Background: The dietary intake of hospitalised patients is often compromised during hospitalisation, which can be a causal factor for hospital malnutrition. This is considered a public health problem worldwide and is associated with an increased risk of other complications. Objectives: Our objective was to determine the dietary intake of hospitalised individuals and if the prescribed diet influences it. Methods: Food intake data were collected from 299 lunches of patients admitted to a hospital, using the visual estimation method with a five-point scale. Three existing diets were considered, and the energy and macronutrient values of the meal were calculated. The minimum energy and protein requirements were also calculated. Results: The components of the tray with the highest intake were soup and dessert; no significant differences were found between the percentage intake of each element and the prescribed diet. More than 50% of the individuals did not meet their minimum energy requirements, and only 36.5% had a protein intake that was within the recommendations. Conclusions: Dietary intake is much lower than prescribed, and nutritionists need to act to reduce the prevalence of hospital malnutrition.

Objectives: To evaluate the offer of children’s menus offered in fast food restaurants present in the Uber Eats delivery application through the Kids Menu Healthy Score ‘KIMEHS’ in Greater Santiago. Methods: Observational, descriptive, cross-sectional. Research in fast food restaurants present in the Uber Eats delivery app. A total of 858 restaurants were selected. The KIMEHS was used to assess menu quality. KIMEHS index and descriptive statistics were calculated. Results: 558 restaurants were evaluated through the app; 57 offered children’s menus, yielding 114 children’s menu options from 18 different municipalities. The common offer was based on fried and/or processed lean meat accompanied by French fries in 71%. Moreover, 99% of the menus assessed obtained the minimum score in the KIMEHS placing them in the ‘not healthy at all’ category. When associations were made between foods and the lowest KIMEHS score quartile, the presence of chips had the strongest association (OR; 40.36: CI95% 11.43–201.08). Conclusions: Most restaurants offer a children’s menu of low nutritional quality and poor balance, where their dishes are commonly based on fried and processed products, pointing to the urgent need for legislation on guidelines to be applied on the different actors influencing the food offered to children.

Background: Lung cancer (LC) patients are prone to suffer from malnutrition. Malnutrition negatively affects patients’ response to therapy, increases the incidence of treatment-related side effects, and decreases survival. Early identification of LC patients who are malnourished or at risk of malnutrition can promote recovery and improve prognosis. Objective: This study aimed to assess the risk and nutritional status of lung cancer patients who are hospitalised, as well as to evaluate the impact of nutritional intervention on the risk of malnutrition. Methods: From January 2022 to December 2023, 53 LC patients hospitalised in a pulmonology department had their nutritional risk (initial and final) and nutritional status (initial) assessed. All were selected for nutritional intervention. Nutrition counselling was the first intervention option, along with dietary changes with/without oral nutritional supplements. Results: At the time of hospitalisation, 90.6% of the patients were at nutritional risk, 45.3% were classified as moderately malnourished, and 35.8% were classified as severely underweight. After the hospitalisation, 73.6% were at nutritional risk at the time of discharge, suggesting a statistically significant decrease in the number of patients with nutritional risk. Conclusions: Most LC patients hospitalised presented an altered nutritional status. Our study suggests that a nutritional intervention must be implemented to reduce malnutrition risk, which may impact prognosis. The comprehensive nutritional problems experienced by LC patients require nutritional assessment and improved individually tailored nutritional support.

Background: The Mediterranean diet is characterized by the predominance of the consumption of fruit, vegetables, cereals, nuts, and pulses; consumption of olive oil as the main source of fat; regular but moderate consumption of win; moderate consumption of fish, dairy products, eggs, and white meats; and low consumption of red meat as well as sugar and sugary products. In addition to the reported health benefits, the Mediterranean diet has also been widely recognized as a sustainable food pattern. The objective of this study was to understand the relationship between the degree of adherence to the Mediterranean diet of employees of the University of Porto and the relationship with the carbon footprint of their food consumption. Methods: An observational, analytical study was carried out, through the analysis of food consumption data collected in the form of a survey in the previous 24 h inserted in the eAT24 software, as well as the analysis of sociodemographic, lifestyle, and health data collected in the questionnaire. The carbon footprint was calculated from the previous 24 h surveys using data available on a website, obtained in carbon dioxide equivalent per kilogram of food. Sociodemographic, eating habit, and lifestyle questions were selected to understand the relationship between these and adherence to the Mediterranean diet and the carbon footprint of food consumption. Results: In total, 13.2% of the participants had a Mediterranean diet score equal to or greater than six, and the sample had an average food intake carbon footprint of 8146 ± 3081 CO2eq/Kg of food. A weak, statistically significant positive correlation (r = 0.142, p = 0.006) was observed between Mediterranean diet adherence and the carbon footprint of food intake. Conclusions: Most of the participants had a low adherence to the Mediterranean diet, as well as a high carbon footprint of food intake when compared to other countries. People with higher scores for Mediterranean diet adherence have, on average, a higher carbon footprint from food consumption intake.

