Knowledge about sources of dietary fibres and health effects using a validated scale: a cross-country study

Objectives Dietary fibre (DF) is one of the components of diet that strongly contributes to health improvements, particularly on the gastrointestinal system. Hence, this work intended to evaluate the relations between some sociodemographic variables such as age, gender, level of education, living environment or country on the levels of knowledge about dietary fibre (KADF), its sources and its effects on human health, using a validated scale. Study design The present study was a cross-sectional study. Methods A methodological study was conducted with 6010 participants, residing in 10 countries from different continents (Europe, America, Africa). The instrument was a questionnaire of self-response, aimed at collecting information on knowledge about food fibres. The instrument was used to validate a scale (KADF) which model was used in the present work to identify the best predictors of knowledge. The statistical tools used were as follows: basic descriptive statistics, decision trees, inferential analysis (t-test for independent samples with Levene test and one-way ANOVA with multiple comparisons post hoc tests). Results The results showed that the best predictor for the three types of knowledge evaluated (about DF, about its sources and about its effects on human health) was always the country, meaning that the social, cultural and/or political conditions greatly determine the level of knowledge. On the other hand, the tests also showed that statistically significant differences were encountered regarding the three types of knowledge for all sociodemographic variables evaluated: age, gender, level of education, living environment and country. Conclusions The results showed that to improve the level of knowledge the actions planned should not be delineated in general as to reach all sectors of the populations, and that in addressing different people, different methodologies must be designed so as to provide an effective health education.

Clinical communication and adverse health events: literature review

Abstract Health institutions have an increased risk of occurrence of errors due to their diversity, specificity and volume of services, representing a great concern for health professionals whose main function is to protect the health and lives of their patients. We intend to identify a body of evidence, that shows what the most common adverse events are and what adverse events potentially arise from clinical miscommunications. An integrative literature review using the keywords "Adverse Events", "Patient Safety", "Communication". An inquiry was made on databases PubMed, Web of Science, Scielo and CINAHL, in articles published between January 2010 and March 2016, available in Portuguese and English. Of the 216 articles that emerged were selected eight articles that answered the research questions: what are the most common adverse events that have their origin in communication errors? Analyzing the selected studies, it appears that the most common adverse events arise in the context of obstetrics and pediatrics, in surgical contexts, in the continuity of care and related medication. Patient safety should be seen as a key component of quality in health care, with good management of the risk of fundamental error for the promotion of this security. The knowledge and understanding that communication failures are one of the main factors contributing to the occurrence of errors in the context of health care, allows the subsequent development of strategies to improve this process and thus ensure safer healthcare.

Nurses knowledge of health effects of dietary fibre

Introduction: Nurses accompany patients throughout their health care to prevent and treat disease, so their knowledge about diet and dietary fibre is key to successful diet therapy, which is an essential part of a patient's non-pharmacological treatment. It is known from the literature that a high proportion of nurses have limited knowledge about diet therapy and about sources of soluble fibre and other foods that can prevent or treat certain diseases. Given the position of nurses as key providers of dietary guidance, and given the health benefits of dietary fibre, we wanted to assess the level of fibre-related knowledge among nurses in Croatia. Material and Methods: Cross-sectional study based on data collected between October 2014 and March 2015 using a survey developed by the CI&DETS Polytechnic Institute in Viseu, Portugal. The survey contains questions about demographic characteristics as well as about knowledge of sources of dietary fibre, recommended daily intake and effects of fibre intake on particular diseases. The study included a total of 369 nurses from two health institutions and one nursing school from Croatia older than 18 years. Differences in knowledge were assessed for significance using the non-parametric Mann-Whitney U test. Possible associations among variables were explored using Spearman's rank correlation. For all statistical analyses, the threshold of significance was defined as P<0.05. Results: The level of knowledge among nurses in Croatia about dietary fibre varied from «undecided» to «partial knowledge». The median for level of knowledge ranged from 3 to 4 with low variability ranging from 0.11 to 0.33. Average levels of knowledge in percentages varied from 57.6% to 82.1%. Nurses with higher education levels showed significantly higher knowledge levels about the influence of dietary fiber intake on the risk of certain diseases (p = 0.007), constipation (p = 0.016), bowel cancer (p = 0.005) and breast cancer (p = 0.039). Conclusion: The level of nurses’ knowledge about dietary fiber is suboptimal. This indicates the need to strengthen nurse education in the areas of diet and diet therapy. Increase the level of knowledge of nurses about nutrition can positively influence the quality of care.

Bioactive Compounds in Some Culinary Aromatic Herbs and Their Effects on Human Health

Culinary herbs are herbaceous (leafy) plants that add flavour and colour to all types of meals. There is a wide variety of herbs that are used for culinary purposes worldwide, which are also recognized for their beneficial health effects, and thus have also been used in folk medicine. Besides their nutritional value herbs are rich in many phytochemical components with bioactive effects, thus improving human health. The aim of the present work was to make a general overview of some of these herbs, including their gastronomic usage, their chemical composition in bioactive components and their reported health effects. This work showed that the health effects are very diverse and differ according to the herb in question. However, some of the most frequently citted biological activities include antioxidant, antimicrobial, and antiviral effects.

