riculture Organization of the United Nations (FAO) and the New Partnership for Africa's Development (NEPAD). In addition, FAO provided technical assistance to better mainstream nutrition into the ECOWAP 2016-2025 process. This was supported by strengthened partnerships and coordination at regional and national level

**Results:** This collaborative work between ECOWAS and regional and national stakeholders have led to the elaboration of the ECOWAP Strategic Orientation Framework 2016-2025 and the Regional Agricultural and Food and Nutrition Security Investment Program (RAFNSIP) 2016-2020, with a stronger integration of nutrition (from objectives to interventions, indicators and budget). Concerning national support, activities are being carried out to ensure a better integration of nutrition into their National Agricultural and Food and Nutrition Security Investment Plans. through effective engagement of multi-sectoral training workshops.

**Conclusions:** The progress made so far highlights the necessity to develop strong commitment and ownership by Regional Economic Communities, and to strengthen partnerships both at regional and national levels. The need to also build capacities of all stakeholders to develop more agricultural policies/programs and investments with a "nutrition lens" is fundamental to ensure that agricultural transformation plays a stronger role in combating food insecurity and malnutrition.

**Keywords:** Mainstreaming, Nutrition, RAFNSIP, RECs, ECOWAS

**Background and objectives:** Fruits and vegetables are important sources of nutrients and are associated with the reduction of risk from non-communicable diseases. Despite these benefits, there is a gap in consumption. The World Health Organization equated 5.2 million deaths globally in 2013 to inadequate fruit and vegetable consumption.

There are many contributing factors to the lack of consumption including spoilage, lack of availability, taste and other consumer preferences. Through genetic improvement methods, such as breeding, and improved management practices, these issues are beginning to be addressed, and continue to improve as the science advances.

**Methods:** In this study we assessed the market needs and opportunities for addressing food loss and waste for fruit and vegetable products. Results of our findings on key areas of impact and gaps will be presented. In addition, detailed examples with

be provided to illustrate the findings. For example, tomato transportation losses in India are estimated at 40% after harvest due to the lack of cold storage and inadequate infrastructure, which is devastating in a country where nearly half of the children are malnourished and underfed. By using breeding techniques, researchers addressed two contributing factors to the spoilage to tomatoes – shelf life and the firmness needed to make the journey to market – while still maintaining flavor and color quality consumers demand. Over a two-year period more than 500 tomato genotypes were evaluated for transportability traits. Analysis was done on the firmness, color, brix and acidity.

**Results:** This led to two tomato hybrids being commercialized. These tomatoes feature a 12-14-day shelf life, much improved over the 5-7-day range before the tomatoes would typically spoil. This has allowed tomatoes to be accessible to almost all of India, rather than just the central regions, close to the farms.

**Conclusions:** By developing strong genetic traits that disable challenges from farm to table, consumers can access the produce that is important for their nutritional needs.

**Keywords:** Fruit Vegetable Consumption Genetic Improvement

**Conflict of Interest Disclosure:** Authors are Employees and stock holder of Monsanto Company

**Background and objectives:** Studies have shown that dietary diversity is associated with socio-economic status and household food security. Conducting household dietary diversity surveys within agricultural projects is important for targeting as well as to assess the impact of these projects on food and nutrition security. Household dietary diversity survey was conducted in household that were part of the Support to Agricultural Research for Development of Strategic Crops in Africa (SARD-SC), is a multi-national CGIAR-led project, whose overall objective was to enhance food and nutrition security and contributing to reducing poverty in selected Regional Membership Countries (RMCs) in Africa. The main objective of conducting the household dietary diversity score in this case was to assess the impact of the project on household food access but also to determine the predictors of dietary diversity. We present herein the results of the predictors of dietary diversity.

<footnote>(¹)Lemke, Shawna; (²)Purcell, John; (³)Kishore, VK.</footnote>

<footnote>(¹)PhD; (²)PhD. Vice President Global Research and Development Lead. Monsanto Vegetable Seed Division. United States; (³)EMEA Solanaceous Breeding Lead. Monsanto Vegetable Division. United States.</footnote>

<footnote>(¹)Gichohi, Wanjiku; (²)Dontsop, Paul; (³)Yomeni, Marie; (⁴)Akem, Chrysanthus.</footnote>

<footnote>(¹)PhD. Nutritionist.International institute of Tropical Agriculture. Dar es Salaam.Tanzania; (²)PhD.Economist.International institute of Tropical Agriculture.Kalambo.DRC; (³)PhD.Agronomist. International Institute of Tropical Agriculture.Free Town.Sierra Leone; (⁴)PhD.Plant pathologist.International Institute of Tropical Agriculture.Ibadan, Nigeria.</footnote>
**Methods:** The household dietary diversity questionnaire was administered to the person who was responsible for meal preparation for the household the previous day. The respondent was asked about all foods eaten inside the home during the previous day and night, by any member of the household. Foods were then classified and scored into 12 food groups and an overall score obtained.

