# DIETARY PATTERN AND DIETARY INTAKE AMONG CHINESE ADULTS WITH DIFFERENT SELF-AWARENESS AND MANAGEMENT STATUS OF HYPERTENSION -A CROSS-SECTIONAL STUDY IN SEVEN CITIES OF CHINA

(1)Zhao, Ai; (2)Zheng, Wei; (3)Szeto, Ignatius Man Yau; (4)Wang, Yan;

(4)Li, Ting; (5)Zhang, Yumei.

(1)Peking University Health Science Center; (2)PhD.School of Public Health.Peking University Health Science Center. P.R. China.; (3)PhD.Manager.Yili Innovation Center, Inner Mongolia Yili Industrial Group Co., Ltd. Inner Mongolia Dairy Technology Research Institute Co., Ltd. P.R. China.; (4)MSc.Yili Innovation Center, Inner Mongolia Yili Industrial Group Co., Ltd. Inner Mongolia Dairy Technology Research Institute Co., Ltd. P.R. China.; (5)PhD.Professor. School of Public Health.Peking University Health Science Center. P.R. China.

**Background and objectives:** Hypertension is one of the key risk factors for cardiovascular disease. The prevalence of hypertension in Chinese adult population was reported as high as around 30% and characterized by a low self-awareness rate. This study was conducted 1) to estimate the awareness rate and control rate of hypertension in Chinese adults, and 2) to explore the dietary pattern and intakes in participants with different awareness and management status of hypertension.

**Methods:** A multi-center study was conducted in seven cities of China. A total of 1704 adults aged 18-80 years were recruited. A three discrete times of 24h dietary records were used to obtain the data of dietary intake. Food Frequency questionnaire was used to obtain intake frequencies of 17 food categories in past one month and analyzed for the food pattern with Principal Component Analysis.

**Results:** A total of 26.1% of participants were showed an abnormal blood pressure (BP), however, only 12.7% of them had self-awareness. The control rate of hypertension was 40.5%. According to the self-awareness and management status of hypertension, we divided the participants to four groups which were healthy group, ignorant group, bad-controlled group, and well-controlled group. Overall, 87.6% of participants salt intake higher than 6g/d. The ignorant group had a significant higher salt intake(10.1±5.4 g/d), comparing with well-controlled group(8.9±4.1g/d), healthy group (9.4±4.6g/d) and the bad-controlled group(9.6±4.3g/d). For the nutrients intake, the well-controlled group had a lowest sodium intake, the median(25th,75 th) was 3665.4(2643.9,5019.1)mg/d, while sodium intake in bad-controlled group and ignorant group were 4093.8(2697.4,5200.7) mg/d and 4015.6(2892.2,5481.7.7) mg/d respectively. A significant higher intake of energy and carbohydrate were also found in ignorant group. There were no significant associations between dietary pattern's factor loading and self-awareness and management of hypertension. However, pickles had a significant higher intake frequencies in ignorant group (P=0.018).

**Conclusions:** The self-awareness of hypertension associated with dietary behaviors and might result in a different health out-

come. A comprehensive dietary strategy should be conducted in Chinese population. To reduce sodium intake not only the salt intake should be emphasized to the public in China.

**Keywords:** Hypertension, Self-Awareness, Dietary intake, Dietary pattern

# PROMOTION OF HEALTHY EATING AND EXERCISES AT A WORKPLACE – TANZANIAN EXPERIENCE

Lukmanji, Zohra.

Public Health Nutritionist/Clinical Dietitian. Independent Consultant/Advisor.

**Background and objectives:** Overnutrition is a growing problem in countries including Tanzania along with the existing undernutrition problem. The Tanzania Steps Survey in 2012 reported that 26% of adults over 25 were overweight and 8% obese. From 2005 to 2015 over nutrition increased among both rural and urban women aged 15-49(Demographic health survey). Workplaces are proven to be ideal settings for health promotion and disease prevention. A 3 month health promotion program intended to prevent and manage overweight and obesity was initiated at a food aid organization, in collaboration with the management.

**Methods:** The program, the first of its kind in Tanzania, was targeted at all 60 staff based in the head office in Dar es Salaam. Activities included orientation and advocacy workshops, baseline health assessment (anthropometry, fasting blood sugar, blood pressures measurements, and an interview to determine knowledge, attitude, and practices about weight, fruit and vegetable consumption, diet, and exercise. Individual counselling, education seminars, exercise sessions, and pop up health messages continued for 8 weeks. The menu at the staff canteen was changed. Evaluations, including a structured questionnaire for participants, examined the feasibility and sustainability of the interventions

**Results:** Of 55 staff assessed at baseline, 60% were obese or overweight; 2/3 hypertensive (diagnosed or undiagnosed). Few women engaged in regular exercise. Almost 60% reported consuming fruits and vegetables 4-7 times per week, and few reported 5 a day. Many had been or were on fad or crash diets. Workload and lack of time appeared to affect food consumption and exercise patterns.

By the end of 3 months, the participants were more conscious of their weight, healthy eating, and regular exercise. But, the impact on their BMIs was insignificant.

**Conclusions:** Extensive and varied interventions over 3 months sensitized the staff to healthy eating and the benefits of exercise, which they practiced. They understood the health risks of overnutrition, although their BMIs did not change much. A longer term program (atleast 9 months) is necessary.

**Keywords:** Workplace, Overnutrition, Interventions, Healthy-eating, Exercises

**Further collaborators:**
**Background and objectives:** Few study with large sample size has assess effects of dietary patterns, susceptibility genes and their interactions on the risk of cardiovascular complications among diabetic patients. This study aimed to examine the effects of dietary patterns, susceptibility genes, and their interactions on the risk of cardiovascular complications with diabetes.

**Methods:** We used a case-control design and diabetics were recruited in hospital. Cases were diabetics with new onset cardiovascular events including non-lethal myocardial infraction and stroke, and controls were diabetics. 20 polymorphisms within 11 candidate genes were measured. Dietary intake was assessed by a food frequency questionnaire through face-to-face interview. Factor analyses and dietary scoring methods were used to establish dietary patterns and dietary scores. Logistic regression analyses were used to analyze the effects of dietary patterns, polymorphisms, or their interaction on the risk of cardiovascular complications among diabetics.

**Results:** A total of 1005 participants included in the final analysis (543 cases, 461 controls). No significant results were observed for the distribution of 20 polymorphisms among cases and controls, and no polymorphism was significantly associated with the risk of the study disease. Dietary pattern typified by the consumption of soybeans and fungus (soybean and fungus pattern) and another pattern typified by the consumption of vegetables (vegetables pattern) were associated with a 38% (95%CI: 9%, 58%) and a 54% (95%CI: 32%, 69%) decrease risk of cardiovascular complications respectively. Dietary index of HEI2005 can also decrease risk of 35% (95%CI: 7%, 55%) at maximum. Analyses of interactions showed that, ADOIPOQ gene rs37563 polymorphism and soy-

bean and fungus pattern had an interaction effect (P interaction = 0.007), and the inversely linear trend were among patients with C allele (GC + CC) (P trend = 0.013); MTHFR gene rs1801131 polymorphism and the vegetables pattern had an borderline interaction effect (P interaction = 0.053), and the strong inversely linear trend were found among patients with wild type TT (P trend <0.001).

**Conclusions:** Diabetics consumed more soybeans, fungus, vegetables, and a balanced diet are recommended to reduce risk of cardiovascular complications, and these effects were more effective among patients with rs37563 C allele and rs1801131 TT genotype.

**Keywords:** cardiovascular complications with diabetes; dietary patterns; susceptibility genes; interactions

**Background and objectives:** Chronic renal patients may have high concentrations of uremic toxins, which when bound to protein become difficult to remove on dialysis. Some of these toxins originate from dietary protein and may have harmful effects, especially related to the cardiovascular system. The present study had as objective to evaluate the concentrations of two uremic toxins and to relate their values with personal, clinical and nutritional variables.

**Methods:** This study was performed with 39 patients older than 18 years on hemodialysis for at least 5 months. Personal and clinical data, such as: age, time of dialysis and biochemical tests (Kt/V, urea, creatinine and albumin) were obtained through interviews and medical records. The food consumption was assessed through a 3-day food diary and the nutritional status was investigated by the 7-point Global Subjective Assessment and the Body Mass Index (BMI). For the measurement of the uremic toxins p-cresyl sulfate (PCS) and indoxyl sulfate (IS) blood samples were collected, which were prepared and dosed by high performance liquid chromatography (HPLC). The data statistical analysis consisted of verifying the mean and standard deviation values and the application of the Spearman Correlation Coefficient. The level of significance was 5% (p <0.05).

<footnote>(1)Ye, Yan-bin; (2)Peng, Long-yun; (3)Chen, Yu-ming; (4)Liu, Juan; (4)Li, Yan-bing; (5)Zhuo, Shu-yu; (6)Lu, Wei; (5)Mai, Hai-yan; (5)Fang, Shi.</footnote>

<footnote>(1)MD. The Department of Clinical Nutrition. The First Affiliated Hospital of Sun Yat-sen University. P.R. China; (2)MD. Department of Cardiovascular Medicine. The First Affiliated Hospital of Sun Yat-sen University. P.R.China.; (3)PhD. Guangdong Provincial Key Laboratory of Food. Nutrition and Health. School of Public Health, Sun Yat-sen University. P.R.China; (4)MD. Department of Endocrinology. The First Affiliated Hospital of Sun Yat-sen University. R.China.; (5)MS. Department of Clinical Nutrition.The First Affiliated Hospital of Sun Yat-sen University. R.China.; (6)BS. Department of Clinical Nutrition.The First Affiliated Hospital of Sun Yat-sen University. R.China.</footnote>

<footnote>(1)Pansani Maniglia, Fabiola; (2)Casale Aragon, Davi; (3)Sumie Nakao, Lia; (4)Juliana Ribeiro Dolenga, Carla; (5)Cardeal da Costa, José Abrão.</footnote>

<footnote>(1)MSc. Nutritionist. Ribeirão Preto Medical School. University of São Paulo. Brazil.; (2)PhD. Statistician. Ribeirão Preto Medical School. University of São Paulo. Brazil.; (3)PhD. Chemist. Biological Sciences. Federal University of Paraná. Brazil.; (4)MSc. Veterinarian. Biological Sciences. Federal University of Paraná. Brazil.; (5)PhD. Nephrologist. Ribeirão Preto Medical School. University of São Paulo. Brazil.</footnote>
**Results:** The mean and standard deviation of serum IS and PCS concentrations were 147.5 ± 71.6 µM and 279.9 ± 161.1 µM, respectively. There was an association between serum IS and creatinine (r = 0.49, p <0.01), but this was not observed with PCS concentrations. There was no correlation between the serum concentrations of IS and pCs with the values of protein intake, as well as with the other personal, clinical and nutritional variables.

**Conclusions:** Although admittedly derived from the metabolism of consumed proteins, uremic toxins showed no correlation with dietary intake and nutritional status of patients. It is believed that studies with a larger sample are necessary to investigate the effects of clinical and nutritional status, as well as food consumption in the production and, consequently, the concentrations of these toxins.

**Keywords:** uremic toxins, hemodialysis, nutritional assessment, chronic kidney disease.

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SENSORY PROPERTIES AND GLYCAEMIC EFFECT
OF A FORMULATED 'ACHA' BASED BISCUIT IM-
PROVED WITH RED KIDNEY BEAN AND UNRIPE
PLANTAIN

(1)Eme, Paul; (2)Nwambeke, Evaristus; (3)Mbah, Obioma.

(1)PhD student. School of Public Health. Massey University. New Zealand; (2)BSc. Department of Nutrition and Dietetics. University of Nigeria, Nsukka. Nigeria; (3)PhD. Department of Nutrition and Dietetics. University of Nigeria, Nsukka. Nigeria.

**Background and objectives:** Diabetes mellitus (DM) is on the increase yearly. The increase in younger age group diagnosed with diabetes poses an economic threat over and above more direct disease cost to the public. The study evaluated the sensory properties and glycaemic effect of a formulated ‘acha’ based biscuit improved with red kidney bean and unripe plantain.

**Methods:** 'Acha' (Digitaria exilis), unripe plantain (Musa paradisiaca) and red kidney (Phaseolus vulgaris) bean flours were produced and blended in the ratio of 70:10:20 and 70:15:15 to obtain composite flour, 100% 'acha' were also produced. The blends were labelled thus, 100% 'acha' (AB1), 70% 'acha', 10% unripe plantain and 20% red kidney bean (AB2) and 70% 'acha', 15% unripe plantain and 15% red kidney bean (AB3), 100% wheat flour (WB) served as control. These composite flour blends were used with baking ingredients to produce biscuits. The biscuits were fed to normoglycemic adult human beings aged (20-25 years) to determine their effect on post prandial blood glucose. Glycemic control was carried using ACCU-CHEK, glucometer. Statistical Product for Service Solution (SPSS) version 20 was used to analyze for descriptive statistics (the mean, standard deviation) and the analysis of variance (ANOVA) was used to separate the means of the biscuits

**Results:** All the formulated products had good rating; however, the biscuit produced from 100% wheat (WB) and ratio of 70:15:15% acha, unripe plantain and red kidney bean (AB2) had

the best scores. The glycemic indices (GI) were found to be 55.11%, 41.60% and 49.31% for AB1, AB2 and AB3 respectively

**Conclusions:** The values recorded scored well for low glycemic index which invariably posits that the biscuit would be a good diabetic snack.

**Keywords:** Diabetic, Snacks, glyceamic index, Sensory, Acha

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QUINOA CONSUMPTION REDUCES SERUM TRI-
GLYCERIDES IN OVERWEIGHT AND OBESE PEO-
PLE

(1)Navarro Perez, Diana Teresa; (2)Jois, Mark; (3)Shepherd, Sue;

(3)Radcliffe, Jessica.

(1)PhD Candidate. Department of Physiology, Anatomy and Microbiology. La Trobe University. Melbourne. Australia; (2)PhD. Department of Physiology Anatomy and Microbiology. La Trobe University. Melbourne. Australia; (3)PhD. Department of Rehabilitation Nutrition and Sport. La Trobe University. Melbourne. Australia.

**Background and objectives:** Quinoa (Chenopodium quinoa) is a pseudocereal originally cultivated in the Andean region. The popularity of its seeds has increased in recent years due to the claims of health benefits and superfood qualities. Studies to date on health benefits of quinoa have been mostly restricted to animal models, with few human studies providing weak to moderate evidence to support improved lipid profiles. Clinical trials in humans to examine the claims of health benefits of quinoa in overweight and obese are lacking. The aim of this randomized clinical trial was to investigate the effect of quinoa consumption on body composition and serum lipid profile in overweight and obese humans

**Methods:** A total of 57 subjects with a body mass index of 25 or greater completed the 12-week intervention trial. Participants were randomly allocated to one of three different treatment groups: 0 (control), 25 or 50 g quinoa seeds per day. Measurements made at 0, 6 and 12 weeks included body composition by Dual Energy X-ray Absorptiometry, serum concentration of total cholesterol, LDL, HDL and total triglycerides by enzymatic methods and nutrient intake (3-day food diary). At 0 and 12 weeks physical activity was monitored for 3 days by tri-axial accelerometry (ActiGraph wGT3X).

**Results:** Body composition, total cholesterol, LDL, HDL, nutrient intake, and activity were not significantly altered by quinoa consumption (P>0.05). Serum triglyceride concentration was reduced significantly in the 50 g quinoa group from 1.36 mmol /L to 0.83 mmol/L at 12 weeks (P<0.05). No significant changes in triglyceride levels were observed in the control and 25 g quinoa groups

**Conclusions:** Consumption of 50 g / d of quinoa consumption lowers serum triglyceride levels in overweight and obese subjects.

**Keywords:** Quinoa seeds, randomized controlled clinical trial, dose response, triglycerides
# WHOLE MILK INCREASED HDL CHOLESTEROL COMPARED TO SKIMMED MILK WITHOUT ADVERSELY AFFECTING OTHER LIPIDS, GLUCOSE, AND INSULIN IN A 2X3 WEEK CROSSOVER STUDY

(¹)Engel, Sara; (²)Tholstrup, Tine.

(¹)MSc. PhD-student. Department of Nutrition, Exercise and Sports. Faculty of Science. University of Copenhagen. Denmark;

(²)PhD. Associate Professor. Department of Nutrition, Exercise and Sports. Faculty of Science. University of Copenhagen. Denmark.

**Background and objectives:** Dietary guidelines have for decades recommended to cut down on high-fat dairy products such as whole milk due to the high content of saturated fat which is known to increase LDL cholesterol concentrations in the blood. However, meta-analyses of prospective cohort studies have found no association between saturated fat or dairy intake and risk of cardiovascular disease (CVD) and even point to an inverse association with type 2 diabetes (T2D). Whole milk and skimmed milk contain almost the same food matrix except from the fat content (3.5 vs 0.1%). Therefore, it was possible to compare high-fat with low-fat milk and study the effect of milk fat on risk of CVD and T2D.

**Methods:** In a randomized, controlled, 2x3 week crossover intervention study we compared the effect of intake of 0.5 L of whole milk with skimmed milk on blood lipids, glucose, and insulin. Besides drinking milk the 17 men and women consumed their habitual diet.

**Results:** Subjects were 65 % women with a mean age of 25.7 y and a body mass index (in kg/m2) of 21.8. Whole milk increased HDL cholesterol significantly (P < 0.05) compared to skimmed milk. We found no significant differences between whole milk and skimmed milk in effect on total and LDL cholesterol, TAG, glucose and insulin. There was a tendency (P = 0.06) for total cholesterol to be higher with whole milk compared to skimmed milk.

**Conclusions:** Intake of 0.5 L/d of whole milk did not adversely affect risk markers of CVD and T2D compared to skimmed milk. Moreover, intake of whole milk increased HDL cholesterol concentration compared to skimmed milk. These findings suggest that it might be reasonable to include whole milk as part of a healthy diet.

**Keywords:** Dairy, milk, CVD, cholesterol, healthy adults

**Conflict of Interest Disclosure:** Supported by the Danish Dairy Research Foundation. The milk was donated by Arla Foods AMBA, Denmark. The sponsors had no influence on the implementation, analysis and interpretation of the data as well as the manuscript and conclusions of the study.

TT has received research grants from Arla Foods AMBA, Denmark; The Danish Dairy Research Foundation; and the Dairy Institute, Rosemont, IL. SE had no conflict of interest to declare.

# VITAMIN D DEFICIENCY IS ASSOCIATED WITH HIGH BLOOD PRESSURE IN 24-H AMBULATORY BLOOD PRESSURE MONITORING IN PATIENTS WITH TYPE 2 DIABETES

(¹)de Paula, Tatiana; (²)Sperb, Luiza; (³)Moreira, Juliano; (⁴)de Freitas, Mauren; (⁵)Miller, Maria Elisa; (⁶)da Silva, Andressa; (⁷)Viana, Luciana; (⁸)Azevedo, Mirela.

(¹)PhD. Nutricionist. Federal University of Rio Grande do Sul. Brazil; (²)Medical Student. Federal University of Rio Grande do Sul. Porto Alegre. Brazil; (³)Medical Doctor. Hospital de Clínicas de Porto Alegre. Porto Alegre. Brazil; (⁴)Registered Dietitian. Hospital de Clínicas de Porto Alegre. Porto Alegre. Brazil; (⁵)Medical Student. Federal University of Rio Grande do Sul. Porto Alegre. Brazil; (⁶)Nutritional Science student. Hospital de Clínicas de Porto Alegre. Porto Alegre. Brazil; (⁷)Medical Doctor. Hospital de Clínicas de Porto Alegre. Porto Alegre. Brazil.

**Background and objectives:** Plasma vitamin D measurements are negatively correlated with BMI and blood pressure (BP) in general population (1,2). Since most patients with type 2 diabetes (DM2) are obese and hypertensive, it is relevant to identify vitamin D status in this population. The aim of this study was to evaluate factors associated with vitamin D deficiency [25(OH)D<20 ng/ml] in patients with DM2 and hypertension.

**Methods:** In this cross-sectional study BP was assessed by office measurements (Omron HEM-705CP) and 24h ambulatory blood pressure monitoring (ABPM) - Spacelabs®. Physical activity was evaluated by steps count

(pedometer - Yamax Digi-Walker). Clinical, nutritional, and laboratory parameters were evaluated by a standardized

protocol. Body composition was determined by DXA-Lunar®. Exclusion criteria were: use of vitamin supplements,

serum creatinine >2.0 mg/dl, BMI >40 kg/m², gastrointestinal diseases associated with malabsorption.

**Results:** A total of 116 patients (age 65±8.9 years; 43% males; BMI 30.3±4.1 kg/m², diabetes duration 12.3±8.3

years; HbA1c 7.6±1.4%) were included. Mean 25(OH)D was 20.1±9.1 ng/ml and 43% of patients were considered as deficient. Office systolic and diastolic BP were 150.7±20.9 and 83.5±11.0 mmHg, respectively. At ABPM, patients with hypovitaminosis D had higher systolic BP in 24h (135.7±10.2 vs 130.2±13.3 mmHg; P=0.016) and during daytime (138.1±11.3 vs 132.8±13.4 mmHg; P=0.026) than sufficient patients. Patients with vitamin D deficiency had also lower steps count [4350.0 (2647.8-6598.0) vs 6390.6 (4706.9-8081.1) steps/day] and urinary calcium [47.0 (32.0-141.2) vs 89.5 (67.7-152.5) mEq/24h) than sufficient patients. Regarding to dietary intake, patients with hypovitaminosis D consumed less milk (35.6 vs 64.4%; p =0.009) and less fish (31.2 vs 68.8%; p<0.001) than non-deficient patients. In multivariate logistic regression, steps count <5600 steps/day (OR=2.9, CI95% 1.1-7.6) and no milk (OR=3.9 IC95% 1.3-11.9) and no fish consumption (OR=3.4 IC95% 1.4-10.8), remained associated to vitamin D deficiency; fat mass was not associated with vitamin D deficiency.
# EFFECTS OF AVENA NUDA L. ON CHINESE PATIENTS WITH HYPERTENSION ASSOCIATED WITH TYPE 2 DIABETES MELLITUS: SECONDARY ANALYSIS OF A RANDOMIZED CLINICAL TRIAL

(1)Li, Yong; (2)Mao, Ruixue; (2)Xu, Meihong; (2)Wang, Junbo.

(1)Prof. Nutritionist. Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191; (2)PhD. Nutritionist. Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191.

**Background and objectives:** While China-original naked oat with whole germ (NOG, Avena nuda L.) is an excellent choice of whole grain for its higher soluble dietary fiber (beta-glucan), unsaturated fatty acid and lower slowly digestible starch than common oat (Avena sativa L.), there is limited information about the effect of NOG intake with structured dietary intervention on patients with hypertension associated with type 2 DM.

**Methods:** In a randomized, single-blinded, 28-day centralized trial in China, a total of 73 participants meeting the WHO/ISH hypertension guidelines (1999) diagnostic criteria were selected from 445 patients meeting the ADA standards of medical care in diabetes (2013) diagnostic criteria between 50 and 60 years of age, randomly assigned into one of the 3 groups: diet group (n=24, systematic diet plans and intensive health education), 50g-NOG group (n=25) and 100g NOG group (n=24). The composition of NOG has been determined. Subsequently NOG was daily boiled into porridge as replacement based on diet group. The relative changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), 2-hour postprandial blood glucose (PBG) measured respectively on day 0, 28 (SBP, DBP) and day 0, 7, 14, 21, 28 (FBP, PBG) were the primary outcomes. Data was analyzed by the SPSS 19.0 software package with descriptive analysis, one-way analysis of variance, and paired t test.

**Results:** The rate of adherence to a study diet was 100% at day 28. Among 3 groups above, SBP, DBP, FBG and PBG values declined significantly over the intervention period (P<0.05). The changes in SBP are more favorable for both 100g-NOG group and 50g-NOG group than the diet group (P<0.05). The improvements in FBG were better in 100g-NOG group than in diet group (P<0.05). The 100g-NOG group had the most significant reduction of PBG values (P<0.05 for all comparisons among 3 groups).