Drying Peppers: Technolocy and Properties

The peppers can be very diverse, from sweet to hot peppers, varying in shape, in colour, in properties and usages. While some are eaten in the fresh state, many of them undergo a drying process to be preserved for a longer time and to increase availability and convenience. Hence, after harvesting, in many cases a drying operation is involved, and the present chapter aims to address this operation, of pivotal importance. In ancient times, the drying of foods in general and peppers in particular was done by exposure to the solar radiation. However, despite its cheapness and easiness, this process involved many drawbacks, like long drying times, probability of adverse atmospheric conditions and contaminations of the product. Hence, nowadays its usage is reduced. The most popular industrial drying method is the hot air convective drying. However, the high temperatures to which the product is exposed can cause changes in the composition and nutritional value as well as in the physical properties or organoleptic quality of the products. Other alternative methods can be used, but sometimes they are more expensive or more time consuming, such as is the case of freeze drying. Still, this last also has visible advantages from the quality point of view, minimizing the changes in texture, colour, flavour or nutrients. The knowledge of adequate drying operating conditions allows the optimization of the product characteristics, and hence to know the drying kinetics or the isotherms is fundamental to properly design the most adequate drying processes, and therefore preserve the organoleptic characteristics as well as the bioactive compounds present.

Perception of health benefits of dietary fibre among the Portuguese population

Introduction: Dietary iber (DF) has been part of human diet since ever, and its beneits for the human health have been well estab-lished and scientiically conirmed. Among these stand improved gastrointestinal functions, prevent cholesterol, diabetes or CVD. Objectives: To study the level of knowledge of people residing in Portugal about the health effects related to an adequate ingestion of DF. Methods: This is a descriptive cross-sectional study carried out on a non-probabilistic sample of 382 adults residing in Portugal. The questionnaire included a section about the socio-demographic characteristics (age, gender, level of education and living environ- ment) and another about the relation between dietary iber and possible beneicial effects to treat and prevent diseases. The data was treated using the SPSS software (V22). Results: The results allowed concluding that people were dif- ferently informed about the effects of DF in preventing and/or treating different diseases, being constipation the most recog- nized, followed in decreasing order by obesity, bowel cancer, cholesterol, cardiovascular diseases, diabetes and breast can- cer. The results also showed that signiicant differences were encountered between age groups for most of the diseases evalu- ated, but not between genders, levels of education or living en- vironments. Conclusions: Generally, it was concluded that the participants in this study were relatively well informed about the roles of DF in preventing and/or treating various diseases.

Hábitos de consumo de alimentos enriquecidos com fitoesteróis

O interesse crescente pelos alimentos enriquecidos com esteróis vegetais deve-se ao fato de que estes diminuem as concentrações sanguíneas de colesterol sem efeitos adversos colaterais. Neste contexto, o enriquecimento de alimentos com esteróis vegetais poderá constituir uma ajuda importante na proteção da população contra a aterosclerose e doenças cardiovasculares. As informações sobre o comportamento alimentar são praticamente inexistentes em Portugal, pelo que se torna indispensável perceber a importância dos produtos funcionais nos hábitos de consumo. O presente trabalho pretendeu avaliar os hábitos de consumo de uma população de Viseu relativamente aos leites fermentados com baixo teor de gordura enriquecidos com esteróis vegetais e margarinas enriquecidas com fitoesteróis. Para cada produto foram feitos 577 inquéritos a indivíduos escolhidos aleatoriamente numa população que efetuava as suas compras semanais em vários hipermercados da cidade de Viseu. Inquiriu-se sobre vários parâmetros respeitantes a leites fermentados com baixo teor de gordura enriquecidos com esteróis vegetais e margarinas enriquecidas com fitoesteróis. Os resultados preliminares obtidos mostraram que, para a maioria dos inquiridos a compra dos alimentos era condicionada pelo seu custo elevado. Os indivíduos que afirmaram consumir os produtos eram maioritariamente mulheres com idade entre os 40≤65 anos. Relativamente aos parâmetros avaliados não se observam diferenças estatisticamente significativas entre ambos os sexos. Estes inquiridos ingeriam maioritariamente o alimento 1vez/dia (leites fermentados, margarina (fatia/dia)) fazendo esta escolha por apresentarem colesterol elevado ou por lhes atribuírem efeitos preventivos para a doença. Para além disso quer os que estavam sob terapêutica antidislipidémica quer os que não estavam declararam observar efeitos positivos na hipercolesterolemia. Parece evidente que são as preocupações com a saúde que influenciam a aquisição dos leites fermentados com baixo teor de gordura e margarinas enriquecidos com fitoesteróis. As declarações feitas sobre os níveis de colesterol, ingestão declarada e efeitos observados parecem sugerir uma ingestão com quantidade e frequência suficiente. Também a faixa etária que mais consome parece estar de acordo com as recomendações. A elevada taxa de não consumidores encontrada no estudo e que alega não necessidade e descrença de efeitos mesmo quando tal não acontece pode atribuir-se à escassez de informação nos rótulos e/ou custo acrescido do produto. Esclarecer sobre a importância da inclusão destes produtos na dieta sozinhos ou como coadjuvantes de terapêutica instituída poderá ser uma forma de conseguir o equilíbrio na gestão da hipercolesterolemia.

