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Aims: To evaluate changes in glycated haemoglobin (HbA1c) and sensor‐based glycaemic metrics after glucose sensor commencement in adults with T1D. Methods: We performed a retrospective observational single‐centre study on HbA1c, and sensor‐based glycaemic data following the initiation of continuous glucose monitoring (CGM) in adults with T1D (n = 209). Results: We observed an overall improvement in HbA1c from 66 (59–78) mmol/mol [8.2 (7.5–9.3)%] pre‐sensor to 60 (53–71) mmol/mol [7.6 (7.0–8.6)%] on‐sensor (p <.001). The pre‐sensor HbA1c improved from 66 (57–74) mmol/mol [8.2 (7.4–8.9)%] to 62 (54–71) mmol/mol [7.8 (7.1–8.7)%] within the first year of usage to 60 (53–69) mmol/mol [7.6 (7.0–8.4)%] in the following year (n = 121, p <.001). RT‐CGM‐user had a significant improvement in HbA1c (Dexcom G6; p <.001, r = 0.33 and Guardian 3; p <.001, r = 0.59) while a non‐significant reduction was seen in FGM‐user (Libre 1; p =.279). Both MDI (p <.001, r = 0.33) and CSII group (p <.001, r = 0.41) also demonstrated significant HbA1c improvement. Patients with pre‐sensor HbA1c of ≥64 mmol/mol [8.0%] (n = 125), had attenuation of pre‐sensor HbA1c from 75 (68–83) mmol/mol [9.0 (8.4–9.7)%] to 67 (59–75) mmol/mol [8.2 (7.6–9.0)%] (p <.001, r = 0.44). Altogether, 25.8% of patients achieved the recommended HbA1c goal of ≤53 mmol/mol and 16.7% attained the recommended ≥70% time in range (3.9–10.0 mmol/L). Conclusions: Our study demonstrated that minimally invasive glucose sensor technology in adults with T1D is associated with improvement in glycaemic outcomes. However, despite significant improvements in HbA1c, achieving the recommended goals for all glycaemic metrics remained challenging. [ABSTRACT FROM AUTHOR]

Abstract Aims To evaluate changes in glycated haemoglobin (HbA1c) and sensor‐based glycaemic metrics after glucose sensor commencement in adults with T1D. Methods We performed a retrospective observational single‐centre study on HbA1c, and sensor‐based glycaemic data following the initiation of continuous glucose monitoring (CGM) in adults with T1D (n = 209). Results We observed an overall improvement in HbA1c from 66 (59–78) mmol/mol [8.2 (7.5–9.3)%] pre‐sensor to 60 (53–71) mmol/mol [7.6 (7.0–8.6)%] on‐sensor (p

Background: The Dose Adjustment for Normal Eating (DAFNE) course teaches insulin dose adjustment to match dietary carbohydrates and improve glycaemic control in participants with type 1 diabetes mellitus (T1DM). We investigated the association between socioeconomic deprivation and reduction in HbA1c as a marker of sustained glycaemic control, after attending DAFNE education. Methods: This retrospective observational study identified adults with T1DM who attended DAFNE training in NHS Lothian, South East Scotland. We extracted age, sex, postcode‐based Scottish Index of Multiple Deprivation (SIMD) quintiles and annual HbA1c measurements available four years before and after course attendance. We calculated mean HbA1c before (baseline) and after attendance at DAFNE, across four annual measurements. Change in mean HbA1c (mmol/mol) was categorised into three groups: decrease (≥ − 2.5), no change (<±2.5), increase (≥ + 2.5). We used multivariable ordinal logistic regression, with baseline mean HbA1c as a covariate, to investigate the association of SIMD quintile with reduction in mean HbA1c. Results: 335 participants were included. Age and sex distribution were similar across SIMD quintiles (Mean age = 45, range 21–91, 59% women). Lower SIMD quintiles (greater deprivation) had higher baseline mean HbA1c (SIMD 1: 76.0, SIMD 5: 69.0). Higher SIMD quintiles (lower deprivation) were associated with lower odds of no change/increase in mean HbA1c (SIMD 5, odds ratio = 0.25, 95% confidence interval 0.10, 0.58, p = 0.001, multivariable analysis). Conclusion: Socioeconomic deprivation was associated with higher baseline mean HbA1c and lower reduction in HbA1c following DAFNE education. Future research could explore causes and how best to support participants from deprived areas. Previous submissions: This work has not been previously submitted to a journal. This work was presented as a poster at The ABCD Conference 2021 and the abstract (of no more than 300 words) from the meeting has been published: Innes CWD, Henshall DE, Wilson B, Poon M, Morley SD, Ritchie SA. Socioeconomic deprivation is associated with reduced efficacy of an insulin adjustment education programme for people with type 1 diabetes. Br J Diabetes. 2021; 21: 293–296. [ABSTRACT FROM AUTHOR]