**Results:** Mean HDDS were 4.5, 4.4 and 4.9 in Mali, Sierra Leone and DRC respectively. In investigating the predictors of HDDS in Mali, proportion of household (HH) members working on farm, proportion of HH members working off farm, proportion of time women spend farming, number of parcels operated, parcel size and whether a farmers household received fertilizer subsidies or not and household income were predictors of HDDS (P<0.05). In addition to this, predictors of HDDS in Sierra Leone were the proportion of household members aged 15-65 years (P<0.05). Proportion of family members working on farm was not a significant predictor of HDDS. The only significant predictor of HDDS in Zanzibar was proportion of HH members working on farm.

**Conclusions:** Different factors influence HDDS in different settings. A thorough understanding of these factors is important for program design and optimal targeting.

**Keywords:** Household dietary Diversity, Agriculture, Nutrition

144/1981

## MODERATE AND SEVERE FOOD INSECURITY WAS ASSOCIATED WITH STUNTING AMONG PANAMANIAN CHILDREN UNDER FIVE YEARS OLD IN RURAL COMMUNITIES

**Background and objectives:** The Panama Agricultural Research Institute (IDIAP) has implementing a national project using high nutritional quality crops. The prevalence of Stunting among children under five years old in indigenous communities is a current public health problem in Panama. There is no evidence in Panama about the association between food insecurity at household level and stunting prevalence. Objective: to explore the association between food insecurity at household level with stunting in children under five years old in Panamanian rural communities.

**Methods:** A cross-sectional study with 135 children under five years old in five geographically-dispersed rural areas (indigenous: Nole Düima and Müná; and non-indigenous: Soná, Olá, and Los Pozos). Data was collected from June-September 2015. Food insecurity was defined using the Latin America and the Caribbean Food Security Scale (ELCSA), adequate food provision monthly-based (AFPMB); anthropometric measurements (weight and height were using to calculate haz and baz according with WHO2008 growth standards); and sociodemographic data were also collected. Univariate statistical analyses, principal components analysis for categorical data, and multivariate logistic regression area, age and sex controlled with robust standard errors were used to assess the association between stunting prevalence with moderate and severe food insecurity and AFPMB.

**Results:** Age mean and standard deviation (SD) was 33.7±18.2 months, (50% female and 55% from indigenous area). Mean and SD for HAZ was 1.16±1.34, a significantly difference were found in indigenous (-1.73±1.14) than in non-indigenous (-1.73±1.14) (ttest, p<0.05); for BAZ was 0.67±0.99, a significantly difference were found in indigenous (0.98±0.91) than in non-indigenous (0.29±0.96) (ttest, p<0.05). Also, the prevalence of food insecurity (moderate and severe) was significantly higher in indigenous (84.9%) than non-indigenous (31.2%) (proportional test, p<0.05). Principal component analyses show relation among area (indigenous vs non-indigenous), food insecurity and AFPMB. After controlling by area, sex and age, stunting prevalence was significantly associated with food insecurity OR=4.4 (CI95%=1.1-17.9), AFPMB OR=4.5 (CI95%=1.2-17.4), and indigenous area OR=5.2 (CI95%=1.7-15.7).

**Conclusions:** moderate and severe food insecurity was strongly associated with stunting among children under five years old living in indigenous area. Comprehensive nutritional interventions should incorporate strategies to promote dietary food diversification using biofortified crops in vulnerable groups.

**Keywords:** HAZ, BAZ, Stunting, Biofortified Crops, children

**Further collaborators:**

Teresita Henriquez. MSc. Statistical Teacher. Regional Centre of the University of Panama. Penonome City. Panama.

144/2048

## INCREASING PRODUCTIVITY OF SMALLHOLDER FARMERS THROUGH IMPROVED TOOLS AND EDUCATION

**Background and objectives:** The Food and Agricultural Organization of the United Nations has identified advancements

<footnote>(1)Barría, Maika; (2)Barría, Maika; (3)Rios, Israel; (4)Barba, Armando;</footnote>

<footnote>(5)Mojica, Eyra; (6)Vergara, Omaris.</footnote>

<footnote>(1)Nutritionist. Research and Innovation Division in Genetic and Biodiversity Resources. The Panama Agricultural Research Institute (IDIAP).; (2)Nutritionist. Research and Innovation Division in Genetic and Biodiversity Resources. The Panama Agricultural Research Institute (IDIAP). Panama.; (3)MSc. Nutritionist. Regional Nutrition Officer. Food and Agriculture Organization of the United Nations. Sub Regional Office for Mesoamerica. Panama;</footnote>

<footnote>(4)MSc. Nutritionist. Panama Ministry of Health. Panama;</footnote>

<footnote>(5)Nutritionist. Consultant HarvestPlus for Latin America and the Caribbean. Panama.; (6)MSc. Food Engineer. School of Science and Food Technology. Regional Centre of the University of Panama. Penonome City. Panama.</footnote>

