Ana Isabel Rito

• PhD in Public Health Nutrition
• Researcher at National Institute of Health Dr. Ricardo Jorge

Summary Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data...

Despite growing recognition of the importance of applying a systems lens to action on obesity, there has only been limited analysis of the extent to which this lens has actually been applied. The CO-CREATE project used a youth-led participatory action research approach to generate policy ideas towards the reduction of adolescent overweight and obes...

Introduction.-Between 2019 and 2021, 199 adolescents collaborated with adults in 15 partici-patory action research projects, called Youth Alliances, to contribute to system-directed obesity prevention in five EU countries. We investigated if and how these Youth Alliances included diverse youth, enhanced engagement, generated policy proposals and ch...

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6 . Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural an...

The CO‐CREATE project focuses on the need for research on obesity prevention in adolescents to move away from studies of single interventions, toward the investigation of systems‐based research incorporating youth involvement. This paper provides an overview of the project, presenting the objectives, design, and novel methodologies applied, as well...

The CO‐CREATE project aims to collaborate with adolescents across Europe in developing policy ideas that contribute to overweight and obesity prevention. In this paper, we present the theoretical basis and methodological approach to recruitment and engagement in the project. The principles of youth‐led participatory action research were employed to...

Introduction: This position statement on medical nutrition therapy (MNT) in the management of overweight or obesity in children and adolescents was prepared by an expert committee convened by the European Association for the Study of Obesity (EASO) and developed in collaboration with the European Federation of the Associations of Dietitians (EFAD)...

Engaging youth in obesity prevention research and policy action is essential to develop strategies that are relevant and sensitive to their needs. Research with young people requires critical reflection to safeguard their rights, dignity, and well‐being. The CO‐CREATE project used various methods to engage approximately 300 European youth aged 15–1...

Background Excessive salt consumption—associated with a range of adverse health outcomes—is very high in Portugal, and bread is the second largest source. Current Portuguese legislation sets a maximum limit of 1.4 g salt per 100 g bread, but imported and traditional breads are exempted. In 2017 the Ministry of Health proposed reducing the salt thre...

Background Physical activity is key for preventing obesity and development of noncommunicable diseases later in life. Previous research suggests that socioeconomic factors, such as parental education or income, may influence a child’s risk of obesity. However, previous research on this has provided heterogeneity in results. Our aim was to investiga...

Background Children are becoming less physically active for a variety of interrelated reasons. The availability of opportunities for safe active playgrounds, recreational activities and active transport has decreased, while time spend on sedentary screen-based activities has increased. This study aimed to evaluate physical activity (PA), sedentary...

Proper nutrition in infancy and early childhood is crucial to ensuring optimal child development, growth, and better health outcomes later in life. The nutrient profile model proposed by WHO/Europe aims to assess the nutritional quality and promotional/marketing aspects of commercial baby foods aimed at children up to 36 months. We used commercial...

Introduction: Parents can act as important agents of change and support for healthy childhood growth and development. Studies have found that parents may not be able to accurately perceive their child's weight status. The purpose of this study was to measure parental perceptions of their child's weight status and to identify predictors of potentia...

Over the past two decades, a concerted effort to combat the rising tide of childhood overweight and obesity has taken shape. The World Health Organization (WHO) Commission on Ending Childhood Obesity (ECHO) provides recommendations for six priority areas of action, including the promotion of healthy food consumption, promotion of physical activity,...

Establishment of the WHO European Childhood Obesity Surveillance Initiative (COSI) has resulted in a surveillance system which provides regular, reliable, timely, and accurate data on children's weight status-through standardized measurement of bodyweight and height-in the WHO European Region. Additional data on dietary intake, physical activity, s...

Background Commercially available complementary foods (CACFs) have been assuming an important proportion of infants and toddlers' diets in high-income countries, despite the concerns regarding their nutritional content and potential problematic marketing strategies used to promote these products. In 2016, the WHO guidance on ending the inappropriat...

The Childhood Obesity Surveillance Initiative (COSI) routinely measures height and weight of primary school children aged 6-9 years and calculates overweight and obesity prevalence within the World Health Organization (WHO) European Region using a standard methodology. This study examines the trends in the prevalence of overweight and obesity from...

