar, Carlos; Silva Cardoso, José; Fonseca, Cândida; Franco, Fátima; Macedo, Filipe; Moura, Brenda; Pinto, Fausto J.; Vaz-Carneiro, António; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Sociedade Portuguesa de Cardiologia | ElsevierIntroduction and objectives: Heart failure (HF) has significant morbidity and mortality, and its prevalence will continue to increase in the future. This unfavorable evolution requires reflection as well as recommendations and decisions based on expert critical and strategic appraisal. Methods: In the Acceleration on Heart Failure Empowerment and Awareness – the Portuguese Challenge (ATHENA-PT) study, a range of strategic factors that represent the strengths, weaknesses, threats, and opportunities (SWOT) of HF in Portugal were established. These factors were assessed quantitatively by experts, to create a final SWOT matrix for the management and prevention of HF in Portugal and to outline recommendations. Results: For HF management, the panel emphasized the following strategic recommendations: (i) reimbursement of natriuretic peptides testing in primary healthcare; (ii) reimbursement of Doppler assessment in echocardiographic studies and promotion of detailed information in reports; (iii) intervention to improve the prognosis of patients with HF with preserved ejection fraction; (iv) ensuring effective healthcare transition between hospital and ambulatory units, using checklists/protocols; and (v) reinforcement and commitment to the training of primary health physicians and to the cardiac rehabilitation of patients. For the prevention of HF, the following recommendations/proposals were proposed: (i) campaigns to raise awareness of cardiovascular disease risk factors; (ii) promotion of physical exercise and healthy eating; and (iii) avoidance of therapeutic inertia in the management of risk factors. Conclusions: The acknowledgment of various strategic factors and their prioritization by experts made it possible to create and reinforce a range of new strategic recommendations for the management and prevention of HF.
- Management of early treated adolescents and young adults with phenylketonuriaPublication . Burton, Barbara K.; Hermida, Álvaro; Bélanger-Quintana, Amaya; Bell, Heather; Bjoraker, Kendra J.; Christ, Shawn E.; Grant, Mitzie L.; Harding, Cary O.; Huijbregts, Stephan C.J.; Longo, Nicola; McNutt, Markey C.; Nguyen-Driver, Mina D.; Santos Pessoa, André L.; Rocha, Júlio César; Sacharow, Stephanie; Sanchez-Valle, Amarilis; Sivri, H. Serap; Vockley, Jerry; Walterfang, Mark; Whittle, Sarah; Muntau, Ania C.; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS); Elsevier Science B.V., Amsterdam.Background: Early treated patients with phenylketonuria (PKU) often become lost to follow-up from adolescence onwards due to the historical focus of PKU care on the pediatric population and lack of programs facilitating the transition to adulthood. As a result, evidence on the management of adolescents and young adults with PKU is limited. Methods: Two meetings were held with a multidisciplinary international panel of 25 experts in PKU and comorbidities frequently experienced by patients with PKU. Based on the outcomes of the first meeting, a set of statements were developed. During the second meeting, these statements were voted on for consensus generation (≥70% agreement), using a modified Delphi approach. Results: A total of 37 consensus recommendations were developed across five areas that were deemed important in the management of adolescents and young adults with PKU: (1) general physical health, (2) mental health and neurocognitive functioning, (3) blood Phe target range, (4) PKU-specific challenges, and (5) transition to adult care. The consensus recommendations reflect the personal opinions and experiences from the participating experts supported with evidence when available. Overall, clinicians managing adolescents and young adults with PKU should be aware of the wide variety of PKU-associated comorbidities, initiating screening at an early age. In addition, management of adolescents/young adults should be a joint effort between the patient, clinical center, and parents/caregivers supporting adolescents with gradually gaining independent control of their disease during the transition to adulthood. Conclusions: A multidisciplinary international group of experts used a modified Delphi approach to develop a set of consensus recommendations with the aim of providing guidance and offering tools to clinics to aid with supporting adolescents and young adults with PKU.