<footnote>(1)Lemke, Shawna; (2)Purcell, John; (3)Edge, Mark; (4)Young, Mark.</footnote>

<footnote>(1)PhD. Food Strategy and Stakeholder Lead. Monsanto Company. United States; (2)PhD. Vice President Global Research and Development Lead. Monsanto Vegetable Seed Division. United States; (3)Director of Collaborations for Developing Countries. Monsanto Company. United States; (4)Chief Technology Officer. Climate Corp. United States.</footnote>
stevia ingredient market is expected to cross $700M. High yields, desired quality traits, resistance to pests and diseases, and dependable economic returns are key characteristics of any domesticated commercial crop. Such basic characteristics are generally selected over many generations through intensive plant breeding efforts to create improved varieties. Although systematic cultivation of stevia started in the 1970s in China, South America and Japan, only recently crop improvement efforts have been focused on making stevia more scalable and an economically sustainable crop.

**Methods:** Despite limited understanding of genetics, biology and physiology of stevia, recent demand for SGs requires rapid improvement of stevia cultivars currently used in commercial cultivation. To rapidly facilitate this, we have sequenced, generated a chromosomal level genome assembly, and fully annotated the genomes of three commercial stevia varieties with improved levels of minor rebaudiosides.

**Results:** This data has been further integrated into a comprehensive bioinformatics database for visualization and analytics of all available genomic, transcriptomic and metabolomic stevia datasets. This interface will enable specialists from multiple disciplines, such as chemists, biochemists and geneticists, to mine this database to understand and improve existing SG biosynthesis pathways through traditional breeding or discover new pathways or compounds for similar non-GMO improvement.

**Conclusions:** This information can be used to enable improved traditional stevia breeding for improved agronomic and sustainability benefits and to improve the production of SGs to enable reduced sugar intake, which can contribute to improved health.

**Keywords:** stevia, genome, breeding, agronomy, steviol-glycosides

**Conflict of Interest Disclosure:** Dr(s) Stephen Schauer, Tengfang Huang and Fayaz Khazi work at Keygene.

Dr Priscilla Samuel works at the Global Stevia Institute which is funded by PureCircle Ltd.

Dr Avetik Markosyan works at PureCircle Ltd that funded the genome research.

144/2114

THE MODAL SALIENT BEHAVIORAL, NORMATIVE AND CONTROL BELIEFS ABOUT NUTRITIONAL CLAIMS ON PREPACKAGE FOOD PRODUCTS

(1)Opolski Medeiros, Caroline; (2)Macedo Fraiz, Gabriela; (1)Labronici Bertin, Renata; (1)Stangarlin Fiori, Lize.

(1)PhD. Nutritionist. Department of Nutrition, Federal University of Paraná, Brazil.; (2)BsC. Nutritionist. Department of Nutrition, Federal University of Paraná, Brazil.

**Background and objectives:** Consumers make purchasing decisions very quickly, so, brief messages, related to nutritional content, printed on food product labels can stimulate their decisions. These messages are known as nutritional claims. There are few studies that evaluate the use of nutritional claims in the moment of food purchase and the consumer beliefs. This study iden-

tified the modal salient beliefs about the use of nutritional claims on prepackage food products among nutrition students.

**Methods:** The exploratory qualitative research were conducted with 13 nutrition students in November 2015, considering the Theory of Planned Behavior. A focus group was used to identify consumers' salient beliefs. The discussion was recorded with two recorders and data transcription was then conducted to allow content analysis of the focus group, by two independent evaluators. Modal salient beliefs were considered those mentioned at least, 75% of the total number of citations.

**Results:** All students were single and female with an average age of 20.2 ± 1.2 years. Two modal salient behavioral beliefs were identified and considered as a disadvantage of using food label: "products are more expensive to have these nutritional claims" and "nutrition content are not specific as it should be". Considering the modal salient control beliefs, most nutrition students did not mention factors that facilitate or impede them at the purchasing moment. However, one student mentioned the "facility in accessing the nutritional claim" as a factor that facilitates the use of nutritional claims in the moment of food purchase. In regard of modal salient normative beliefs, only one belief was identified: "food product producers". Prepackage food producers were mentioned as the people who would approve the use of nutritional claims since it could help consumers to buy their products.

**Conclusions:** Six modal salient beliefs were identified. They are important to explain the participant's behavior of using nutritional claims on prepackage food products. Considering the consumer's beliefs is relevant to develop actions and measures that aim the health education to increase their knowledge about nutritional claims.

**Keywords:** Food label. Consumer behavior. Behavioral research.

144/2157

FAMILY ORCHARD-GARDENS AND BACKYARD POULTRY AS ALTERNATIVE FOR IMPROVING FOOD SECURITY: UNDERGRADUATE STUDENT'S EXPERIENCE IN A MAZAHUAS COMMUNITY IN MEXICO

(1)Maafs Rodríguez, Ana Gabriela; (2)Gutierrez Gomez, Yareni Yunuen; (3)Carrillo Domínguez, Silvia; (4)Amezcua Jagger, Teresita.