Estudo das propriedades físico-químicas e avaliação de compostos bioativos em camarinhas ('Corema album' L.D. Don)

As camarinhas ('Corema album' L. D. Don) são pequenos frutos selvagens que se desenvolvem em arbustos dunares ao longo das costas da Península Ibérica. Apesar de serem ainda pouco conhecidas, as camarinhas são pequenos frutos que podem pertencer ao vasto grupo dos frutos vermelhos, vulgarmente conhecidos pelos seus efeitos benéficos na saúde. Desta forma, neste estudo foram realizadas várias análises às camarinhas no que respeita a propriedades de natureza física e química e em particular a alguns compostos com efeitos bioativos. Com a realização deste trabalho pretendeu-se avaliar as propriedades físico-químicas das camarinhas, bem como dos compostos bioativos com potenciais benefícios para a saúde. Nesse sentido, as bagas de camarinha foram avaliadas quanto às suas propriedades físicas (dimensões, peso, cor e textura), propriedades químicas (humidade, acidez, ºBrix, fibra, açúcares totais, açúcares redutores e vitamina C) e propriedades fenólicas (compostos fenólicos totais, orto-difenóis, flavonóides, taninos e atividade antioxidante, por DPPH e ABTS), em diferentes extratos de amostras de polpas e de grainhas liofilizadas. Os primeiros extratos ainda foram submetidos a uma simulações das condições do trato digestivo, para avaliar a bioacessibilidade dos compostos fenólicos e da atividade antioxidante. Este trabalho teve ainda como objetivo conhecer a bioacessibilidade dos compostos fenólicos totais e da sua atividade antioxidante, através do método da simulação “in vitro” das diferentes etapas do trato gastrointestinal. No que diz respeito às propriedades físicas analisadas, as camarinhas frescas demonstraram uma altura média de 8,6 mm, um diâmetro médio de 9,4 mm e uma massa média de 0,7 g. Relativamente à caraterização da cor, estas apresentavam uma cor clara (L*=79,8). Quanto à textura apresentaram alguma elasticidade média (2,9 mm) e uma baixa dureza (1,9 N). Nas análises químicas as camarinhas revelaram ser compostas, maioritariamente, por água (87,9%), por açúcares totais e fibras. Para além disso, apresentavam um teor em sólidos solúveis totais de 6,3 ºBrix, uma acidez de 1,4 g ácido tartárico/100 g e um teor de vitamina C de 2,8 mg de ácido ascórbico/100 g.Na quantificação dos compostos fenólicos totais e flavonóides, os extratos de acetona:água das amostras de polpas de camarinha branca apresentaram os valores mais elevados, 1614,1 mg EAG/100 g e 143,7 mg EQ/100 g, respetivamente. Relativamente à quantificação dos orto-difenóis e dos taninos os extratos de metanol e de acetona:água das amostras de grainhas de camarinha branca registaram os valores de 23,4 mg EAG/100 g e 915,7 mg/100 g, respetivamente. Na atividade antioxidante por DPPH e ABTS os extratos de acetona:água das amostras de polpas de camarinha branca apresentaram, respetivamente, os valores de 40,1 µmol ET/g e de 79,6 µmol ET/g. Na avaliação da bioacessibilidade verificou-se que ocorreu uma maior percentagem de compostos fenólicos disponíveis para absorção e uma maior preservação da sua atividade antioxidante nos extratos das grainhas, comparativamente aos extratos das polpas. Com este estudo concluiu-se que as camarinhas são pequenos frutos portadores de um grande potencial em diversos compostos bioativos benéficos para a saúde dos consumidores.

Probiotics, Prebiotics and Synbiotics

Probiotics are living microorganisms which, when ingested in certain amounts, have a positive impact on human health, mainly due to their roles in improving the balance of the intestinal microflora. On the other hand, the prebiotic are food ingredients that may also have a positive impact in the improvement of the intestinal flora. These components, which fall into the category of fibers, are not digested in the upper gastrointestinal tract, and therefore reach the colon where they stimulate the growth and/or the activity of some types of bacteria. The term synbiotic is used for products that contain both probiotics and prebiotics, thus taking advantage of both the addition of beneficial bacteria and the encouragement of the growth of resident beneficial bacteria. The present chapter aims to review the scientific literature related to prebiotics, probiotics and synbiotics, including their identification, properties and health benefits.