Celiac disease (CD) is the chronic immune-mediated enteropathy of the small bowel, manifesting when exposure to gluten occurs in genetically predisposed individuals. Nowadays, the only treatment considered safe for CD is a gluten-free diet (GFD). However, one of the problems faced by celiac patients is the cross-contamination of gluten-free food when preparing meals, in addition to utensils, surfaces and equipment. This study aimed to evaluate cross-contamination in gluten-free products and strategies for removing gluten from cross-contamination in cooking environments. The selection of papers for this integrative review was carried out by searching different databases. Gluten cross-contamination is a global concern for celiac patients in food environments. Although some practices are positive, such as gluten labeling on processed food in several countries, it is crucial to promote good practices in food services around the world. Only a few studies showed effective results in removing gluten from surfaces and utensils; furthermore, sampling was limited, making it difficult to identify appropriate procedures to reduce cross-contamination. The variation in contamination in different kitchen environments also highlighted that celiac patients must continue paying attention to the methods used to prepare gluten-free food. More research is needed, especially into methods of removing gluten from surfaces and utensils, to ensure food safety for celiac patients in many food environments.

The addition of lupin into other foods can enhance their nutritional value and may be an acceptable approach to introducing lupin into the food supply, particularly as an ingredient. Lupin could be used in many food products (bakery products, pasta, beverages, meat products and dairy products) to improve their protein content and possible nutraceutical effects. The main aim of this study is to summarise the recent formulation trends with lupin as an ingredient of new food products based on consumer perception and acceptability. The present systematic literature review was conducted through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The eligibility criteria for the articles to be considered were: (a) the manufacturing of a food product with lupin as a formulation ingredient; (b) the food product developed was tested by a sensorial panel. A total of 33 studies filled the inclusion criteria and were incorporated into the qualitative synthesis. The sensory analysis of each product was notoriously different based on the jury evaluators and measurement scales used but revealed high acceptability rates for possible future consumers. The high protein and fibre contents of lupin were the most cited reason associated with the importance of nutrient-rich food products for consumers. More research on foods with high nutrition profiles and well-established sustainability parameters is crucial to promote healthier food environments.

Background The workplace is recognized by the World Health Organization as suitable for health promotion, as it can contribute to the reduction of harmful lifestyles, promoting the development of enterprises and, in turn, economic growth. The purpose of this study was to characterize eating habits and determinants of food consumption from a Portuguese company of employees. Methods: To characterize the nutritional and general health status of the employees, questionnaires previously developed and used in Portuguese employees were adapted and applied. Questionnaires include multiple choice and short answers to obtain socioeconomic, food habits and health data, namely the prevalence of chronic diseases. Statistical analysis was carried out, which allowed the study of the sample with detail, drawing some conclusions and the interconnection of different factors, such as type of food consumed for snacks, Body Mass Index (BMI), gender, and lunch place. Results: It was verified that some of our results did not resemble those presented in available scientific literature, such as the relationship between academic qualifications and BMI. However, were obtained some interesting and enlightening results, such as the main conditioners of the lunch place. Conclusions: The results show the need for greater investment in this area by companies’ managers, both nationally and internationally, since they impact employees’ health and, consequently, their productivity.