To meet the need for regular and reliable data on the prevalence of overweight and obesity among children in Europe, the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) was established in 2007. The resulting robust surveillance system has improved understanding of the public health challenge of childhood ov...

Ready-to-eat cereals (RTECs) have become a popular breakfast option claiming to provide important nutrients to children’s diets, despite being a source of excess sugar and, therefore, a health concern. Thus, food reformulation constitutes an important public health strategy that could benefit from inputs provided by nutrient profiling. This study a...

Background Socioeconomic differences in children's food habits are a key public health concern. In order to inform policy makers, cross-country surveillance studies of dietary patterns across socioeconomic groups are required. The purpose of this study was to examine associations between socioeconomic status (SES) and children's food habits. Metho...

Childhood overweight and obesity have significant short- and long-term negative impacts on children's health and well-being. These challenges are unequally distributed according to socioeconomic status (SES); however, previous studies have often lacked standardized and objectively measured data across national contexts to assess these differences....

Background and Aims Body composition in childhood is not only a marker of the prevalence of obesity, but it can also be used to assess associated metabolic complications. Bioelectrical impedance analysis (BIA) shows promise as an easy to use, rapid, and non-invasive tool to evaluate body composition. The objectives of this study were to: (a) develo...

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in di...

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in di...

Background: To make effective progress towards a global reduction in obesity prevalence, there needs to be a focus on broader structural factors, beyond individual-level drivers of diet and physical activity. This article describes the use of a systems framework to develop obesity prevention policies with adolescents. The aim of this research was...

Background The term “nutrient profile” (NP) has been associated with several concepts arising from the need to regulate the choice of food products, and to allow consumers to make informed and healthier food choices. The use of NP models as a policy tool to improve public health nutrition and reduce the prevalence of non-communicable diseases, is r...

Background: Children are becoming less physically active as opportunities for safe active play, recreational activities, and active transport decrease. At the same time, sedentary screen-based activities both during school and leisure time are increasing. Objectives: This study aimed to evaluate physical activity (PA), screen time, and sleep dur...

Background: Children are becoming less physically active as opportunities for safe active play, recreational activities, and active transport decrease. At the same time, sedentary screen-based activities both during school and leisure time are increasing. Objectives: This study aimed to evaluate physical activity (PA), screen time, and sleep durati...

Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled ana...

Background An investment in nutrition at the earliest possible stage, providing appropriate complementary feeding, is critical to ensure proper growth and to prevent noncommunicable diseases (NCDs). Food and drinks high in fats, free sugars and salt are being marketed for consumption by young children and represent particular concern. Aim This stu...

The aim was to determine whether commercial baby foods marketed within Europe (up to 36 months of age) have inappropriate formulation and high sugar content and to provide suggestions to update European regulations and recommendations as part of a nutrient profile model developed for this age group. The latter was produced following recommended Wor...

Consuming a healthy diet in childhood helps to protect against malnutrition and noncommunicable diseases (NCDs). This cross-sectional study described the diets of 132,489 children aged six to nine years from 23 countries participating in round four (2015–2017) of the WHO European Childhood Obesity Surveillance Initiative (COSI). Children’s parents...

High sodium (salt) consumption is associated with an increased risk of developing non-communicable diseases. However, in most European countries, Portugal included, sodium intake is still high. This study aimed to assess the sodium content of school meals before and after the Eat Mediterranean (EM) intervention—a community-based program to identify...

Introduction: In Portugal, obesity is the most prevalent disease in childhood, with 1 in every 3 children being overweight, although in the last decade it has been showing a downward trend. Ongoing, community-based programs at local level seem to respond effectively to this problem. MUN-SI emerged in 2008 as a program to promote child health in mun...

Background Excessive consumption of sugar has a well-established link with obesity. Preliminary results show that a tax levied on sugar-sweetened beverages (SSBs) by the Portuguese government in 2017 led to a drop in sales and reformulation of these products. This study models the impact the market changes triggered by the tax levied on SSBs had on...

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Objectives: Eat Mediterranean (EM), a community-based Public Health Program, was developed with the goal to reduce nutritional inequalities in school children through the promotion Mediterranean Diet, giving priority to the school environment1 The present study addresses the evaluation of school meals nutritional composition, before and after the...

Introduction: Following the World Health Organization European Healthy Cities Network, the Portuguese Healthy Cities Network was formally created by municipalities equally committed to promote equity, health and quality of life through local action. Objectives: To evaluate the health promotion strategies and initiatives implemented at municipality...

