Duration: 2016-2020
Abstract: Obesity prevalence has increased over recent decades, with WHO pinpointing childhood obesity as one of the most serious global public health challenges for the 21st century (1). Recent data suggests that prevalence of childhood obesity is levelling off in some countries (2), but this may not be the case across all socioeconomic strata (3). Childhood obesity is likely to continue into adulthood, and many problems linked with obesity are more severe if obesity has been present for a long period: adults who were obese during childhood have higher risk of premature death, cardiovascular disorders, and other diseases. A growing body of research has shown the deleterious health effects of obesity on childhood health status (4) and across lifetime (5). Portugal has one of the highest rates of childhood obesity among European countries, with 31.6% in 2002 and 30.5% in 2009 for children aged 7-10 years old (7). Portugal faces a deep economic crisis since 2008 leading to increased poverty and inequalities. Unemployment rate shifted from 9.4% (2009) to 16.2% (2013). In 2012, 18.7% of people were at risk of poverty, with children (0-17 years) being the most affected, reaching a value of 30.9% in 2012. Therefore, unemployment, social exclusion, decreasing mutual trust and social cohesion, and decreasing public and private investments are strong contributors for environmental vulnerability; all these factors hinder access to a healthy diet, health care and family’s healthy lifestyle. Moreover, several features in the environment shifted, such as closing of small restaurants, supermarkets, and other food stores. Data shows a consistent social gradient in childhood obesity, with lowest social classes exhibiting highest values of obesity. Childhood obesity has been our main focus of research over the last decade. We developed important and innovative studies in Portugal, namely the assessment, for the first time, of prevalence rates (6), predictors (8), sedentary behaviours (9,10), sleep duration (11), breastfeeding, urban-rural disparities, family socioeconomic status and behaviours (12), parental perceptions of neighbourhood environments (13) and lately the effect of the build and social environment (14) on obesity. Given the serious crisis that Portugal is facing, it is crucial to proceed with research on the health impacts that this crisis will likely have on childhood obesity. We aim to develop prospective and comparative studies about changes in families’ behaviour and in environmental infrastructures from 2009 to 2015-16 and to assess their impact in childhood obesity. Our main questions are: what changed in families’ behaviours regarding nutrition, food insecurity, physical activity, and other lifestyle factors as well as neighbourhood’s resources availability, safety and social organization, as a consequence of the social and economic crisis? How it impacts in childhood obesity? These questions highlight a major challenge faced by the scientific and policymaker community, which is to prevent that the economic crisis turns also into a health crisis. Lisbon and Coimbra, two Portuguese cities with different characteristics will be our cases studies. The same schools that we studied in 2009 will be re-evaluated in 2015-16, sampling children aged 3-10 years old. Anthropometric measures to evaluate weight status and questionnaires to parents on: family sociodemographic characteristics, perceptions of their local neighborhoods, quality of life index (WHOQOL-BREF), depression anxiety stress scale for children and parents, diet patterns, food insecurity (Household Food Security Scale – HFSS), child sedentary behaviors as well as physical activity and sleep duration.
Coordinator (PI): Cristina Padez (CIAS)
Participants: Aristides M Machado-Rodrigues (CIAS), Helena Nogueira (CIAS), Jorge Gustavo Melendez (Escola de Enfermagem da Universidade Federal de Minas Gerais), Cláudia Ferreira (Universidade de Coimbra), Larissa Mendes (Universidade Federal de Minas Gerais), Augusta Gama (Universidade de Lisboa), Maria Raquel Silva (Universidade Fernando Pessoa, Porto), Marina Cunha (Universidade de Coimbra), Marta Agostinho, Milene Pessoa (Universidade Federal de Viçosa, Minas Gerais), Vítor Rosado Marques (Instituto de Investigação Cientifica Tropical), Margarida Pereira (CIAS), Daniela Rodrigues (CIAS)
Financial support: PT2020 – SAICT –PTDC/ICDT by FCT – Fundação para a Ciência e a Tecnologia
Reference: PTDC/DTP-SAP/1520/2014
Duration: 2016-2020
Abstract: Childhood Obesity is increasing worldwide and is a major public health concern due to its consequences throughout life. A thorough understanding of the determinants of obesity is important for the development of scientific-based preventive interventions. Socioeconomic inequalities impact health in various ways and, in Portugal they have increased during the European economic crisis. Broader social inequalities seem to contribute to increase childhood obesity rates. Research in this matter benefits from using the Social Ecological Model (SEM) which categorizes health determinants in different levels and serves as theoretical framework in both quantitative and qualitative studies. This study aims to deepen the knowledge about the processes by which the environment determinants, namely the social, economic and built environment, impact childhood obesity during and after the 2008-2014 economic crisis in Portugal. The relation between the environment features and obesity were objectively assessed and municipality level initiatives to promote healthy lifestyles in children were analyzed, at different SEM levels. Quantitative data analysis was performed using GIS which allows the joining, management and analysis of large datasets from different sources and levels and qualitative data analysis was used to analyze municipality programs aiming to promote healthy lifestyles in children thus, preventing obesity during childhood.