Shift Work contribute to dysregulation of the typical sleep and awake periods that cause circadian distortions, increasing the risk of cardiovascular mortality and morbidity and developing metabolic diseases. Firefighting is a career that demands much of individuals and has a great impact on their health, making it a high-risk job. Objectives: This study aims to characterize shift workers’ blood pressure profiles in an attempt to understand the repercussions of shift work on the circadian blood pressure rhythm in a sample of professional firefighters. Materials and methods: Participants were classified based on their dipping status: dipper drop of 10–20%; non-dipper 0–10%; invert-dipper when there is a rise in BP; extreme-dipper superior to 20%. Results: Abnormal dipping was found in 55.6% of the participants, and there was a marked difference in gender in percentage where dipping is concerned, with 66.7% of women having abnormal dipping against 50% of the men. It was proved that men had a slower heart rate than women (p-value = 0.029) and that dippers had a higher 24 h DBP compared with those of abnormal dipping (p-value = 0.049). Conclusions: Shift work is a high-risk module of labor, and its consequences require a more thorough examination. Abnormal dip- ping prevailed in firefighters, and the differences between genders need to be better characterized in future studies.

Purpose The purpose is to analyse the nutritional adequacy and carbon footprint of intermediated meals provided to preschool children and primary-level students in a Portuguese municipality. Design/methodology/approach An observational cross-sectional study was conducted with a convenience sampling consisting of school snacks from a Portuguese municipality. The nutritional assessment used food labels and a Portuguese food composition table. The literature review for carbon footprint assessment was conducted by searching for the products under analysis or similar ones. Findings The results showed that 80% of snacks have a higher energy value than recommended. The majority of options are below recommendations for protein and fat and above recommendations for carbohydrates. The intermediated meals with more dairy products in composition have the highest carbon footprint. The carbon footprint included the packaging of the products, and it wasn't possible to determine the influence of non-food products. Research limitations/implications This study has limitations in the fact that we do not know the carbon footprint of Portuguese products and we had to compare them with others, from different countries, with possibly different types of production. Practical implications Intermediate meals are inadequate, and the carbon footprint is higher when the intermediated meals include products of animal origin – the reason why the composition of intermediated meals should be redesigned considering the achievement of these targets. Social implications The promotion of intermediated meals that promote the Mediterranean eating pattern contributes to health and well-being and is a vehicle for nutrition education and healthy food consumption in schools. Originality/value Many studies have been conducted to analyse the carbon footprint and environmental impact of school meals, but commonly lunch is the meal evaluated and the assessment of intermediated meals' impact is an open field.

The association of food safety knowledge and climate with gender, education level, length of employment, food safety training, and professional role was measured using a 15-item food safety climate survey and a 20-item food safety questionnaire on a sample of 263 employees from 19 small and medium-sized university canteens in Croatia, Hungary, and Portugal. The relationship between knowledge and climate and the demographic determinants of both variables were examined. Food safety knowledge was inadequate (45.5% of correct responses), while perceptions of food safety, as measured by the food safety climate survey, were positive (2.69 out of a maximum of 3.00). The perception of resources in canteens was the least favorable across all countries. Leaders did not exhibit better food safety knowledge or perceptions. Food safety climate and knowledge were significantly positively correlated and influenced by training. Perceptions of food safety compared to employee knowledge levels indicated that some employees were overly optimistic about food safety risks. Therefore, food safety knowledge and food safety climate should be assessed in parallel, and both could be improved through ongoing training of employees, especially leaders.

Several authors have shown that vegetables a re the most commonly wasted component in school lunches and enhance the importance of food education on topics such as food waste and vegetable consumption. The present research evaluated the efficacy of a single session of food education on vegetables waste and consumption. The data collection was focused on primary school students from a school located in Guarda district (Portugal). A vegetable selective aggregate weighing from the lunch plate was required in two distinct phases: before and after a single 30 min nutritionist’s intervention. The variables collected were the quantities of vegetables produced, leftovers and plate waste. Through these weighings, it was possible to measure the variables: distributed vegetables, consumed vegetables, vegetables waste, leftovers index, plate waste index. The use of materials such as a scale, suitable containers, gown, disposable gloves, cap and office supplies were necessary. In total during the two phases, 870 meals were evaluated. Measures of central tendency and statistical analysis tests were used. At the end of the present research, it was possible to verify significant results in the reduction of the vegetables leftovers index and in the increase in vegetable consumption per capita, through the nutritionist’s intervention. There were significant differences in the reduction of the index of vegetable leftovers and in the increase in the consumption of vegetables per capita and no significant differences in total vegetable waste. Potential causes and strategies for future research were also discussed. This study demonstrates how a nutritionist’s intervention, in a school context, could translate into behavioral change in nutrition and sustainability terms.