(1)Nutritionist, M. Ed. Department of Animal Nutrition. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Life Sciences Department. Instituto Tecnológico y de Estudios Superiores de Monterrey. Mexico.; (2)Nutritionist, MSc, PhD. Life Sciences Department. Instituto Tecnológico y de Estudios Superiores de Monterrey. Mexico.; (3)Veterinarian, MSc, PhD. Department of Animal Nutrition. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Mexico.; (4)Veterinarian, MSc. Department of Animal Nutrition. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Mexico.

**Background and objectives:** Challenge based learning allows students to submerge in real life problems while developing knowledge and skills. The Mazahuas are an ethnic minority in
Mexico, with high prevalence of food insecurity, marginalization and poverty. Most families possess ground for growing vegetables and fruits, and keeping poultry. However, their current practices are not enough to ascertain an adequate nutrition. This context represented a great opportunity to set the goal for nutrition and sustainability engineering undergraduate students to analyze food security, family orchard-gardens and backyard poultry practices in eight Mazahua families, to identify strategies in order to improve food security in a different environment.

**Methods:** During an intensive week in September 2016, 40 nutrition and sustainability-engineer undergraduate students visited a Mazahua community to assess food security, agricultural and poultry activities of eight families. The evaluation was conducted using context-adapted questionnaires from FAO: Food Security Scale for Latin America and the Caribbean (ELCSA) and Revisions of Poultry Development. Data was analyzed to stablish food insecurity level, agricultural and poultry activities. Students put forward strategies to improve food security in the evaluated families.

**Results:** All families presented food insecurity, have a family orchard-garden and sufficient cultivation ground. Only five families grow enough food for selling and self-consumption. Products losses occur mainly due to weather changes and lack of water. All households have livestock, but only 4 families are able to obtain animal products sufficient for selling and self-consumption, and there is little or no control on the animal's diet. Students proposed strategies to improve current practices, including vegetables exchange among farmers, "nopal" wall for preventing crops freezing, use of waste for improving animal's diet and incrementing egg production for hens.

**Conclusions:** Real-life experiences are an excellent opportunity for students to understand concepts related to their filed work and to promote adequate practices in family orchard-gardens, livestock and backyard poultry in order to improve food security by increasing food variety, enhancing animal production and improving orchard care. At the same time, the experience allowed students to understand the importance of multidisciplinary work.

**Keywords:** Family orchard-gardens, backyard poultry, food insecurity, marginalized communities.

Program (PNAE – Programa Nacional de Alimentação Escolar in Portuguese). The aim of this study was to discuss how the interface between family farming and school feeding has being built in Santa Catarina state, southern Brazil, in terms of the factors that represent obstacles to its consolidation and also on those that are mechanisms for addressing and overcoming those limitations, from the perspective of different social actors involved in the process.

**Methods:** In order to collect data, a semi-structured interview technique was used, applying specific guides for each category of social actor. For data analysis, one adopted the technique of thematic content analysis, from two previous categories: barriers and coping mechanisms in the construction of the family farming interface with school feeding. The Ethics Committee for Research Involving Human Subjects approved this study (Opinion No. 1,207,443).

**Results:** The group of the research subjects consisted of 35 social actors involved in the studied interface: managers (8 technical managers, nutritionists responsible for PNAE); farmers (9 family farmers); consumers (10 members of the School Feeding Council/CAE, teachers, principals and school cooks); members of the Technical Assistance and Rural Extension/ATER (8 technicians and rural extensionists). The barriers identified were the cost of goods, bureaucracy, insufficient technical assistance, resistance to changes, weaknesses in the organization of farmers and public managers. The coping mechanisms observed in facing those obstacles were dialogue, intersectionality, investment, training activities and organization. These mechanisms have encouraged the establishment and strengthening of trustful relationships that promoted awareness of all parties about the importance of PNAE and contributed to making the necessary adjustments to meet the program requirements, guided by its goals and guidelines.

**Conclusions:** We conclude that public policies as PNAE can provide favorable changes for farmers and the students and their communities, contributing to local development and for achieving higher levels of food security and nutrition both in rural as in urban spaces. Acknowledgements: CNPq/Brasil (445595/2014-0).

**Keywords:** Local Development, Rural Development, Programs and Policies for Nutrition and Nourishment.

144/2320

BARRIERS AND COPING MECHANISMS IN THE INTERFACE BETWEEN FAMILY FARMING AND SCHOOL FEEDING FROM THE PERSPECTIVE OF DIFFERENT SOCIAL ACTORS IN SOUTHERN BRAZIL

(1)Teo, Carla Rosane Paz Arruda; (2)Mossmann, Márcia Pozzagnol.

