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The study aimed to describe trajectories of free sugar (FS) intake, its main sources and the associations with socio-economic status (SES) in Portuguese children/adolescents evaluated at 4, 7, 10 and 13 years of age from Generation XXI birth-cohort. Dietary intake was assessed through 3-day food diaries ( n 5268). Added sugar intake was estimated following a systematic methodology, and FS was based on the WHO definition. A mixed-effects model with linear and quadratic terms for time was used to estimate FS trajectories and its association with SES, adjusting for children's sex, age, BMI and SES. The FS mean intake (g/day) was 37, 47, 51 and 48 at 4, 7, 10 and 13 years, respectively. FS intake increased 4·6 g/year (CI 95 %: 4·20, 5·04), but velocity decreased by 0·3 g/year 2 until 13 years. At all ages, the main food source was sweets. Some item's consumption declined (sweets 25-21 % and yoghurts 22-7 %) as children grew older. Inversely, soft drink intake increased (9-18 %). Boys and children from younger mothers had higher FS intake, whereas higher maternal-SES was associated with lower children's FS intake: occupational status ( β = -3·5; 95 % CI: -4·97, -1·94), years of education ( β = -3·7; 95 % CI: -4·93, -2·40) and household income ( β = -4·9; 95 % CI: -6·50, -3·27). The FS trajectories were similar by SES categories but different by obesity status (interaction term β = -1·04; CI 95 % (-1·50, -0·59)). An increasing FS trajectory during childhood is mainly driven by an increasing intake of soft drinks and nectars. The FS trajectory pattern did not change according to SES categories, but children's FS intake was always higher when their mothers had a lower SES.

Background: Although the deleterious effect of micronutrient deficiency at sensitive periods on neurodevelopment is well established, the potential influence of macronutrient intake on early life neurodevelopment of healthy term infants has been seldomly studied. We aimed to explore whether macronutrient intake at 12 months was related to neurodevelopmental scores in preschool children., Methods: Analyses were based on data from the EDEN mother-child cohort. Macronutrient intake was assessed by 3-day food records at 12 months of age. Neurodevelopment was assessed at 3 years using the French version of the Ages and Stages Questionnaire (ASQ) (n = 914), and at 5-6 years, using the French version of the Wechsler Preschool and Primary Scale of Intelligence-Third Edition (n = 785). An association between macronutrient intake and neurodevelopmental scores were analysed by multivariable linear regression for 3-year Full Score ASQ or 5-6-year intelligence quotient scores and multivariable logistic regression for 3-year ASQ subdomains., Results: Macronutrient intake in infancy was not associated with neurodevelopmental scores in preschool children. No association was found between PUFA intake and overall neurodevelopmental scores, after accounting for multiple testing., Conclusion: In the present study, macronutrient intake at one year did not appear to influence the child's cognitive ability at 3 and 5-6 years. Further studies are needed to clarify the relationship between early fatty acid intake and neurodevelopment., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

Background/objectives: Few studies have assessed the independent and longitudinal effects of each macronutrient intake on adiposity throughout childhood. We aimed to prospectively assess the independent associations between each macronutrient intake at 4, 7, and 10 years (protein, carbohydrates, fat, and fibre) and each measure of adiposity from 7 to 10 years of age by sex., Methods: Data from the population-based birth cohort Generation XXI was used (n = 3999). At 4, 7, and 10 years old, dietary, anthropometric and sociodemographic data were collected. The dietary intake of the children was evaluated by a validated food frequency questionnaire. Age- and sex-specific body mass index z-scores (zBMI), percentage of body fat (%FM) from bio-impedance, and waist-to-hip ratio (Whr) were used as measures of adiposity. Path analysis tested the independent associations between each macronutrient intake (protein, carbohydrates, fat, and fibre) and each measure of adiposity from 7 to 10 years of age., Results: In fully adjusted models, an increase in energy from fibre intake at the age of 7 was associated with lower zBMI at the same age (β = -0.073; 95%CI [-0.127,-0.019]) and at 10 years (β = -0.083; 95%CI [-0.137,-0.029]). Similar results were found for %FM and Whr, and in each sex separately. At the age of 10, an increase in energy from fibre intake was associated with lower %FM and Whr, while an increase in energy from protein was associated with an increase in Whr (β = 0.061; 95%CI [0.014, 0.107])., Conclusions: Our study supports the protective effect of fibre intake on adiposity development during childhood in both sexes., (© 2022 World Obesity Federation.)