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3–6. Here we use 2,009 population-based studies, with measurements of height and...

Background: In Europe, although the prevalence of childhood obesity seems to be plateauing in some countries, progress on tackling this important public health issue remains slow and inconsistent. Breastfeeding has been described as a protective factor, and the more exclusively and the longer children are breastfed, the greater their protection fr...

Background: The World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) was established more than 10 years ago to estimate prevalence and monitor changes in overweight and obesity in children aged 6-9 years. Since then, there have been five rounds of data collection in more than 40 countries involving more than ha...

Non-communicable diseases (NCDs) are associated with avoidable behavioural risk factors and several opportunities for intervention - such as unhealthy diets, lack of physical activity, tobacco use and excessive alcohol con-sumption - are available. Unhealthy diets are among the most contributable risk factors to the decrease in healthy life years...

Background: Despite its health benefits, adherence to the Mediterranean diet (MD) has been decreasing, particularly in young generations and in Mediterranean regions, including Portugal. Socioeconomic and lifestyle factors have been shown to influence children and adolescents’ eating habits. This study aimed to assess the association between socioe...

Background/objectives: Ready-to-eat cereal (RTEC) breakfasts have been increasing in Portugal, among children. Eat Mediterranean (EM), a Portuguese comprehensive community-based intervention, proposed to improve breakfast patterns of children and adolescents and to evaluate the healthiness of RTEC according to WHO/Europe nutrient profile model (Eu...

It is unclear how dietary, physical activity and sedentary behaviors co-occur in school-aged children. We investigated the clustering of energy balance-related behaviors and whether the identified clusters were associated with weight status. Participants were 6- to 9-year-old children (n = 63,215, 49.9% girls) from 19 countries participating in the...

The community-based intervention Eat Mediterranean: a program for eliminating dietary inequality in schools (EM), promoted by the Portuguese Regional Health Administration of Lisbon and Tagus Valley, aimed to contribute to the reduction of nutritional inequalities in the school environment through the promotion of the Mediterranean Diet, an healthy...

INTRODUÇÃO: O Programa Eat Mediterranean: A Program for Eliminating Dietary Inequalities in Schools foi desenvolvido através de uma abordagem abrangente a nível individual e comunitário, centrada no ambiente escolar. A escola constitui um ambiente privilegiado para educação para a saúde, promoção de estilos de vida saudáveis e equidade social, assu...

Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those...

BACKGROUND:Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends...

Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128•9 million children, adolescents, and adults NCD Risk Factor Collaboration (NCD-RisC)* Summary Background Underweight, overweight, and obesity in childhood and adolescence are associated w...

Background Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare tr...

Introduction: Considerable inequalities in overweight and obesity are evident among European children. Particularly in Portugal, a country with one of the highest prevalence of childhood obesity, understanding the most relevant socio-economical factors such as maternal education, is crucial to promote children's immediate health and well-being thro...

Background: Excess risk of childhood overweight and obesity occurring in socioeconomically disadvantaged families has been demonstrated in numerous studies from high-income regions, including Europe. It is well known that socioeconomic characteristics such as parental education, income and occupation are etiologically relevant to childhood obesity...

Background.TheWorld Health Organization European Childhood Obesity Surveillance Initiative (COSI) conducted examinations in 6–9-year-old children from 16 countries in the first two rounds of data collection. Allowing participating countries to adhere to their local legal requirements or adapt to other circumstances required developing a flexible pr...

To assess to what extent eight behavioural health risks related to breakfast and food consumption and five behavioural health risks related to physical activity, screen time and sleep duration are present among schoolchildren, and to examine whether health-risk behaviours are associated with obesity. Cross-sectional design as part of the WHO Europe...

Both sleep duration and screen time have been suggested to affect children's diet, although in different directions and presumably through different pathways. The present cross-sectional study aimed to simultaneously investigate the associations between sleep duration, screen time and food consumption frequencies in children. The analysis was based...

p>Objective To assess to what extent eight behavioural health risks related to breakfast and food consumption and five behavioural health risks related to physical activity, screen time and sleep duration are present among schoolchildren, and to examine whether health-risk behaviours are associated with obesity. Design Cross-sectional design as par...