**Conclusions:** Comparison between 50-100g/day NOG replacement to structured diet and diet alone suggests that the former intervention (especially at a dose of 100g/day) provided better benefits to patients with hypertension associated with type 2 DM in their disease management and cardiovascular disease risk control.

**Keywords:** naked oat; structured diet; hypertension; type 2 diabetes mellitus

**Further collaborators:**

Some issue about the T2DM.

# THE CONTROL OF BLOOD GLUCOSE AND COMPLICATIONS AMONG TYPE 2 DIABETES MELLITUS PATIENTS BASED ON THE DYNAMIC CHANGES OF DIETARY INTAKE DURING THE FOLLOW-UP SURVEY PERIOD

(1)Li, Yong; (2)Fan, Rui; (2)Xu, Meihong; (2)Wang, Junbo.

(1)Prof. Nutritionist. Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191; (2)PhD. Nutritionist. Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191.

**Background and objectives:** Centralized intervention can provide a balanced diet on glycemic control among patients with Type 2 diabetes mellitus (T2DM), but most individuals may not follow the recommended diet guidelines in the long run. The real dietary behavior and its outcomes during the follow-up periods are scarce. Therefore, how the dietary behavior changed and what were the outcomes brought during the follow-up survey were reported for the first time in this study.

**Methods:** One hundred and seventy-five elder participants with T2DM for more than 2 years who previously been randomized to receive centralized intervention were included. We analyzed the association between the blood glucose and each nutrients intake through logistic regression, the effects of dynamic changes of dietary intake had been evaluated based on glycemic control and complication prevalence in three years.

**Results:** The optimal diet assistant decreasing blood glucose characterized as low fat (<25%), standard-protein (25%), high complex carbohydrate and high fiber (>18 g/1000kcal). The participants adhering to this diet showed a satisfactory outcomes in three years. Compared with the baseline, Hemoglobin A1c (HbA1c), fasting plasma glucose (FPG) and 2h-plasma glucose (2h-PG) decreased from 8.3%, 9.62 mmol/L and 18.28 mmol/L to 7.3%, 7.81 mmol/L, and 11.3mmol/L, respectively. Additionally, they also exhibited a decrease in nephropathy prevalence, and their prevalence of diabetic foot ulcer and neuropathy remained unchanged.

**Conclusions:** The obviously control of blood glucose, HbA1c as well as the prevalence of complications occurred on those elder participants persisted in the optimal diet. Therefore, this study will provide strategies to guide clinicians with their dietary prescription to control complications and is promising with regard to further exploration of comprehensive diabetes care.

**Keywords:** Type 2 diabetes mellitus, complication, diet, glycemic control, HbA1c

**Further collaborators:**

Some issue about the T2DM.
THE POSITIVE EFFECTS OF NAKED OAT ON GLYCEMIA AND BLOOD LIPID RISK FACTORS FOR CARDIOVASCULAR DISEASE IN PATIENTS WITH TYPE 2 DIABETES AND METABOLIC SYNDROME: ONE YEAR RESULTS OF A RCT

(1)Li, Yong; (2)Li, Ye; (2)Xu, Meihong; (2)Fan, Rui.

(1)Prof. Nutritionist. Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191; (2). Nutritionist. Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191.

**Background and objectives:** Patients with type 2 diabetes and metabolic syndrome are at increased risk for cardiovascular complications. Comprehensive cardiovascular risk reductions are critical for this high-risk population. The aim of this study was to evaluate the effects of long-term naked oat consumption on cardiovascular disease risks in patients with type 2 diabetes and metabolic syndrome.

**Methods:** 244 participants met type 2 diabetes and metabolic syndrome criteria were selected from a randomized clinical trial who completed the one year dietary program. They were randomly allocated to four groups: control group; diet group; 50g-NOG group and 100g-NOG group. Participants in the control group continued their usual diet. The diet group had structured diets. The participants in the 50g-NOG group received structured dietary intervention and replaced some of the staple foods with 50g NOG. And the 100g-NOG group also received structured dietary intervention while the daily substitute of staple foods was 100g NOG. At baseline and 12 months, physical examinations and blood tests were carried out and food-frequency questionnaires were administered to investigate changes from baseline and compliance with the dietary intervention.

**Results:** After 1 year intervention, HbA1c, FPG and PG were significantly decreased compared to the control group particularly at 100g-NOG group (-1.0±1.7%, -2.1±3.2mmol/l, and -6.9±5.9mmol/l, respectively, P<0.05). Reductions were also achieved in TG (-0.2±1.1mmol/l to -0.6±1.6mmol/l), TC (-0.2±1.1mmol/l to -0.5±1.2mmol/l), and LDL-c (-0.2±0.8mmol/l to -0.4±0.8mmol/l) in the intervention groups (P<0.05). The groups differed significantly with respect to the percent of patients who reached the treatment goals in glycosylated hemoglobin, cholesterol and triglycerides (P<0.05). Glycemic control was better in patients of 100g-NOG group with 23.8% having HbA1c below 6.5%. And more patients reached lipid goals in the NOG group. 44.4% of patients in the 100g-NOG group had cholesterol below 4.5mmol/l, and 57.1% had triglycerides below 1.7mmol/l. No adverse events were reported throughout the study period.

**Conclusions:** The results of the present study suggest the beneficial effects of naked oats on cardiovascular disease risk factors, especially on glycemic regulation and lipid metabolism in patients with type 2 diabetes and metabolic syndrome.

**Keywords:** naked oat; cardiovascular disease; diabetes mellitus, type 2; metabolic syndrome

**Further collaborators:** Some issue about the T2DM.

EFFECTS OF MEAL INTERVENTION COMBINED WITH WALKING ON EXERCISE ABILITY AND PHYSIQUE OF MIDDLE-AGED AND OLD PEOPLE

(1)Li, Yong; (2)Chen, Qihe; (2)Mao, Ruixue; (2)Xu, Meihong.

(1)Prof. Nutritionist. Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191; (2)PhD. Nutritionist. Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191.

**Background and objectives:** To investigate the effects of vigorous walking and diet intervention on exercise capacity and physical fitness of middle-aged and elderly people.

**Methods:** According to the different physical condition of the middle-aged and old people, the data were divided into 93m / min, 100m / min, 107m / min, 110m / min, 114m / min 5 by comparing their own before and after the test. Blood pressure, heart rate, heart rate, body weight, waist circumference, hip circumference, systolic blood pressure, diastolic blood pressure, heart rate, BMI and other data were collected in the intervention group with the maximum exercise load of 50%.

**Results:** Compared with the baseline, the 6-min walking distance, cardiac recovery rate, systolic blood pressure, diastolic blood pressure, body weight, hip circumference and BMI of the subjects were significantly improved (P <0.05). Have different degrees of improvement.

**Conclusions:** Jianbu walking and take the joint dietary intervention in the exercise capacity of the elderly and physical fitness has significant effect, it is recommended to promote.

**Keywords:** vigorous walking; diet; 6min walking test; blood pressure; heart rate; circumference

**Further collaborators:**

Some issue about the T2DM.

THE INTERPLAY BETWEEN MOTHER'S KNOWLEDGE, ATTITUDE AND PRACTICE, BMI AND INFANTS' NUTRITIONAL STATUS IN DELTA STATE, NIGERIA

(1)Ofili, Oghenefego; (2)Fadupin, Grace T.

(1)PhD Student, Department of Human Nutrition, University of Ibadan; (2)PhD, Nutritionist, Senior Lecturer, Department of Human Nutrition, University of Ibadan.

**Background and objectives:** The health and nutritional status of an infant is largely dependent on the mother's knowledge, attitude and practice (KAP) of certain widely researched guidelines such as GOBIFFF and the Essential Nutrition Actions (ENA). This report is from the baseline survey conducted as part of an intervention project aimed at improving the KAP of mothers on
infant nutrition and health care practices through behavior change communication in Delta State, Nigeria. This study seeks to gather evidence for policy advocacy on nutrition behavior change communication as a key strategy to improving infant health and nutrition in Nigeria.

**Methods:** A baseline assessment as part of formative research was conducted to review the situation and gaps in knowledge, skill or other issues related to infant nutrition and health of mothers in Delta State. A semi-structured questionnaire was used to gather information on demographic characteristics, nutritional status of mother-child pair and KAP of infant nutrition and health care strategies in 6 communities in Delta State. Knowledge, attitude and practice scores were determined by the number of correctly answered questions.

**Results:** 68.3% of infants in this study population were severely stunted, 15% were wasted, while 28.6% of infants in Delta State were found to be severely underweight. Infants whose mothers were overweight or obese had more tendency to have normal weight-for-age than infants whose mothers were underweight or normal. **Results: Conclusions:** The nutritional status of an infant is strongly linked to the mother's KAP of infant nutrition and health care strategies. Also, the ability of a mother to maintain a healthy BMI does not necessarily result in an infant with a healthy/normal nutritional status. There needs to be more intervention programs in the area of nutrition education at the community level.

**Keywords:** Infant, Knowledge, Attitude, Practice, Malnutrition

which the data were calculated based on the National Health and Nutrition Examination Survey 2010-2013. The surveillance included about 200 thousand adults aged 18 and over, which were sampled from 150 surveillance points by Multi-stage cluster random sampling. Hypertension was defined as systolic BP of at least 140mm Hg and diastolic BP of at least 90 mm Hg, self-reported use of antihypertensive medications, or both. Hypertension control was defined as systolic BP values of less than 140 mm Hg and diastolic BP values of less than 90 mm Hg.

**Results:** The prevalence of hypertension among Chinese adults aged 18 and over was 25.2% in 2012, 26.2% and 24.1% among men and women, respectively; 26.8% and 23.5% among urban and rural adults, respectively, and 10.6%, 35.7% and 58.9% among the groups of 18-44, 45-59, and 60 years old and over, respectively. Among adults with hypertension in 2012, 46.5% were aware of their hypertension, 41.1% were currently taking medication to lower their blood pressure, and 13.8% were controlled hypertension. Compared with 2002, the prevalence of hypertension increased by 6.4%, and the awareness, treatment and control of hypertension increased by 16.3%, 16.4% and 7.7%, respectively.

**Conclusions:** The prevalence of hypertension among Chinese adults has remained at a high level and has showed a rapid rising trend. Although the rates for awareness, treatment, and control of hypertension have improved markedly, they are still at a low level. These findings suggest that it is necessary to strengthen the health education and comprehensive management of hypertension in China.

**Keywords:** Hypertension; Prevalence; Awareness; Treatment; Control

**Background and objectives:** Unreasonable dietary rich in saturated fatty acid and salts may increase the risk of many chronic diseases. The dietary structure of Chinese population has changed greatly during the recent decades and the problem of related chronic diseases becomes more and more serious. Hypertension is a major risk factor for cardiovascular disease and treatment and control of hypertension reduces risk. The study aims to evaluate the prevalence, awareness, treatment and control of hypertension among China adults.

**Methods:** Data were extracted from the report of Chinese national nutrition and chronic disease status issued by National Health and Family Planning Commission of China in 2015, in

**Background and objectives:** introduction: Nutrition education is one of the fundamental axes in the management of diabetes.

**Objective:** study the impact of two types of nutrition education (personalized and collective) on the glycemic control of diabetics in the province of Kenitra.

**Methods:** The population was composed of 184 patients (86 men, 98 women) with an average age of (51.7 ± 14.0) and an age range of [20 to 88.5]. Data collection was carried out using a questionnaire containing socio-demographic and anthropometric informations.

Glycemic control was based on fasting glucose (GAJ), postprandial glucose (GPP), and glycated hemoglobin (HbA1c). These analyses were taken in three separate phases with a duration of 3 months; T0 represents the initial state (before our intervention),
t1 and t2 which represent the values of the three analyzes after our intervention.

Participants were randomized into two groups: a group that received collective nutrition education (n = 105) and another group (n = 79) had a personalized (individual) education.

BMI was the only anthropometric measure used

**Results:** The whole population is overweight (BMI> 25) for either women or men, also the results of glycemic control are superior to the norms in the three stages (t0, t1 or t2). Nutrition education Personalized shows statistically significant differences in the variables studied as a function of time more than those studied in collective nutrition education (p = 0.00 <0.05). Also the difference is significant between collective nutrition education and personalized nutritional education (P = 0.00 <0.05) for the means of HBA1C (%) at t1 and at t2; Fasting glucose (g / l) at t1 and t2 and post-prandial glucose (g / l) at t1 and t2.

**Conclusions:** The results of this study show that collective nutrition education yields significant results in terms of impact on glycemic control of those diabetics. The number of studies on this aspect (nutrition education) remains modest, another study is desirable on a larger sample to better confirm our results

**Keywords:** nutrition education, glycemic control, diabetes,

**Further collaborators:**

Rachid Sbaibi

affiliation: Laboratory of Nutrition, Health & Environment | Biology Department | Faculty of Science | Ibn Tofail University, PB 133 | Kenitra 14 000 | Morocco |

## 144/436

### VITAMIN B12 DEFICIENCY ASSOCIATED WITH USE OF METFORMIN IN ELDERLY ADULTS WITH T2 DIABETES MELLITUS

(1) Yamaguchi, Analía Verónica Verónica; (2) Ferro, Leticia; (3) Pieniazek, Diana; (4) Lerner, Mirta; (5) Stolarza, Zulema.

(1)PhD. Nutritionist. Hospital César Milstein. Docente University of Buenos Aires; (2) PhD. Nutritionist; (3) PhD. Nutritionist. Hospital César Milstein.; (4) PhD. Nutritionist. César Milstein Hospital. University of Buenos Aires; (5) PhD. Nutritionist. César Milstein Hospital. University of Buenos Aires.

**Background and objectives:** Introduction: Vitamin B12 (VB) is an essential micronutrient, its deficiency causes neurological diseases. Type 2 Diabetes Mellitus (DM2) is a rising condition, Metformin (MTF) is the most widely used drug, its use is associated with B12 deficiency (DVB). MTF competitively blocks the binding of the intrinsic factor VB complex to its receptor, this interaction rarely generates an anemia that is reversible upon discontinuation of metformin or the addition of VB. Some individuals seem more predisposed than others to this interaction. Prevalence is variable

**Objective:** To determine the association between the use of MTF and DVB in elderly patients with DM2.

**Methods:** Descriptive observational study. The sample was obtained from patients who attended the Milstein Hospital Nutrition service between May and June 2016. Folic acid (AF), VB, VCM, hematocrit (HTO) were requested. The following data were obtained from the medical records: DM years, MTF doses, years of MTF use. It was considered deficit of VB12<200 mg, partial deficiency (DP) between 201 and 300, and as pathological values of VCM>100 and HTO<35%. The sample was divided into 2 subgroups according to age: advanced age (EA) between 60 and 74 years old, elderly aged between 75 and 89 years. P<0.05 statistically significant.

**Results:** The sample size was 192 patients, 56% were women, the prevalence of DVB was 12.5%, a partial deficiency was 29.5, HbA1c mean 7%, MTF dose of 1.7g, with a 8 years median of use for DVB patients and 5 years for DP, we found no statistically significant differences when analyzing HTO, VCM or AF values (p 0.58), nor differences in B12 dosage when analyzed each age subgroup.

**Conclusions:** The DVB reveals a public health problem. HTO, VCM and AF would not provide relevant data at the time of DVB suspicion. The control of the elderly with DM2 should include VB dosing, regardless of the dose of MTF. Studies with larger sample size are required.

**Keywords:** Vitamin B12; Metformin; Elderly Adults; Diabetes Mellitus T2

## 144/438

### EFFECT OF FORMULATED DRINK AND SNACK FROM COCOA, MORINGA, COMPOSITE FLOUR AND THAUMATOCOCCUS DANIELLI AS AN ORGANIC SWEETENER ON THE NUTRITIONAL STATUS OF WISTER RATS

(1) Oyebamiji, Emmanuel; (2) Atinmo, Tola; (3) Attah, Alfred.

(1) (BSc, MSc). Nutritionist. Department of Human Nutrition. University of Ibadan. Nigeria; (2) Professor. Nutritionist. Department of Human Nutrition. University of Ibadan. Nigeria; (3) PhD. Department of Pharmacognosy. University of Ibadan. Nigeria.

**Background and objectives:** Micronutrient deficiencies cause an estimated 1.1 million of the 3.1 million child deaths that occur each year. This study, therefore, investigates the effect of formulated nutritional supplements on the nutritional status of Wistar rats using formulated nutritional drinks and snacks from cocoa and Moringa with Thaumatococcus Danielle as an organic sweetener.

**Methods:** Twelve Wistar rats weighing 120g were subjected to formulated drinks and snacks to determine the nutritional effects. The rats were fed for two weeks, after the initial acclimatization, and grouped into three groups equally, the first group were given the 1mls of the formulated drink with normal rat diet, drink composed of Moringa, cocoa and spices, the second group were given formulated bread from Cocoa, Moringa, with Cassava flour and
Thaumatococcus Danielle with normal drinking water, and the control group were given normal rat diets which were the control. At the end of the two weeks, the experimental rats were weighed before they were sacrificed and there was a significant difference in their weight. Blood samples were collected to determine micro-nutrient (vitaminA, iron, zinc, calcium, and iodine) level in the experimental rat's blood serum.

**Results:** The result revealed a significant (p≤0.05) increase in the treatments in respect to the micronutrient status of the experimental rats when compared with the control group. Furthermore, there was an appreciable non-significant increase among micronutrient levels of those that were fed with the bread and drinks respectively (group two and one), except for vitamin A with 0.007.

**Conclusions:** Based on the results of this study, the formulated drinks and snacks had a significant effect on the growth and micronutrient levels of the experimental rats and thus can be used in combatting malnutrition.

**Keywords:** Malnutrition, Moringa, Cocoa, Thaumatococcus Danielle

**Further collaborators:**

J.O Moody. Professor. Department of Pharmacognosy. University of Ibadan. Nigeria.

Adeola Sonibare. Professor. Department of Pharmacognosy. University of Ibadan. Nigeria

144/451

HIGH FODMAP PRODUCTS CONSUMPTION AMONG CHILDREN WITH GASTROINTESTINAL DISORDERS

**Background and objectives:** Gastrointestinal disorders are one of the most commonly diagnosed diseases among children. Preliminary studies indicate that FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols) improves symptoms in gut disorders. Low FODMAP diet seems to be effective diet therapy mostly in IBS but also in others functional gastrointestinal symptoms [1,2].

The purpose of this pilot study was to valuate of differences in the frequency of high FODMAP products consumption among children with various gastroenterological diseases.

**Methods:** Retrospective study was conducted among 67 children, age range 4-17 years, who reported abdominal pain and problems with defecations. Respondents were patients of Department of Pediatrics, Gastroenterology and Nutrition Children's Hospital in Olsztyn. Symptoms have been diagnosed as constipation, functional abdominal pain and celiac disease. A food fre-

quency questionnaire was used to collected information about consumption of high FODMAP products categorized in 6 groups: sweets and snacks, dairy products, cereal products, fruits, vegetables and drinks.

**Results:** The most commonly consumed high FODMAP products were dairy products (mean 2,60 times a day, 95% CI: 2,32-2,89) and the least eaten were vegetables (mean 0,69 times a day, 95% CI: 0,56-0,83). Children with functional abdominal pain consumed high FODMAP food the most often during the day (mean 9,87 times a day, 95% CI: 8,53-11,20) and patients with celiac disease the least often (mean 7,91 times a day, 95% CI: 6,70-9,12). The results showed a significantly lower intake of high FODMAP cereal products among children with celiac disease compared to the other groups.

**Conclusions:** The pilot study showed that children with gut disorders consumed high FODMAP products from different food groups which may induce the occurrence of symptoms of disease. More long term research conducted among children is needed to confirm this association.

1. Chumpitazi BP, Shulman RJ. Dietary Carbohydrates and Childhood Functional Abdominal Pain. Ann Nutr Metab 2016; 68(suppl 1):8-17 doi: 10.1159/000445390

2. Marsh A, Eslick EM, Eslick GD. Does a diet low in FODMAPs reduce symptoms associated with functional gastrointestinal disorders? A comprehensive systematic review and meta-analysis. Eur J Nutr. 2016; 55(3): 897-906. doi: 10.1007/s00394-015-0922-1.

**Keywords:** FODMAP, children, functional gastrointestinal diseases, diet therapy, celiac disease

144/463

ASSOCIATIONS OF WAIST-TO-HEIGHT RATIO WITH EMOTIONAL EATING, IRREGULARITY OF EATING, EATING FAST, EATING UNTIL FULL, EXTERNAL EATING AND MAKING ENVIRONMENT TO PROMOTE EATING IN JAPANESE ADULTS

**Background and objectives:** Waist-to-height ratio (WHtR) has started gaining attention as a measure of abdominal obesity. While the associations between various eating behaviors and higher BMI or obesity/overweight determined by BMI have been reported, studies focused on the relationship between eating behaviors and WHtR in adults are scarce. This cross-sectional study aimed to clarify eating behaviors associated with a higher WHtR in Japanese adults.

<footnote>(1)Boradyn, Katarzyna Mirosława; (2)Jarocka-Cyrta, Elżbieta;</footnote>

<footnote>(3)Przybylowicz, Katarzyna Eufemia.</footnote>

<footnote>(1)MSc. Department of Human Nutrition. University of Warmia and Mazury in Olsztyn. Poland.; (2)Prof. Department of Clinical Pediatrics. University of Warmia and Mazury in Olsztyn. Poland.;</footnote>

<footnote>(3)Prof. Department of Human Nutrition. University of Warmia and Mazury in Olsztyn. Poland.</footnote>

<footnote>(1)Nakade, Makiko; (2)Aiba, Naomi; (3)Morita, Akemi; (4)Miyachi, Motohiko; (5)Deura, Kijo; (6)Watanabe, Shaw.</footnote>

<footnote>(1)RD, PhD. Tokai Gakuin University. Japan.; (2)RD, PhD. Kanagawa Institute of Technology. Japan.; (3)MD, PhD. Koshien University. Japan.; (4)PhD. National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition. Japan.;</footnote>

<footnote>(5)MD. Saku Central Hospital. Japan.; (6)MD, PhD. Life Science Promotion Foundation. Japan.</footnote>
**Methods:** Subjects were 2818 men and women aged 20 to 75 years who had participated in baseline assessments of a cohort study in Japan from 2009 to 2013. They underwent assessments including physical examination and answered questionnaire regarding various eating behaviors (emotional eating, irregularity of eating, eating fast, eating until full, external eating and making environment to promote eating), lifestyles, and stage of change regarding diet. The relationship between the WHtR (<0.5 as a reference) and each eating behavior was examined using multiple logistic regression analysis adjusting for age, sex, lifestyles, and stages of change regarding diet.

**Results:** After adjusting for covariates, the WHtR showed significant positive relationships with eating behaviors regarding all items of emotional eating, having late-night snack, eating between meals, having many occasions to go to drinking parties, eating fast, eating until full, all items of external eating and making environment to promote eating. Skipping breakfast and having dinner late did not show significant associations with the WHtR.

**Conclusions:** Some eating behaviors were associated with a higher WHtR in adults. Putting more emphasis on these specific eating behaviors may effectively decrease the WHtR and prevent cardiovascular diseases.

**Keywords:** waist-to-height ratio, eating behaviors, adults

**Conflict of Interest Disclosure:** This study was supported by a fund from a Research-in-Aid Grant for Cardiovascular Diseases from the Ministry of Health, Labour and Welfare and the Foundation for Total Health Promotion.

144/471

EFFECT OF DIETARY SUPPLEMENTATION OF 25-HYDROXYVITAMIN D3 ON IMMUNE RESPONSES OF CHICKENS

(1)Chou, Pao-Chia; (2)Lai, Lih-Shiuh; (3)Chen, Shuen-Ei.

