Abstract
This study aimed to identify dietary patterns (DPs) and their associations with sociodemographic factors and diet quality in Portuguese adults and the elderly. Cross-sectional data were obtained from the National Food, Nutrition and Physical Activity Survey (2015–2016), with two non-consecutive dietary 24 h recalls. Food items were classified according to the NOVA system and its proportion (in grams) in the total daily diet was considered to identify DPs by latent class analysis, using age and sex as concomitant variables. Multinomial logistic and linear regressions were performed to test associations of DPs with sociodemographic characteristics and diet quality, respectively. Three DPs were identified: “Traditional” (higher vegetables, fish, olive oil, breads, beer and wine intake), “Unhealthy” (higher pasta, sugar-sweetened beverages, confectionery and sausages intake) and “Diet concerns” (lower intake of cereals, red meat, sugar-sweetened and alcoholic beverages). “Unhealthy” was associated with being younger and lower intake of dietary fiber and vitamins and the highest free sugars and ultra-processed foods (UPF). “Diet concerns” was associated with being female and a more favorable nutrient profile, but both DPs presented a higher contribution of UPF than the “Traditional” DP. These findings should be considered for the design of food-based interventions and public policies for these age groups in Portugal.
Highlights
Non-communicable disease prevalence has been increasing worldwide, making dietrelated diseases one of the leading risks for mortality and disabilities [1], and were the cause for 88% of the deaths in Portugal in 2017 [2]
According to the guidelines proposed by the European Food Safety Authority (EFSA) for the European population, one third of adults and almost half of the elderly had low protein intake, whereas excessive saturated fatty acids intake in adults and the elderly reached 54% and 31%, respectively, and 76% of the Portuguese population exceed the maximum tolerated value for sodium intake in Changes in the dietary patterns (DPs) of populations worldwide include increasing consumption of ‘convenience’ food and beverages for time-pressured consumers [9], and many studies have been conducted to investigate the impact of these products on diet quality and health, for example with soft drinks and other sweetened beverages [10]
Compared with followers of “Traditional” DP, subjects following the “Diet concerns” DP presented lower total energy intake, energy density, contribution of processed culinary ingredients and total fats, as well as alcohol, dietary fiber and sodium per 1000 kcal, but higher contribution of ultra-processed foods (UPF), proteins and carbohydrates, vitamin A, vitamin C, potassium, calcium, phosphorus, magnesium and zinc. Both “Unhealthy” and “Diet concerns” DPs presented a higher contribution of UPF compared with the “Traditional” DP, differences in its profile can be highlighted
Summary
Non-communicable disease prevalence has been increasing worldwide, making dietrelated diseases one of the leading risks for mortality and disabilities [1], and were the cause for 88% of the deaths in Portugal in 2017 [2]. A high body mass index (BMI) is an important risk factor for non-communicable diseases [3], and in recent decades the prevalence of overweight and obesity has been increasing worldwide [4]. 20% of population was considered obese in 2015–2016, and prevalence among the elderly was twice as much [5] These transitions observed in epidemiological profile are due to countries’ rapid urbanization and shifts in the way people commute, eat, exercise, as well as changes in the food system, reflected in food production and processing [6]. According to the guidelines proposed by the European Food Safety Authority (EFSA) for the European population, one third of adults and almost half of the elderly had low protein intake, whereas excessive saturated fatty acids intake in adults and the elderly reached 54% and 31%, respectively, and 76% of the Portuguese population exceed the maximum tolerated value for sodium intake in
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