Abstract Background People with type 1 diabetes who attend structured education training in self-management using flexible intensive therapy achieve improved blood glucose control and experience fewer episodes of severe hypoglycaemia. However, many struggle to sustain these improvements over time. To inform the design of more effective follow-up support we undertook a review of qualitative studies which have identified factors that influence and inform participants’ self-management behaviours after attending structured education and their need for support to sustain improvements in glycaemic control. Methods We undertook a meta-ethnography of relevant qualitative studies, identified using systematic search methods. Studies were included which focused on participants’ experiences of self-managing type 1 diabetes after attending structured education which incorporated training in flexible intensive insulin therapy. A line of argument approach was used to synthesise the findings. Results The search identified 18 papers from six studies. The studies included were judged to be of high methodological quality. The line of argument synthesis developed the Follow-Up Support for Effective type 1 Diabetes self-management (FUSED) model. This model outlines the challenges participants encounter in maintaining diabetes self-management practices after attending structured education, and describes how participants try to address these barriers by adapting, simplifying or personalising the self-management approaches they have learned. To help participants maintain the skills taught during courses, the FUSED model presents ten recommendations abstracted from the included papers to provide a logic model for a programme of individualised and responsive follow-up support. Conclusions This meta-ethnography highlights how providing skills training using structured education to people with type 1 diabetes does not necessarily result in participants adopting and sustaining recommended changes in behaviour. To help people sustain diabetes self-management skills after attending structured education, it is recommended that support be provided over the longer-term by appropriately trained healthcare professionals which is responsive to individuals’ needs. Although developed to inform support for people with type 1 diabetes, the FUSED model provides a framework that could also be applied to support individuals with other long term conditions which require complex self-management skills to be learned and sustained over time. Trial registration PROSPERO registration: CRD42017067961.

Background: Fasting during Ramadan is a form of intermittent fasting in which a person abstains from oral intake between the hours of sunrise and sunset. The fasting month of Ramadan is observed by Muslims worldwide. People with type 1 diabetes (T1DM) who choose to fast during Ramadan are at a particularly high risk of acute diabetes complications including hypoglycemia and significant hyperglycemia. We hypothesized that people with uncomplicated T1DM would be able to fast safely during Ramadan following structured education and with daily advanced glucose monitoring.Methods: People with stable and uncomplicated T1DM treated with multiple daily injections (MDIs) or continuous subcutaneous insulin infusion (CSII) who chose to fast during Ramadan were recruited for the study. Participants attended Dose Adjustment for Normal Eating (DAFNE) structured education training, and basal insulin was reduced in a controlled fashion. Participants were assigned a sensor-augmented insulin pump or FreeStyle Libre for advanced glucose monitoring. The primary endpoint was the rate of hypoglycemia during Ramadan compared to before Ramadan. Secondary endpoints were percentage time spent 10 mmol/L (range, 4–10 mmol/L), episodes of diabetic ketoacidosis (DKA), and acute kidney injury or hospitalization for any cause.Results: Rates of hypoglycemia were significantly reduced during Ramadan compared with rates before Ramadan (0.53 ± 0. 49 vs. 0.81 ± 0.69 episodes/day, p = 0.0015). No episodes of severe hypoglycemia, DKA, acute kidney injury, or hospitalization occurred during Ramadan period. Percentage time spent >10 mmol/L (46.7 ± 17.7% vs. 42.5 ± 16.4%, p = 0.03) was significantly increased, and percentage time [range, 4–10 mmol/L (48.8 ± 15.9% vs. 50.9 ± 15.9%, p = 0.13)] and percentage time spent