(1)PhD student. Department of Food Science and Biotechnology, National Chung Hsing University, Taichung, Taiwan; (2)PhD. Department of Food Science and Biotechnology, National Chung Hsing University, Taichung, Taiwan; (3)PhD. Department of Animal Science, National Chung Hsing University, Taichung, Taiwan.

**Background and objectives:** Innate immunity acts as the frontline of the host defence system against pathogens, such as bacteria and viruses. Macrophages and neutrophils can internalize and destroy pathogens and activate subsequent humoral immune responses. Obesity is associated with dyslipidemia, systemic inflammation, and a susceptibility to pathogen invasion. Vitamin D3 has been shown to ameliorate obesity-related cardiomyopathy and systemic inflammation, but the role of innate immune cells against bacterial infection in obese individuals and by the effect of vitamin D3 is elusive. The preset study aimed to investigate the effect of obesity and dietary supplementation of vitamin D3 on the invasion defense in chickens using Salmonella as a pathogen.

**Methods:** Hens provided with a basal control diet or with vitamin 25 OH-D3 inclusion, then were released for ad libitum (AD) feeding or continued with restricted (R) feed intake. Four weeks after treatment, hens were sampled for blood collection for peripheral leukocyte isolation in the following weeks. Freshly isolated heterophils and monocytes were analyzed for bacterial killing (5 × 10⁵ freshly cells to 106 CFUs of opsonized Salmonella Typhimurium) or migration (2 × 10⁶ cells/well). Fasting plasma were analyzed for glucose, triglyceride and cholesterol concentrations.

**Results:** Hens with AD feeding ± 25OH-D3 treatment had the highest bacterial killing activity in the monocytes, but heterophils showed AD heterphiils had the highest bacterial killing activity. In both R and AD hens, cell migration rate of monocytes was increased significantly (p < 0.05) by 25OH-D3 supplementation, but not in the heterophils. AD hens had a higher plasma triglyceride levels than R hens. 25OH-D3 supplementation suppressed plasma triglyceride and cholesterol levels but slightly increased glucose concentrations in AD hens but not in R hens.

**Conclusions:** These results suggest a cell type- and obesity-dependent innate immune cell response to 25OH-D3.

**Keywords:** monocytes; heterophils; Salmonella Typhimurium; migration; pathogen invasion

144/486

A MULTI-ETHNIC AUSTRALIAN COHORT WITH CORONARY HEART DISEASE ADHERE WELL TO A MEDITERRANEAN DIET INTERVENTION AND IMPROVE PLASMA ADIPONECTIN LEVELS

(1)Mayr, Hannah; (2)Bendall, Cassandra; (3)Tierney, Audrey; (4)Kingsley, Michael; (5)Radcliffe, Jessica; (3)Itsiopoulos, Catherine; (6)Thomas, Colleen.

(1)BHsc (Hons). Accredited Practicing Dietitian. Department of Rehabilitation, Nutrition and Sport. La Trobe University. Australia.; (2)BHsc. Nutritionist. Department Rehabilitation, Nutrition and Sport. La Trobe University. Australia.; (3)PhD. Accredited Practicing Dietitian. Department Rehabilitation, Nutrition and Sport. La Trobe University. Australia.; (4)PhD. Exercise Physiologist. La Trobe Rural Health School. La Trobe University. Australia.; (5)PhD. Nutritionist. Department Rehabilitation, Nutrition and Sport. La Trobe University. Australia.; (6)PhD. Department of Physiology, Anatomy and Microbiology. La Trobe University. Australia.

**Background and objectives:** The AUstralian MEDiterranean (AUSMED) Heart Trial aims to determine the efficacy of a 6-month Mediterranean Diet (MedDiet) intervention, compared to a low fat diet, in reducing secondary cardiovascular events at 12 months in a multi-ethnic Australian cohort (target n=1032) of high-risk patients, with a prior coronary event. We report initial data on participant adherence to the MedDiet intervention and whether the MedDiet improves markers of cardiometabolic risk profile at 6 months.
**Methods:** An initial cohort of AusMed participants (n=39, mean age 64 years, 87% male) were randomised to a MedDiet (n=24) or a Low-fat diet (n=15). Participants attended appointments with a Dietitian at 0, 3 and 6 months. Haemodynamic, anthropometric and body composition were measured and blood samples were collected for biomarker analyses. In addition, at these time points, adherence to the MedDiet was assessed using a validated 14-item questionnaire and 7-day food diaries allowed dietary composition changes to be recorded.

**Results:** Intervention participants adhered well to the MedDiet (baseline score of 5/14 increased to 11/14 at 6 months; p<0.001). The MedDiet adherence score of Low-fat diet participants did not change significantly. MedDiet participants had a higher intake of monounsaturated fat (22.0% vs 13.6% of total energy intake p=0.01) and polyunsaturated fat (9.2% vs 7.4% of total energy intake, p=0.02) after 6-months, compared to Low-fat diet participants. Compared to the Low-fat diet, the MedDiet did not change visceral adipose tissue, waist circumference, body weight, blood pressure or lipid profile (p>0.05). Plasma levels of the anti-inflammatory and insulin-sensitising biomarker adiponectin tended to increase in response to the MedDiet compared to the Low-fat diet after 6 months (4.7±2.3 mg/ml to 5.6±3.7 mg/ml vs. 5.1±2.5 mg/ml to 3.5±1.2 mg/ml, respectively; p=0.08).

**Conclusions:** These preliminary findings demonstrate that Mediterranean diet intervention in a multi-ethnic Australian population with coronary heart disease can change dietary behaviour, especially increase intake of healthy fats. This dietary change positively influences plasma adiponectin concentrations, an established protective cardiometabolic risk marker, compared with a conventional low fat diet.

**Keywords:** Coronary heart disease, randomised controlled trial, Mediterranean diet, secondary prevention, adiponectin

gering their IBS symptoms. Sourdough baking method could theoretically improve tolerability of wheat bread due to lower content of FODMAPs, additives and immunogenic proteins (i.e. amylase trypsin inhibitor, ATIs) of sourdough bread.

**Methods:** Our aim was to evaluate if sourdough wheat bread, i.e. "artisan wheat bread", that is fermented for a long time (>12 hours) and baked without baking improvers, added gluten or preservatives would be better tolerated than regular industrial wheat bread in subjects with IBS who have poor subjective tolerance of wheat. The study was conducted as a randomized double-blind controlled parallel-group study (n=26). Participants first followed a gluten-free diet run-in period for seven days and then were randomly assigned to receive regular industrial wheat bread or artisan wheat bread for seven days while maintaining the gluten-free diet. Gastrointestinal and other symptoms were assessed on a visual analogue scale (VAS).

**Results:** There were no differences in the gastrointestinal signs of IBS i.e. flatulence, bloating, abdominal pain, dyspepsia, and stomach rumbling etc. between the study breads. There were statistically significantly (p≤0.03) more feelings of tiredness, joint symptoms and decreased alertness when the participants ate the artisan wheat bread. The treatment differences (mm) were 16 (95% CI 4-27, p=0.01),7 (1-13, p=0.03) and 14 (5-22, p=0.003), respectively.

**Conclusions:** The present results do not support the hypothesis that artisan wheat bread (sourdough bread) that contains no preservatives, added gluten or improvers would be better tolerated than regular wheat bread.

**Keywords:** ODMAP, gluten, grains, wheat sensitivity, irritable bowel syndrome

**Conflict of Interest Disclosure:** Fazer Bakeries funded the study and provided the breads. Reijo Laatikainen has written a Finnish book on irritable bowel syndrome and diet. He is also founder and owner of Booston Ltd, which provides IBS related dietetic services to IBS patients, health care professionals and various organisations. Sanna-Maria Hongisto and Jussi Loponen are employees of Fazer Bakeries. Tuija Poussa has received consultation fees from Booston Ltd. Others have no personal interests to declare.

## RANDOMISED CONTROLLED TRIAL: ARTISAN WHEAT BREAD VS. INDUSTRIAL WHEAT BREAD TO RELIEVE THE SYMPTOMS OF IRRITABLE BOWEL SYNDROME

**Background and objectives:** Industrial wheat bread has a high gluten content, relatively high amounts of FODMAPs (Fermentable Oligo-, Di-, Monosaccharides And Polyols), is baked with yeast and usually contains dough improvers (baking additives). Wheat bread is often considered by many patients as trig-

## THE EFFECTS OF PROBIOTIC LACTOBACIL-LUS FERMENTUM ME-3 (LFME-3) CONTAINING REG'ACTIV CHOLESTEROL SUPPLEMENT ON BLOOD LIPOPROTEIN PROFILES AND INFLAM-MATORY CYTOKINES

<footnote>(1)Laatikainen, Reijo; (2)Koskenpato, Jari; (3)Hongisto, Sanna-Maria;</footnote>

<footnote>(3)Loponen, Jussi; (4)Poussa, Tuija; (5)Korpela, Riitta.</footnote>

<footnote>(1)M Sc, Dietician, Medical Faculty, Department of Pharmacology, Medical Nutrition Physiology, University of Helsinki, Finland; (2)Aava Medical Centre, Helsinki, Finland; (3)Fazer Bakeries Ltd, Vantaa, Finland; (4)STAT Consulting Ltd, Nokia, Finland; (5)Medical Faculty, Pharmacology, Medical Nutrition Physiology, University of Helsinki, Finland.</footnote>

<footnote>(1)Kals, Jaak; (2)Kullisaar, Tiiu; (3)Zilmer, Kersti; (4)Salum, Tiit; (5)Rehema, Aune; (6)Zilmer, Mihkel.</footnote>

<footnote>(1)Institute of Biomedicine and Translational Medicine, Department of Biochemistry, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, Estonia.; (2)PhD. Associate Professor. Institute of Biomedicine and Translational Medicine, Department of Biochemistry, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, Estonia; (3)PhD. Specialist. Institute of Biomedicine and</footnote>
Translational Medicine, Department of Biochemistry, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, Estonia; (⁴)MD.PhD. Senior Assistant. Institute of Biomedicine and Translational Medicine, Department of Biochemistry, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, Estonia; (⁵)MD.PhD. Associate Professor. Institute of Biomedicine and Translational Medicine, Department of Biochemistry, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, Estonia; (⁶)PhD. Professor. Institute of Biomedicine and Translational Medicine, Department of Biochemistry, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, Estonia.

**Background and objectives:** Cardiovascular diseases and type 2 diabetes continue to be a challenge and burden to heath. Positive shifts in well accepted risk factors of them are the key of long-term success. We aimed to establish if the targeted composition of innovative supplement Reg'Activ Cholesterol (RAC) has a positive influence to the human cardiovascular-inflammatory and diabetes-related parameters.

**Methods:** 45 apparently healthy participants consumed an RAC containing an antioxidative and antiatherogenic probiotic LFME-3 for 4 weeks. The parameters measured were total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, oxidized LDL (oxLDL), hsCRP, IL-6 and glycosylated haemoglobin (HbA1c%).

**Results:** Significant improvement of the cardiovascular and diabetes risk profile of the participants was established according to next data: the reduction of total cholesterol (from 6.5±1.0 to 5.7±0.9 mmol/l, p=9.90806E-11) was on the account of LDL cholesterol as the HDL cholesterol level rose from 1.60±0.31 to 1.67±0.34mml/l, p=0.01; HbA1c% was reduced from 5.85±0.28 to 5.66±0.25 p=4.64E-05 and oxLDL decreased from 84±20 to 71±15 U/l, p=4.66292E-08.

**Conclusions:** The consumption of RAC in clinically asymptomatic volunteers with border-line-high values of risk factors for cardiovascular disease for 4 weeks had a positive effect on blood lipoprotein, antioxidative stress and inflammatory profile.

This trial was an open label pilot study within the framework of a larger special clinical trial (ISRCTN55339917).

**Keywords:** Blood serum lipid profile, L. fermentum ME-3, Oxidized LDL, HbA1c%, Human clinical trial

**Background and objectives:** The American Diabetes Association recommends monitoring, among others, the nutritional status of children with type 1 diabetes mellitus (T1DM), to maintain normal metabolic control that does not contribute to the morbidity of the disease. The objective is to determine the nutritional status in children with T1DM, according to body mass index (BMI) and height for age (HA) using the WHO tables, and according to waist circumference (wc).

**Methods:** Prevalence study in children aged 2-18 years of the Hospital Universitario del Valle (HUV) "Evaristo García" from Cali, Colombia, who were given sociodemographic (age, sex), anthropometric variables [weight (W), height (H), wc] and were diagnosed as having malnutrition due to BMI (obesity, overweight, risk of overweight, undernutrition and severe undernutrition), altered height (low stature and severe low stature) and abdominal obesity per wc (> p90%).

**Results:** 147 children from HUV in Cali, Colombia; 54.4% female, 10.9±3.5 years of age, with W=39.1±17.8 kg, H=138.3±24.1 cm and wc=64.9±9.0 cm. They presented malnutrition=30.8%, altered height=10.9% and none with abdominal obesity. There was predominance of malnutrition in girls with no statistical significance (p> 0.05).

**Conclusions:** About 1/3 of these children presented malnutrition (undernutrition=7.5%, overweight and obesity=21.8%), few were of low height, and no abdominal obesity; without possible associations or risk factors.

**Keywords:** Body mass index, Height for age, Waist circumference, Type 1 Diabetes Mellitus, Children
tion (CDC) from United States recently published growth charts for American children with Down Syndrome (DS). The objective is to determine the nutritional status in children with DS, according to body mass index (BMI) and height for age (HA) using the DSGS/CDC tables, and according to waist circumference (wc).

**Methods:** Prevalence study in children between 2-18 years of age from Cali and Bucaramanga, Colombia, to whom sociodemographic (age, sex), anthropometric variables [weight (W), height (H), wc] were taken and diagnosed by BMI on malnutrition (Obesity, overweight, risk of overweight, undernutrition and severe undernutrition), altered height by HA (low height -2 and -3 SD and low severe height > -3 SD) and abdominal obesity by wc (> p90%).

**Results:** There were 76 children (37 Cali and 39 Bucaramanga, Colombia), 59.2% were males, 9.4±4.3 years of age, W=30.8±15.0 kg, H=122.2±19.2 cm and wc=64.8±12.4 cm. They presented malnutrition=29.0%, altered height=27.6% and abdominal obesity=4.0%. There was a predominance of malnutrition in children aged 5-12 years and altered height in male children (p>0.05).

**Conclusions:** About 1/3 of these children presented malnutrition (undernutrition=15.8%, overweight and obesity=11.8%) and altered height (low height=15.8%) and 4.0% of abdominal obesity; without possible associations or risk factors.

**Keywords:** Body mass index, Height for age, Waist circumference, Children, Down Syndrome

(TCV), Prot=10-15% tcv, Fat=30-35% TCV, Fib=Age + 5 grams, Fe+=9-18 mg, FolAc=300-400 µg and VitA=500-700 µg.

**Results:** 2006 Colombian children were included; 50.5% male, 12.8±2.2 years old, with kcal=1924.0±644.7 kcal/m2/d, CH=258.6±110.7 g/d, Prot=327.6±297.5 g/d, Fat=321.9±304.5 g/d, Fib=21.4±14.8 g/d, Fe+=72.7±74.0 mg/d, FolAc=329.8±248.2 µg/d and VitA=648.1±1492.4 µg/d, malnutrition=25.9%, low height=6.9%, abdominal obesity=3.1% and FGDs=18.2%. They presented a hypocaloric daily consumption=73.5%, hypoglycemia=40.1%, hyperprotein=70.6%, hyperlipid=43.2%, low in Fib=50.8%, Fe+=67.5%, FolAc=75.3% and VitA=68.8% deficiency and as more frequent FGDs functional constipation=8.3% and irritable bowel syndrome (IBS)=4.3%; being the possible risk factor for IBS daily hypoproteic consumption (OR=2.78, 95%CI=1.13-7.30 p=0.0127).

**Conclusions:** The daily consumption of these Colombian schoolchildren and adolescents with FGDs was hypocaloric, hypoglycemic, hyperprotein, hyperfat, low in fiber, deficient in Fe+, AcFol and VitA; being the hypoproteic feeding the only possible risk factor for IBS.

**Keywords:** Daily food consumption, Functional gastrointestinal disorders, Children

**Background and objectives:** The prevalence of functional gastrointestinal disorders (FGDs) in Colombian children is 29.0%; being its pathophysiology multifactorial and one of the possible risk factors, feeding. The objective is to determine the prevalence and possible risk factors of daily consumption of kilocalories (Kcal), carbohydrates (CH), proteins (Prot), fats (Fat), dietary fiber (Fib), iron (Fe+), folic acid (FolAc) and vitamin A (vitA) by means of a 24-hour reminder according to the Program for the Evaluation of Diets and Management of Food (DIAL) in Colombian children with FGDs.

**Methods:** Prevalence study in schoolchildren (n=897) and adolescents (n=1109) between 8-18 years of age in the Colombian Andean (La Unión=476), atlantic (Cartagena=427), pacific (Cali=1220, Quilichao=356) and amazonic (Florencia=392) zone, of public school, to whom sociodemographic (age, sex), anthropometric (weight, height, waist circumference) variables and were diagnosed as malnutrition by index of body mass, low height by height/age, abdominal obesity by waist circumference, and FGDs according to Rome III Criteria in Spanish. Normal daily consumption of kcal=1750-2250 kcal/m2, CH=50-55% total caloric value

**Background and objectives:** Recently, it has been reported that there are close relationships between intestinal bacteria and various diseases including obesity and diabetes. One of common methods evaluating the intestinal bacterial flora is a DNA sequence analysis using a next generation sequencer, but it is not easy to do it for any laboratory from the viewpoint of experimental equipment and analytical cost. Previously, we have established simple separation method, which can quickly crash mouse feces and separate it into three layers including polar fraction, nonpolar fraction and feces. Terminal restriction fragment length polymorphism (T-RFLP) is a method which can analyze microbiota as mixed DNA fragment information of various microorganisms. In this study, by combining the above two methods, we aimed to simplify the analytical method for evaluating gut microbiota.

**Methods:** Fecal samples were collected from four male mice. Bacterial DNA was extracted using a stool DNA extraction kit from the separated fecal layer by simple separation method. The 16S rDNA was amplified by PCR using 6-FAM-labeled 8F primer and 1492R primer. The PCR products were reacted with restriction enzyme MspI at 37°C and 1 h, and the digested fragments were analyzed by Genetic Analyzer. Finally, the obtained data were analyzed by statistical software "R", and the similarity of the flora among individual animals were compared.
**Results:** It was possible to perform from the collection of feces to comparison of microflora in less than 1 day. Using the method, four mice could be grouped based on the similarity of the flora.

**Conclusions:** We established a simple method for evaluating gut microbiota. Using this method, it is possible to compare quickly and simply the similarity, for example circadian change, of microbiota among individual animals and to survey the sequential change of microbiota in a single animal.

**Keywords:** T-RFLP, gut microbiota, mouse.

HOMA2-IR (p=0.0007) after adjusting for potential confounders, but not with other MS components.

**Conclusions:** A poor vitamin D status is significantly associated with an increased risk of having metabolic syndrome and insulin resistance among Chinese adults, warranting further investigation in large prospective studies.

**Keywords:** Vitamin D, 25(OH)D, Metabolic syndrome

**Further collaborators:**

All phases of this study were supported by research grant from the National Nature Science Foundation of China (No.81472976).

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## SERUM 25(OH)D CONCENTRATION AND METABOLIC SYNDROME AMONG ADULTS IN SOUTHWEST CHINA

(1)Li, Danting; (2)Xue, Hongmei; (2)Liang, Yi; (1)Chen, Mengxue; (2)Quan, Liming; (3)Zhao, Li; (4)Gong, Yunhui; (5)Cheng, Guo.

(1)BSc. West China School of Public Health. Sichuan University. Chengdu. China.; (2)MD. West China School of Public Health. Sichuan University. Chengdu. China.; (3)West China Research Center for Rural Health Development, Sichuan University. Huaxi Medical Center. Sichuan University. Chengdu. China;

(4)Department of Obstetrics and Gynecology, West China Second University Hospital. Sichuan University. Chengdu. China.;

(5)PhD. West China School of Public Health. Sichuan University. Chengdu. China.

**Background and objectives:** Vitamin D deficiency has been suggested as a risk factor for various chronic metabolic diseases. However, evidence regarding this issue among Chinese population is limited. The present study aimed to examine the association between serum 25-hydroxy vitamin D (25(OH)D) and metabolic syndrome (MS) in Chinese adults.

**Methods:** Serum 25(OH)D was measured in a cross-sectional sample of 920 non-diabetic adults (62.61% women) aged 25-65 years recruited from Southwest China. Data on dietary intake and physical activity were collected by validated questionnaires. MS was defined according to the criteria of Chinese Diabetes Society. Fasting plasma glucose (FPG), insulin, glycated hemoglobin (HbA1c), the homeostatic model assessment-insulin resistance (HOMA2-IR), lipid profile and blood pressure were evaluated. Anthropometry measurement included waist circumstance (WC), height and weight, and the last two were used to calculate body mass index (BMI). Data were analyzed by multivariable-adjusted regression models.

**Results:** We observed that 7.17% participants had MS, and the percentage of overweight or obese individuals (BMI ≥ 25kg/m2) in our study was 29.24%. Compared with the lowest tertile of serum 25(OH)D, a statistically significant 53% lower odds of metabolic syndrome was observed for adults in the highest tertile (OR: 0.47, 95%CI: 0.24-0.89), after adjusting for age, gender, personal monthly income, smoking status, energy intake, and physical activity. Moreover, we observed significant inverse associations of 25(OH)D with fasting insulin (p=0.0007), HbA1c (p=0.0001),

144/539

## COUNSELING ON IYCF PRACTICE TO SICK BABY (NEUROLOGICALLY DAMAGED & OTHER) TO IMPROVE BREASTFEEDING STATUS -A HOSPITAL BASED STUDY IN BANGLADESH

(1)Roy, Swapan Kumar; (2)Cubra, Khadijatul; (3)Jahan, Khurshid.

(1)MBBS, MSc, Dip in Biotech, PhD, FRCP, Senior Scientist, Chairperson, Board of Trustees Bangladesh Breastfeeding Foundation. Chairperson Nutrition Foundation. Bangladesh;

(2)MSc, Divisional Officer, Bangladesh Breastfeeding Foundation. Bangladesh; (3)MSc. Director. Bangladesh Breastfeeding Foundation. Bangladesh.

**Background and objectives:** Specific attachment & position is effective for production and flow of breast milk. Counseling to mother on breastfeeding includes continuation of breast feeding during illness when sick baby recovers earlier. Breastfeeding is a challenge to neurologically damaged baby. Some of the baby cannot cry & cannot reflect his demand, cannot suck, most of the time it sleeps. Usually babies are kept NPO (nothing per oral) or fed expressed breast milk. The fat content of hind breast milk insulates nerve fibers and speeds electrical signals increases with breast feeding. Brain development takes place from birth. Breastfeeding helps the baby develop coordination of the muscles and nervous system. The jaw and mouth movements needed for technical help along breastfeeding.

**Methods:** Counseling about Breast feeding & complementary feeding was done at the pediatric ward at Rangpur Medical College Hospital in Rangpur, Bangladesh, from September 2016 to March 2017. Mothers of 144 infants at neonatal unit were taught specific attachment & position effectively for special situation of baby & mother. From total number of baby, 35 were neurologically impaired, other suffered from different illness. We taught the mothers the cross cradle position, modified cross cradle position; which is effective for flat nipple, inverted nipple, large nipple, sore nipple, nipple infection, low birth weight baby, sick baby such as: neurologically damaged, jerking problem baby & the baby who are given saline and breast fed often (8 to 12 times in 24 hours)

**Results:** A total of 144 sick baby were studied. About 24.3% infants were neurologically impaired baby. All neurologically damaged baby were successfully breast feed immediately, after 30 minutes, the improvement of sucking quality were visible. The rest
were kept NPO, so I gave them counseling about the technique of breast feeding of neurologically damaged baby. Babies who took less amount of breast milk had kidney infection, dysentery for giving powder milk (BIOMIL).