Background/aims: There is a consistent body of evidence on the association between single nutrients and cognition, but the role of a healthful dietary pattern on cognition in children has been seldomly studied. This study aims to assess the association between dietary patterns at 4 years (y) and cognitive abilities at 10-13y and examine whether adiposity mediated these associations., Methods: This study used data from a sub-sample of the population-based birth cohort Generation XXI, with complete information on diet and cognition (n = 3575). At 4y, data on dietary intake was collected by a validated food frequency questionnaire and dietary patterns were derived by latent class analysis, namely Energy-dense food (EDF) pattern, Snacking pattern and Healthier pattern (Reference). At 10-13y, the Portuguese Version of the Wechsler Intelligence Scale for Children®-Third Edition was administered by trained psychologists and age-adjusted composite scores were computed: a Full-Scale Intelligence Quotient (IQ), plus a Verbal IQ, Performance IQ and Processing Speed IQ. Age- and sex-specific body mass index (BMI) z-scores, body fat percentage from bioimpedance, and waist-to-weight ratio and waist-to-hip ratio were used as measures of adiposity. Regression coefficients and 95% confidence intervals (CI) were computed using linear regression models (adjusted for maternal age and education, pre-pregnancy BMI, smoking and alcohol intake during pregnancy, child's sex, birthweight, exclusive breastfeeding duration and having siblings at 4y). Mediation analysis was conducted using path analysis., Results: After adjustment, children classified in the EDF or a Snacking patterns at 4y were more likely to have lower scores on total IQ (β = -0.116; 95%CI:-0.192,-0.039 and β = -0.148; 95%CI -0.252,-0.044, respectively), Verbal IQ (β = -0.104; 95%CI -0.177, -0.031 and β = -0.163; 95%CI -0.262,-0.064, respectively) and Performance IQ (β = -0.116 95%CI -0.193,-0.040 and β = -0.147; 95%CI -0.250,-0.042, respectively) at 10-13y, when compared to those classified in the Healthier pattern. None of the adiposity measures seemed to explain the associations between dietary patterns and IQ., Conclusion: This study supports that early unhealthy dietary patterns were associated with lower child's cognitive ability, but this effect did not seem to be mediated by adiposity., Competing Interests: Conflict of interest None., (Copyright © 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Background and Aim: To evaluate the association of Glycemic Load (GL) with glucose metabolism and blood lipids among young adults., Methods and Results: This study included 1538 participants (51% females), evaluated at 21 years of age as part of the EPITeen cohort. The GL of each individual was obtained from the assessment of their dietary intake by using a 86-item semi-quantitative food frequency questionnaire. The evaluation included anthropometric measurements and a fasting blood sample was used to measure glucose, insulin, triglycerides, total cholesterol, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Insulin resistance was calculated based on the homeostasis model method (HOMA-IR). The association between the GL and the biochemical parameters was evaluated by linear regression models using β and 95% confidence intervals (95% CI), stratified by sex and adjusted for body mass index (BMI), energy and fiber intake, and self-perceived social class. No association was found between GL and the glucose metabolism parameters after adjustment. Regarding blood lipids, a positive association was found with LDL-C (β = 1.507, 95% CI 0.454; 2.561 for females; β = 0.216, 95% CI -0.587; 1.020 for males) and a negative association with HDL-C (β = -0.647, 95% CI -1.112; -0.181 for females; β = -0.131, 95% CI -0.422; 0.160 for males)., Conclusions: Our results suggest that, in healthy young subjects, a high GL diet may have a negative impact on lipid profile., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose., (Copyright © 2021 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

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.

Purpose: To prospectively evaluate the relation of free sugars intake and glycemic load with adiposity and insulin resistance, from adolescence into early adulthood., Methods: Data from the population-based cohort EPITeen (Porto, Portugal) at 13 and 21 years old was used (n = 1034). At both ages, dietary assessment was obtained by food frequency questionnaires (FFQ). Added sugar of each food item was estimated based on a systematic methodology described by Louie et al. Free sugars (FS) were defined according to World Health Organization. To each food item of the FFQ, a calculated mean value of FS and glycemic index was assigned. Dietary glycemic load (GL) was determined for each participant. Sex- and age-specific body mass index z-score (BMIz) and waist-to-weight ratio (WWr) were used as measures of adiposity, and the homeostasis model assessment (HOMA-IR) as a measure of insulin resistance. A cross-lagged path analysis was performed to examine causal relationships between FS intake or dietary GL with BMIz, WWr or HOMA-IR., Results: No significant association was found between intake of FS and dietary GL at 13 years with BMIz, WWr or HOMA-IR at 21. A significant inverse association was found between BMIz at 13 and FS (β = -0.595,95%CI -0.830, -0.359) and dietary GL (β = -0.687,95%CI -0.937,-0.437) at 21 years. Intake of FS, dietary GL, as well as BMIz, WWr and HOMA-IR tracked from 13 to 21 years., Conclusion: No significant association was found between consumption of FS and GL at 13 years with cardiometabolic features at 21 years. Dietary intake and cardiometabolic outcomes tracked from adolescence into early adulthood., (Copyright © 2020 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.)