Background: Fasting during Ramadan is a form of intermittent fasting in which a person abstains from oral intake between the hours of sunrise and sunset. The fasting month of Ramadan is observed by Muslims worldwide. People with type 1 diabetes (T1DM) who choose to fast during Ramadan are at a particularly high risk of acute diabetes complications including hypoglycemia and significant hyperglycemia. We hypothesized that people with uncomplicated T1DM would be able to fast safely during Ramadan following structured education and with daily advanced glucose monitoring. Methods: People with stable and uncomplicated T1DM treated with multiple daily injections (MDIs) or continuous subcutaneous insulin infusion (CSII) who chose to fast during Ramadan were recruited for the study. Participants attended Dose Adjustment for Normal Eating (DAFNE) structured education training, and basal insulin was reduced in a controlled fashion. Participants were assigned a sensor-augmented insulin pump or FreeStyle Libre for advanced glucose monitoring. The primary endpoint was the rate of hypoglycemia during Ramadan compared to before Ramadan. Secondary endpoints were percentage time spent <4 mmol/L, >10 mmol/L (range, 4–10 mmol/L), episodes of diabetic ketoacidosis (DKA), and acute kidney injury or hospitalization for any cause. Results: Rates of hypoglycemia were significantly reduced during Ramadan compared with rates before Ramadan (0.53 ± 0. 49 vs. 0.81 ± 0.69 episodes/day, p = 0.0015). No episodes of severe hypoglycemia, DKA, acute kidney injury, or hospitalization occurred during Ramadan period. Percentage time spent >10 mmol/L (46.7 ± 17.7% vs. 42.5 ± 16.4%, p = 0.03) was significantly increased, and percentage time [range, 4–10 mmol/L (48.8 ± 15.9% vs. 50.9 ± 15.9%, p = 0.13)] and percentage time spent <4 mmol/L (4.7 ± 5.4.7% vs. 5.7 ± 6.3%, p = 0.09) were reduced, but these differences were not significant. Conclusions: People with uncomplicated T1DM could safely participate in intermittent fasting similar to Ramadan fasting if equipped with structured education and advanced glucose monitoring systems. [ABSTRACT FROM AUTHOR]

This pre‐Ramadan workshop was aimed at educating and counselling people with type 1 diabetes, who graduated from the Dose Adjustment for Normal Eating (DAFNE) Kuwait programme, on safe fasting practices as well as determining their views on the challenges associated with fasting. The workshop also served as a pilot for a Ramadan‐specific module to inform its implementation in all DAFNE programmes with the goal of meeting the needs of Muslim DAFNE graduates wishing to fast safely. A 2‐day workshop (5 hours each) was conducted at DAFNE Kuwait 3 days before the start of Ramadan 2018 and all DAFNE graduates were invited to attend. The workshop consisted of group discussions about fasting‐related challenges, followed by three interactive lectures and hands‐on experience with popular Ramadan dishes. A qualitative approach was employed to determine the experiences of the participants with fasting by conducting three focus group discussions. The discussions were recorded via handwritten notes and analysed thematically. Seventy‐two people with type 1 diabetes attended and 47 participated in the group discussions. Participants discussed their past experiences with fasting and the associated challenges, and shared practices adopted over the years. In addition, they confirmed the positive impact of DAFNE on their fasting experiences. The workshop provided a platform for people with type 1 diabetes to share their experiences with fasting and learn how to fast safely. Furthermore, it provided preliminary information that can be further explored to inform recommendations for safer fasting practices and the implementation of a specific fasting curriculum for people with type 1 diabetes. [ABSTRACT FROM AUTHOR]