**Conclusions:** Mothers of sick baby specially neurologically damaged baby's mothers need more support & guidance about effective breastfeeding.

**Keywords:** Positioning, Attachment, breast feeding, sick baby

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IMPACT OF PHYSICAL ACTIVITY (45 MINUTES DAILY AND 15 MINUTES THREE TIMES A DAY AFTER MEALS) ON BODY MASS INDEX OF TYPE 2 DIABETES MELLITUS FEMALE PATIENTS

(1)Malik, Monica; (2)Singh, Kalyani; (3)Bhansali, Anil; (4)Sehgal, Shruti.

(1)MSc. Foods and Nutrition. Associate Professor. Government Home Science College. Chandigarh. India.; (2)MSc. Foods and Nutrition. Faculty. Panjab University. Chandigarh. India; (3)DM. Endocrinologist. PGIMER, Chandigarh, India.; (4)MSc. Nutritionist. Fortis. Mohali. India.

**Background and objectives:** Type 2 Diabetes Mellitus is a chronic progressive metabolic disorder. Obesity is its major driver. Physical activity as a part of lifestyle intervention is the cornerstone for its prevention and management. Objective of the cross-sectional study was to compare impact of physical activity (walk) 45 minutes daily to 15 minutes physical activity (walk) three times a day after each meal on Body Mass Index (BMI) of type 2 diabetic females.

**Methods:** Female respondents (N=175) were prospectively enrolled from Endocrinology OPD of Post Graduate Institute of Medical Research (PGIMER), Chandigarh, India. Respondents were made to walk regularly for 45 minutes followed by 15 minutes post meal walk for 6 weeks each. Self designed questionnaire and WHO validated Global Physical Activity Questionnaire (version 2) were used for data collection. Data analysis was done using SPSS software (version 20).

**Results:** Family history of diabetes was seen among 78.9% respondents. 95.4% respondents were diabetic for more than 6 months. Mean BMI was 28.14±3.63kg/m2, 27.93±4.05kg/m2 and 27.79±4.07kg/m2 at initiation, 45 minutes walk and 15 minutes walk after each meal respectively. Mean HbA1C was 8.31±1.96, 8.09±1.93 and 7.64±1.64 at initiation, 45 minutes walk and 15 minutes walk after each meal respectively. Mean Fasting plasma glucose (FPG) was 140.99±57.13mg/dL, 133.01±41.10mg/dL and 115.26±27.46mg/dL at initiation, 45 minutes walk and 15 minutes walk after each meal respectively. Highly significant difference between BMI, HbA1C and FPG (p <0.001) was found between 45 minutes and 15 minutes post meal walk.

**Conclusions:** Post meal physical activity (walk) was seen to be significantly effective for diabetics in achieving health benefits as compared to one time walk daily.

**Keywords:** Type 2 diabetes, physical activity, BMI, FPG, HbA1C

**Conflict of Interest Disclosure:** None

**Further collaborators:** Post Graduate Institute of Medical Research, Chandigarh, India.

144/590

EFFECTIVENESS OF HOMEMADE IMPROVED RECIPE WITH NUTRITION COUNSELLING IN THE MANAGEMENT OF SEVERELY WASTED AND SEVERELY UNDERWEIGHT CHILDREN

(1)Roy, Swapan Kumar; (2)Jahan, Khurshid; (3)Ara, Ferdous; (4)Akter, Syeda Mahsina.

(1)MBBS, MSc, Dip in Biotech, PhD, FRCP, Senior Scientist, Chairperson, Board of Trustees Bangladesh Breastfeeding Foundation. Chairperson Nutrition Foundation. Bangladesh.;

(2)MSc. Director. Bangladesh Breastfeeding Foundation (BBF). Bangladesh; (3)MSc, MPhil. Senior Program Officer. Bangladesh Breastfeeding Foundation (BBF). Bangladesh; (4)M.Sc, Food & Nutrition, M.Sc, Nutrition and Health. Assistant Director. Bangladesh Breastfeeding Foundation (BBF). Bangladesh.

**Background and objectives:** In Bangladesh, management of Severe Acute Malnutrition (SAM) includes the use of commercially produced therapeutic foods. The study aimed to measure the impact of selected homemade improved recipes with nutrition counselling on nutritional status of SAM and Severely undernourished children.

**Methods:** An experimental study among 44 children aged 6 to 59 months with uncomplicated SAM was conducted in the Institute of Child and Mother Health (ICMH), Dhaka. Subjects were purposively allocated from SAM unit of ICMH after recovery from acute phase of infection. After screening, recipe trial for 10 days was conducted by providing 6 improved homemade recipes containing 100-110 kcal/kg/day for first 4 days and 130-150 kcal/kg/day for next 6 days. Nutrition counselling using IEC materials and demonstration of cooking were provided to the mothers or caregivers of the children. Daily body weight was recorded to measure the improvement of nutritional status. Children were followed-up weekly at home for 1 month to monitor dietary compliance and nutritional status.

**Results:** Median age of children was 9.00 (6-42) months; Weight, Height & MUAC were (mean±SD) 5.3(±1.2) kg, 64.9(±9.6) cm & MUAC 10.8(±1.0) cm respectively. Mean calorie (kcal/kg body weight) and protein (g/kg body weight) intake were 119(± 62) and 4.5(± 2.3) at 1st day and 129(±77) and 4.92± 2.87 at 7th day. Weight gain was 18.1±16.8 g/kg/day at 4th day & 12.4 (±7.3) g/kg/day at 7th day. In community follow-up, 0.5±1.5 kg (mean±SD) weight was increased in 4th follow-up from the 1st follow-up. Practice of providing appropriate complementary food was followed by 62.5% in 1st follow-up and increased to 66.7% at 4th. Providing vitamin A and animal protein rich foods were 87.5% and 62.5% at 1st follow-up while improved to 100% at 4th follow-up. Giving breastmilk substitute reduced to 25% at 4th follow-up from 46% in 1st follow-up.
**Conclusions:** Nutrition rehabilitation with homemade foods of improved recipe and nutrition education at both hospital and community setting was fruitful for improving nutritional status of SAM children.

**Keywords:** SAM, Nutrition education, homemade improved recipe

144/595

GASTROINTESTINAL SYMPTOMS, HYDROGEN
EXCRETION AND GASTROINTESTINAL CONDI-
TIONS MEASURED WITH SMARTPILL® IN IRRI-
TABLE BOWEL SYNDROME PATIENTS - MEAL
STUDY ON LOW-FODMAP AND REGULAR RYE
BREAD-MEALS

**Background and objectives:** Grains are often considered as
triggers of irritable bowel syndrome (IBS) symptoms but less is
known about effects of grain products with differing content of
FODMAPs on gastrointestinal transit times, pH and intraluminal
pressure in patients with IBS. In a previous study intraluminal pH
was lower among IBS subjects than in healthy controls possibly
demonstrating higher rate of colonic fermentation in IBS.

**Methods:** Our aim was to evaluate if rye bread low in FODMAPs would cause less hydrogen excretion, lower intraluminal pressure, higher colonic pH and less IBS symptoms than regular rye bread. The study was conducted as a randomized double blind controlled cross-over meal study. Female IBS patients (n=7) ate study breads on 3 consecutive meals, i.e. for breakfast, lunch and dinner and were followed for 630 minutes. Intraluminal conditions were measured by SmartPill®, an indigestible motility capsule.

**Results:** Postprandial hydrogen excretion, a marker of colonic fermentation, expressed as AUC(0-630 min) was [median (range)] 6300 (1785-10800) for low-FODMAP rye bread and 10 635 (4215-13080) for regular bread (p=0.028). The means of the VAS measurements of individual gastrointestinal symptoms during the follow-up (30 to 630 min) tended to be numerically lower after the low-FODMAP rye bread but did not show any statistically significant differences between the breads.

Intraluminal pressure correlated significantly with total symp-
tom score after regular rye bread (p=0.786, p=0.036) and nearly
significantly after low-FODMAP bread consumption (p=0.75,
p=0.052). We found no differences in pH, contractions or gastro-

intestinal transit times between the breads. Gastric emptying of
SmartPill was slower than reported in previous studies.

**Conclusions:** Our meal study demonstrated that low-FODMAP rye bread reduces colonic fermentation but no difference could be found in median values of IBS symptoms, pH, colonic pressure of gastrointestinal tract when compared to regular rye bread. Our observation on the correlation between increased intra-colonic pressure and symptom severity warrants further studies in IBS.

**Keywords:** IBS, FODMAP, rye, colonic fermentation, intraluminal pressure

**Conflict of Interest Disclosure:** Fazer Bakeries funded the study and provided the breads. Reijo Laatikainen has written a Finnish book on irritable bowel syndrome and diet. He is also founder and owner of Booston Ltd, which provides IBS related dietetic services to IBS patients, health care professionals and various organisations. Laura Pirkola, Sanna-Maria Hongisto and Jussi Loponen are employees of Fazer Bakeries. Others have no personal interests to declare.

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INFLUENCE OF PUBERTAL STAGE IN CUT OFF
VALUES OF WAIST CIRCUMFERENCE ASSOCIAT-
ed TO ALTERED ANTHROPOMETRIC VARIABLES
AND BLOOD PRESSURE AS CARDIOMETABOLIC
RISK MARKERS IN BRAZILIANS ADOLESCENTS

**Background and objectives:** The adolescents' development should not be determined just by the chronological age, once it is influenced by other environmental and intrinsic factors. The pubertal stage associated with anthropometric data, such as waist circumference (WC) is considered essential for screening risk of morbidities in adolescents, especially cardiovascular disease. This measure has proved to be a useful tool for identifying nutritional status, as well as its association with chronic noncommunicable diseases. The aim of the present study was to verify the influence of pubertal stage in cut off values of waist circumference associated to altered anthropometric variables and blood pressure.

**Methods:** A total of 557 adolescents aged 10 to 15 years were recruited from public schools, who were classified according to pubertal stage, by Tanner criteria. The interest variables, WC and the independent variables, such as

<footnote>(1)Laatikainen, Reijo; (2)Pirkola, Laura; (3)Hongisto, Sanna-Maria;</footnote>

<footnote>(3)Loponen, Jussi; (4)Hillilä, Markku; (5)Linderborg, Kaisa; (5)Yang, Baoru; (5)Nuora, Anu; (2)Freese, Riitta.</footnote>

<footnote>(1)M Sc, Dietician, Medical Faculty, Pharmacology, Medical Nutrition Physiology, University of Helsinki, Finland.; (2)Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Finland.; (3)Fazer Bakeries Ltd, Vantaa, Finland; (4)Clinic of Gastroenterology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; (5)Division of Food Chemistry and Food Development, Department of Biochemistry, University of Turku, Finland.</footnote>

<footnote>(1)Alves dos Santos, Ivete; (2)Passos, Maria Aparecida; (3)Ganen, Aline;</footnote>

<footnote>(2)Sampaio, Isa; (4)Fisberg, Mauro.</footnote>

<footnote>(1)MSc. Nutritionist. Mestrado Profissional em Nutrição: do nascimento à adolescência. Centro Universitário São Camilo. Brazil.; (2)PhD. Nutritionist. Departamento de Especialidades Pediátricas do Centro de Atendimento e Apoio ao Adolescente. Universidade Federal de São Paulo. Brazil.; (3)PhD. Nutritionist. Mestrado Profissional em Nutrição: do nascimento à adolescência. Centro Universitário São Camilo. Brazil.; (4)MD. Nutrologist and pediatrician. Departamento de Especialidades Pediátricas do Centro de Atendimento e Apoio ao Adolescente. Universidade Federal de São Paulo. Brazil.</footnote>
gender, age and weight were evaluated. The predictive power and cut off points of WC for overweight/obesity prevention were identified using ROC curves, as well as sensibility and specificity. Indeed, it was verified the correlation between the WC, anthropometric measures and blood pressure.

**Results:** According to the nutritional status, the adolescents were 58% eutrophic, 25.2% overweight and 13.9% obese, there was no difference between genders. It was observed a strong correlation between CC and weight, BMI, neck circumference, arm circumference, rip circumference and WC/height ratio in both genders. In addition, it was showed a weak correlation but statistically significant between WC and systolic and diastolic pressure. The WC cutoff points to determine overweight/obesity showed high sensitivity and specificity in girls and boys in all pubertal stages, pubere being representing by 64,9, 66,45 and 70,65cm in prepubescent, Pubere and post-pubere respectively in boys and by 68,5, 69,15 and 69,45cm in female adolescents.

**Conclusions:** The creation of WC cutoff points according to the pubertal stage, specific for the Brazilian adolescent population, proved to be an excellent, non-invasive and low cost tool for identifying overweight/obesity and cardiometabolic risk, and it is extremely relevant, due to changes in body composition resulting from puberty events.

**Keywords:** adolescence, waist circumference, pubertal status, cardiometabolic risk, overweight.

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## THE EFFECT OF BLACK SEED POWDER ON BLOOD GLYCAEMIA, BLOOD LIPIDEMIA AND BODY COMPOSITION ON ADULTS AT RISK FOR CARDIOVASCULAR DISEASES

(1)Al Dhaheri, Ayesha; (2)Al Khatib, Dana; (2)Jarrar, Amjad.

(1)PhD. Nutrition and Health Department. College of Food and Agriculture. United Arab Emirates University; (2)MSc. Nutrition and Health Department. College of Food and Agriculture. United Arab Emirates University. UAE.

**Background and objectives:** In United Arab Emirates (UAE), 39.6% of the population were diagnosed with metabolic syndrome (MetS) according to a previous study, while the prevalence of the MetS in the Gulf Cooperation Council Countries (GCC) is 10-15% higher than in most developed countries. Abdominal obesity, high fasting blood glucose, high blood pressure, elevated triglycerides and reduced high-density lipoprotein cholesterol (HDL-C) are the risk factors for MetS. Traditional spices, such as black seed, are used as medications for treating some of these diseases. However, several studies have proven that black seed has antioxidant, anti-inflammatory, anti-diabetic, lipid-lowering functions and thymoquinone was found to be the active form of black seeds.

**Objectives:** To measure the effect of 3 grams of black seed (Nigella Sativa) powder for 12 weeks on participants at risk for cardiovascular diseases for fasting blood glucose, HbA1c levels, blood pressure, blood lipid profile levels and waist circumference.

**Methods:** A controlled, randomized, single blind, parallel-design study conducted on 51 participants with risk of developing heart diseases. Participants were randomly assigned to consume either 3g/day of black seed powder or placebo for 12 weeks. Each of weight, height, waist circumference, body composition and systolic and diastolic blood pressure were measured at baseline, midpoint (after 6 weeks) and endpoint (after 12 weeks). Fasting blood glucose, HbA1c, total cholesterol, LDL-C and HDL-C were tested at baseline, midpoint and endpoint.

**Results:** After 12-weeks consumption of black seed powder, each of waist circumference, percent body fat, cholesterol, HDL and LDL levels were highly significantly improved (p-value < 0.01). In addition, body weight and triglyceride level were significantly improved (p-value <0.05).

**Conclusions:** Consumption of 3g of black seed powder daily for 12 weeks have shown positive effect on fasting blood glucose, blood pressure, blood lipid profile levels and waist circumference on individuals who are at risk of developing cardiovascular diseases.

**Keywords:** Black seed powder, metabolic syndrome, cardiovascular diseases, blood lipidemia, blood glycaemia.

144/615

## OVERWEIGHT/OBESITY: LOOKING TO EXPAND THE LIPID PROFILE

(1)Lucentini, Marcelo; (2)Sobol, Dana; (2)Riega, Eduardo; (3)Castiñeyras, Sofia.

(1)PhD; (2)Md; (3)Nutritionist.

**Background and objectives:** Our objectives in this work are: to establish the incidence of overweight or obesity in adult patients who perform clinical consultation for periodic health examination; describe the most frequent laboratory abnormalities observed in such patients and try the search of new biochemical parameters permitting to assess more thoroughly the insulin resistance presenting the majority of these patients.

**Methods:** We studied 177 patients, whose ages ranged from 18 to 75 years and who attended outpatients clinic medical of the Hospital de Clinicas, to carry out a periodic review of health, between January 1, 2010 and January 1, 2017. All patients underwent: complete clinical history, physical examination (including back of eye) and is asked the following laboratory blood tests: complete blood count; blood glucose; lipid profile (total cholesterol, HDL, LDL, triglycerides and cholesterol non-HDL; risk); apo A and apo B; T3, free T4 and TSH; Vitamin D; insulinemia; HOMA; Ultrasensitive CRP (Hscrp); full hepatograma and complete examination of urine.

**Results:** Of the 177 patients studied, the following results were obtained: 36,72% were overweight and 24.86% suffered from obesity. Of the total of patients, 49.7% presented alterations of blood glucose; Hypertriglyceridemia: 51.5%; hypercholesterolemia: 55.7%. The HOMA > 2.5: 41,09%; Hscrp > 3 mg/l: 31.78%; Vitamin D < 20 ng/ml: 44,19%; TSH > 4 UIU/l: 7.75%; Non-HDL
cholesterol > 130 mg/dl: 74,42%; TG/HDL > 3.5: 26.36%; insulin values higher than 20 µU/ml were obtained in 60,47%. Of the 86 patients studied for apo A decrease, the 24.24% were below 119 mg/dl; with respect to Apo B, only 6.45% showed values higher than 163 mg/dl.

**Conclusions:** Emphasizes the need to strengthen the strategy of primary health care to prevent the development of Overweight/ obesity and to count on a competent laboratory that encompasses the entire spectrum of the IR, in particular, the determinations of: HOMA, PCR us; dosage of vitamin D and the TG/HDL ratio. In- tends this index to identify simple individuals with insulin resist- ance and increased risk of developing disease franchises in relation to go through a simple, economical, calculation of acceptable sen- sitivity and specificity, which is done with routine.

**Keywords:** Overweight; Obesity

**Further collaborators:**

Mariela Cerminaro

144/628

EFFECTS OF ARGININE ON THE MOBILIZATION
OF ENDOTHELIAL PROGENITOR CELLS AND TIS-
SUUE INJURY IN A MOUSE MODEL OF HINDLIMB
ISCHEMIA/REPERFUSION

(1)Yeh, Sung-Ling; (2)Hsieh, Kuan-Feng; (2)Hou, Yu-Chen.

(1)School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University; (2)School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan.

**Background and objectives:** Acute limb ischemia is a fre-
quent event that may be caused by arterial embolism, vascular
thrombosis, injury or trauma. Endothelial progenitor cells (EPC)
are unique cells circulate in the blood with the ability to differen-
tiate into endothelial cells and can contribute to vascular repair in
ischemia/reperfusion (I/R) injury. This study investigated whether
administration of L-arginine (L-Arg), the precursor of nitric ox-
ide (NO), enhances blood EPC percentages and protects against
I/R-induced inflammatory response in a mouse model of hind-
limb I/R injury.

**Methods:** There were 1 normal control (NC) and 4 I/R groups. The NC group did not undergo the I/R procedure. The mice in the I/R groups were subjected to hindlimb compression with 4.5-oz orthodontic rubber bands for 150 min. Saline (S) groups were intravenously injected with saline whereas L-Arg (A) groups injected with L-Arg (300 mg/kg body weight) before reperfusion. Mice in the I/R groups were sacrificed 24 or 48 hr after reperfusion respectively. Blood and tissue samples were collected for analysis.

**Results:** I/R led to a significantly lower blood EPC percent-
age and plasma NO levels. However, plasma interleukin-6 levels
as well as the inflammatory cytokine gene expressions in muscle
were elevated. Compared to the saline groups, L-Arg administra-
tion resulted in a higher EPC percentages. Also, plasma NO lev-
els, matrix metallopeptidase-9 and vascular endothelial growth

factor concentrations were upregulated whereas muscle keratin化cyte-derived chemokine and monocyte chemoattractant protein-1 mRNA expressions reduced after reperfusion. Histological findings consistent with the finding that muscle injury was attenuated during I/R insult when L-Arg was administered.

**Conclusions:** A single dose of L-Arg administration before reperfusion increases the percentage of EPCs and reduces the inflammatory reaction locally and systemically.

**Keywords:** L-arginine, ischemia/reperfusion, endothelial pro-
genitor cell, nitric oxide, inflammatory cytokine

144/633

DIETARY INTAKE AND NUTRITIONAL STATUS OF
PATIENTS WITH PHENYLKETONURIA IN TAIWAN

(1)Weng, Hui-Ling; (2)Hwu, Wuh-Liang; (3)Lee, Ni-Chung; (4)Cheng, Chin-Pao; (3)Chien, Yin-Hsiu.

(1)MD.Dietitian; (2)PhD. Professor. Department of Medical Genetics and Pediatrics, National Taiwan University Hospital, Taipei, Taiwan; (3)PhD. Associate Professor. Department of Medical Genetics and Pediatrics, National Taiwan University Hospital, Taipei, Taiwan; (4)PhD. Dietitian. Department of Dietetics, National Taiwan University Hospital, Taipei, Taiwan.

**Background and objectives:** Phenylketonuria (PKU) is due to phenylalanine hydroxylase deficiency and is characterized by accumulation of phenylalanine (Phe). Untreated patients develop severe intellectual disabilities. Early diagnosis such as universal newborn screening and early treatment by diet instruction may maintain patients' cognitive function. However, the Phe-restriction diet treatment should be maintain for lifelong and adequate nutritional status in these patients are also important. In this study, we characterize the body composition and the growth status in Taiwan PKU patients, correlating with their metabolic control status, to know if they have nutritional disturbances due to the Phe-restriction diet treatment.

**Methods:** We enrolled 22 controls (8-39y; 19.73 ± 10.6, table 1), and 22 patients with PKU (8-27y; 14.96 ± 5.27) including 14 patients (64%) receiving PKU-free formula as the dietary supplement. Anthropometric features (height, weight and body mass index) and body composition were analyzed. Dietary intake was also collected. For continuous parameters, the data was expressed as median ± standard deviation and Mann-Whitney U test has been used to test the difference among the groups.

**Results:** All patients met dietary reference intakes (DRIs) in protein (106.79 ± 33.27% of DRIs ) and energy intake (103.7 ± 21.63% of DRIs). Compared to the control, PKU patients have similar height (Z-score, -0.18 ± 1.18 v.s. 0.43 ± 0.78, p=0.72), weight (Z-score, 0.04 ± 0.97 v.s. 0.39 ± 1.08,p=0.69) and body mass index (Z-score, 0.23 ± 1.10 v.s. 0.24 ± 0.98,p=0.43). The detailed body composition analysis showed that they have similar muscle mass (73.40 ± 8.79 v.s. 75.51±7.42,p=0.45) and body fat percentage (20.75 ± 8.70 vs 8.67 ± 7.53,p=0.46). Among PKU patients, the more natural protein they consumed, the more body muscle mass
they gained (Correlation coefficient 0.5360, p=0.0101) and the less fat mass they got (Correlation coefficient -0.5370, p= 0.0082).

**Conclusions:** Overall, Taiwan PKU patients do not show differences in body composition and growth status in comparison with controls. A normal intellectual development is expected when adequate treatment is started early in life and continued during life.

**Keywords:** Phenylketonuria, dietary intake, nutritional status

DISTRIBUTION OF DIETARY CARBOHYDRATE LOADING BY KIWIFRUIT ALTERS GLYCAEMIC RESPONSE CHARACTERISTICS

Monro, John Alexander; Mishra, Suman.

Carbohydrate Digestion and Metabolism Team, New Zealand Institute for Plant and Food Research.

**Background and objectives:** Partial equal carbohydrate substitution of kiwifruit sugars for starch in foods co-ingested with whole kiwifruit (KF) leads to a substantial reduction in glycaemic response. The reduction in response is due to both exchange of fructose for glucose, and to the physical influence of undigested KF remnants in the foregut. As fructose consumption has been reported to promote blood glucose disposal, and KF remnants appear to retard processes that mediate absorption of starch-derived glucose from the foregut, it is possible that overall modulation of glycaemic response to starchy food by KF may be affected by the temporal proximity of the KF and starchy staple ingestion events.