The ability of antibiotic resistant E. faecalis and E. faecium isolated from food to form biofilm at different temperatures in the absence or presence of 0.75% glucose was evaluated. A synergistic effect on biofilm at 10 °C, 28 °C, 37 °C and 45 °C and glucose was observed for E. faecalis and E. faecium.

Limbic encephalitis is a syndrome characterised by irritability, depression, sleeping disturbance, convulsion, hallucination and short-period memory loss that is commonly associated with a malignancy even if there is no evidence of it by the time of presentation. Most reported cases of limbic encephalitis as a paraneoplastic syndrome are associated with small-cell lung cancer and lymphoma. This article is a case report of a patient with limbic encephalitis associated with an oesophageal adenocarcinoma. The patient is a middle-aged man who presented apathy and unstable mood. After months, developed diplopia, reduced visual acuity and involuntary movements. Later, gait disability, disorientation, memory loss and aggressive behaviour were detected, associated with seizures. After investigation, limbic encephalitis was diagnosed and, as the patient developed dysphagia, oesophageal adenocarcinoma was detected. Oesophageal carcinoma usually does not have neurological symptoms associated.

Objectives: To describe and compare patient demographics, inpatient lengths of stay (LOS), and walking-related functional outcomes of individuals with spinal cord injuries (SCIs) of traumatic (TSCI) and non-traumatic (NTSCI) etiologies. To contrast these features between individuals who walked from those who did not walk at discharge from inpatient rehabilitation., Design: Prospective observational study; comparisons between TSCI and NTSCI, walkers and non-walkers. Information collected as a pilot project within a provincial SCI informatics strategy., Setting: Rehabilitation hospital specialized for SCIs., Participants: Adults with NTSCI (n = 31) or TSCI (n = 59) admitted to inpatient rehabilitation, 2007-2009., Outcome Measures: Lower-extremity motor scores (LEMS), spinal cord independence measure version III (SCIM-III) total and mobility subscores, functional independence measure (FIM), Length of Stay (LOS) at inpatient facilities., Results: Groups (NTSCI vs. TSCI) did not differ in the proportion of individuals that achieved "walker" status (SCIM-III mobility indoors (MI) score ≥ 3 at rehab discharge) (P = 0.41, 48.9% overall). Inpatient LOS at both acute care and rehabilitation facilities did not differ between groups; however, TSCI non-walkers had longer inpatient rehabilitation LOS than TSCI walkers. Among walkers, improvement was shown on all three mobility subscores of the SCIM-III between admission and discharge from rehabilitation; highest significance was shown on the SCIM-III MI. Walking status at discharge (SCIM-III MI) was most strongly correlated with LEMS at rehab admission (r = 0.71, P < 0.001)., Conclusion: Walking outcomes are comparable among individuals with NTSCI vs. TSCI admitted for specialized SCI rehabilitation. Routine use of SCIM-III mobility items for assessment of walking outcome is recommended for inpatient rehabilitation.

Rationale: Delta(9)-Tetrahydrocannabinol (Delta(9)-THC) disrupts working memory. The prefrontal cortex (PFC) is involved in the processing of working memory, and its medial portion (mPFC) is part of a brain reward circuit as constituted by the mesocorticolimbic dopaminergic system., Objective: This study examined the involvement of the mPFC in the effects of Delta(9)-THC on spatial working memory., Methods: Ten male Wistar rats well-trained in a radial arm maze and with bilateral cannula implanted in the mPFC received Delta(9)-THC intra-cortically (Delta(9)-THC IC) at doses of 0 (VEH), 32, 100 or 180 microg, 5 min before a 5-s or a 1-h delayed task in order to measure a short- or long-term spatial working memory, respectively. By contrast, 11 other animals received Delta(9)-THC intraperitoneally (Delta(9)-THC IP) at doses of 0 (VEH), 0.32, 1 or 1.8 mg/kg, 30 min before a 5-s or a 1-h delayed task. Additionally, after a 15-day washout, the effect of an IP or IC pre-exposure of Delta(9)-THC was examined by repeating both dose-effect curves in a crossover order for the routes of administration., Results: Delta(9)-THC IP produced significantly larger number of errors at doses of 0.32 or 1 mg/kg as compared to VEH in the 1-h post-delay performance. Delta(9)-THC 100 microg IC also produced significantly larger number of errors as compared to VEH and also to the other doses (32 or 180 microg) IC in the 1-h post-delay performance. Previous exposure to Delta(9)-THC IP or IC did not significantly affect the disruptive effect of this cannabinoid., Conclusions: Delta(9)-THC administered directly in the mPFC impaired 1-h delayed task in the radial arm maze in a manner similar to that observed for its systemic administration, suggesting that the mPFC is involved in the disruptive effects of Delta(9)-THC on spatial working memory.