Background and Aims: Although people with type 1 diabetes are exempt from fasting the month of Ramadan due to the risk to their health, many wish to fast nonetheless. Little is known about the impact of structured education on the fasting experiences of people with type 1 diabetes. This study aimed to explore how the Dose Adjustment for Normal Eating (DAFNE) course affected people with type 1 diabetes' fasting experiences to provide insight into the benefits of structured education for people wishing to fast while managing their diabetes.Methods: Semi-structured interviews were conducted with 40 DAFNE graduates who fasted Ramadan. The purposive sample was selected from the DAFNE registry at Dasman Diabetes Institute in Kuwait. The interviews were transcribed verbatim and analysed thematically in an iterative process. Topics discussed included fasting experiences prior to attending the DAFNE course, fasting experiences this year, and how DAFNE affected their fasting.Results: Five themes emerged; (1) Reduction in fluctuations and complications, (2) Improvement in confidence and self-reliance, (3) Tailored support for dose and pump programming adjustments, (4) Positive effect on wellbeing, and (5) Encouraging informed-decision making about fasting.Conclusions: The findings have provided insight into the impact of DAFNE structured education on the fasting experiences of people with type 1 diabetes and has shown how overall, DAFNE had enhanced the quality of fasting. In addition, by assisting them in fulfilling their fasting wishes, DAFNE has had a positive effect on their wellbeing. [ABSTRACT FROM AUTHOR]

Copyright of Cuadernos de Filología Clásica: Estudios Latinos is the property of Universidad Complutense de Madrid and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To assess household availability of NOVA food groups in nineteen European countries and to analyse the association between availability of ultra-processed foods and prevalence of obesity.Design: Ecological, cross-sectional study.Setting: Europe.Subjects: Estimates of ultra-processed foods calculated from national household budget surveys conducted between 1991 and 2008. Estimates of obesity prevalence obtained from national surveys undertaken near the budget survey time.Results: Across the nineteen countries, median average household availability amounted to 33·9 % of total purchased dietary energy for unprocessed or minimally processed foods, 20·3 % for processed culinary ingredients, 19·6 % for processed foods and 26·4 % for ultra-processed foods. The average household availability of ultra-processed foods ranged from 10·2 % in Portugal and 13·4 % in Italy to 46·2 % in Germany and 50·4 % in the UK. A significant positive association was found between national household availability of ultra-processed foods and national prevalence of obesity among adults. After adjustment for national income, prevalence of physical inactivity, prevalence of smoking, measured or self-reported prevalence of obesity, and time lag between estimates on household food availability and obesity, each percentage point increase in the household availability of ultra-processed foods resulted in an increase of 0·25 percentage points in obesity prevalence.Conclusions: The study contributes to a growing literature showing that the consumption of ultra-processed foods is associated with an increased risk of diet-related non-communicable diseases. Its findings reinforce the need for public policies and actions that promote consumption of unprocessed or minimally processed foods and make ultra-processed foods less available and affordable. [ABSTRACT FROM AUTHOR]