The concept of the personalized portion is associated with the amount of food adapted to each person and their needs, the proposal is based on the integration of work environment of companies that collaborate with the contract catering sector. The key points to act and implement in the companies are: the implementation of the nutrition appointments; the development of the database with the information of each employee; the translation of this information for the distribution in macronutrients and grams that, finally, are converted from the image of the employee’s "dish" of simple and fast interpretation.

As contínuas alterações demográficas colocam-nos perante uma população cada vez mais envelhecida e com necessidades crescentes de cuidados alimentares, tanto numa ótica de cuidados de saúde, como de fornecimento de refeições, necessidade frequentemente suprida por serviços de alimentação coletiva. A qualidade nutricional e alimentar da oferta assume-se como um determinante major na saúde e satisfação dos idosos, sendo o plano de ementas uma das mais importantes ferramentas de gestão na área. Para que seja promovida uma oferta alimentar adequada, é essencial a existência de orientações que a balizem e que sejam alvo de atualização e melhoria contínua. A envolvência de nutricionistas no processo possibilita a revisão por pares e uma maior adaptação à realidade, permitindo obter ferramentas que auxiliem na tomada de decisão e na sustentação do trabalho desenvolvido. O presente estudo tem como objetivo explorar a perceção e os contributos de nutricionistas sobre o documento “Proposta de Ferramenta de Avaliação Qualitativa de Ementas destinadas a Idosos”, visando uma proposta de atualização. Foi adotada uma metodologia qualitativa através da realização de grupos focais a partir de uma amostra por conveniência, constituída por 38 nutricionistas. Os resultados sugerem que, apesar de ser considerada útil, a ferramenta carece de atualização para uma maior adaptação à faixa etária e à realidade prática. Da análise de critérios específicos, os participantes identificam vários de difícil cumprimento (ex. oferta equitativa de métodos de confeção, não repetição de fruta, oferta de oleaginosas, refeições de ovo e de massa ou arroz integral), partilhando os motivos para tal. Sugerem ainda a necessidade de inclusão de critérios para alimentação de textura modificada e refletem acerca de possíveis melhorias na própria dinâmica de aplicação da ferramenta. Em suma, a discussão promovida deixa importantes contributos para uma possível atualização da ferramenta, numa ótica de maior ajuste à faixa etária e de inclusão de critérios sobre tópicos emergentes.

Food labels are the first information tool used by consumers in the purchase and consumption of food products. Food labeling is a tool that can influence the consumers’ perception of quality and, in turn, their food choice. This study characterizes and demonstrates the importance of labeling and the degree of consumers’ perception and literacy about food labels through the application of an online questionnaire. The results obtained, in a sample of n = 467, showed that Portuguese consumers have the habit of reading the label and recognizing its importance but do not understand all the information contained in the label. They have an easier time understanding the front-of-pack labeling systems, especially those presented through symbols/colors. Thus, it demonstrates the need for greater education and literacy in the areas of food and nutrition so that through the reading and interpretation of labels, consumers can make informed food choices.