**Methods:** To test this possibility KF (200 g = flesh of two KF) was ingested 10 h, 90 min, 30 min before, at the same time as, or 30 min after a starch-based wheaten biscuit (WB) containing the same amount of available carbohydrate, mainly starch, as the KF. Capillary blood glucose concentrations and satiety were measured after ingestion of the foods.

**Results:** Partial substitution of WB by KF caused a 20-30% reduction in total glycaemic response irrespective of the separation of KF and WB ingestion. However ingesting KF 30 min before WB decapitated the blood glucose “spike”, whereas the reverse, WB 30 min before KF did not.

**Conclusions:** The results suggest that both the temporal distribution of available carbohydrate (meal slowness) and differences in composition of foods consumed at different stages in a meal may be used to manage glycaemic response.

**Keywords:** glycaemia, temporal distribution, kiwifruit, carbohydrates

ASSESSMENT OF URINARY SODIUM EXCRETION AMONG UAE POPULATION

(1)Jarrar, Amjad; (2)Al Dhaheri, Ayesha; (3)Cheikhismail, Leila.

(1)MSc. Instructor. Nutrition and Health Department. UAE University; (2)Ph.D. Nutrition and Health Department. UAE University; (3)Ph.D. Nutrition. Oxford University.

**Background and objectives:** Chronic diseases such as cardiovascular diseases (CVD), cancer, chronic respiratory diseases (CRD), and diabetes are increasing worldwide and becoming the leading cause of death. Positive relationship is found between CVD and the intake of salt, trans-fatty acid (TFA) and saturated fatty acid (SFA).

**Methods:** A cross sectional study was conducted from March - June 2015 in United Arab Emirates. A random sample of 476 healthy individuals were recruited, (n= 214 male, n= 262 female). A screening questionnaire was designed to collect data about demographic information, lifestyle, past medical history, medications use and the current health status in addition to anthropometric measurements were assessed using standardized procedures. A single timed 24-hr urine collection was obtained for estimation of sodium excretion, and urinary creatinine and urine volume were used to measured adequacy of 24-hr urine volume. The samples were analyzed by Inductively Coupled Plasma/Optical Emission Spectrometry (ICP-OES). Dietary information was collected using 24-hr dietary recall. Energy, carbohydrate, fat, protein, unsaturated fat, saturated fat, trans-fat, cholesterol and sodium were analyzed using ESHA Food Processor and Kuwaiti Food Composition Database.

**Results:** Participants mean age was 37.3 ± 12.5, 55 % were females. The majority of the participants were overweight (36.1%) or obese (23.7%). The majority of the participants reported that they add salt during cooking and while eating. Majority (68.9%) reported that they were aware that high salt intake could cause a serious health problem. The mean sodium intake from food records was 2829.1 ± 1404.9 mg while mean sodium excretion in urine was 2713.4 ± 713 mg. This amount of sodium is significantly higher (P<0.001) than the amount recommended by WHO which is above the WHO recommendations.

**Conclusions:** A large proportion of UAE population consumes sodium above levels recommended by WHO. This is probably the reason for the high incidence of CVD in UAE.

**Keywords:** Urinary sodium excretion, cardiovascular diseases, urinary creatinine, Non-communicable diseases, ESHA Food Processor
**Background and objectives:** Children whose mothers work outside the home are most of the time left in the hands of secondary caregivers for certain period of time. Investigating the knowledge and management of food allergy among these caregivers then becomes necessary as the severe case of this immunological response can lead to life threaten action. This study assessed the knowledge and management of food allergy among pre-school child caregivers in Ogun State, Nigeria.

**Methods:** Descriptive survey using multisampling technique was adopted to select eight-two (82) child caregivers from the study area. A validated Food Allergy Knowledge and Management Questionnaire (FAKMQ) was used for data collection. Knowledge and management scale of 0-10 was adopted and categorized high: ≥7, moderate: 4.0-6.9 and poor: 0-3.9. Data collected were analyzed using descriptive statistic and t test at p=0.05.

**Results:** The results of the findings showed that respondents possessed low knowledge in the following areas: food that can cause allergic reactions in children (2.45±0.42), signs and symptoms of food allergy (3.20±0.85), factors that increase the risk of having food allergy (2.20± 0.62), severe allergic reactions (anaphylaxis) (2.0±0.26). Most respondents could not differentiate between food allergy and food intolerance (1.20±0.35). Results: **Conclusions:** Knowledge and management of food allergy was poor among pre-schools child caregivers in Ogun State Nigeria. Regular training should be organized for caregivers to increase their knowledge on food allergy by reviewing past occurrences to identify better ways of management.

**Keywords:** Food Allergy, Management, Caregivers

**Background and objectives:** Nutritional therapy on hemodialysis (HD) is complex and a challenging for patients, since significant changes in eating habits and behavioral patterns are required. Thus, the objective of the present study was to evaluate

the impact of change in food behavior on hyperphosphatemia and fluid control of HD individuals.

**Methods:** This intervention study based in transtheoretical method enrolled 83 HD subjects (55 men/28 women, age: 61 ± 15 years) attended at a Nephrology Center. In the nutritional intervention, three individual consultations and two group meetings were conducted during four months, to achieve improvement of metabolic disorders by change in food behavior. The stages of change were classified as pre-contemplation, contemplation, preparation, action and maintenance, grouped into active (action and maintenance) and inactive (pre-contemplation, contemplation and preparation). Serum phosphorus and interdialytic weight gain (IWG) were collected in the medical records and evaluated before and after the intervention.

**Results:** At the beginning of the study, 2.4% of the participants were allocated to pre-contemplation, 42.2% contemplation, 28.9% preparation and 26.5% action. After nutritional intervention, 2.4% of patients presented in the pre-contemplation stage, 10.8% contemplation, 26.6% preparation and 60.2% action. The effectiveness of the intervention on stages of change was confirmed by the observed impacts on the metabolic markers. Hyperphosphatemia significantly reduced (41.0 vs. 10.8%, p<0,001). The individuals considered inactive, in relation to the behavioral stage, presented higher IWG in relation to the actives (2.4 ± 1.0 vs. 1.9 ± 0.7 kg, respectively; p = 0.022). In addition, the active presented a reduction in the serum phosphorus concentration after the intervention, when compared to the inactive (4.8±1.4 vs. 4.1±0.8 mg/dL, respectively; p=0,006).

**Conclusions:** The intervention based on the transtheoretical model promoted a behavior change with increase to action stage (active condition) in HD individuals, which had direct and positive impact on the metabolic markers of important control in HD subjects. Financial support: CAPES, FAPEMIG and CNPq.

**Keywords:** Transtheoretical model, food behavior, serum phosphorus, interdialytic weight gain, chronic kidney disease.

**Background and objectives:** Depression, anxiety disorders, and obesity are common co-occurring disorders. Psychodietetics

<footnote>(1)Hermsdorff, Helen Hermana; (2)Ribeiro, Priscila; (2)Balbino, Karla;</footnote>

<footnote>(2)Epifânio, Andreza; (1)Moreira, Ana Vládia.</footnote>

<footnote>(1)Assistant professor. PhD. Nutritionist. Department of Nutrition and Health. Universidade Federal de Viçosa; (2)MSc. Nutritionist. Department of Nutrition and Health. Universidade Federal de Viçosa.</footnote>

<footnote>(1)Przybylowicz, Katarzyna Eufemia; (2)Obara-Golębiowska, Małgorzata; (3)Boradyn, Katarzyna Mirosława; (4)Morze, Jakub.</footnote>

<footnote>(1)Prof. Department of Human Nutrition. University of Warmia and Mazury in Olsztyn. Poland; (2)PhD. Department of Psychology of Development and Education. University of Warmia and Mazury in Olsztyn. Poland.; (3)MSc. Department of Human Nutrition. University of Warmia and Mazury in Olsztyn. Poland.; (4)Student. Faculty of Medical Sciences. University of Warmia and Mazury in Olsztyn. Poland.</footnote>
# NUTRITION AND CANCER IN PRIMARY PREVENTION: NEW INSIGHTS FROM CIRCADIAN REGULATION

(1)Srou, Bernard; (2)Plancoulaine, Sabine; (3)Andreeva, Valentina;

(4)Fassier, Philippine; (4)Lécuyer, Lucie; (5)Galan, Pilar; (6)Hercberg,

Serge; (7)Deschasaux, Mélanie; (8)Latino-Martel, Paule; (9)Touvier,
Mathilde.

(1)PharmD MPH. PhD candidate. Nutritional Epidemiology Research Team (EREN). Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS) Inserm U1153 Inra U1125 Cnam Paris 13 University. France.; (2)MD PhD. Researcher. Early ORigins of Child Health and Development Team (ORCHAD). Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS) Inserm U1153 Paris-Descartes University. France;

(3)PhD. Associate Professor. Nutritional Epidemiology Research Team (EREN). Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS) Inserm U1153 Inra U1125 Cnam Paris 13 University. France.; (4)MSc. PhD candidate. Nutritional Epidemiology Research Team (EREN). Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS) Inserm U1153 Inra U1125 Cnam Paris 13 University. France.; (5)MD PhD. Research Director. Nutritional Epidemiology Research Team (EREN). Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS) Inserm U1153 Inra U1125 Cnam Paris 13 University. France.; (6)MD PhD. Professor and Hospital Practitioner. Nutritional Epidemiology Research Team (EREN). Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS) Inserm U1153 Inra U1125 Cnam Paris 13 University. France.; (7)PhD. Nutritional Epidemiology Research Team (EREN).

Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS) Inserm U1153 Inra U1125 Cnam Paris 13 University. France.; (7)PhD. Nutritional Epidemiology Research Team (EREN). Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS) Inserm U1153 Inra U1125 Cnam Paris 13 University. France.; (8)PhD. Research Director. Nutritional Epidemiology Research Team (EREN). Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS) Inserm U1153 Inra U1125 Cnam Paris 13 University. France.; (9)PhD. Researcher. Nutritional Epidemiology Research Team (EREN). Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS) Inserm U1153 Inra U1125 Cnam Paris 13 University. France.

**Background and objectives:** Circadian disruption, resulting from shiftwork, has been classified as probably carcinogenic to humans by the International Agency for Research on Cancer. The biological circadian clock is subject to environmental effects, particularly light exposure and rhythmic food intake. However, the association between circadian nutritional behaviors and cancers has never been well explored. We investigated the prospective associations between time of the last eating episode, number of eating episodes, night-time fasting duration and the nutritional quality of the last eating episode, with overall, breast and prostate cancer risks.

**Methods:** This prospective study included 41,389 men and women of the French population-based NutriNet-Santé cohort (2009-2016) who completed at least three 24h-dietary records during the first two years of follow-up. The risk of developing can-

cer was compared across different groups using multivariable Cox models.

**Results:** 1,732 first primary incident cancer cases were diagnosed during follow-up, among which 428 breast cancers and 179 prostate cancers. Late eaters (last eating episode after 9:30 pm) had an increased risk of breast cancer (HR=1.48 (1.02-2.17), p=0.03) and prostate cancer (HR=2.20 (1.28-3.78), p=0.004); on the other hand, early eaters (last eating episode before 7 pm) had a lower risk of overall cancers (HR=0.78 (0.63-0.96), p=0.02). No association was observed between the number of eating episodes, nighttime fasting duration and the nutritional quality of the last eating episode, with cancer risk.

**Conclusions:** This large cohort study suggests that circadian disruption associated with late time of last food intake may be involved in carcinogenesis at different locations. Beyond nutritional quality of food intake, targeting time of food intake might be interesting in cancer prevention.

**Keywords:** feeding time, cancer risk, circadian rhythm, prospective study

# NUTRITION KNOWLEDGE AND DIETARY HABITS OF PATIENTS WITH TYPE-2 DIABETES ATTENDING POST MANAGEMENT REVIEW CLINIC: A CROSS-SECTIONAL SURVEY

(1)Issah, Ra-uf; (2)Hayford, Frank Ekow Atta; (3)Ainuson-Quampah, Joana.

(1)MSc. Dietitian. Department of Nutrition and Dietetics. University of Ghana. Legon. Accra. Ghana; (2)MPhil. Dietitian, Department of Nutrition and Dietetics, University of Ghana. Legon. Accra. Ghana.; (3)PhD. Dietitian. Department of Nutrition and Dietetics. University of Ghana. Legon. Accra. Ghana.

**Background and objectives:** Chronic diseases such as type-2 diabetes require continuous medical care and ongoing patient self-management education and support to prevent multiple complications and premature mortality. Adequate nutrition knowledge and appropriate dietary habits play key roles in the nutritional management of type-2 diabetes. Therefore, providing adequate nutrition information and skills on indicators such as good diet, adequate physical activities have been shown to improve the well-being of individuals. The objective was to assess the nutrition knowledge and dietary habits of type-2 diabetes patients attending routine clinical review at a regional hospital in Ghana.

**Methods:** A cross-sectional study consisting of one hundred and seventeen participants recruited using systematic random sampling technique. Structured questionnaire and validated FFQ were used to assessed nutrition knowledge and dietary habits respectively. Data was captured in excel, cleaned and then exported into SPSS version 20 for statistical analyses. Nutrition knowledge was scored using performance-rating scale.

**Results:** The mean BMI for the female and male participants were 28.59±4.699kgm-2 and 24.96±4.019kgm-2 respectively. Most
participants' (45.3%) nutrition knowledge was below average and generally had poor dietary habits with majority (90%) consuming sweets and high fat food source thrice (3×) daily, indicating poor nutritional status.

**Conclusions:** Below average nutrition knowledge was associated with poor dietary habits. Type-2 diabetic subjects therefore must be encouraged to take part in nutrition education programs in order to effectively manage their disease condition.

**Keywords:** Dietary habit, Nutrition knowledge, Type-2 diabetes, Ghana

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### PERCEPTION OF CHANGES IN HEALTH CONDITIONS AND LIFESTYLE AFTER PERSONALIZED NUTRITIONAL INTERVENTION: PROCARDIO-UFV STUDY

(1)Hermsdorff, Helen Hermana; (2)Almeida, Alinne; (2)Lopes, Lilian;

(3)da Costa, Thiago; (1)da Costa, Glauce.

(1)Assistant professor. PhD. Nutritionist. Department of Nutrition and Health. Universidade Federal de Viçosa; (2)PhD Student. MSc. Nutritionist. Department of Nutrition and Health. Universidade Federal de Viçosa.; (3)Assistant Professor. PhD. Administrator. Department of Administration and Accounting. Universidade Federal de Viçosa.

**Background and objectives:** Many nutrition care programs have been performed to treatment of obesity and other cardiometabolic conditions, but the evaluation of related-stages has not been reported. Thus, this study evaluated the perception of the suitability of nutritional treatment activities and lifestyle changes in users of the Cardiovascular Health Care Program, Universidade Federal de Viçosa, Minas Gerais, Brazil (PROCARDIO-UFV).

**Methods:** The PROCARDIO-UFV is a nutritional intervention program for individuals with cardiometabolic risk who have some connection with the UFV (ReBEC – Id:RBR-5n4y2g). The study included 53 users of the program (31 women/ 22 men, 43.5-15.9 years), all of them with cardiometabolic risk. The subjects answered an evaluation questionnaire based in the Likert Scale regarding to: Process (diet meal plan, orientations and educational actions for health promotion) and Results (information comprehension, lifestyle changes and clinical and metabolic improvement) of the program, according to with the method proposed by Donabedian.

**Results:** Among the users, 96.2% (n=51) reported having received and understood the diet meal plan passed on during the nutritional treatment; 81.1% (n=43) said that the diet meal plan was adapted to their reality and disease and 94.3% (n=50) said they received some kind of educational material to encourage the adoption of healthy food. In addition, 96.2% (n=51) considered the nutritional treatment to be effective and satisfactory. Finally, the users reported having acquired knowledge about food and healthy lifestyle (94.3%, n=50) as well as having presented clinical-metabolic improvement (88.7%, n=47) and changes in lifestyle (84.9%, n=45), after the nutritional intervention offered by CARDIO-UFV.

Interestingly, there was a negative correlation between the perception of clinical-metabolic improvement by users and reductions of body weight (r=-0,333; p=0,036), waist circumference (r=-0,458; p=0,003) and BMI (r=-0,333; p=0,036) after three months of intervention.

**Conclusions:** The users have evaluated as satisfactory the methods using by PROCARDIO-UFV in nutritional treatment and health education, at the same time they presented a perception of improvement in clinical-metabolic conditions and lifestyle, with emphasis on a healthier diet. Altogether, our results indicate the importance of personalized nutrition in the treatment of individuals with cardiometabolic risk. Financial support: FAPEMIG, CAPES CNPq.

**Keywords:** Cardiovascular Disease, Diet, Health Service, Health Assessment.

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### VITAMIN D INSUFFICIENCY AFFECTS CALCIUM ABSORPTION EFFECTIVENESS OF PREBIOTICS

(1)Zeni, Susana N; (2)Seijo, Mariana; (3)Duran, Francisco; (4)Bryk, Gabriel; (5)Pita Martin de Portela, Maria Luz.

(1)Metabolic Osteopaties Laboratory. Clinical Hospital. INIGEM (UBA-CONICET); (2)MD. Metabolic Osteopaties Laboratory. Clinical Hospital. INIGEM (UBA-CONICET); (3)BSc. Metabolic Osteopaties Laboratory. Clinical Hospital. INIGEM (UBA-CONICET); (4)PhD. Metabolic Osteopaties Laboratory. Clinical Hospital. INIGEM (UBA-CONICET); (5)PhD. Nutrition Department. School of Pharmacy and Biochemistry. University of Buenos Aires.

**Background and objectives:** Low Ca intake (CaI) is related to osteoporosis among others pathologies. Passive and active intestinal Ca absorption (Abs) is regulated by vitamin D within limits, which compensate for the lesser CaI. Prebiotics also positively affect Ca Abs by selectively increasing acid lactic bacteria's which releases short-chain fatty acids which improve Ca salts solubility by lowering intestinal pH, and favor colonic epithelial cell proliferation. The aim of the present report was to evaluate the effectiveness of prebiotic to absorb Ca in adult rats feeding a low Ca diet and vitamin D insufficiency. Objectives: The effectiveness of Galacto-oligosaccharides/Fructo-oligosaccharides (GOS/FOS*) mixture to increase CaAbs was evaluated in a model of VD insufficiency (-VD) and established osteopenia.

**Methods:** Female adult Wistar rats were ovariectomized and fed a commercial diet during 15 days postsurgery. Then, rats were divided: 32 fed a diet VD-free (0 IU%) during 45 days to become VD insufficient (-VD) and 16 fed a normal VD diet (100 IU%) (+VD). At day-60, +VD were subdivided in 2 groups and received during 45 days: AIN'93 (control diet)(+VD Ca0.5%); AIN'93 containing 0.3%Ca and 2.5% GOS/FOS* (9:1) (+VD Ca0.3%Prebiotics); -VD were subdivided in 4 groups and received during 45 days: VD free-AIN'93 (-VD Ca0.5%); VD free-AIN'93 contain-
ing 0.3%Ca (-VD Ca0.3%); VD free-AIN'93 containing 0.3%Ca and 2.5% prebiotics (-VDCa0.3% Prebiotics) or VD free-AIN'93 containing 0.3%Ca and prebiotics 5% (-VDCa0.3%:Prebioticsx2). Food intake and faeces (F) were collected to determine Ca intake (CaI) and Ca en feces (CaF). Ca Abs% = CaI - CaF/ CaI x 100.

**Results:** Ca Abs % as mean±SD: -VDCa0.5%: 32.71±1.74; -VDCa0.3%: 38.33±2.33;

-VD0.3%Prebiotics: 44.71±1.84; -VD0.3%x2Prebiotics: 56.40±1.39; +VD0.3%Prebiotics: 87.45±1.82; +VD0.5%: 67.80±2.21. As expected, VD insufficiency reduced Ca Abs%

(-VDCa0.5% and -D0.3% vs. +VDCa0.5%; p<0.001). Moreover, GOS/FOS® effectiveness was negatively affected (-VD0.3% Prebiotics vs. +VD0.3% Prebiotics; p<0.001). Ca Abs% of free-VD diets containing GOS/FOS® mixture was improved by increasing prebiotic % in the diet (-VD0.3% Prebiotics vs. -VD0.3:2xP; p<0.01).

**Conclusions:** Under our experimental conditions VD nutritional status affected the effectiveness of prebiotics on Ca Abs.

**Keywords:** Prebiotics, low calcium intake, vitamin D insufficiency, rats

**Further collaborators:**

Grants: UBACyT 20020130100091BA and PIP (CONICET) 11220130100199CO

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CARDIOMETABOLIC PREDISPOSITION AT ESCUELA AGRÍCOLA PANAMERICANA ZAMORANO 2016

(1)Di iorio, Adriana; (2)Hernández, Adriana; (3)Espinal, Raul; (4)Fuentes, José isidro.

(1)MS.c. Investigación en atención primaria de la salud. Universidad Miguel Hernández. España; (2)DSP. Doctorado en salud Publica. Universidad de San Carlos. Guatemala; (3)PhD. Grain Science and Post-Harvest Technology. Kansas State University; (4)BsC. Agroindustria Alimentaria. Escuela Agrícola Panamericana Zamorano. Honduras.

**Background and objectives:** In the bodily composition, fatty components show a tight bond with obesity and the development of non-transmissible chronic diseases. The posed objectives were:

- Assess blood glucose level, cholesterol and blood pressure

- Determined the BMI, % visceral fat, muscle mass and body water

- Link levels of income and physical activity

**Methods:** It is a descriptive study with a sample of 30-years-old and older 80 voluntary employees (56% female) with three years or more of seniority in Zamorano. An equipment of bioelectric impedance mBCA SECA 514 was used. The sample was estimated with a reliability of 99%, precision of 3% for a bilateral hypothesis adjusted to 5% lost.

**Results:** Age and seniority averaged 43±9.92 y 15.6±2, respectively. 67% of the women and 63% of the men showed prediabetes. 9% of females and 15% of males presented high levels of CT. 16%

of women and 9% of the men showed diabetes and hypertension. Higher physical activity was linked with higher levels of TAS (r=-0.273, p=0.016). 82% of females and 89% of males presented android obesity, males reported visceral fat percentages of 4.05% in comparison to females (2.69%) (p=0.0022). The muscle media was 25.38Kg in women and 33.5 Kg in men inducing to a Sarcophenic obesity. 77% of the population registered optimum levels of hydration as compared to high levels of hydration in physically active employees. Higher levels of income correlated to a higher T.E.E r=0.8472 p<0.001 and r=0.453 p=0.001 and a low physical activity. Lower incomes reported higher P.A.E.E.

**Conclusions:** The BMI glucose, cholesterol, visceral fat and P.A.E.E revealed that employees are at a high risk of cardio metabolic disease not only affecting their quality of life but also their work performance.

**Keywords:** diabetes, hypertension, bioelectric impedance, metabolic syndrome

**Further collaborators:**

ITCH

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HOST TRANSCRIPTIONAL RESPONSES FOLLOWING EX VIVO RE-CHALLENGE WITH MYCOBACTERIUM TUBERCULOSIS AMONG A MALNOURISHED POPULATION

(1)Yu, Elaine A.; (2)John, Serene H.; (1)Tablante, Elizabeth C.; (2)Kenneth, John; (3)Russell, David G.; (1)Mehta, Saur.

(1)Division of Nutritional Sciences, Cornell University, Ithaca, New York; (2)Division of Infectious Diseases, St. John's Research Institute, Bangalore, Karnataka, India; (3)Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, New York.

**Background and objectives:** The identification of immune correlates that are predictive of disease outcome for tuberculosis remains an ongoing challenge. To address this issue, we evaluated gene expression profiles from peripheral blood cells following ex vivo challenge with Mycobacterium tuberculosis (M. tb), among participants with active TB disease (ATBD), latent TB infection (LTBI), and previous active TB disease (after successful treatment; PTBD), relative to controls.