En este artículo se destaca la figura de Dafne por ser la primera protagonista de un drama musical cantado, antecedente de lo que hoy se denomina ópera. Se ponen de relieve los orígenes de esta última como producto de las discusiones sobre el futuro de la música en el seno de la Camerata Florentina, fundada por Jacopo Corsi alrededor de 1580 y se comentan los aportes teóricos de Vincenzo Galilei que dio forma escrita a las inquietudes vigentes sobre el devenir musical. Los miembros de la Camerata fundaban su concepción de la música en el modelo de los antiguos griegos y tendían hacia el ideal de una música capaz de expresar cabalmente el sentimiento de la palabra y de influir sobre el ánimo del oyente, capacidad que atribuían al arte musical de la antigüedad clásica, según los escritos de poetas y filósofos. Dicha concepción marca un punto de ruptura con el modelo polifónico vigente en el momento, que privilegiaba el sonido por sobre el significado del texto. Se analiza el 'afortunado malentendido' del cual provino la ambición de componer una pieza teatral con parlamentos cantados: la idea de que la tragedia griega era cantada en toda su extensión, noción que con el tiempo se reveló como inexacta. A continuación se presentan libreto y breve descripción de la música de la ópera primigenia La Dafne y otras posteriores del período barroco, para culminar con la creación que Richard Strauss dedica al personaje en el primer cuarto del s. XX.This article deals with the origins of Opera, which started as a musical drama based on the legend of Daphne, and the subsequent musical versions of the text written originally by Ottavio Rinuccini, composed by Peri, Caccini and other musicians of the XVIIth Century. A brief discussion follows about the ideals and aspirations of the Camerata Fiorentina, a society of artists who met at the Palazzo Bardi in Florence at the end of the XVIth century and who are considered the intellectual fathers of Opera. The above mentioned musicians were members of this group, one of whose main leaders was Vincenzo Galilei who resumed his and the musical thinking of the Camerata in his Dialogo della Musica Antica e della Moderna. This theoretical work marks the break point between polyphonic and hetherophonic music, the former more appropriate for the church, the latter more capable of expressing human feelings. The belief, shared by the members of the Camerata, that Greek tragedy was sang in all its extension was later proved as untrue but it gave born to the opera as a side product. Daphne was also chosen as opera subject by Richard Strauss who composed a beautiful piece of music for a text written by Josef Georg, in 1934.

The paper illustrates the metamorphosis as a limit’s figure, as a petrifaction. Metamorphic myth, passed on occidental culture thanks to the great poem of Ovid’s Metamorphoses, concerns, indeed, more than the transformational variety of its figurations, the fundamental structure of a subjectivity. The study presupposes the psychoanalytic fantasy’s perspective (Freud, Lacan) that considers metamorphosis not as a magic or fantastic anomaly but, beyond its paradoxical, teratological or astonishing phenomenology, as the fantasy’s essential bond which constitutes a being. Metamorphosis represents the paradigmatic figure of a Subject who places himself upon a limit or who overcomes it, venturing his life, in order to obtain the possession of an inaccessible object. Metamorphosis corresponds to a fate different from death, characterized by that entre-deux, by the limen between the living and the dead which is the only shelter for those who are in difficulties. The metamorphic hero is actually punished with a mutation but, at the same time, he escapes from death or intolerable sufferings. So metamorphosis turns out as a subjectivity form suspended between life and death, like (for choosing just one of the numerous examples of transformations disseminated all over the literature and art from time immemorial) in Daphne’s metamorphic adventures in which a nymph is transformed in a tree under the pressure of a desire that is impossible to avoid anymore.

Abstract: Objective: Evaluation of an ambulatory diabetes teaching and treatment refresher programme (DTTP) for the optimization of intensified insulin therapy in patients with type 1 diabetes (refresher course). Methods: 85 outpatients took part in this prospective multicentre trial. Metabolic and psychosocial data were analyzed at baseline (V1), 6 weeks (V2) and 12 months after DTTP (V3). Results: In patients with baseline HbA1c>7% (88%), HbA1c decreased by 0.36% (p =0.004). The percentage of patients with HbA1c≤7% increased from 21.3 to 34.9% and with HbA1c above 10% decreased from 6.6 to 1.6% at V3. The incidence of hypoglycaemia decreased significantly: non severe hypoglycaemia from 3.31 to 1.39episodes/pat/week (p =0.001) and severe hypoglycaemia from 0.16 to 0.03episodes/pat/year (p =0.02). The treatment satisfaction increased by +10 of maximal ±18 points. The negative influence of diabetes on quality of life decreased from −1.93 to −1.69 points (p =0.031). Conclusion: In a group of patients with moderately controlled diabetes type 1 who were already treated with intensified insulin therapy, metabolic control, treatment satisfaction and quality of life were improved after participation in an ambulatory DTTP without increasing insulin dosage, number of injections or insulin species. Practice implications: This DTTP is effective for the optimization of intensified insulin therapy. [Copyright &y& Elsevier]