INTRODUÇÃO: O nutricionista é um profissional de saúde que entende o contexto em que a nutrição e a alimentação se processam, sendo competente tecnicamente, crítico e comprometido com a realidade existente. Questões relacionadas com sustentabilidade alimentar aplicam-se a todas as áreas da nutrição e dietética, com particular enfoque na área da alimentação coletiva e restauração sendo preciso valorizar as atribuições e contribuições do nutricionista na promoção de um futuro de qualidade. OBJETIVOS: Descrever a perceção dos nutricionistas que exercem atividade na área da alimentação coletiva e restauração sobre a sua atuação na promoção da sustentabilidade alimentar. METODOLOGIA: Estudo transversal, realizado por inquirição da população-alvo com um questionário online, através de uma técnica de amostragem não aleatória selecionada por conveniência. A amostra deste estudo é composta por nutricionistas, residentes em Portugal e a exercer atualmente na área da nutrição. Os dados sumarizaram-se através de frequências absolutas e relativas, e através de média, desvio-padrão, mediana e amplitude interquartil. Utilizou-se o teste de Kolmogorov-Smirnov para analisar a adesão das variáveis em estudo à distribuição normal e, conforme os resultados, utilizou-se o teste de Mann-Whitney para comparação entre grupos. RESULTADOS: Dos 115 participantes, 48,7% consideram totalmente importante a promoção da sustentabilidade alimentar na sua atuação e 46,1% concordam que podem melhorar a sua ação. Os conceitos que mais relacionam com a sustentabilidade alimentar são a redução do desperdício alimentar, preservação do meio ambiente e dos recursos naturais. As principais ações praticadas são a promoção da Dieta Mediterrânica e redução do desperdício alimentar. Verificaram-se diferenças estatisticamente significativas entre as dificuldades e ações dos nutricionistas que exercem atividade em alimentação coletiva e os que não o fazem. CONCLUSÕES: Os resultados demonstram que os participantes acreditam na sua capacidade para colocar ações em prática e reforça a necessidade de reconhecer e capacitar os nutricionistas como importantes agentes promotores da sustentabilidade alimentar.

Introdução: Sendo a alimentação um fator de risco modificável significativo para a incapacidade e morte prematura, urge a promoção de ambientes alimentares saudáveis incluindo sistemas que promovam uma dieta diversificada, equilibrada e saudável nos setores público e privado. A correta intervenção alimentar pode representar um importante reflexo na saúde dos clientes de uma Unidade de Alimentação e Nutrição, visto que, para muitos, a alimentação recebida na empresa/organização onde trabalha representa a grande refeição do dia e pode representar a base de uma alimentação saudável, com reflexos positivos para a saúde, podendo servir de exemplo para a criação de hábitos alimentares adequados nos comensais. Objetivos: Elaborar ferramenta de avaliação qualitativa de ementas destinada à população adulta e saudável, com base nas necessidades energéticas totais e distribuição de porções por dia e por refeição segundo as recomendações nacionais e hábitos alimentares da população nacional. Metodologia: Foram identificadas as necessidades energéticas totais de acordo com as recomendações da Roda dos Alimentos Portuguesa e distribuídas as porções de alimentos para a refeição do almoço. Foram compilados e analisados os critérios referentes a cinco documentos de avaliação qualitativa de ementas e adaptados para a população alvo. Resultados: Obteve-se uma lista de verificação/grelha para avaliação qualitativa de ementas, constituída por 55 pressupostos divididos por 8 grupos. As ementas serão avaliadas segundo uma classificação de “muito boa”, “boa”, “aceitável” e “não aceitável” consoante os valores percentuais obtidos. Conclusões: A lista de verificação/grelha obtida com os principais critérios de alimentação saudável para aplicação aquando da elaboração de ementas pretende representar uma ferramenta que auxilie os responsáveis pela elaboração de ementas e os nutricionistas num processo de melhoria da qualidade nutricional das ementas.

Purpose The aim of this study is to identify and characterize kids' menu offer in fast-food and traditional restaurants located in shopping centres in five different countries. Design/methodology/approach An observational cross-sectional study is carried out, though a study was performed in all restaurants located in shopping centres from main cities, in five countries: Brazil, Chile, Croatia, Hungary and Portugal. A tool for assessing the quality of menus is used for the analysis (Kids Menu Healthy Score (KIMEHS)). Menu prices between countries were compared. Findings A total of 192 kids' menus were collected, 44 in Portugal, 57 in Brazil, 66 in Chile, 15 in Hungary and 10 in Croatia. All the countries have average negative KIMEHS values for the menus, indicating that the offer is generally poor in terms of healthy options. The cost of children's menus in European countries is generally low. In Brazil, the price is significantly more expensive, which may limit the accessibility by social economically deprived populations. No significant differences were found in the average cost of meals from different restaurants typology. Traditional/Western restaurants present the highest price. Practical implications Globally, kids' menus are composed by unhealthy food items, pointing to the need of improvements in food availability, aiming to promote healthy food habits among children. Originality/value This study presents innovative data on children's menus, allowing for characterization of meals offered to children and comparison between different countries. Key points Kids’ menus are composed by unhealthy food items. Improvement of kids' menus quality will promote children food habits. Healthier out-of-home food consumption will contribute to public health.