**Methods:** Study participants with TB were recruited at a rural hospital in India, which has a clinical population with a high prevalence of malnutrition (median body mass index 18.7 kg/m2 [interquartile range 16.8, 22.1]). Peripheral blood mononuclear cells from participants with ATBD (n=10), LTBI (n=10), and PTBD (n=10), and controls (n=10) were infected with live M. tb. Differential gene expression profiles were assessed by suppression-subtractive hybridization, dot blot, real-time polymerase chain reaction, and the comparative cycle threshold methods.

**Results:** Comparing ATBD to control samples, greater fold-increases of gene expression were observed for a number of chemotactic factors (CXCL1, CXCL3, IL8, MCP1, MIP). ATBD was also
associated with higher IL1B gene expression, relative to controls. Among LTBI samples, gene expression of several chemotactic factors (CXCL2, CXCL3, IL8) were similarly elevated, compared to individuals with PTBD.

**Conclusions:** Our results demonstrate that samples from participants with ATBD and LTBI have distinct gene expression profiles in response to ex vivo M. tb infection. These findings indicate that there is value in further characterizing the peripheral responses to M. tb challenge as a route to defining immune correlates of disease status or outcome, particularly among populations with a high burden of malnutrition.

**Keywords:** Mycobacterium

Tuberculosis

Gene expression profiling

Subtractive hybridization techniques

**Conflict of Interest Disclosure:** E.A.Y., S.H.J., E.C.T., D.G.R., and J.K. have no conflicts of interest. S.M. is an unpaid board member of a diagnostic start-up focused on developing assays for low-cost and point-of-care measurement of certain nutrients from a drop of blood using results from his research as a faculty member at Cornell University.

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TRIGLYCERIDE-GLUCOSE INDEX (TYG INDEX) AS AN INDICATOR OF CARDIOMETABOLIC RISK IN OVERWEIGHT MAN APPARENTLY HEALTHY

(1)Caldas, Ana Paula; (2)Alves, Raquel Duarte Moreira; (3)Bressan, Josefina.

(1)MSc. Nutritionist. Department of Nutrition and Health.
Universidade Federal de Viçosa. Brazil.; (2)PhD. Nutritionist.
Department of Nutrition. Univiçosa. Brazil.; (3)PhD. Nutritionist.
Department of Nutrition and Health. Universidade Federal de
Viçosa. Brazil.

**Background and objectives:** The detection of insulin resistance in apparently healthy individuals represents an important clinical tool in the prevention of cardiovascular diseases. Recently, the Triglyceride-glucose index (TyG index) was considered a promising marker of insulin resistance associated with the occurrence of cardiovascular events regardless of the presence of other risk factors. This way, the objective of present study was use TyG index for evaluate the insulin resistance and your association with other cardiometabolic risk factor in overweight man apparently healthy.

**Methods:** This was a cross sectional study performed with 64 overweight man (BMI: 26 - 34,9 kg/m2; 18-50 years) apparently healthy that, after informed consent, gave blood in fasting condition. The volunteers were submitted the anthropometric and cardiometabolic markers measurements. TyG index {TyG= Ln [fasting triglyceride (mg/dL) × fasting plasma glucose (mg/dL)]/2} was used as a measure for to assess the degree of insulin resistance

**Results:** The volunteers had on average 27,5 ± 0,9 y and BMI 29,7 ± 0,3. Altogether, 61% (n = 39) were overweight and the rest were obese. According to TyG index TyG, 50% (n=32) of the volunteers were insulin resistant (TyG > 4,65). There were significant correlations between the TyG index and fasting glucose (r= 0,640, p<0,001), fasting insulin (r=0,600, p<0,001), total cholesterol (r=0,256, p=0,041), triglycerides (r=0,988, p<0,001), HDL-c (r= -0,450, p<0,001), VLDL-c (r=0,987, p<0,001), LDL-c:HDL-c (r=0,488, p<0,001), total cholesterol:HDL-c (r= 0,685, p<0,001) and Non-HDL cholesterol (r=0,459, p<0,001). There were no correlations between TyG index and weight, BMI or waist circumference. When grouped in resistant and non-insulin resisting using to TyG index, insulin resistant individuals had higher values of BMI (p=0,026), waist circumference (p=0,014), fasting glucose (p<0,001), fasting insulin (p<0,001), total cholesterol (p=0,007), triglycerides (p<0,001), HDL-c (p=0,002), VLDL-c (p<0,001), LDL-c:HDL-c (p<0,001), total cholesterol:HDL-c (p<0,001) and Non-HDL cholesterol (p<0,001) In relation to non-insulin resistant individuals.

**Conclusions:** The present study demonstrated the efficiency of the TyG index in the identification of insulin resistance associated with cardiometabolic risk in apparently healthy overweight men.

**Keywords:** Cardiometabolic markers, Overweight man, TyG index.

**Further collaborators:**

The number of authors did not exceed the allowed total

144/801

K36, A SYNTHETIC CAFFEAMIDE DERIVATIVE, IMPROVES THE PATHOLOGY OF ALZHEIMER'S DISEASE IN STREPTOZOTOSIN AND HIGH FAT DIET-INDUCED TYPE 2 DIABETIC RATS

(1)Shen, Szu-Chuan; (1)Wu, Pei-Chin; (1)Tu, Meng-Shiuan; (1)Tu, Rong-Shiuan; (1)Lin, Shih-Shiang; (2)Kuo, Yeuh-Hsiung; (3)Chang, Wen-Chang; (3)Ting, Yu-Wen; (3)Wu, James Swi-Bea; (1)Wu, ChHao.

(1)National Taiwan Normal University; (2)China Medical University;

(3)National Taiwan University.

**Background and objectives:** Type 2 diabetes mellitus (T2DM) is a metabolic disease accompanied with hyperglycemia and hyperinsulinemia. T2DM, which is major caused by obesity, characterized with insulin resistance, may result in the metabolic disorder. Epidemiology studies showed that T2DM is a high risk factor of Alzheimer's disease (AD). Previous studies confirmed that caffeamide may improve serum glucose and insulin resistance in diabetic animals. This study aims to investigate the protective effect of caffeamide derivative compound K36 on pathology of AD in the streptozotosin (STZ)-high fat diet (HFD)-induced T2DM rats.

**Methods:** The male Wistar rats fed HFD (60% fat of calorie) for 4 weeks, then were intraperitoneally (ip) injected STZ (30mg/ kg b.w.). After injection, the rats were served HFD continuously for 8 weeks to induce T2DM, and then orally administered with
K36 (15mg/kg b.w.) once a day for 13 weeks. The rats were re-
ceived cognition test before sacrificing. The blood biochemical
analysis was conducted after the rats were scarified. The expres-
sion of cerebral hippocampus and cortex insulin signaling, synap-
tic function protein and synaptic expression related protein were
analyzed by western blotting.

**Results:** The results showed that rats exhibit hyperglycemia (216.8 mg/dl) and hyperinsulinemia (1.53 µg/mL) after STZ injection and HFD feeding for 8 weeks, indicating the induction of T2DM. The serum total cholesterol (TG, p<0.05), serum triglyceride (TC, p<0.05), free fatty acid (FFA, p<0.01) is significantly decreased in K36 treated T2DM rats compared to the T2DM rats (p<0.05). The results from Morris Water Maze task indicated K36 significantly improves the cognition ability in T2DM rats (p<0.05). Western blotting analysis revealed that the protein expression of cerebral insulin receptor substrate-1 (IRS-1), brain-derived neurotrophic factor (BDNF), postsynaptic density protein 95 (PSD-95) in K36 treated T2DM rats were increased compared to the T2DM rats (p<0.05).

**Conclusions:** In addition, K36 also suppresses the expression of amyloid beta precursor protein (βAPP) and amyloid beta (Aβ) in T2DM rats. According to the above results, we suggest that caffeamide derivative K36 may prevent AD progression via alleviating cerebral insulin resistance and ameliorating synaptic plasticity in STZ-induced T2DM rats.

**Keywords:** caffeamide derivative, Alzheimer's disease, type 2 diabetes mellitus, cerebral insulin resistance.

**Methods:** Male Wistar rats were fed HFD (60% fat of calorie) for 4 weeks followed by single intraperitoneal injection of streptozotocin (STZ, 30mg/kg), and then served HFD continuously for 8 weeks to induce hyperglycemia. The HFD-STZ-induced diabetic rats were orally administered with ALA once a day at a dosage of 200 mg/kg for 13 weeks. After rats were sacrificed, the serum lipid profiles were measured, the VAT (epididymal and perirenal adipose tissues) was picked up and weighed, and the pro-inflammation related cytokines of VAT were analyzed.

**Results:** Our results showed that HFD plus STZ treatment results in markedly hyperlipidemia and hyperglycemia in rats. The administration of ALA significantly reduced the levels of fasting serum insulin, total cholesterol, low density lipoprotein, triglyceride and free fatty acid by 55%, 39%, 73%, 68% and 53%, respectively, whereas significantly increased high density lipoprotein level by 1.54 fold in diabetic rats (p<0.05), suggesting the reduction on the risk of CVD-related complications. The relative VAT weight was significantly decreased by 40% in ALA treated diabetic rats (p<0.05), indicating the suppression of lipid accumulation. Moreover, ALA also significantly decreased the levels of pro-inflammatory cytokines such as interleukin 6, tumor necrosis factor-alpha in serum and IL-1β in VAT of diabetic rats (p<0.05).

**Conclusions:** In conclusion, the present study demonstrates that ALA may have benefits on preventing the progression of hyperlipidemia via ameliorating blood lipid profiles and inflammation of VAT in HFD-STZ-induced diabetic rats.

**Keywords:** alpha lipoic acid, hyperlipidemia, inflammation, type 2 diabetes mellitus, visceral adipose tissue

144/804

ALPHA LIPOIC ACID ALLEVIATES HYPERLIPI-
DEMIA AND INFLAMMATION OF VISCERAL ADI-
POSE TISSUE IN HIGH FAT DIET PLUS STREPTO-
ZOTOCIN -TREATED RAT MODEL

(1)Shen, Szu-Chuan; (1)Tu, Meng-Shiuan; (1)Wu, Pei-Chin; (1)Tu, Rong-Shiuan; (1)Lin, Shih-Shiang; (1)Chang, Yu-Yuan; (2)Chang, Wen-Chang; (2)Ting, Yu-Wen; (2)Wu, James Swi-Bea; (1)Wu, ChHao.

(1)National Taiwan Normal University; (2)National Taiwan University.

**Background and objectives:** Hyperlipidemia is a symptom commonly occurred in type 2 diabetes mellitus (T2DM). Studies suggest that individuals with both T2DM and hyperlipidemia may increase the risk of cardiovascular disease (CVD)-related complications, such as coronary artery disease. The dysfunction of visceral adipose tissue (VAT) is considered to be associated with insulin resistance and subsequently may result in the lipid metabolism abnormality in T2DM. Evidence indicates that inflammatory related markers are associated with the high serum lipid level. Alpha lipoic acid (ALA) is an endogenous cofactor located in mitochondria. Previous studies reported that ALA has therapy potential on improving hypoglycemia in diabetic rats. This study investigates the effect of ALA on hyperlipidemia in high-fat-diet (HFD) plus STZ-induced diabetic rats.

144/806

EFFECT OF DIFFERENT DIETARY OIL COMBINED
WITH LYCIUM BARBARUM POLYSACCHARIDE
EXTRACT ON LIVER FIBROSIS INDUCED BY CCL4
IN RATS

(1)Chao, Jane; (2)Chiang, Yun-Yun.

(1)PhD. Professor. School of Nutrition and Health Sciences. Taipei Medical University. Taiwan; (2)MSc. Student. School of Nutrition and Health Sciences. Taipei Medical University. Taiwan.

**Background and objectives:** The effective therapy for liver fibrosis is still elusive. Olive oil and Lycium barbarum polysaccharides were considered to act as hepatoprotective activity. This study investigated anti-inflammatory and anti-fibrotic effects of olive oil and Lycium barbarum polysaccharide extract (LBE) on CCL4-induced liver fibrosis in rats.

**Methods:** Male Sprague-Dawley rats were divided into 7 groups: normal diet (N), soybean oil diet (S), olive oil diet (O), soybean oil/olive oil diet (mix oil, M), soybean oil diet + LBE (S+L), olive oil diet + LBE (O+L), and soybean oil/olive oil diet + LBE (M+L). The LBE-treated groups were given 50 mg/kg/day LBE. Except for the N group, other six groups were injected with CCL4 intraperitoneally for 8 weeks.
**Results:** The results showed that CCL4 caused more severe liver fatty change, necrosis, and fibrosis, and increased plasma activities of aspartate aminotransferase and alanine aminotransferase (ALT), while the groups treated with mix oil or LBE decreased plasma ALT activity compared with the S group or corresponding group without LBE. Compared with the N group, liver interleukin (IL)-10 level was significantly lower in the S, O, and S+L groups, but liver tumor necrosis factor-α (TNF-α) level was not changed in the S group. The mix oil group restored liver IL-10 level compared with the S group, and the LBE-treated groups decreased liver TNF-α level. The N group had significantly higher matrix metalloprotein (MMP)-2 level than other groups. The S group had significantly higher tissue inhibitors of metalloprotein (TIMP)-1 level than the N group, and olive oil or LBE decreased liver TIMP-1 level compared with the S group. Liver hydroxyproline was significantly higher in the O, M, and S+L groups compared with the N group, and olive oil reduced hydroxyproline when LBE was given.

**Conclusions:** Mix oil and LBE decreased liver injury and inflammation. Olive oil or mix oil combined with LBE inhibited inflammation but improved liver fibrosis partially.

**Keywords:** olive oil, Lycium barbarum polysaccharides, inflammation, liver fibrosis

**Conflict of Interest Disclosure:** All authors declare no conflict of interest. The study is supported by the Ministry of Science and Technology, Taiwan (grant no. 105-2320-B-038-036-MY3).

**Further collaborators:** Prof. Suh-Ching Yang

daily for 12 weeks based on the recommended energy requirement. Serum interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), malondialdehyde (MDA), and total antioxidant capacity (TAC) were measured at weeks 0, 6, and 12.

**Results:** Serum IL-10 and TAC levels in the treatment group were increased significantly at week 12. Moreover, serum IL-6, TNF-α, CRP, and MDA levels in the treatment group were decreased significantly at week 12. There were no significant differences for inflammatory and oxidative stress markers in the control group at weeks 0, 6, and 12. Increases in serum IL-10 level in the treatment group were significantly greater than those in the control group at week 12 compared with the baseline. Furthermore, decreases in serum TNF-α and CRP levels in the treatment group were significantly greater than those in the control group at week 12 compared with the baseline.

**Conclusions:** Our results suggest that oral balanced nutritional supplement is effective for anti-inflammation and antioxidation in hemodialytic patients.

**Keywords:** oral supplement, inflammation, oxidative stress, hemodialysis

**Further collaborators:** Prof. Shwu-Huey Yang

## 144/807

### EFFECTS OF ORAL BALANCED NUTRITIONAL SUPPLEMENT ON INFLAMMATION AND OXIDATIVE STRESS IN HEMODIALYTIC PATIENTS

(1)Chao, Jane; (2)Un, Teng-Hong.

(1)PhD. Professor. School of Nutrition and Health Sciences. Taipei Medical University. Taiwan; (2)MSc. Student. School of Nutrition and Health Sciences. Taipei Medical University. Taiwan.

**Background and objectives:** According to the United States Renal Data System 2015 Data Report, Taiwan had the highest prevalence of end-stage renal disease (ESRD) in the world. Inflammation and oxidative stress are risk factors of cardiovascular disease in ESRD patients. Insufficient data show whether intake of oral balanced nutritional supplement can improve inflammation and oxidative stress in hemodialytic patients. Therefore, this study evaluated the effect of oral balanced nutritional supplement on inflammation and oxidative stress in hemodialytic patients.

**Methods:** One hundred hemodialytic patients were recruited and divided evenly into two groups. The subjects in the control group were kept on their regular diet without supplement. The subjects in the treatment group were assigned one or two packages (43 g per package) of oral balanced nutritional supplement (200 kcal energy, 48% carbohydrate, 32% fat, and 20% protein per package) containing arginine (0.7%, w/w) and glutamine (4.8%, w/w)

## 144/815

### EFFECTS OF MELATONIN ON GLUCOSE HOMEOSTASIS, ANTIOXIDANT ABILITY AND ADIPOKINE SECRETION IN NA/STZ-INDUCED DIABETIC ICR MICE

(1)Chien, Yi-Wen; (2)Lo, Chung-Cheng; (3)Yang, Ting-Hsuan; (3)Ou, Tzu-Hsuan.

(1)PhD., RD; (2)MS, Department of Nutrition and Health Science, Taipei Medical University, Taipei, Taiwan ROC; (3)Department of Nutrition and Health Science, Taipei Medical University, Taipei, Taiwan ROC.

**Background and objectives:** The relationship between the melatonin and diabetes has been previously investigated. Moreover, supplement of melatonin on obese diabetic rats can improve their metabolic syndromes, such as blood glucose, plasma lipid and adipokine. The aim of this study was to investigate the effects of different dosage of melatonin on glucose hemostasis, oxidative state and adipokine secretion in diabetic ICR mice.

**Methods:** Mice were divided into five groups, including: control (C), diabetic (D), three dosage melatonin-treated group. Treated group were subdivided into L, M and H that given melatonin respectively 10, 20, 50 mg/kg. Melatonin was dissolved in vehicle (ethanol aqueous solution). After the diabetes induction, the mice were given melatonin or vehicle orally between 17:00-19:00 daily. Oral glucose tolerance test (OGTT) was performed at week 0 and 6. After the six-week-intervention, hepatic and plasma lipid, malondialdehyde (MDA), and anti-oxidative enzyme were analyzed by colorimetric method. Plasma insulin, leptin and adiponectin were measured.
**Results:** Although none of melatonin-treated group performed reduced glucose level, H group performed significant less increased glucose level and higher insulin level compared to diabetic group (p < 0.05). Treating melatonin could reduce diabetes-increased MDA level in liver and plasma and increase superoxide dismutase activity in liver. Moreover, there were no significant differences in relative fat mass between D and treated group, but melatonin-treated group revealed significant higher adiponectin and lower leptin and leptin/adiponectin ratio compared to diabetic group, especially in H group.

**Conclusions:** High dosage of daily oral melatonin administration ameliorates the glucose tolerance, oxidative stress and adipokine without affecting fat mass in NA/STZ-induced diabetic mice.

**Keywords:** melatonin, diabetes, leptin, adiponectin and insulin resistance

144/834

BODY COMPOSITION BY BIOELECTRICAL IMPEDANCE IN A MULTI-ETHNIC POPULATION FROM GERMANY, MEXICO AND JAPAN

**Background and objectives:** According to the WHO Expert Consultation, current BMI cut-offs should be retained as an international classification. It is therefore important to consider the impact of race/ethnic differences on clinically meaningful body composition at these cut-offs.

The aim of the study was to analyze ethnic differences in the bioelectrical impedance analysis (BIA) outcome measures fat mass index (FMI), fat-free mass index (FFMI), skeletal muscle mass (SMM), visceral adipose tissue, extracellular/total body water (ECW/TBW), bioelectrical vector analysis (BIVA) and phase angle.

**Methods:** Body composition was measured (seca mBCA 514/515) in 3,069 healthy adults with a wide range of age and BMI (18-78 y, BMI 13.9-44.3 kg/m²) from Germany, Japan and Mexico (1,048 Caucasians, 995 Japanese and 1,026 Mexican). Regression analyses between BIA outcome variables and BMI were used to predict ethnic-specific reference values for different WHO-BMI cut-off points.

**Results:** Caucasian men and women had the highest fat free mass (FFM) per fat mass (FM) whereas Japanese and Mexican populations had a lower and similar amount of FFM per FM at an underweight and normal weight BMI. However in obesity, the Japanese phenotype corresponds more closely to the Caucasian body composition. In the Japanese population, phase angle was lower compared with Caucasians (compatible with lower SMM/FFM and higher ECW/TBW) and BIA vector was shorter compared with Mexicans.

**Conclusions:** Ethnic-specific relationships between BMI and body composition vary with weight status and emphasize the need for ethnic-specific normal values for the diagnosis of obesity, sarcopenia or disturbed hydration.

**Keywords:** Ethnicity, body composition, BIA, BIVA, reference values

**Conflict of Interest Disclosure:** Björn Jensen and Michael Maisch are employees of seca gmbh & co. kg, Hamburg, Germany. The remaining authors declare no conflict of interest.

144/836

LONG-TERM DITYROSINE ADMINISTRATION INDUCES MYOCARDIAL DYSFUNCTION BY OXIDATIVE STRESS

**Background and objectives:** Cardiovascular disease is connected with inflammation and oxidative stress. Previous studies indicated administration of oxidized protein impairs antioxidant system in organs. Dityrosine is an oxidative biomarker of acute myocardial infarction and generated during food processing and storage. This studies aim to explore the role of dityrosine in cardiac diseases.

**Methods:** The rats were administered with dityrosine for 24 weeks. Blood pressure and heart rate were measured. T-AOC, GSH-Px and other oxidative stress markers as well as CK-MB, LDH, AngII, NO, FFA were examined. The ultrastructural features of heart mitochondria were examined under a transmission electron microscope. And quantitative PCR was carried out to examine the expression level of related genes.

<footnote>(1) Jensen, Björn; (2) Moritoyo, Takashi; (3) Kaufer Horwitz, Martha;</footnote>

<footnote>(4) Peine, Sven; (5) Maisch, Michael Johannes; (6) Matsumoto, Aya;</footnote>

<footnote>(7) Masui, Yuka; (8) Velázquez-González, Antonio; (9) Domínguez-García, Jannet; (10) Bosy-Westphal, Anja.</footnote>

<footnote>(1) Diploma. Research and development. seca gmbh & co. kg. Hamburg. Germany; (2) MD, PhD. The University of Tokyo Hospital. Japan; (3) PhD. Researcher. Clínica de Obesidad y Trastornos de la Conducta Alimentaria. Departamento de Endocrinología y Metabolismo. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. México; (4) MD. Institute for Transfusion Medicine. University Hospital Hamburg-Eppendorf. Germany; (5) MD. seca gmbh & co. kg. Hamburg. Germany; (6) MSc. The University of Tokyo Hospital. Japan; (7) BSc. The University of Tokyo Hospital. Japan; (8) MD. Chief. Departamento de Medicina Transfusional. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. México; (9) BSc. Nutritionist. Clínica de Obesidad y Trastornos de la Conducta Alimentaria. Departamento de Endocrinología y Metabolismo. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. México; (10) PhD, MD. Institut für Ernährungsmedizin. Universität Hohenheim. Stuttgart. Germany.</footnote>

<footnote>(1) Le, Guowei; (2) Zhao, Qi; (3) Li, Zhuqing; (4) Shi, Yonghui.</footnote>

<footnote>(1) PhD. School of food science and technology, the research centre of nutrition and functional factors. Jiangnan University. China.; (2) MSc. School of food science and technology, the research centre of nutrition and functional factors. Jiangnan University. China.</footnote>
**Results:** Dityrosine administration increases DBP and SBP, but no change in heart rate. CK, CK-MB, LDH, ICTP, PIIINP and FFA were upregulated by dityrosine and NO was downregulated. With dityrosine administration for 24 weeks, the biomarkers of oxidative stress in myocardium such as MDA, AOPP, DT were increased, while T-AOC and GSH-Px were decreased, indicating impaired antioxidant capacity by dityrosine administration. Transmission electron microscopic result suggested the alternation of heart mitochondria ultrastructure induced by dityrosine. Finally, Dityrosine upregulated TNF-α, IL-6 and P38 expression level and downregulated PPARα expression level in myocardium of rats.

**Conclusions:** These results indicated dityrosine induce oxidative stress in myocardium and reduce myocardial collagen degradation rate, which lead mitochondrial dysfunction and myocardial energy generation.