(1)PhD. Nutritionist. Health Sciences Area. Universidade Comunitária da Região de Chapecó/Unochapecó. Brasil.; (2)MSc. Nutritionist. Health Sciences Area. Universidade Comunitária da Região de Chapecó/Unochapecó. Chapecó. Brasil.

**Background and objectives:** Family farming came to school as a public policy in Brazil, linked to the National School Feeding

144/2327

FAMILY FARMING AND SCHOOL FEEDING: PERCEPTIONS OF SOCIAL ACTORS ON THE LEGISLATION AND ITS IMPLEMENTATION

(1)Teo, Carla Rosane Paz Arruda; (2)Mossmann, Márcia Pozzagnol.

(1)PhD. Nutritionist. Health Sciences Area. Universidade Comunitária da Região de Chapecó/Unochapecó. Brasil.; (2)MSc. Nutritionist. Health Sciences Area. Universidade Comunitária da Região de Chapecó/Unochapecó. Chapecó. Brasil.

**Background and objectives:** In Brazil, Law 11.947/2009 determines that 30% of funds transferred to municipalities by the Federal Government to support the National School Feeding Program (PNAE) must be applied in purchasing from family farming
food that promote healthy eating. The study aimed to identify perceptions of different social actors on the Law 11.947 / 2009 and its implementation.

**Methods:** This is a qualitative research with 35 social actors involved in school feeding in Santa Catarina state, southern Brazil: 8 nutritionists; 9 family farmers; 10 members of the School Feeding Council; 8 rural extensionists. The Ethics Committee for Research Involving Human Subjects approved this study.

**Results:** The Law emerged as an element of strengthening family farming, by providing social valuation and income generation for the segment, resulting in a greater possibility of family permanence in the field. Local development was perceived as a positive repercussion of the Law, as it increases the economic situation of the municipality and the farming families. Therefore, the Law was perceived as a vector for healthy eating, family farming strengthening and local development. Regarding the implementation of the Law, different factors were pointed out as being involved in this process: initiative, mobilization and participation. The initiative was, mainly, from the nutritionists. The mobilization of the other actors took place by dissemination mechanisms, mapping the local production and encouragement to the family farmers become suppliers. In the scope of participation, there was a certain passivity of some actors, such as the members of the School Feeding Council, who were generally not very active. We also observed some distancing from the rural extensionists, which revealed a lack of articulation with other sectors involved. Thus, it was verified the centrality of the process is placed in the nutritionist. In addition, it is worth noting that farmers do not perceive themselves as actors in the process, which certainly limits the production of more expressive advances in the implementation of the Law.

**Conclusions:** We conclude that encouraging the participation and leadership of all the actors involved is strongly recommended. Acknowledgements: CNPq/Brasil (445595/2014-0).

**Keywords:** Key words: Local Development, Rural Development, Nutrition Programs and Policies.

144/2360

GRAIN LEGUME CULTIVATION AND CHILDREN'S DIETARY DIVERSITY IN SMALLHOLDER FARMING HOUSEHOLDS IN RURAL GHANA AND KENYA

(1)de Jager, Ilse; (2)Abizari, Abdul-Razak; (3)Douma, Jacob C.; (4)Giller, Ken; (5)Brouwer, Ingeborg.

(1)Msc. Nutritionist. Division fo Human Nutrition. Wageningen University. The Netherlands; (2)PhD. Nutritionist. Department of Community Nutrition. School of Allied Health Sciences. University for Development Studies. Tamale. Ghana;

(3)PhD. Researcher. Centre for Crop Systems Analysis group. Wageningen University. The Netherlands; (4)Professor. Plant Production Systems group. Wageningen University. The Netherlands; (5)PhD. Nutritionist. Division of Human Nutrition. Wageningen University. The Netherlands.

**Background and objectives:** Boosting smallholder food production can potentially improve children's nutrition in rural

Sub-Saharan Africa through a production-own consumption and/or an income-food purchase pathway. Rigorously designed studies are needed to provide evidence for nutrition impact, but are often difficult to implement in agricultural projects. Mixed method design is used more frequently in project evaluations as the triangulation of complementary methods may add to the rigor in evaluations. Structural equation modelling (SEM) may be a relevant new and additional method in this field.

**Methods:** In the framework of a large agricultural development project supporting legume production (N2Africa), we studied the potential to improve children's dietary diversity by comparing N2Africa and non-N2Africa households in a cross-sectional quasi-experimental design followed by structural equation modelling (SEM) and focus group discussions in rural Ghana and Kenya.

**Results:** We found no evidence that participating in N2Africa is associated with improved children's dietary diversity, mainly due to methodological limitations. For soybean, SEM indicated a relatively good fit to the posteriori model in Kenya but not in Ghana, and in Kenya only the production-own consumption pathway was fully supported with no effect through the income-food purchase pathway. Results: **Conclusions:** These findings confirm the importance of the food environment for translation of enhanced production into improved nutrition. This study shows that in a situation where rigorous study designs cannot be implemented, SEM is a useful option to analyse whether agriculture projects have the potential to translate into improved nutrition.