Coordinator (PI): Margarida Pereira (CIAS)
Supervisors: Helena Nogueira (CIAS, Supervisor), Cristina Padez (as Co-Supervisor, CIAS)
Financial support: Portuguese national funding agency for science, research and technology (Portugal)
Reference: SFRH/BD/133140/2017
Duration: 2014-2020
Abstract: Este projecto tem como objectivos: 1) etnografar uma unidade/centro de referência para o tratamento da obesidade mórbida num hospital português oferecendo uma praxiografia de obesidade; 2) recolher narrativas pessoais de doença de forma a aceder às experiências pessoais; 3) retratar a biomedicalização da obesidade em Portugal; e 4) fornecer uma análise da obesidade à luz da economia política.
Coordinator (PI): Marta Roriz
Participants: Cristina Padez (as Supervisor, CIAS) and Luís Quintais (as Co-Supervisor, CES, UC)
Funding: FCT (Portuguese national funding agency for science, research and technology) under POCH funding
Reference: SFRH/BD/97206/2013
Duration: 2014-2020
Abstract: The global economic and financial crisis has spurred some political developments that affect the living conditions of people in countries with the greatest economic difficulties, particularly those in southern Europe, such as Portugal. The spectrum of malnutrition can therefore be expected to increase in Portugal, with a potential impact on the disruption of school performance and the health of children and the elderly. This project aims to evaluate the impact of economic restrictions caused by the current crisis on the nutritional status of children from 6 to 10 years old and elderly in the Municipality of Lisbon. In the case of children, a longitudinal study was carried out for a period of 4 years that began in the school year 2014/15 and in the case of adults, a cross-sectional study was conducted during 2018. The samples consist of 1000 children from 28 public schools, aged between 6 and 10 years and 434 autonomous elderly who attended Day Centers and other similar institutions of the Lisbon Social Network (28), aged between 60 and 99 years. The assessment of nutritional status in the elderly will be made through the application of a sociodemographic questionnaire and the Mini Nutritional Assessment – MNA, that includes the calculation of Body Mass Index (BMI). In children the assessment of nutritional status is the result of measurements of weight and height over the 4 years of the study (2 measurements per year). The results of this project may provide evidence to substantiate the effects of the economic crisis on the nutritional status of children and the elderly and alert those entitled to the nutritional problems facing some children and their families in this context of economic and austerity crisis. And, at the same time, be an important tool in tracking the evolution of the problem.
Coordinator (PI): Vítor Rosado-Marques (Faculdade de Motricidade Humana, Universidade de Lisboa; CIAS)
Participants: Augusta Gama (Faculdade de Ciências, Universidade de Lisboa; CIAS)
Partner institutions and Funding: Faculdade de Motricidade Humana (FMH) da Universidade de Lisboa, Câmara Municipal de Lisboa (protocol between CML and FMH), and CIAS.
Duration: 2013-2017
Abstract: Extracurricular sport has the potential to increase total physical activity (PA) which plays an important role in the prevention of a number of health problems, including obesity. However, most children do not achieve the recommended guidelines. Sport participation may be influenced by a number of factors, but little is known how those risk factors may vary according to children’s sex and place of residence. A cross-sectional study was done in 2013-2014. The sample comprised 793 children aged 6-10 years, and 834 parents, living in an urban (Coimbra) and a non-urban (Lousã) setting, both situated in central Portugal. Data was collected by questionnaires, interviews and anthropometric measurements. This study shows that participation in sport is associated with both intrapersonal and social factors, and that those factors may varied according to the level of urbanization. Boys and girls participate in sport in similar rates, but efforts should be made to change the notions that parents and children have about sport. By identifying barriers in different domains, this study reinforces that actions to promote PA are most effective when they enable alterations in different factors and include multiple levels of influence, starting in the nuclear family, but including teachers, schools, and government policies.
Coordinator (PI): Daniela Rodrigues (CIAS)
Supervisors: Cristina Padez (as Supervisor, CIAS) and Aristides M. Machado-Rodrigues (as Co-supervisor, CIAS)
Funding: FCT (Portuguese national funding agency for science, research and technology) under POCH funding
Reference: SFRH/BD/90737/2012
Duration: 2010-2014
Abstract: The project investigated how common environmental, family and socioeconomic risk factors for obesity, asthma and rhinitis modulate the association between these diseases and to study whether birth weight (BW) values differ between overweight children with asthma/rhinitis and children with asthma/rhinitis and normal weight. The study showed that childhood obesity and especially high body fat levels increase the risk of
asthma and rhinitis, which seemed to be independent of common risk factors. Obesity showed a stronger effect on asthma for girls than for boys. Results suggest that the overweight/obese asthmatics might already be born with a predisposition to this phenotype, which might indicate its prenatal origin. High level of asthma heterogeneity highlights the need for individualized, phenotype- or patient-specific prevention, intervention, and treatment strategies.
Coordinator (PI): Magdalena Muc (University of Liverpool)
Participants: Cristina Padez (CIAS), Anabela Mota Pinto (University of Coimbra)
Funding: Portuguese national funding agency for science, research and technology (FCT, Portugal)
Reference: SFRH/BD/66877/2009
