The assessment of food consumption data using harmonized methodologies at the European level is fundamental to support the development of public policies. Portugal is one of the countries with the most outdated information on individual food consumption. The objective of this study was to describe the design and methodology of the National Food, Nutrition and Physical Activity Survey, 2015-2016, developed to collect national and regional data on dietary habits, physical activity (PA), and nutritional status, in a representative sample of the Portuguese general population (3 months-84 years). Participants were selected by multistage sampling, using the National Heath Registry as the sampling frame. Data collection, during 12 months, was harmonized according to European guidelines (EU-MENU, European Food Safety Authority [EFSA]). Computer-assisted personal interviewing (CAPI) was performed on a specific electronic platform synchronized with nutritional composition data and considering the FoodEx2 classification system. Dietary assessment was performed using 24-hour recalls (two nonconsecutive, 8-15 days apart) or food diaries in the case of children aged <10 years, complemented with a food propensity questionnaire; PA data (International Physical Activity Questionnaire [IPAQ], the Activity Choice Index [ACI], and 4-days PA diaries); sociodemographic data, and other health-related data were also collected. A sample of 6553 individuals completed the first interview, and 5811 participants completed two dietary assessments. The participation rate among eligible individuals was 33.38% (6553/19,635), considering the first interview, and 29.60% (5811/19,635) for the participants with two completed interviews (about 40% in children and adolescents and 20% in elderly individuals). Results of the survey will be disseminated in national and international scientific journals during 2018-2019. The survey will assist policy planning and management of national and European health programs on the improvement of nutritional status and risk assessment related to food hazards, and the enhancement of PA. The infrastructures and data driven from this Survey are a solid basis to the development of a future national surveillance system on diet, PA, and other health behaviors reproducible over time.

This study aimed to investigate the association of ultra-processed food consumption at 4 and 7 years of age with appetitive traits at 7 years and BMI at 10 years of age. Participants were 1175 children of the population-based birth cohort Generation XXI, who provided food diaries and complete data on socio-demographic variables, anthropometric measures and the Portuguese Children’s Eating Behaviour Questionnaire (P-CEBQ). Foods were grouped according to NOVA classification into: ‘unprocessed, minimally or moderately processed, and culinary preparations’; ‘processed’ and ‘ultra-processed’. To assess tracking of groups’ consumption, Pearson’s correlation coefficient (r) and the intraclass correlation coefficient (ICC) were calculated. Generalised linear models were fitted to test main associations, mediators and interactions among the variables. Ultra-processed consumption exhibited a fair level of stability between ages 4 and 7 years (r0·34; ICC = 0·32; 95 % CI 0·25, 0·39), corresponding, respectively, to 27·3 % (1881·9 (SD908·8) kJ/d) and 29·3 % (2204·5 (SD961·1) kJ/d) of total energy intake. After adjusting for maternal and child characteristics, higher ultra-processed consumption at 4 years was associated directly with ‘Food Responsiveness’ (β= 0·019; 95 % CI 0·007, 0·037) and indirectly through energy intake with avoidant traits: ‘Food Fussiness’ (β= –0·007; 95 % CI 0·002, 0·012) and ‘Satiety Responsiveness’ (β= –0·007; 95 % CI 0·003, 0·012). Ultra-processed consumption at 4 years old was associated with BMI at 10 years old, but appetitive behaviours were not powerful mediators of this association. The results suggest a path by which ultra-processed products may impact on later appetitive traits and higher BMI in children.

The substitution of minimally processed food and culinary home preparations for ready-to-eat products is increasing worldwide, which is overlooked as a cause of concern. The technological developments and the rise in highly processed food availability have introduced the concept of ultra-processed food (UPF). Food classification systems based on processing are now a new basis for epidemiological research. Different results from these classifications might influence conclusions on the population’s consumption of UPF or its association with health outcomes. The aim of this study was to compare classification systems and to find out if their results are comparable when evaluating the extent of high/UPF on the overall diet. Portuguese data from the year 2000 was extracted from the DAFNE-AnemosSoft, and 556 food/beverages items were classified according to five systems. The contribution of UPF was calculated as a percentage of total available amount and discrepancy ranges used for comparisons. Results of UPF availability contributions were: NOVA 10.2%; UNC 15.2%; IFPRI 16.7%; IFIC 17.7%; IARC 47.4%. The highest discrepancy ranges were from alcoholic beverages (97.4%), milk/milk products (94.2%), sugar/sugar products (90.1%), added lipids (74.9%), and cereals/cereal products (71.3%). Inconsistencies among classifications were huge and the contribution from highly/UPF presented high discrepancies. Caution must be taken when comparing and interpreting such data.

Objective: To determine and compare the effect of two interventions in reducing the plate waste of school lunches.Design: A between-group analysis was conducted among children from three primary schools: (i) a group receiving intervention A, designed for children and focusing on nutrition education and food waste; (ii) a group receiving intervention B, intended for teachers and focusing on the causes and consequences of food waste; and (iii) a control group with no intervention. For each child, physical weighing of individual meals and leftovers was performed on three non-consecutive weeks at baseline (T0), 1 week (T1, short term) and 3 months (T2, medium term) following the intervention. Plate waste was recorded for a total of 1742 lunches during 14 d over eight different menus.Setting: Portuguese public primary schools in the city of Porto.Subjects: All fourth-grade children (n212) attending the three preselected schools.Results: After intervention A focusing on nutrition education designed for children, a decrease in soup waste was observed compared with the control group. The effect was greater at T1 (−11·9 (se2·8) %;P<0·001) than at T2 (−5·8 (se4·4) %;P=0·103). The plate waste of identical main dishes decreased strongly at T1 (−33·9 (se4·8) %;P<0·001). However, this effect was not found at T2 (−13·7 (se3·2) %;P<0·001). After intervention B involving teachers, plate waste decreased at T2 (−5·5 (se1·9) % for soup; −5·4 (se2·4) % for identical main dishes).Conclusions: Nutrition education designed for children was more effective in the short than the medium term. Thus, this kind of intervention was not effective in reducing food waste in the medium term. In contrast, an intervention focusing on teachers revealed better results in the medium term than in the short term.