BackgroundThis study includes, for the first time, estimates of general and abdominal obesity prevalence for all ages of the Portuguese population, using common standardized methodologies. Results are compared by sex, age groups, educational level and geographical regions.MethodsParticipants were a representative sample of the Portuguese population aged between 3 months and 84 years of age (n = 6553), enrolled in the National Food, Nutrition and Physical Activity Survey, 2015–2016. Objective anthropometric measurements included length/height, weight and body circumferences, performed according to standard procedures. Body mass index (BMI) was classified according to the World Health Organization (WHO) growth charts for children and adolescents, and WHO criteria for adults. Abdominal obesity was defined in adults as waist-hip ratio ≥ 0.85 in women or ≥ 0.90 in men. Prevalence estimates and 95% confidence intervals (95%CI) were weighted according to a complex sampling design, considering stratification by seven geographical regions and cluster effect for the selected Primary Health Care Unit.ResultsThe national prevalence of obesity is 22.3% (95%CI: 20.5–24.0), significantly higher in women. Obesity prevalence is much higher in the elderly (39.2%, 95%CI. 34.2–44.2), while children and adolescents have the lowest prevalence around 8–9%. In a regression model, three knot points denoting an inflection of obesity prevalence across the life span were observed around 5, 15 and 75 years.The prevalence of pre-obesity at national level is 34.8% (95%CI: 32.9–36.7), higher in men, and almost 18% of children and 24% of adolescents have pre-obesity.The sex- and age-standardized prevalence of obesity ranged from 38.3% (95%CI: 34.6–42.1) to 13.1% (95%CI: 10.3–15.9) for the less and the most educated individuals, respectively. Although some geographical region disparities, obesity prevalence did not significantly differed across regions (p = 0.094).The national prevalence of abdominal obesity in adults is 50.5% (95%CI: 47.9–53.1), particularly high in the elderly (80.2%).ConclusionAlmost 60% of the general Portuguese population is obese or pre-obese. Women, elderly and less educated individuals present the highest obesity prevalence. Abdominal obesity, in particular, seems to be a relevant public health problem among the elderly men.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5480-z) contains supplementary material, which is available to authorized users.

Objective:To assess total sugar (TS), added sugar (AS) and free sugar (FS) intakes, dietary sources, adherence to recommendations and determinants of consumption, in a Portuguese national sample.Design:Cross-sectional study. Dietary assessment was obtained by two food diaries in children aged <10 years and two non-consecutive 24 h recalls for other age groups. TS, AS and FS intakes were estimated by using SPADE software. TS content in food was estimated at the ingredient level. AS content in food was assessed through a systematic methodology and FS was based on the WHO definition.Setting:National Food, Nutrition and Physical Activity Survey (IAN-AF 2015–2016), Portugal.Participants:Representative sample from the Portuguese population, aged from 3 months to 84 years (n 5811).Results:Mean daily intake and contribution to total energy intake (E%) were 84·3 g/d (18·5 E%) for TS, 32·1 g/d (6·8 E%) for AS and 35·3 g/d (7·5 E%) for FS. Of the population, 76 % adhered to the FS recommendation (FS < 10 E%). The lowest adherence was in children (51·6 %) and adolescents (51·3 %). The main dietary source of TS was fruit across all ages, except in adolescents which was soft drinks. In children, the main dietary sources of FS were yoghurts and sweets, soft drinks in adolescents and table sugar in adults/elderly. FS intake was lower in children with more educated parents and in adults who practised physical activity regularly, and higher among smokers.Conclusions:Interventions ought to be planned towards decreasing intakes of added and free sugars considering population-specific characteristics.

Ultra-processed foods (UPFs) are common worldwide and associated with poorer health outcomes. This work aimed to explore the UPF consumption associated factors and its main dietary sources, by sex, in Portugal. Participants from the National Food, Nutrition and Physical Activity Survey (IAN-AF) 2015–2016, aged 3–84 years, were included (n 5005). Dietary intake was assessed through two 1-day food diaries/24 h recalls. UPFs were identified using the NOVA classification. Associations were evaluated through linear regression models. Median UPF consumption was 257 g/d (10⋅6 % of total quantity; 23⋅8 % of total energy). Adolescents were those with higher consumption (490 g/d). Compared to adults, younger ages were positively associated with UPF consumption (e.g. adolescents ( $\hat{\beta }$ -females: 192, 95 % confidence interval (CI): 135, 249; $\hat{\beta }$ -males: 327, 95 % CI: 277, 377)). A lower educational level was associated with lower UPF consumption ( $\hat{\beta }$ -females: −63; 95 % CI: −91, −34; $\hat{\beta }$ -males: −68; 95 % CI: −124, −12). Also, a lower UPF consumption was observed in married males/couples compared to singles ( $\hat{\beta }$ : −48, 95 % CI: −96, −1). Furthermore, female current/former smokers were associated with a higher UPF consumption v. never smokers ( $\hat{\beta }$ : 79, 95 % CI: 41, 118; $\hat{\beta }$ : 42, 95 % CI: 8, 75, respectively). Main UPF sources were yoghurts, soft drinks and cold meats/sausages differing strongly by sex, age and education level. Yoghurts containing additives were the main contributors to the UPF consumption in children and adult females from all education (~20 %). Soft drinks were leaders in adolescents (females: 26⋅0 %; males: 31⋅6 %) and young male adults (24⋅4 %). Cold meats/sausages stood out among low-educated males (20⋅5 %). Males, younger age groups, higher education, children with less-educated parents, married/couple males and smoking females were positively associated with UPF consumption.

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This study aimed to evaluate the association between socio-economic factors and the food consumption of a young population. Participants were from the Portuguese National Food, Nutrition and Physical Activity Survey (IAN-AF 2015–2016) aged from 3 to 17 years (n 1153). Food consumption was assessed using two non-consecutive days of food diaries in children and two 24-h recalls for adolescents. A latent class analysis (LCA) was used to classify children’s socio-economic status (socio-economic composite classification (SCC)), categorised in low, middle or high. The associations between socio-economic variables and food consumption were evaluated through linear or logistic regression models, weighted for the Portuguese population distribution. A positive association was found between belonging to a higher level of SCC and consumption of fruits and vegetables (FV), by children (β = 2·4, 95 % CI 1·1, 3·8) and by adolescents (β = 52·4, 95 % CI 9·6, 95·3). A higher SCC, but particularly higher maternal education, was positively associated with consumption of ‘white meat, fish and eggs’. Both higher SCC and parental education were positively associated with salty snack consumption in the adolescents’ group. In conclusion, children and adolescents with higher educated parents and belonging to a high socio-economic level have a higher daily intake of FV and white meat, fish and eggs. Socio-economic factors play an important role in justifying differences in the food consumption of children and adolescents and must be considered in future interventions. The relationship between higher socio-economic position and salty snack consumption in adolescents needs to be further explored in other populations.

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