**Keywords:** dietary diversity, legume production, SEM analysis, children, Ghana

144/2399

PRODUCTION OF ORANGE-FLESHED SWEET POTATO (IPOMOEA BATATAS) INTERCROPPED WITH MORINGA OLEIFERA IN KAFFRINE, AGRO-ECOLOGICAL ZONE OF GROUNDNUT BASSIN IN SENEGAL

(1)Sylla, Papa Mamadou dit Doudou; (2)Tall, Ndéye Codé Laure;

(3)Mbaye, Mame Samba; (4)Ndoye, Fatou; (5)Diallo, Bassirou; (6)Diouf, Adama; (7)Dossou, Nicole; (8)Donnen, Philippe; (9)Wade, Salimata;

(3)Noba, Kandioura.

(1)MSc. Nutritionist. Botany and Biodiversity Laboratory. Cheikh Anta Diop University.; (2)PhD. National Laboratory for Plant Production Research. Senegalese Institute of Agricultural Research.; (3)PhD. Botany and Biodiversity Laboratory. Cheikh Anta Diop University.; (4)PhD. Nutritionist. Nutrition Laboratory. Cheikh Anta Diop University.; (5)Université Libre de Bruxelles. Ecole de Santé Publique Médecine.

**Background and objectives:** Biofortification is key to improve household nutrition. In Senegal, the prevalence of vitamin A deficiency (VAD) remains high, and affects 24% of children in rural areas. To prevent VAD, an intercropping trial of orange-fleshed sweet potato, an excellent source of provitamin A, with Moringa
oleifera was undertaken for the first time in the agro-ecological
zone of groundnut basin of Senegal. The objective of this study is
to identify varieties that adapt better to the agro-ecological condi-
tions of the Kaffrine region and which gives better results in asso-
ciation with Moringa oleifera.

**Methods:** Our study is conducted in a randomized complete block design with three replications for a varietal test of 4 cultivars of sweet potato and a growing test associated with the Moringa oleifere. The Four different cultivars of sweet potato were tested in pure stand and in association with Moringa oleifera variety PKM1. These cultivars differing in the color of the tuber flesh, Kander (orange), Yajendee (light orange), Caromex (yellow), Gandiol1 (white). Growth and physiological parameters were recorded in four steps during the plant life cycle. After 135 days, tubers were harvesting and the nutritional quality analysed to determine carotenoid composition of tested cultivars.

**Results:** Results showed that, the four cultivars behave well under the agro-ecological conditions of groundnut bassin. A low incidence of diseases and pests for the different cultivars both in pure and intercropping situations is observed. significant increases of tuber weight and size in intercropped plots for Kander and Yajendee cultivars compared to pure culture. Moreover, the Kander cultivar had the highest concentration in carotenoids (84.6 ± 24 mg/kg).

**Conclusions:** Sweet potato cultivars performed well under agroclimatic conditions of Kaffrine. There is no difference in behavior under pure culture conditions, whereas intercropping with Moringa oleifera has a positive effect on tuber development of the Kander and Yajendee varieties. Thus, this cropping system would be a promising route for the sustainable production of sweet potatoes with orange flesh in this area.

**Keywords:** Orange-fleshed sweet potato, moringa oleifera, Provitamin A, Senegal

**Further collaborators:** Supported by Académie de Recherche et d'Enseignement supérieur, Belgian cooperation

144/2400

HEALTH RISK INDEX OF HEAVY METALS IN COM-
MONLY CONSUMED CONTAMINATED VEGETA-
BLES IN OGUN STATE. NIGERIA

(1)Wahab, Nimot; (2)Adedokun, Balikis.

(1)Tai Solarin University of Education. Ijebu-Ode. Ogun state.
Nigeria.; (2)Student. Department of Home Economics and Hotel
management. Tai Solarin University of Education. Ijebu-Ode.
Ogun State. Nigeria.

**Background and objectives:** As long as vegetables are consumed almost raw, heavy metals accumulated in higher quantities in them get transferred into human body which can pose a life threat risk to human health. This study thus assessed the health risk index of heavy metals (As, Cd, Hg and Pb) in contaminated vegetables present in the root, stem and leafy shoot of six leafy vegetables (Corchorus oliotorus, Celosia argentia, Telfairia occidentalis,

Talinum triangulare, scotty bons and egg plants). Commonly grown and consumed by the populace of Ijebu Ife, Ijebu East Local Government area Ogun State.