**Keywords:** Dityrosine, Oxidative stress, Myocardial dysfunction

**Conflict of Interest Disclosure:** There are no competing financial interests in relation to the work.

lation between the amount of iron, protein or zinc intake per day and hemoglobin level. (iron: r = 0.575, protein: r = 0.630 and zinc: r = 0.661, respectively)

**Conclusions:** The measurement of hemoglobin using fingertip sensor might be useful option for monitoring the status of iron nutrition to prevent sports anemia.

**Keywords:** sports anemia, hemoglobin, non-invasive fingertip sensor, protein, iron

144/837

## ESTABLISHMENT OF HEMOGLOBIN MEASURING METHOD FOR THE PREVENTION OF SPORTS ANEMIA IN FEMALE ATHLETES

(1)Abe, Hirooshi; (2)shirai, Anna; (2)Matsumoto, Megumi.

(1)Master of student; (2)Nihon University.

**Background and objectives:** For a female athlete, iron deficiency and anemia is one of the symptoms which remarkably lowers performance, and could cause health impairment. Athletes frequently undergo anemia due to rigorous training, reducing food intake for weight control and destruction of erythrocyte by repeated sole impulse. In addition, menses make it difficult for females to improve anemia.

In this study, we focused on the collegiate female athletes of land jump, volleyball and fencing who often complain anemia, and tried to establish the simple method of measuring the hemoglobin concentration in blood using non-invasive fingertip sensor, in order to monitor the status of iron nutrition easily.

**Methods:** Subjects were composed of each 27 collegiate female athlete of land jump, volleyball and fencing. The hemoglobin concentration was measured at before training using measuring instrument of non-invasive fingertip sensor (Pront-7). Furthermore hearing investigation was performed to record the physical condition and food intake frequency of one week.

**Results:** In hearing investigation, the athletes who complained symptom of anemia were 70%, 40% and 35% in land jump, volleyball and fencing, respectively. The score of anemia condition negatively correlated with hemoglobin concentration. Hemoglobin concentrations were 12.4±0.2 g/dL, 12.1±0.4 g/dL and 12.9±0.2 g/dL athletes of land jump, volleyball and fencing, respectively. As a result of surveying the meal intake frequency in the athletes of jumping events of athletic competition, there was a positive correlation between the amount of iron, protein or zinc intake per day and hemoglobin level. (iron: r = 0.575, protein: r = 0.630 and zinc: r = 0.661, respectively)

144/842

## ASSISTING THE MANAGEMENT OF NUTRITION CARE WITH COMPUTER SYSTEMS

(1)Chen, Jiyuen-Tieng; (1)Lin, Shu-Chi; (2)Tsai, Hsiao-Jung; (2)Jen, Kai-Lin.

(1)MSc. Dietitian. Department of nutrition. Taiwan Adventist Hospital. Taiwan.; (2)BSc. Dietitian. Department of nutrition. Taiwan Adventist Hospital. Taiwan.

**Background and objectives:** In the treatment of cancer patients, it is necessary to provide adequate nutritional support. Traditionally, patients' conditions are recorded on paper by physicians, and screening for a nutrition consultation was done manually. However, patients' needs were often neglected due to the lengthy work process. In order to simplify the nutrition consultation process, and further avoid the possibility of missing cancer patients' needs, we set up computer systems to better assist the management of nutrition care.

**Methods:** The nutrition consultation standard for gastrointestinal tract cancer patients was developed in 2013. The "ICD Code Consultation Standard" for gastrointestinal tract cancer was established as the main consultation guide. When a doctor assigns a patient with a cancer ICD code, the computer system screens and sends a nutrition consultation notice immediately. Dietitians then advise the patient according to the resulting consultation list, providing nutrition care and advice based on the assessment. The nutrition recommendations and intake of these patients are recorded to analyze the effectiveness of nutritional care.

**Results:** 826 patients were counseled with gastrointestinal cancer nutrition care within 48 hours after consultation from 2013 to 2016. When enteral nutrition (EN) support was inadequate, parenteral nutrition (PN) support was provided as alternative nutritional intervention. The actual calorie intake of patients through EN or PN was recorded and analyzed. During hospitalization, the average percentage of recommended calorie intake increased from 53% to 75% (2013 to 2016), and recommended protein intake increased from 58% to 74% (2014 to 2016).

**Conclusions:** With improvement in nutritional consultation delivery supported by technology, cancer patients can receive early nutrition intervention, and get better nutrition care.

**Keywords:** Computer; Nutritional consultation; Gastrointestinal tract cancer
# DIET QUALITY SCORES AND LUNG CANCER RISK: A CASE-CONTROL STUDY OF ADULTS MEN FROM THE NORTH-EASTERN REGION OF POLAND

(1)Hawrysz, Iwona; (2)Slowinska, Malgorzata Anna; (3)Wadolowska, Lidia; (4)Krusinska, Beata; (5)Janiszewska, Katarzyna; (6)Czerwinska, Anna; (7)Golota, Janusz Jacek.

(1)MSc. Department of Human Nutrition. University of Warmia and Mazury in Olsztyn. Poland.; (2)PhD. Department of Human Nutrition. University of Warmia and Mazury in Olsztyn. Poland.;

(3)Prof. Department of Human Nutrition. University of Warmia and Mazury in Olsztyn. Poland.; (4)MD. Independent Public Complex Tuberculosis and Lung Diseases in Olsztyn. Poland.;

(5)PhD. Clinic of Thoracic Surgery. Medical Center Ars Medica. Olsztyn. Poland.

**Background and objectives:** Lung cancer is the most common cause of cancer death in men worldwide [1, 2]. The studies describing the cumulative effect of food consumption on the lung cancer risk are limited. Objective: Assessment of the association between diet quality and risk of lung cancer in men from the north-eastern region of Poland.

**Methods:** The case-control study involved 339 men aged 29-83 years from the north-eastern region of Poland. Lung cancer was diagnosed in 140 men. On the basis of the food frequency questionnaire (QEB) [3] two diet quality scores were created. Pro-Healthy Diet Index-8 (pHDI-8) included 8 items: fruit, vegetables, wholemeal bread, milk, fermented milk drinks, cottage cheese, fish, legumes. Non-Healthy Diet Index-8 (nHDI-8) included 8 items: sweets, fried food, instant soups, fast foods, canned, sweetened carbonated beverages, energy drinks and alcoholic drinks. Multiple logistics regression analysis was used. Two models were created: crude and adjusted for: age, SES index, overall physical activity, sedentary lifestyle, occupational exposure, smoking, prevalence of cancers in family, BMI, weight change and waist-to-height-ratio.

**Results:** The odds ratios (ORs) of lung cancer prevalence in comparison to the absence of cancer (OR=1.00) were from 0.37 (95% confidence interval 95% CI: 0.21-0.65; p<0.001; crude) to 0.25 (95% CI: 0.12-0.51; p=0.0001; adjusted) in men in the upper tertile of the p-HDI-8. The ORs of lung cancer in comparison to the absence of cancer (OR=1.00) were 0.57 (95% CI: 0.33-0.98; p<0.05; crude) in men in the upper tertile of the n-HDI-8, but not significant after adjustment.

**Conclusions:** In men from north-eastern Poland, the high diet quality score characterized by the frequent consumption of the pro-healthy foods strongly reduced the incidence of lung cancer, independently of confounders. The associations between low diet quality score and lung cancer risk was not clear and needs further research. References: [1] Vieira AR et al. Fruits, vegetables and lung cancer risk: a systematic review and meta-analysis. Ann Oncol, 2016, 27(1):81-96. [2] Didkowska J et al. Lung cancer epidemiology: contemporary and future challenges Worldwide. Ann Transl Med, 2016, 4(8):150. [3] http://www.uwm.edu.pl/edu/lidiawaradolowska/, available at: 24.03.2017.

**Keywords:** lung cancer, men, dietary pattern, pro-healthy diet, non-healthy diet

**Conflict of Interest Disclosure:** None. Research relating to this abstract came from Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn and was funded by Polish Ministry of Science and Higher Education.

# POLISH ADAPTED PRO-MEDITERRANEAN DIET SCORE AND OTHER DIETARY PATTERNS AND BREAST OR LUNG CANCER RISK: A POOLED ANALYSIS OF TWO CASE-CONTROL STUDIES

(1)Krusinska, Beata; (2)Hawrysz, Iwona; (3)Wadolowska, Lidia;

(3)Slowinska, Malgorzata Anna; (4)Biernacki, Maciej; (5)Czerwinska, Anna; (6)Golota, Janusz Jacek.

(1)MSc. Department of Human Nutrition. University of Warmia and Mazury in Olsztyn. Poland.; (2)Prof. Department of Human Nutrition. University of Warmia and Mazury in Olsztyn. Poland.;

(3)PhD. Department of Human Nutrition. University of Warmia and Mazury in Olsztyn. Poland.; (4)PhD. Department of Surgery. University of Warmia and Mazury in Olsztyn. Poland.; (5)MD.

Independent Public Complex Tuberculosis and Lung Diseases in Olsztyn. Poland.; (6)PhD. Clinic of Thoracic Surgery. Medical Center Ars Medica. Olsztyn. Poland.

**Background and objectives:** Results: Methods: This pooled analysis of two case-control studies involved 560 subjects (280 men and 280 women) aged 40-75 years from north-eastern Poland. Breast cancer in 140 women and lung cancer in 140 men were diagnosed. The food frequency consumption for selected 21 food groups was collected using the FFQ-6 [2]. Three DPs were identified in Principal Component Analysis: 'Prudent', 'Non-Healthy' and 'Dressings and sweetened-low-fat dairy'. The 8-items Pro-Mediterranean diet (Pro-MED) score (range: 0-8 points) included: vegetables, fruit, whole grain, fish, legumes, nuts and seeds, ratio of vegetables oils to animal fat, red and processed meat. Multiple logistics regression analysis was used. Two models were created: crude and adjusted for: age, sex, type of cancer, BMI, SES index, overall physical activity, smoking status and abuse of alcohol.

**Results:** The odds ratios (ORs) of both cancers prevalence in comparison to the cancer absence (OR=1.00) were 0.37 (95% confidence interval 95%CI:0.21-0.64;p<0.001; adjusted) and 0.35 (95%CI:0.21-0.58;p<0.0001; crude) in the top category (6-8 points) of the Pro-MED score and in the upper tertile of the 'Prudent' DP was 0.62 (95%CI:0.41-0.94;p<0.05; crude), not significant after adjustment. The cancer ORs in comparison to the cancer absence were 1.65 (95%CI:1.05-2.59;p<0.05; adjusted) and 1.89 (95%CI:1.25-2.86;p<0.01; crude) in the upper tertile of the 'Non-Healthy' DP. The cancer ORs for the 'Dressings and sweetened-low-fat dairy' DP were not significant.

**Conclusions:** In Polish adults from northern-eastern Poland, the high adherence to the Mediterranean diet significantly low-
ered the chance of the breast or lung cancer, independently of confounders. The beneficial effect of the Mediterranean diet was stronger than the ‘Prudent’ pattern. The high adherence to the ‘Non-Healthy’ pattern increased chance of the breast or lung cancer. References: [1]Schwingshackl L., Hoffmann G. Adherence to Mediterranean diet and risk of cancer: an updated systematic review and meta-analysis of observational studies. Cancer Medicine, 2015, 4(12):1933-1947. [2]http://www.uwm.edu.pl/edu/lidiawadolowska/, available: 25.03.2017.

**Keywords:** breast cancer, lung cancer, dietary pattern, Mediterranean diet, adults

**Conflict of Interest Disclosure:** None. Research relating to this abstract came from Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn and was funded by Polish Ministry of Science and Higher Education.

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## THE ASSOCIATION BETWEEN DIETARY CHOLESTEROL INTAKE AND DYSLIPIDEMIA PREVALENCE AMONG ADULTS IN CHINA: FINDINGS FROM THE CHINA HEALTH AND NUTRITION SURVEY

**Background and objectives:** There is still controversy about deleting the recommendation of no more than 300mg/d dietary cholesterol for the healthy person. This study aims to examine the dose-response association between dietary cholesterol intake beyond 300mg/d and serum lipids-profile in Chinese adults.

**Methods:** Data from China Health and Nutrition Survey in 2009, 6,521 adults aged 18 to 65 who had complete diet data, serum lipids and sociodemographic data were selected as the analysis sample. Dietary cholesterol intake was assessed with consecutive 3-d 24-h recall and classified into 6 levels (0-<100mg/d, 100-<200mg/d, 200-<300mg/d, 300-<400mg/d, 400-<500mg/d and ≥400mg/d). The adults were defined as dyslipidemia (including high triglycerides, high total cholesterol, high LDL-C and low HDL-C) according to Guidelines for prevention and treatment of dyslipidemia in Chinese adults revised in 2016.

**Results:** About 36.4% of the men and 28.3% of the women had at least one abnormal serum lipid and only 21.9% of the men and 26.7% of the women had ideal level of the lipids-profile. The prevalence of high triglycerides, high total cholesterol, high LDL-C and low HDL-C in Chinese adults was 19.3% (men 22.9%

vs. women 16.0%, P<0.05), 8.6%, 10.1 and 10.7% (men 14.1% vs. women 7.5%, P<0.05), respectively. Multivariate Logistic regressions showed that the odds of having high TC and high HDL-C among the adults with dietary cholesterol intake higher than 500mg/d were 1.81 times (95%CI: 1.03, 3.22, p-trend>0.05) and 1.70 times (95%CI: 1.02, 2.81, P-trend>0.05) the odds in the adults with dietary cholesterol intake of 200-300 mg/d after adjusting for all potential covariates, respectively. However, the levels of dietary cholesterol intakes were not associated with the prevalence of high TG and low HDL-C.

**Conclusions:** it was found that the impact of dietary cholesterol intake on the prevalence of high TC and high LDL-C in Chinese adults may be threshold, rather than linear trend, at the level of 500mg/d or higher instead of limit of 300mg/d Prospective study in this field is needed to confirm the findings.

**Keywords:** Dietary cholesterol, lipids-profile, dyslipidemia, adults, China

**Further collaborators:** Hongru Jiang, Chang Su

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## INTAKE OF ADDED SUGARS AND SATURATED FAT IN HEART FAILURE

**Background and objectives:** Heart failure (HF) has high rates of hospitalization and mortality. There is no consensus in the literature whether diets rich in saturated fat and added sugars contribute to the incidence and progression of HF. This study aimed to evaluate if the intake profile of saturated fat and added sugars would be associated with HF.

**Methods:** The study used data from DIGITALIS, a study that estimated the prevalence of HF in the population assisted by the Family Medical Program in Niterói, Rio de Janeiro - Brazil. It was applied FFQ to evaluate the intake of added sugars and saturated fat. HF was diagnosed by clinical examination, electrocardiogram, echocardiogram and B-type natriuretic peptide and the population classified as: healthy (0), no symptomatic with risk factor (A), no symptomatic with functional/structural alterations (B), symptomatic with functional/structural alterations (C) and frequent symptomatic (D). ANOVA test was performed for continuous variables and Chi-Square test for categorical variables, considering $p \le 0.05$ for statistical significance. The intake was evaluated by the recommendation, 10% and 7% of total energy intake for added sugars and saturated fat, respectively, and by quintiles.

<footnote>(1)Wang, Zhihong; (2)Huang, Feifei; (3)Wang, Huijun; (4)Zhang, Jiguo;</footnote>

<footnote>(5)Zhang, Bing.</footnote>

<footnote>(1)PhD. Professor. National Institute for Nutrition and Health, China CDC; (2)MS. Research Assistant. National Institute for Nutrition and Health, China CDC; (3)MS. Professor. National Institute for Nutrition and Health, China CDC; (4)PhD. Research Associate. National Institute for Nutrition and Health, China CDC;</footnote>

<footnote>(5)PhD. Professor. National Institute for Nutrition and Health, China CDC.</footnote>

<footnote>(1)Cardoso, Luciana; (2)Rosa, Maria Luiza; (3)Couto, Camilla; (4)Yokoo, Edna.</footnote>

<footnote>(1)BSc. Nutritionist. Collective Health Institute. Federal Fluminense University. Brazil.; (2)PhD. Physician. Collective Health Post-Graduation Program. Collective Health Institute. Federal Fluminense University. Brazil.; (3)BSc. Nutritionist. Collective Health Post-Graduation Program. Collective Health Institute. Federal Fluminense University. Brazil.; (4)PhD. Nutritionist. Collective Health Post-Graduation Program. Collective Health Institute. Federal Fluminense University. Brazil.</footnote>
**Results:** Around 59% and 70% of the sample exceeded the recommendation for added sugars and saturated fat, respectively. The analyses for recommendation and last quintile for added sugars and saturated fat together, showed there was no statistically significant difference between HF categories and healthy individuals (p=0.905 and 0.127, respectively). The result was similar in the individualized analysis for grams per day (p=0.115 and p=0.331, respectively) and quintiles (p=0.245 and 0.144, respectively).

**Conclusions:** The incidence and progression of HF were not associated with intake of added sugars or saturated fat, either above the recommendation or in the last quintile of intake in this population.

**Keywords:** heart failure, added sugar, saturated fat

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## LOW HDL IS ASSOCIATED WITH REDUCED GLOMERULAR FILTRATION RATE IN CHILDREN WITH OVERWEIGHT/OBESITY

(1)Alonso, Elizabeth; (2)Muzzio, María Luz; (3)Kabakian, Laura; (4)Scricciolo, Romina; (5)Lando, Inés; (5)Brovarone, Lucrecia; (5)Peredo, Maria Soledad; (5)Fernández, Jorgelina; (6)Santucci, Pía; (2)Meroño, Tomas.

(1)MD, Pediatric Specialist. Servicio de Diabetes y Nutrición Infanto-Juvenil, Complejo Médico Churruca-Visca.; (2)PhD. Biochemist. Central Laboratory. Complejo Médico Churruca-Visca. Buenos Aires. Argentina.; (3)MD. Pediatric Specialist. Servicio de Diabetes y Nutrición Infanto-Juvenil. Complejo Médico Churruca-Visca. Buenos Aires. Argentina.; (4)Biochemist. Central Laboratory. Complejo Médico Churruca-Visca. Buenos Aires. Argentina.; (5)Nutritionist. Servicio de Diabetes y Nutrición Infanto-Juvenil. Complejo Médico Churruca-Visca. Buenos Aires. Argentina.; (6)MD. Endocrinology Specialist. Servicio de Diabetes y Nutrición Infanto-Juvenil. Complejo Médico Churruca-Visca. Buenos Aires. Argentina.

**Background and objectives:** Several longitudinal studies have found an association between childhood overweight/obesity and the risk of kidney disease. Indeed, the increasing prevalence of kidney disease in children suggests that obesity-related glomerulopathy might begin at early stages of life. Renal hyperfiltration is postulated as one of the early events in obesity-related glomerulopathy. However, decreased, instead of increased, glomerular filtration rate (GFR) has been recognized in some series of children with overweight/obesity. The aim of this study was to evaluate the correlation between the GFR and biomarkers of the nutritional status in children with overweight/obesity.

**Methods:** Prospective study carried out in 35 children [age: 11(9-13)years] with overweight/obesity who attended the Pediatric Nutrition Unit of the "Complejo Médico Churruca-Visca", Buenos Aires, Argentina. Anthropometric measures were recorded. Z-scores were calculated according to the World Health Organization (WHO) growth charts. GFR was estimated using the Zappitelli combined formula which includes creatinine and cistatin C measurements. Routine laboratory measurements and biochemi-

cal evaluation of selected micronutrients were performed. Differences were evaluated by T or U test and correlations by Pearson or Spearman Correlation test, according to data distribution.

**Results:** Out of the 35 children studied (18 males), 25 were obese and 10 were overweight. Mean GFR was 97±15 ml/min.1.73m2, range: 76-132 ml/min.1.73m2. GFR was lower in males than females (-15%,p<0.01). Neither insulin resistance markers nor plasma levels of ferritin, vitamin B12 and vitamin D were correlated with GFR. GFR was only significantly correlated with HDL-C (r=0.41,p<0.01). Children with low HDL-C (n=23) presented higher Z-BMI (+16%,p<0.05), triglycerides (+33%,p<0.01) and cistatin C (+22%,p<0.01), as well as lower GFR (-21%,p<0.01) and Vitamin B12 (-30%,p<0.01) than children without low HDL-C. No differences in sex distribution were observed between the children with or without low HDL-C.

**Conclusions:** In this study of children with overweight/obesity we did not observe GFR values compatible with hyperfiltration (>135 ml/min.1.73m2). Instead, a trend towards lower GFR values was observed in this population. HDL-C was inversely correlated with the GFR. Children with overweight/obesity and low HDL-C may be at increased risk of renal dysfunction. Longitudinal studies are needed to confirm this hypothesis.

**Keywords:** Obesity, kidney disease, glomerular filtration rate, children, HDL-C.

**Conflict of Interest Disclosure:** The authors have no conflict of interest

**Further collaborators:**

The authors thank the collaboration of the Registered Nurse Beatriz Castillo.

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## NUTRITION SCREENING FOR OVER NUTRITION IN ADULTS AGED 18-49 YEARS IN URBAN CITY OF KAMPALA, UGANDA

Ssenyondo, Muzafaru; Ainomugisha, Prudence; Nyakake, Lynn.

BSc. Department of Food Technology & Nutrition. Makerere University. Uganda.

**Background and objectives:** Background: According to WHO findings, Non-communicable diseases (NCDs) primarily cardiovascular diseases, cancers, chronic respiratory diseases and diabetes, are responsible for 63% of all deaths worldwide (36 million out of 57 million deaths), which could easily be prevented through nutrition education and early screening. About 80% of all NCD deaths occur in low and middle income countries in which Uganda belongs. The lack of nutrition education and direct disease screening programs for communities in urban areas, has been a critical gap in the community and national response to lifestyle diseases, especially nutrition related NCDs. Objective: To create awareness on NCDs, bring screening services closer to the urban population in order to promote an economically productive and non-communicable disease free population through Mobile Nutrition clinics; which provide effective community nutrition
screening and education; to ensure early detection, referral and treatment of nutrition- related NCDs in the community.

**Methods:** A three-day Urban Public Nutrition clinic ( 4th to 6th/09/2016) was organized by the Human nutrition students at Kampala Railway ground. Services provided included screening for 1) Malnutrition using anthropometry, 2) Random blood sugar test to screen for diabetes and 3) Blood pressure measurement. 4) Nutrition education using IEC materials, food demonstrations using the food pyramids, counseling and referrals.

**Results:** A total of 534 (77.7%, Males & 22.3%, Females) adult participants assessed, 41.7% had BMI above normal (>24.9 Kg/ m2). Of these, 66.7% had high blood sugar levels and 49.6% had raised systolic blood pressure. They were counseled and referred to hospitals for treatment.

**Conclusions:** Conclusion: High incidence of NCDs among overweight urban population living in Kampala. Bringing services closer to Kampala urban population would help create awareness, educate and identify NCDs cases early and save lives.

**Keywords:** non- communicable diseases, mobile nutrition clinic, screening, Urban areas and over nutrition.

**Results:** After adjusting for relevant confounders, PRAL (p=0.003), alcohol (p<0.0001), UAE (p=0.03) and meat intake (p=0.003) were positively associated with SUA whereas the intake of fruits & vegetables and of milk products was inversely associated (both p<0.0001). Subgroup analyses among participants without interacting medication use largely confirmed these results. Additionally, participants with lower PRAL had lower odds for hyperuricemia (OR=0.60, 95% CI: 0.43-0.83).

**Conclusions:** Apart from substantiating known dietary influences on SUA, a low PRAL shows itself as a potentially SUA-reducing dietary pattern. This strengthens the importance of dietary alkalization as a future nonpharmacological tool to treat elevated SUA levels and gout.

**Keywords:** Dietary acid load, potential renal acid load, serum uric acid, nutrition, DEGS1

144/938

## POTENTIAL RENAL ACID LOAD: A DIETARY PREDICTOR OF SERUM URIC ACID

(1)Esche, Jonas; (2)Krupp, Danika; (3)B.M. Mensink, Gert; (4)Remer, Thomas.

