Abstract
In Portugal, tetrahydrobiopterin (BH4)-responsive patients with phenylketonuria (PKU) are identified using a loading test (LT). Phenylalanine/natural protein (Phe/NP) intake is increased to elevate blood Phe prior to the LT. In a longitudinal retrospective study, the impact of Phe/NP titration post-LT in 58 patients (19.6 ± 8.2 years) with PKU during 4 study periods (SPs) was examined. In SP1 (2010-2013), patients were diet treated only; in SP2 (2014), the Phe/NP titration was followed by the LT in SP3 (2015). In SP4 (2016), patients received diet treatment only (n = 49) or BH4 + diet (n = 9). The median percentage blood Phe within the target range was higher in SP1 versus SP4 (64 [28-85] vs 45 [0-66]; P <.001). Our results suggest that transient Phe/NP titration, associated with a deliberate increase in NP, may adversely affect metabolic control. Controlled studies are necessary to examine the longer term impact of temporary increased NP with BH4 LT in non-BH4-responsive patients.

Abstract
Background & aims: Bariatric surgery is increasingly common in the fight against morbid obesity. However, after this intervention, it is not fully understood the evolution of weight loss and how body composition changes. The objective of this work is to study the evolution after surgery of weight and body composition of obese patients that underwent bariatric surgery. Methods: In this retrospective and prospective study, we studied initially BMI and body composition of obese patients who attended nutritional appointments at Centro Hospitalar Sao Joao E.P.E. We collected personal data and anthropometric measurements between the pre-surgery appointment up to 60 months after surgery. Results: The sample consisted of 793 patients, of which 86.5% were female and 13.5% were male, with a mean age of 43 years (SD = 10.5 years) and mean height of 1.62 m (SD = 0.079 m). Patients undergoing gastric band, sleeve gastrectomy and gastric bypass had, respectively, an initial BMI reduction of 6.3 kg/ m(2), 13.2 kg/m(2) and 15.4 kg/m(2) and an initial fat mass% reduction of 4.4%, 14.3% and 17.3%. On the other hand, they had an initial increase of 3.2%, 10.8% and 12.4% of water%, 1.4%, 3.9% and 4.6% of fat and waterfree mass%, and 1.9%, 7.3% and 8.9% of skeletal muscle mass%, respectively. BMI and fat mass% on average had a large decrease in the first 12 months, increasing slightly from 24 months onwards. The opposite behaviour was observed for water%, fat and water-free mass% and skeletal muscle mass%. Conclusions: Bariatric surgery initially allows a substantial decrease in BMI as well as beneficial changes in the overall body composition of the individuals. Gastric bypass was the method that caused the most changes, followed by sleeve gastrectomy and, finally, gastric band. On average, after 24 months of follow-up, and for all surgical procedures studied, we observed a reversion in BMI and body composition values, showing the difficulties in maintaining weight and fat loss.

Abstract
In Portugal people aged 65 and above will be the populational group with the highest growth rate of the next decades. Healthy ageing constitutes a challenge as not only the number of years lived are essential, but also the quality of life becomes a priority. The aim of this study was to understand the relationship between health self-perception (HSP), food consumption and nutritional status among Portuguese older adults. Four hundred fifty-nine older adults (aged >= 65) were interviewed, almost half had a positive HSP. The most significant predictor of HSP was nutritional status, p = 0.005, but independence in shopping had the largest impact on how they compared to others, p < 0.001. Interventions need to focus on factors like nutritional status, independency on Activities of Daily Living, Satisfaction with Food-Related Life and utilize them to modify the negative HSP and attitudes towards ageing and health and maximize the positive aspects of old age.

Abstract
The National School Feeding Program - NSFP is the public health policy that guarantees the minimum supply of healthy food and offers space for the construction of healthy eating habits in Brazilian schools. The objective of the present study was to evaluate the presence of Food and Nutrition Education (FNE) actions within the framework of the NSFP to verify its adequacy toward the program's legislation and to investigate which parameters are predictors of running school gardens. This was a cross-sectional observational study using secondary data obtained from the database of the Efficient School Lunch Management Award for the year 2010, with a sample of 749 municipalities in Brazil. A binary logistic regression was performed, considering the running of school gardens as a dependent variable, and the FNE indicators and the demographic variables as independent. The model containing the presence of FNE in the school curriculum was significant (p<0.001). The presence of FNE in school curricula OR=2.406;95%CI=[1.725, 3.357] was the most significant predictor of running school gardens, followed by the use of food from family farms OR=2.049;95%CI=[1.477, 2.842] and the carrying out of culinary workshops OR=2.032;95%CI=[1.442; 2.863], considering p<0.05. The presence of FNE in the school curriculum was positively associated with growing vegetable gardens, showing that complex actions that require more resources can be stimulated from simpler measures, and the NSFP as a public health policy is an important tool to promote actions throughout the national territory.

Abstract
We fit an immune response model to data reporting the CD4(+) T cell numbers from the 28 days following the infection of mice with lymphocytic choriomeningitis virus LCMV. We used an ODE model that was previously used to describe qualitatively the behaviour of CD4(+) T cells, regulatory T cells (Tregs) and interleukine-2 (IL-2) density. The model considered two clonotypes of T cells in order to fit simultaneously the two time series for the gp61 and NP309 epitopes. We observed the proliferation of T cells and, to a lower extent, Tregs during the immune activation phase following infection and subsequently, during the contraction phase, a smooth transition from faster to slower death rates. The six parameters that were optimized were: the beginning and ending times of the immune response, the growth rate of T cells, their capacity, and the two related with the homeostatic numbers of T cells that respond to each epitope. We showed that the ODE model was able to be calibrated thus providing a quantitative description of the data.

Abstract
Waist circumference (WC) has been associated with cardiometabolic diseases. We aim to develop WC references for age and gender in youngsters in Autonomous Region of Madeira, Portugal (RAM). A cross-sectional study was developed in two phases. Between May 2004 and May 2005 (in 1st cycle schools) and between October 2007 and June 2009 (in 2nd and 3rd cycle, and secondary and professional schools). A representative sample of 6987 individuals was gathered, with 3532 girls and 3455 boys aged from 6 to 18 years old. WC was measured with a non-elastic tape at the midpoint between the iliac crest and the last rib. To elaborate smoothed percentiles and z-scores curves for age and gender, values were estimated between 72 and 225 months (every three months) using the LMS statistical procedure, with the exponent of the Box-Cox (L), the median (M), and coefficient of variation generalized (S) through LMSChartMaker software, version 2.76. Mean and standard deviation and charts of smoothed percentiles curves (P3, P5, P10, P25, P50, P75, P85, P90, P95 and P97) and z-scores (-2, -1, 0, 1 and 2) are presented by age and gender. These references constitute a new tool to assess cardiometabolic risk of RAM's children and adolescents.