**Methods:** A total of eighteen samples (three samples of leaf, stem and root) of each vegetables were randomly collected from three different gardens at the study area. Concentration of the metals were determined using Atomic Absorption Spectrophotometer. Daily intake of vegetables were determined from the consumption pattern of the vegetables using direct weighing, and the daily intake of metals (DIM) were calculated through the contaminated vegetables using the relationship given by Cui, Zhu, Zhai, Huang, Qui &Liang, 2004: DIM =Cmetal X Dintake of vegetable/ Average body weight of respondents. Health Risk Index (HRI) were thus calculated Using the formular : HIR= DIM/ ORD(Oral Reference Dose by WHO/FAO). If HIR is lesser than 1, the exposed population is considered to be save (Hassan et al, 2012).

**Results:** The range of various metals concentration of Pb, As, Cd and Hg were 0.103-0.141, 0.095-0.163, 0.085-0.118, 0.0000-0.014 in leaf, 0.113-0.165, 0.103-0.181, 0.103-0.141, 0.0003-0.018 in stem and 0.121-0.172, 0.114-0.194, 0.111-0.149, 0.0005-0.024 in root respectively. The results of the findings showed that the ORD of mercury for all vegetables is above the WHO/FAO permissible limit of 0.0001 and as such the HRI is greater than 1. The high permissible intake were also noticed by some of the metals in some vegetable.

**Conclusions:** consumption of average amount of these contaminated vegetables might pose a health risk for the consumers due to high concentration of metals especially mercury as the value obtained were above the provisional tolerable intake (PTDIs) by joint WHO/FAO.

**Keywords:** Heavy Metals Concentration. Vegetable, Health Risk Index.

144/2419

ACCEPTANCE OF SOAKED AND GERMINATED
CHICKPEA-BASED DISHES

(1)Haileslassie, Hiwot; (2)Henry, Carol; (3)Tyler, Robert.

(1)BSc. MSc. College of Pharmacy and Nutrition. University of Saskatchewan. Canada.; (2)MEd. PhD. College of Pharmacy and Nutrition. University of Saskatchewan. Canada.; (3)B.S.A. PhD. College of Agriculture and Bioresources. University of Saskatchewan. Canada.

**Background and objectives:** Chickpeas are important sources of protein, folate and minerals. However, they contain anti-nutrients which form complexes with minerals such as zinc, iron and calcium, rendering them less available or unavailable for absorption. The level of these anti-nutrients may be reduced by applying food processing techniques such as soaking and germination applicable at household level. Sensory evaluation of the processed dishes is key in determining whether the dishes prepared by applying these strategies will be accepted and utilized by consumers. Thus, we evaluated the effect of soaking and germination on sensory attributes of chickpea-based dishes.
**Methods:** We applied different times of soaking (6, 12, 18 hour) and germination (24, 48, 72 hour) to three chickpea varieties grown in Ethiopia, namely Habru, Mastewal and local. Sensory attributes including appearance, odour, texture, taste and overall acceptability were assessed using 9- and 5-point hedonic scales in phase 1 and 2, respectively. Phase 1 was carried out at Hawassa University School of Nutrition, Food Science and Technology with fifteen panellists recruited from the school. The evaluation was carried out in triplicate. Consumer acceptance tests were conducted in phase 2 in chickpea-growing communities with 30 participants.

**Results:** The overall acceptability of chickpea-based dishes ranged from 5.6 ± 1.6 to 7.1 ± 1.5, that is from "neither like nor dislike" to "like moderately". The highest value for sensory attributes was observed for a Habru-based dish prepared from seed soaked for 18 hours. The lowest score for appearance was seen for a Mastewal-based dish prepared from seed soaked for 6 hours. From germinated chickpeas, Habru germinated for 24 hour received the highest score for appearance, texture, odour and overall appearance.

**Conclusions:** Compared to ordinarily cooked dishes, there was no significant difference in sensory attributes for most chickpea-based dishes.

**Keywords:** Sensory evaluation, soaking, germination, chickpea

language other than Portuguese, English or Spanish. There remained only nine texts. The research was complemented with textbooks.

**Results:** Brazil has a broad legislative mechanism for the production, packaging, transport, conservation and commercialization of food products. One of the main obstacles to the fulfillment of all determinations is the difficulty of inspection in such a large territory. Added to this is the lack of knowledge of many operational procedures by the producers. It is noted that some themes also acquire bioethical connotations, as in the case of transgenics.

**Conclusions:** This legislative branch will ensure an increase in the quality of national food production, given that the country is quite heterogeneous. Patent registration benefits greatly from such legislation, and any crimes of this scope end up being inhibited.

**Keywords:** food law; inspection; national food production

144/2533

BRAZILIAN FOOD LAW: AN INTEGRATIVE LITERATURE REVIEW

(1)Oneti, Ciro Félix; (1)Oneti, Ciro Félix; (2) Nascimento, Lucy Christiane de Souza Hossaine do; (3) Nascimento, Lucy Christiane de Souza Hossaine do.