Copyright of Epos is the property of Editorial UNED and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This literature review examines the evidence base behind Dose Adjustment for Normal Eating (DAFNE), an educational programme for the self-management of type 1 diabetes. The Cumulative Index to Nursing and Allied Health Literature (CINAHL), British Nursing Index (BNI), Embase and Medline databases were accessed to locate relevant studies. Twelve studies were found to meet the review criteria. These provide evidence that DAFNE can help people with type 1 diabetes to achieve better glycaemic control and improve their quality of life. However, DAFNE-induced improvements in glycaemic control tend to reduce as time elapses since programme attendance and literature on the long-term effectiveness is limited. More research is needed to determine whether the benefits last in the long term and to identify how its positive effects can be maintained. [ABSTRACT FROM AUTHOR]

In adapting Rinuccini’s Dafne, German poet Martin Opitz (1597–1639) sought to establish a degree of cultural independence from his Italian model, both by developing a prosodic approach uniquely fitted to the German language and by subtly imbuing his text with a German moralistic hue. The later adaptation of Opitz’s libretto by two 17th-century Italians—Giovanni Andrea Bontempi and Marco Gioseppe Peranda—for the same Dresden court (though for a different Elector) that witnessed the 1627 premiere of Opitz and Heinrich Schütz’s Dafne thus offers important insights into both the desire for German cultural independence and the power of Italian influence to moderate such a desire. This article attempts to draw out some of the distinctive features of Opitz’s adaptation and then examine what Bontempi and Peranda retained, added and altered with respect to Opitz’s aims. Their opera points to changing tastes at the Dresden court under Johann Georg II, and, as a stylistic hybrid, also stands as an early exemplar of a particular line of development in the broader history of German opera. [ABSTRACT FROM AUTHOR]

Objective: To evaluate time trends in the availability of soft drinks, to identify food choices associated with their consumption and to assess the relationship between socio-economic status and daily soft drink availability in a wide range of European countries. Design: Data on food and beverage availability collected through the national household budget surveys and harmonized in the DAFNE (Data Food Networking) project were used. Averages and variability of soft drink availability were estimated and tests for time trends were performed. The daily availability of food groups which appear to be correlated with that of soft drinks was further estimated. Multivariate logistic and linear regression models were applied to evaluate the association between socio-economic status and the acquisition of soft drinks. Setting: Twenty-four European countries. Subjects: Nationally representative samples of households. Results: The availability of soft drinks is steadily and significantly increasing. Households in West and North Europe reported higher daily availability of soft drinks in comparison to other European regions. Soft drinks were also found to be correlated with lower availability of plant foods and milk and higher availability of meat and sugar products. Lower socio-economic status was associated with more frequent and higher availability of soft drinks in the household. Conclusions: Data collected in national samples of twenty-four European countries showed disparities in soft drink availability among socio-economic strata and European regions. The correlation of soft drinks with unfavourable dietary choices has public health implications, particularly among children and adolescents. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To explore long-term outcomes of participation in a Dose Adjustment For Normal Eating (DAFNE) training course, which provided one-off exposure to structured education in intensive insulin therapy to people with established Type 1 diabetes. Methods: A cohort design follow-up of original trial participants at a mean of 44 months (range: 37–51 months) in hospital diabetes clinics in three English health districts. 104 (74%) original participants provided biomedical data; 88 (63%) completed questionnaires including the ADDQoL, measuring impact of diabetes on quality of life (QoL). Results: At 44 months, mean improvement in HbA1c from baseline was 0.36% (9.32±1.1% to 8.96±1.2%, p <0.01) remaining significant but deteriorated from 12 months (p <0.05). Improvements in QoL seen at 12 months were sustained at 44 (e.g. impact of diabetes on dietary freedom: −1.78±2.33 at 44 months versus −4.27±2.94, baseline, p <0.0001; versus 1.80±2.32 at 12 months, ns). Similar results were obtained using last observation carried forward for patients not supplying follow-up data. Conclusions: The impact of a single DAFNE course on glycaemic control remains apparent in the long term, although further interventions will be required to achieve recommended HbA1c. In contrast, improvements in QoL and other patient-reported outcomes are well maintained over approximately 4 years. [Copyright &y& Elsevier]