(1)MSc. DONALD Study Center Dortmund. IEL - Nutritional Epidemiology. University of Bonn. Dortmund, Germany; (2)Dr. Nutritionist. DONALD Study Center Dortmund. IEL - Nutritional Epidemiology. University of Bonn. Dortmund. Germany; (3)Dr. Nutritionist. Robert Koch-Institute. Department of Epidemiology and Health Monitoring. Berlin. Germany; (4)Prof. Nutritionist. DONALD Study Center Dortmund. IEL - Nutritional Epidemiology. University of Bonn. Dortmund. Germany.

**Background and objectives:** Experimental studies indicated that a reduction of dietary acid load, e.g., by an increased consumption of fruits and vegetables, leads to increased renal uric acid excretion and reduced serum uric acid (SUA) levels. Against this background we examined the association between dietary potential renal acid load (PRAL) and SUA in a representative sample of the German adult population.

**Methods:** Cross-sectional analyses were performed in n=6894 participants (18-79y) of the German Health Interview and Examination Survey for Adults (DEGS1). Dietary intake was assessed by a food frequency questionnaire (FFQ). Nutritive acid load and the intake of uric acid equivalents (UAE) were characterized by assigning PRAL and UAE values, respectively, to the reported food consumption. Multiple linear regression models were used to analyze the association of PRAL, UAE and relevant food groups with SUA. Multiple logistic regressions were used to calculate the odds ratio (OR) for hyperuricemia comparing lower (T1) and upper (T3) tertiles of the predictors.

144/942

## ASSESSING THE IMPACT OF DIETARY PATTERNS, ANTHROPOMETRICS, AND LIFESTYLE ON CARDIAC RHYTHM: RESULTS FROM THE HEART RHYTHM AND OBESITY PREVENTION (HEARS) STUDY

(1)LORENZONI, GIULIA; (2)Gregori, Dario; (3)Folino, Franco; (1)Azzolina, Danila; (4)Reginato, Elena; (5)Valentini, Romina; (6)Gafare, Claudia.

(1)MA. PhD student. Unit of Biostatistics, Epidemiology and Public Health. Department of Cardiac, Thoracic and Vascular Sciences. University of Padova. Italy; (2)PhD. Full Professor in Biostatistics. Unit of Biostatistics, Epidemiology and Public Health. Department of Cardiac, Thoracic and Vascular Sciences. University of Padova. Italy; (3)MD. Cardiologist. Unit of Cardiology. Department of Cardiac, Thoracic and Vascular Sciences. University of Padova. Italy; (4)BS. Nurse. Unit of Biostatistics, Epidemiology and Public Health. Department of Cardiac, Thoracic and Vascular Sciences. University of Padova. Italy; (5)MA. Dietitian. Dietetics Unit. Department of Medicine. University of Padova. Italy; (6)BS. Dietitian. Department of Nutrition. University of Buenos Aires. Food and Diet Therapy Service. Acute General Hospital Juan A. Fernández of Buenos Aires. Argentina.

**Background and objectives:** Cardiac rhythm abnormalities are well known to be predictors of severe, life-threatening, cardiac arrhythmias, especially in patients with underlying cardiovascular diseases. In recent years, it has been suggested that eating habits may affect cardiac rhythm and the chance of developing rhythm abnormalities. However, evidence are controversial and inconclusive. The aim of the present study was to inspect relationships among lifestyle, dietary patterns, and anthropometrics with heart rhythm (Heart Rate Variability (HRV), Premature Ventricular and Atrial Complexes (PVC and PAC)), in patients undergoing Holter monitor.

**Methods:** The Heart Rhythm and ObeSity Prevention (HEARS) study is a cross-sectional investigation enrolling sub-
jects undergoing Holter monitor. Socio-demographic character-
istics, body composition (full-body bioimpedentiometry), 24-h
dietary recall, and quality of life were assessed. Generalized Ad-
ditive models, considering a Zero Adjusted Gamma distribution
(accounting for outcomes' skewness), were estimated to assess the
relationship between outcomes of interest and variables collected.

**Results:** The study enrolled 121 patients, showing a median of 33 PVC (1-400; I-III quartiles) and 39 PAC (9-224; I-III quartiles), registered by Holter monitor. At multivariate analysis, fruit consumption was directly associated with HRV (p-value 0.044), while higher BMI was associated with lower HRV. PVC showed significant direct association with age (p-value 0.005), intake of grain-based product (p-value 0.001), snacks (p-value 0.063), and sugars (p-value 0.013); while fruit intake was significantly inversely associated with PVC (p-value 0.024). Regarding anthropometrics, mass of body fat was in a direct relationship with PVC (p-value <0.0001). Aging and cardiovascular comorbidities were significantly associated with PAC. Regarding dietary intake, condiments and sauces raised the likelihood of PAC (p-value 0.01), while protein food consumption was significantly inversely associated to PAC (p-value <0.0001).

**Conclusions:** These findings highlighted that anthropometrics, lifestyle, and nutrition are associated with cardiac rhythm abnormalities, and that factors importance changed according with outcome considered. Despite the need of further studies to better characterize the contribution of such factors to cardiac rhythm abnormalities, these findings might be useful to improve the management of patients attending cardiac rhythm labs, in order to tailor ad hoc prevention strategies (modification of lifestyle and eating habits) based on Holter parameters.

**Keywords:** Heart Rate Variability, Premature Atrial Complex, Premature Ventricular Complex, Eating habits, Adiposity

Imaging Diagnosis. São Paulo State University (UNESP). Botucatu Medical School. Brazil.

**Background and objectives:** HIV-associated lipodystrophy (HALS) is characterized by morphological changes due to fat tissue heterogeneous disorders, with body fat redistribution associated or not to metabolic alterations. Such alterations are consequences of the chronic inflammatory state due the viral infection and the usage of specific therapy to treat the sickness. The HALS is described as a syndrome which consider the fat loss and/or accumulation, classified in three subtypes. The impairments due these metabolic and morphological alterations go beyond esthetic consequences, once there may be an increased risk to the development of other disturbances, such as the Metabolic Syndrome (MS). Considering the existence of body composition differences per gender, the objective of the present study was to verify, among genders, the clinical-nutritional and anthropometric differences of people living with HIV/AINDS with clinical diagnoses of HALS.

**Methods:** The study was observational and transversal, with its sample selected by convenience and performing clinical

immunological characterization, anthropometric assessment,
nutritional diagnosis, body composition of PLHA during the fol-
low-up of specialized outpatient service in infectiology with a clin-
ical HALS diagnosis from July 2015 to July 2016, in regular ART
use for at least a year, ranging from 18 to 60 years old. Pregnant
women, people with chronic kidney failure, nephrotic syndrome,
B and C virus chronic infection, uncontrolled hypothyroidism
were

excluded from the study.

**Results:** Forty individuals were distributed equally by gender, with age of 45,5 ± 8,2 years, diagnostic time of 15,3 ± 6,2 years and antiretroviral therapy usage time of 13,8 ± 5,7 years. The results showed significant difference on lipid profile to female gender, with increased values, exce-pt for HDL-cholesterol. No statisti-cal differences were observed for fasting blood glucose and clin-ical-immunological parameters between genders.

**Conclusions:** Despite the lack of differences, body fat and an-
thropometric indicators presented higher alterations among

women living with HIV/AIDS. Lipid profile significant alter-
ations and high body fat values (even without statistical signifi-
cance) among women suggests an increased risk for cardiovas-
cular diseases when compared to men in the aforementioned
population, highlighting the importance to adopt different follow
up strategies for those patients.

**Keywords:** People living with HIV/aids, lipodystrophy, body composition, metabolic syndrome.

**Further collaborators:**

Support: FAPESP (process 2015/10103-7)

<footnote>(1)Justina Papini, Silvia; (2)Sacilotto, Lívia Bertazzo; (3)Mendes, Adriana Lúcia; (4)Corrente, José Eduardo; (5)Manechini, João Paulo Vieira; (6)Pereira, Paulo Câmara Marques.</footnote>

<footnote>(1)PhD. Nutritionist. Department of Nursing. São Paulo State University (UNESP). Botucatu Medical School. Brazil.; (2)MD. Nutritionist. Department of Tropical Disease and Imaging Diagnosis. São Paulo State University (UNESP). Botucatu Medical School. Brazil.; (3)PhD professor. São Paulo State University (UNESP). Botucatu Medical School. Brazil.; (4)Adjunct professor. Department of Bioestatisc. São Paulo State University (UNESP). Institute of Biosciences. Botucatu. Brazil.; (5)MD student. University of São Paulo (USP), Ribeirao Preto Medical School, Brazil; (6)Adjunct professor. Department of Tropical Disease and</footnote>
# THE ASSOCIATION BETWEEN DEPRESSION AND FOOD INSECURITY STATUS IN TWO IRANIAN ETHNIC GROUPS LIVING IN NORTHWEST OF IRAN

Rezazadeh, Arezoo; Omidvar, Nasrin; Eini-Zinab, Hassan.

Department of Community Nutrition. National Nutrition and Food Technology Research Institute. Faculty of Nutrition and Food Technology. Shahid Beheshti University of Medical Sciences and Health Services. Iran.

**Background and objectives:** Studies approve that Food insecurity (FI) influences on mental health. Minor ethnic group may experience higher level of FI and this situation may be related with higher depression prevalence. The aim of this study was to determine the association of depression with general and central obesity in major (Azeri) and minor (Kurd) ethnicities living in Urmia, West Azerbaijan, Iran.

**Methods:** In this cross-sectional study, 723 participants (427 women and 296 men) aged 20–64 year old, from two ethnic groups (445 Azeri and 278 Kurd) were selected through a multi stage cluster systematic sampling. Depression rate was assessed by “Beck” short form questionnaire (validated in Iranians) through interviews. Household food insecurity status (HFIs) were measured using adapted household food insecurity access scale through face-to-face interviews at homes. Multinomial logistic regression was used to estimate odds ratios (OR) of depression across HFIS.

**Results:** Higher percent of Kurds had moderate and severe depression in comparison with Azeri group (73[17.3%] vs. 86[27.9%]). There was not any significant differences between the two ethnicities in mild depression. Also, of all the subjects, moderate-to-sever FI was more prevalent in Kurds (28.5%), compared to Azeri group (17.3%) [P<0.01]. IN Kurd ethnic group who were food secure or with mild HFI had lower chance to have sever depression (OR=0.097; 95% CI: 0.02-0.47) in comparison to those with sever FI. However, there was no significant association between depression and HFI in Azeri group.

**Conclusions:** Findings revealed that the severity of HFI was related with severity depression in minor studied ethnic groups. However in Azeri ethnicity as a major group other confounders may have influence on the relation with depression and FI that not controlled in the present study.

**Keywords:** depression, food insecurity status, ethnicity, Iran

# ANTHROPOMETRIC AND BIOCHEMICAL PROFILE OF PATIENTS AT THE TIME OF DIAGNOSIS OF HEPATITIS C: A CASE-CONTROL STUDY

(1)Pacheco, Pauline Müller; (2)Mendes, Roberta Hack; (3)Blasquez, Daniele; (4)Marraccini, Patricia; (5)Nascimento, Adriana; (6)Arantes Ferreira Peres, Wilza; (7)Franco-Sena Siqueira, Ana Beatriz; (8)de Moraes Sobrinho Pôrto, Luís Cristóvão.

(1)MSc in Epidemiology. Nutricionist. Department of Social Medicine. Universidade Federal do Rio Grande do Sul. Brazil.;

(2)PhD in Biological Sciences (Physiology). Nutricionist. Histocompatibility and Cryopreservation Laboratory. Universidade do Estado do Rio de Janeiro (UERJ). Brazil.;

(3)PhD in Human and Experimental Biology. Histocompatibility and Cryopreservation Laboratory. Universidade do Estado do Rio de Janeiro (UERJ). Brazil.; (4)Esp. in Clinical Nutrition. Histocompatibility and Cryopreservation Laboratory. Universidade do Estado do Rio de Janeiro (UERJ). Brazil.;

(5)PhD in Histology. Department of Histology and Embryology. Universidade do Estado do Rio de Janeiro (UERJ). Brazil.; (6)PhD in Clinical Medicine. Department of Nutrition and Dietetics.

Universidade Federal do Rio de Janeiro (UFRJ). Brazil.; (7)PhD in Nutrition. Instituto de Nutrição Josué de Castro. Universidade Federal do Rio de Janeiro (UFRJ). Brazil.; (8)PhD in Human Biology. Histocompatibility and Cryopreservation Laboratory. Universidade do Estado do Rio de Janeiro (UERJ). Brazil.

**Background and objectives:** Currently 170 million people worldwide are infected with the hepatitis C virus, the biggest cause of viral hepatitis. The objective of our study was to evaluate the differences between the anthropometric and biochemical profile of patients with hepatitis C diagnosis and controls from the Polyclinic Piquet Carneiro (Rio de Janeiro, Brazil).

**Methods:** Case-control study. Patients were recruited at the time of the diagnostic examination of hepatitis C. We included 99 adult patients with positive diagnosis. The 50 controls were recruited among people without hepatitis C at the time of routine exams. The individuals were weighed and measured. Blood samples were collected for the determination of total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, total bilirubin (TB) and direct bilirubin (DB), glutamic oxalacetic transaminase (GOT), glutamic pyruvic transaminase (GPT) and iron.

**Results:** Most of the subjects were overweight and obese, 40.8% and 24.5% of the patients, and 36.9% and 27.2% of controls respectively. total cholesterol and LDL were significantly higher in control subjects (Md 196.00 mg/dL -IQ 123.00-343.00) and (Md 118.00 mg/dL-IQ 43.00-256.00), when compared to patients with hepatitis C (Md 170.50 mg/dL-IQ 108.00-314.00) and (Md 93.00 mg/dL-IQ 31.60-225.00). The levels of TB, DB, AST, ALT and iron were lower in the controls when compared to patients with hepatitis C. In the final model, adjusted for age and presence of comorbidities, TB (p 0.02), DB (p 0.02), AST(p <0.01) and Iron (p 0.04) remained significantly lower in the controls.

**Conclusions:** Overall, These results demonstrated that patients do not have significant anthropometric alterations at the
time of diagnosis of hepatitis C, but already present significant alterations in the biochemical markers. These results reinforce the importance of the composition of biochemical and anthropometric indicators for a correct diagnosis.

**Keywords:** Hepatitis C; Anthropometry; Biomarkers

**Keywords:** Gastroplasty. Obesity. Nutrition assessment. Quality of life.

**Further collaborators:**
UNIFRAN (University of Franca) and UNIMED Franca.

144/988

NUTRITIONAL CHARACTERISTICS AND QUALITY OF LIFE OF PATIENTS SUBMITTED TO ROUX-EN-Y GASTRIC BYPASS

(1)Pansani Maniglia, Fabíola; (2)Cirino Jacomini, Letícia; (2)Marques Costa, Lauane Cristina; (3)Guilherme Silveira, Ludimila; (4)de Almeida C. R. Torres, Maria Virginia; (5)Rodrigues Navarro, Fábio Henrique.

(1)MSc. Nutritionist. Unifran. Brazil.; (2)Student of Nutrition. Unifran. Brazil.; (3)Nutritionist. Unimed Franca. Brazil.; (4)Nurse. Unimed Franca. Brazil.; (5)Doctor. Unimed Franca. Brazil.

**Background and objectives:** In some cases, bariatric surgery may be an alternative treatment for obesity, which may contribute to weight loss and control comorbidities, but may also lead to food intolerances. The objective of this study was to evaluate the nutritional characteristics and quality of life of patients undergoing bariatric surgery.

**Methods:** 39 patients who are in treatment in a multidisciplinary center and who met these inclusion criteria were enrolled: consent to participate in the research, performance of Gastric bypass Roux-en-Y technique and age between 18 and 59 years. Personal and clinical data were obtained through interview and consultation in medical records and anthropometric measures and dietary reviews were done by a nutritionist. The quality of life evaluation was done by the BAROS protocol.

**Results:** 87.2% of the participants were females and a mean age of the population was 37.2 ± 8.7 years. The mean preoperative body mass index was 45.1 ± 7 kg / m² and a percentage of preoperative weight adequacy corresponded to 204.3 ± 25.9% for women and 236.4 ± 47, 3% for men. Of the 22 patients who reported comorbidities on preoperative, 91% had disease resolution. The mean percentages of excess weight loss according to the postoperative period were, respectively, 24.9 ± 8% (up to 3 months), 52 ± 13% (4 to 11 months) and 62.3 ± 15, 9% (1 year or more). The median postoperative time was 7 months and the minimum and maximum values were 1 to 24 months, respectively. All patients underwent multidisciplinary treatment before and after surgical intervention. The dietary assessment indicated that 23% of the individuals presented intolerance to red meat, 18% did not accept chicken meat and 5.1% had difficulty consuming fish. The vegetables were not accepted by only 2 participants (5.1%). 53.8% of the participants obtained the maximum score in the BAROS Protocol, classifying their quality of life as excellent.

**Conclusions:** Surgery promotes progressive weight loss and resolution of comorbidities, and although there are certain food intolerances, especially with animal protein items, quality of life is considered excellent by the majority of the patients operated on.

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ENTERAL NUTRITION IN CRITICALLY ILL ADULTS: ARE THE PRESCRIPTION AND THE NUTRIENT DELIVERY ACCORDING TO THEIR REQUIREMENTS?

Villa, Roberto.

MD. PhD. Professor of Medicine. Terapia Intensiva Adultos. Obra Social para la Actividad Docente. Argentina.

**Background and objectives:** Identify factors that impede the delivery of enteral nutrition, and assess the amount of nutrients prescribed, required, and actually delivered for critically ill adults.

**Methods:** In a prospective cohort study 55 consecutive patients aged 58.2 ± 11.4 years, who received enteral nutrition for > 2 days through gastric or post-pyloric tubes, were followed from admission until the first 15 days of nutritional delivery. The amounts of prescribed / delivered energy were recorded daily and compared with basal metabolic rate (goal energy) according to the recommendations of WHO (1). The reasons for cessation of enteral feeding were evaluated. The prognostic score The Acute Physiology and Chronic Health Evaluation (APACHE II) (2) and Simplified Acute Physiology Score (SAPS II) was used at admission.

**Results:** The mean caloric intake was 19.5 ± 8.8kcal/kg/day, 60% of the median caloric amount required, and 85% of the prescribed. The ratio delivery/required was > 90% of the goal energy in only 44% of enteral nutrition days (164/370). Low prescription rate was the predominant reason for not achieving the goal energy in the first five days of enteral nutrition; after this study point, other factors were associated. In bivariate analysis, factors significantly associated with low energy delivery were: APACHE II > 14, gastrointestinal complications, use of adrenergic vasoactive drugs regardless of the dose with which the patient is. When the logistic regression model was applied, only the use of adrenergic vasoactive drugs was a independent and significant factor (p=0,043).

**Conclusions:** The prescription and delivery of energy were not appropriated in > 50% of enteral nutrition days. Among the factors analyzed, a low rate of enteral nutrition prescription and the use of adrenergic vasoactive drugs showed association with low energy delivery.

1. Report of a Joint FAO/WHO/UNU Expert Consultation. Human energy requirements WHO Rome, 17-24 October 2001: World Health Organization.

2. Knaus WA, Draper EA, Wagner DP, Zimmermann JE. APACHE II: a severity of disease classification system. Crit Care Med 1985; 10:818-29.

3. FAO/OMS/UNU. Human energy requirements. Technical Paper Series, No. 1. Rome, 2004.
(1)Villa, Roberto; (2)Clochiatti, Natalia; (2)Vargas, Erick.

(1)MD. PhD. Professor of Medicine. Terapia Intensiva Adultos. Obra Social para la Actividad Docente. Argentina.; (2)MD. Physician. Terapia intensiva. Obra social para la actividad docente. Argentina.

**Background and objectives:** The earliest start point of the enteral nutrition (EN), as well as the basal energy expenditure (BEE) achieved in a time space as short as possible seem to benefit a good amount of critical patients.

Objectives: To analyze the time to start the EN and the BEE achieved in the elderly interned with a septic shock diagnose and to verify the association with mortality in these patients.

**Methods:** Prospective cohort hold within 32 months and with 67 patients over 65 years-old in ICU with septic shock where 59 of those had EN. The APACHE II score was carried out in every patient. The following variables were analyzed in this group: the time taken to start the NE, the BEE (achieved or not), the time to reach the BEE in those who got it. These variables were correlated with death and it was still observed if there was correlation between the start time point of EN and the achieved BEE. The statistics tests used were: T test and chi-square, considering 5% as the significance level.

**Results:** The average age was 80 + 7 (min.= 66, max.= 96), the APACHE II average was 18 + 5 (min.= 8, max.= 28), and the time average to start EN was 80 ± 53 h (min. de 12 h e max. de 240 h). The achieved BEE occurred in 69,5% (n= 41) of the patients and the time average to reach it was 115 ± 56 h (min. de 72 h e max. de 360 h). Death was associated with time to start EN (p= 0,001) and with the non-achieved BEE (p< 0,001). However, there was no correlation with time to reach BEE (p= 0,22). The time to start EN did not show association with the achieved BEE (p= 0,08).

**Conclusions:** The EN initiated as soon as possible and the BEE when achieved in this group of patients showed some benefit. The time to achieve the BEE seems not to have correlation with mortality in these patients. The time to start NE did not have association with the BEE achieved in this sample.

**Keywords:** Septic shock, Enteral nutrition, Start nutrition, Mortality

(1)Imai, Eri; (2)Tsubota-Utsugi, Megumi; (3)Sato, Michihiro; (4)Kikuya, Masahiro; (5)Asayama, Kei; (6)Inoue, Ryusuke; (3)Murakami, Takahisa; (7)Metoki, Hirohito; (8)Imai, Yutaka; (9)Ohkubo, Takayoshi.

(1)PhD. RD. Dept of Food Science and Nutrition. School of Human Cultures. The University of Shiga Prefecture. Japan.; (2)PhD. MPH. RD. Dept of Hygiene and Preventive Medicine. Iwate Medical University School of Medicine. Japan.; (3)PhD. Dept of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University. Japan.; (4)PhD. MD. Tohoku Medical Megabank organization. Tohoku University. Japan.; (5)PhD. MD. Dept of Hygiene and Public Health. Teikyo University School of Medicine. Japan.; (6)PhD. MD. Dept of Medical Informatics. Tohoku University Graduate School of Medicine. Japan.; (7)PhD. MD. Department of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University. Japan.; (8)PhD. MD. Dept of Planning for Drug Development and Clinical Evaluation. Tohoku University Graduate School of Pharmaceutical Sciences. Japan.; (9)PhD.MD. Dept of Hygiene and Public Health. Teikyo University School of Medicine. Japan.

**Background and objectives:** To determine the association between dietary patterns identified via a validated food frequency questionnaire (FFQ) and the risk of impaired glucose tolerance in community-dwelling adults.

**Methods:** We followed 798 participants who did not take medication for diabetes treatment and less than 5.4% of HbA1c, completed a self-administered questionnaire at baseline, and participated at least one identical follow-up health check-ups, and who did not develop diabetes (start of medication for diabetes and/or HbA1c 6.5% or more) during the follow-up period. In this study, impaired glucose tolerance was defined as HbA1c concentrations of 5.4-6.4%. The association of dietary patterns with impaired glucose tolerance was examined logistic regression analysis with adjustment for potential confounding variables.

**Results:** During the follow-up period, we identified 378 incident cases of impaired glucose tolerance. Using principal component analysis and dietary data collected through a FFQ, we identified three major dietary patterns: Japanese, high protein, and western breakfast. After adjustment for potential confounding variables, the highest quartile of the high protein pattern was 1.59 times higher risk of developing impaired glucose tolerance (95% confidence interval 1.06-2.40). Other dietary patterns were not appreciably associated with impaired glucose tolerance.

**Conclusions:** Our findings suggest that high protein dietary pattern may be related to increasing the risk of impaired glucose tolerance in Japanese populations.

**Keywords:** dietary pattern, impaired glucose tolerance, community-dwelling adults