Gluten-free products made from naturally gluten-free raw materials have an inferior taste and can cause deficiencies in various nutrients, especially non-starch polysaccharides. To address this problem, scientists are searching for new strategies to eliminate harmful gluten from wheat, rye, and barley and to produce balanced products with good organoleptic properties. This study evaluated the possibility of hydrolysing gluten in wheat bran, a by-product obtained after the dry fractionation of wheat, using plant enzymes. The gluten content of wheat bran after treatment with papain, bromelain, and their combination under different hydrolysis conditions was investigated. The amount of gluten was determined using an enzyme-linked immunosorbent assay ELISA R5 and the reduction in immunogenic gliadins was analysed using high-performance reverse phase liquid chromatography. The results of the study showed that 4 h hydrolysis with bromelain and papain reduced the levels of gluten immunogenic compounds in bran from 58,650.00 to 2588.20–3544.50 mg/kg; however, they did not reach the gluten-free limit. A higher hydrolysis efficiency of 95.59% was observed after treatment with papain, while the combination of both enzymes and bromelain alone were less effective. The results presented in this article will be helpful to other researchers and manufacturers of wheat-based products when selecting methods to reduce gluten immunogenicity and contribute to the development of sustainable technologies.

Abstract Background A significant percentage of the population is working on shift work and according to several studies this type of work schedule has been associated with an increased risk of developing some pathologies, such as obesity, which are one of the biggest mortality causes in the world. To understand if the shift work has a negative influence on the workers' diet and if it affects the Body Mass Index. Methods Observational and cross-sectional research was conducted, through an online survey designed for this purpose, including fruit and vegetables consumption, sociodemographic characteristics, shift work schedule, sleep hours and reported values of weight and height. The study was ethical approval and statistical analysis was performed using the IBM SPSS Statistics software. A critical significance level of 5% was considered. Results 145 workers were evaluated with an average age of 35.90 ± 10.92 years and an average Body Mass Index of 25.12 ± 4.54 kg/m2, 76.6% were female. 51.7% of the individuals worked on shift work. Body Mass Index of shift workers is higher than Body Mass Index day shift workers (P = 0.001), and they sleep, on average, less hours than day workers. No differences was observed related to fruit and vegetables consumptions. Shift workers reported to have higher difficult to management food intake when compared with day workers (P < 0.001). Conclusions Shift work seems to have a negative influence on the workers' sleep and in Body Mass Index. This study is important to develop, in the future, individualized strategies, for these workers

Abstract Background The aged population are often malnourished especially if they live in a Nursing Home (NH) due to their health status, depression and environmental factors. An early and accurate diagnosis of malnutrition is essential so the nutritional therapy can be started as soon as possible. The aim is to study the relationship between the degree of malnutrition in aged population living in two NH and anthropometric measures like brachial perimeter (BP) and leg (PP). Methods Were included elderly people aged ≥65 years. The nutritional assessment status was through the application of the Mini Nutritional Assessment (MNA). Data analysis was performed using the IBM SPSS software with a descriptive and inferential analysis. The level of critical significance chosen was 5%. Results 83 seniors of both genders (78.3% female) were evaluated with a middle age of 83.4 ± 7.9 years. The application of MNA revealed that 33.7% of the seniors are in malnutrition risk and 43.4% malnourished. Older elderly people (P = 0.03) with less mobility (r = -0.722; P < 0.001) and bigger food dependency (r = -0.674; P < 0.001) have a higher risk of malnutrition. Individuals with lower BP (P = 0.024) and PP (P < 0.001) are more likely to be malnourished or at risk of malnutrition, and those who are more dependent on food, a lower PP (P < 0.001). Conclusions In the impossibility of applying MNA, BP and PP can be measured in the admission of the user, as determining factors of malnutrition, for an earlier intervention, despite the fact that the nutritionist’s presence in these institutions is crucial