Abstract: Since the second half of year 2007, the Frascati - factory DAFNE has been running with an upgraded interaction region in order to test the crabbed waist collision scheme. The aim is to reach a large improvement of the specific luminosity of the accelerator. We describe the various detectors realized to have a reliable and fast absolute luminosity measurement, the on-line analysis in order to get rid of the machine background contribution, and the performances of the system. [Copyright &y& Elsevier]

The aim of this study was to investigate the association between regional household diet quality and corresponding mortality data. Two household diet quality scores derived from household budget survey food and nutrient data were used: the Mediterranean Adequacy Index (MAI), assessing adherence to a Mediterranean food pattern, and a revised Healthy Diet Indicator (HDIr), based on compliance with WHO population dietary goals. Seven Portuguese regions were considered, in accordance with the officially adopted national territorial division NUT II. The corresponding regional age-standardised death rates were calculated for selected diet-related mortality causes. In order to allow for a minimum of 10 years latency period between exposure and outcome, dietary scores from 1989/1990 and its components were correlated to the 3-year average 1999/2001 death rates. Tobacco expenses were included for adjustment. Significant negative correlations with the proportion of families with highest MAI (≥4) or HDIr (≥7) scores were observed for mortality from diabetes mellitus (−0.87, P < 0.05; −0.89, P < 0.5), cardiovascular diseases (−0.89, P < 0.05; −0.96, P < 0.01) and ischaemic heart disease (−0.89, P < 0.05; −0.90, P < 0.05). Malignant neoplasms were positively correlated with protein, cholesterol and soft drinks, but inversely with polyunsaturated fatty acids (PUFA). Diabetes showed significant positive correlations with simple sugars and animal fat intake, but inversely with fruits and vegetables. Cardiovascular diseases presented positive correlations with simple sugars, milk and dairy products and animal fat, but inverse with fruits and vegetables and vegetable oils. Despite the limitations of ecological approaches in general and of the statistical power in this particular study, due to the use of broad geographical areas, significant correlations in the expected direction of reduced mortality risk with improved household diet quality was reported. The use of diet quality scores in data from household budget surveys could depict variations in Portuguese regional food and nutrient patterns, which were revealed to be related and partially explain differences in regional cause-specific mortality rates from diet-related diseases. [ABSTRACT FROM AUTHOR]

The present study aimed to compare Portuguese food and nutrient data retrieved from three distinct sources of dietary data: national food supply, household food availability and individual food consumption. In particular it was intended to validate the use of the dietary data derived from the Portuguese household budget surveys (HBS). The data sources used were food balance sheets (FBS) (1990, 1995 and 2000) generated by the Food and Agriculture Organization (FAO), HBS (1990, 1995 and 2000) collected by the National Statistics Institute (INE) and individual consumption obtained through a food frequency questionnaire (FFQ) applied in the context of the EpiPorto study circa 2000. Thirteen comparable food groups were established for analysis. Total energy, macronutrients and other selected dietary components were considered. The average daily values of different dietary sources were compared in absolute amounts (g/person per day) and in relative energy contribution (%E). To evaluate association and agreement between sources, Spearman’s correlation coefficients and distance matrices based on Euclidian distances were computed. The obtained average daily per capita amounts reflect the different points of data collection in the food chain; HBS fall in the expected position, below FBS and closer to FFQ. Agreement between FBS, HBS and FFQ was higher when data were expressed in relative energy contribution than when absolute amounts were considered. In general, the observed discrepancies between the three data sources could be attributed to known differences in the methodological approaches. This study supports the finding that despite their constraints the HBS-derived data are a valid option to evaluate dietary habits in Portugal. [ABSTRACT FROM AUTHOR]