Objectives: To evaluate the association between family income, obesity and food intake in children from three Portuguese municipalities (Oeiras, Seixal and Viana do Castelo) within the MUNSI Program (www.mun-si.com). Material and methods: An observational cross-sectional study was performed in 1673 children aged between 9-11 years old from 91 eleme...

Background: Schools are important settings for the promotion of a healthy diet and sufficient physical activity and thus overweight prevention. Objective: To assess differences in school nutrition environment and body mass index (BMI) in primary schools between and within 12 European countries. Methods: Data from the World Health Organization...

Portugal is one of the countries within the WHO European Region with higher prevalence of childhood overweight (over 30%) and obesity but not all children are affected equally by the burden of obesity and poor health. Children in families that do not have adequate resources are more likely to be obese and face a greater burden of ill health than ch...

Introdução: A obesidade é a doença mais prevalente na infância e continua a ser um desafio global e prioritário nos países da União Europeia. A sua etiologia é multifactorial. Este trabalho pretende estudar a relação entre o peso à nascença e o aleitamento materno e obesidade infantil. Materiais e Métodos O estudo compreende 3637 crianças dos 6-8 a...

Background Current methods for assessing children's dietary intake, such as interviewer-administered 24-h dietary recall (24-h DR), are time consuming and resource intensive. Self-administered instruments offer a low-cost diet assessment method for use with children. The present study assessed the validity of the Portuguese self-administered, compu...

Portugal is one of the countries within the WHO European Region with higher prevalence of childhood overweight (over 30%) and obesity but not all children are affected equally by the burden of obesity and poor health. Children in families that do not have adequate resources are more likely to be obese and face a greater burden of ill health than ch...

Background: The World Health Organization (WHO) Regional Office for Europe has established the Childhood Obesity Surveillance Initiative (COSI) to monitor changes in overweight in primary-school children. The aims of this paper are to present the anthropometric results of COSI Round 2 (2009/2010) and to explore changes in body mass index (BMI) and...

Introduction: Twenty-four-hour dietary recall is the method of choice for assessing food intake among school-age children. Because they require highly trained interviewers, recalls are expensive and impractical for large-scale nutrition research. A new method for assessing dietary intake in children is being developed: the Portuguese self-administe...

Background The majority of chronic disease is caused by risk factors which are mostly preventable. Effective interventions to reduce these risks are known and proven to be applicable to a variety of settings. Chronic disease is generally developed long before the fatal outcome, meaning that a lot of people spend a number of years in poor health. Ef...

Nutritional surveillance in school-age children, using measured weight and height, is not common in the European Region of the World Health Organization (WHO). The WHO Regional Office for Europe has therefore initiated the WHO European Childhood Obesity Surveillance Initiative. To present the anthropometric results of data collected in 2007/2008 an...

Objective: Results of the WHO European Childhood Obesity Surveillance Initiative indicated that on average one out of four primary-school children is overweight or obese. Portugal presented one of the highest prevalences of obesity. Childhood obesity prevention and treatment should be a top priority. The aim of the present study was to evaluate th...

http://repositorio.insa.pt/handle/10400.18/142

Introduction: Childhood obesity is considered by World Health Organization as a serious public health concern. Low levels of physical activity, short sleep duration and the increase of sedentary behaviors are associated with childhood obesity. Objectives: Assess the effect of a community and family based project - Project Obesity Zero (POZ) - in nu...

Introduction: Previous studies place Portugal among the five countries with the highest prevalence of childhood obesity in Europe. This paper describes the prevalence of thinness, overweight and obesity in Portuguese children of 6-8 years of age, based on the first data collection from Childhood Obesity Surveillance Initiative Portugal, which took...

Published in Obesity Facts 2012; 5(Suppl. 1): 13.

Published in . Obesity Facts 2012; 5(Suppl. 1): 14.

http://repositorio.insa.pt/handle/10400.18/1109

Guia Pratico com fichas de atividades para crianças do 1º ciclo do ensino básico: Alimentação, Atividade Fisica, Segurança Alimentar

INTRODUCTION: Childhood obesity represents one of the most serious public health challenges, as it has reached epidemic levels in several countries around the world. Obese children and adolescents are more likely to be obese in adulthood. In addition, childhood and adolescent obesity has adverse psychological, social and health consequences in chil...