(1)Enfermeiro. Universidade Aberta da Terceira Idade (UNATI/UEA/AM). Brasil.; (2)Advogada. Assessora jurídica. Tribunal de Justiça do Estado do Amazonas. Brasil.; (3)Assistente Social. Especialista em Assistência e Família. Universidade Aberta da Terceira Idade (UNATI/UEA/AM). Brasil.

**Background and objectives:** One of the branches of law is in charge of legislating on food-related issues in Brazil. In a country with great territorial extension and still marked by much informality in several sectors of the production chain, it is necessary to act rigorously through a law on the production of foodstuffs to guarantee the protection of consumer health. **Objective:** To emphasize the elementary importance of the legal mechanisms acting in consonance with inspection agencies in the food production chain in the national territory.

**Methods:** This study is an integrative literature review. The search was carried out on the SciELO platform (Scientific Electronic Library Online), with the descriptors Legislation, Food and Brazil. The platform returned 65 results, the search was filtered searching for texts strictly related to the subject and incomplete texts were duplicated, before the year 2012 or published in a lan-

144/2590

PEDIATRIC NUTRITIONAL CARE BASED ON FOOD SAFETY: BASIC CONTROLS

(1)Mestre, Graciela Maria; (2)Brea, Mercedes Maria; (2)Guma, Florencia;

(2)Soto Montesano, Betiana; (2)Blasi, Sandra Nora.

(1)Nutricionist. Food and Nutrition Area. Pediatric Hospital Prof. Dr. J. P. Garrahan. Buenos Aires . Argentina; (2)Nutricionist. Food and Nutrition Area. Pediatric Hospital Prof. Dr. J. P. Garrahan. Buenos Aires. Argentina.

**Background and objectives:** Preventing foodborne infections in inpatients is a mission of the Food and Nutrition Area, supporting their nutritional care. The prevention of food infections is performed using a self-control system of risk assessment of the assisted population and hazards analysis in production and service, keeping the processes controlled and verified according to the protocol. The system requires that three basic controls work effectively: health, hygiene and hygienic habits of staff (based on training), institutional kitchen and equipment hygiene and water safety.

**Aim:** To evaluate the effectiveness of basic controls over the period 2014-2016

**Methods:** A descriptive, retrospective, cross-sectional study of microbiological records of hand swabs, food contact surfaces and monthly public water sampling was conducted.

The swabs that verify handwashing of handlers are performed while they were doing their routine activities, surface swabs after sanitizing, and tap water samples are taken. Samples are microbiologically analyzed by accredited laboratories, their results collated with the criteria of the protocol. The following levels are considered acceptable: for hands: <10 CFU/hand for coliform, absence /hand for S. aureus, E. coli and Salmonella ssp/Shigella ssp. Criteria for surfaces are <1 CFU/cm2 for enterobacteriaceae, <10 CFU/cm2 for mesophilic aerobic bacteria, absence for Listeria monocytogenes. Criteria for water are <0.5 NTU for turbidity (WHO criteria for immunosuppressed people), <3 CFU/ml for mesophilic aerobic bacteria, absence in 100 ml for E. coli and Pseudomonas aeruginosa.
**Results:** All the data of hand swabs from handlers (n: 88) were adequate to criteria. Of the 94 surface swabs, 97% were adequate and 3% acceptable. Thirty samples of water yielded 100% satisfaction for coliforms and Pseudomonas aeruginosa, 90% for mesophilic aerobic bacteria and 78% for turbidity.

**Conclusions:** Tap water, regarding turbidity, did not meet the consumption criteria for immunosuppressed patients, but is safe for healthy people according to the Argentine Food Code. In our institution tap water is used for hygiene processes. For drinking and food preparation it is subjected to heating to 100°C. Basic controls are efficient allowing for proper nutritional, dietary and infectious care of pediatric patients.

**Keywords:** nutrition, food-safety, infection prevention

144/2656

CONDITIONS OF VULNERABILITY OF THE LIVELIHOODS IN NATIVE COMMUNITIES OF PARAGUAYAN CHACO THREATENED BY DROUGHT

(1)Gavilán Jiménez, Mónica; (2)Ferreira Perez, Elisa; (2)Villalba de Gómez, Norma.

(1)PhD Candidate. Agricultural Engineer. Facultad de Ciencias Agrarias. Universidad Nacional de Asunción. Paraguay; (2)MSc. Agricultural Engineer. Facultad de Ciencias Agrarias. Universidad Nacional de Asunción. Paraguay.

**Background and objectives:** This research was executed in the Paraguayan Chaco, an extended territory, characterized to have a population relatively small and disperse (3% of country population) which have the human development index (HDI) most lower of the country. The population of this region is compound of original native people, Mennonite settlers, and Latin population. The objective was performing one line of base to characterize the conditions of vulnerability of the livelihoods in native communities of Paraguayan Chaco threatened by drought.

**Methods:** The type of investigation was descriptive with analytical components and qualitative focus. The study zone covered two departments (President Hayes and Boquerón), where were selected 68 hamlets of 15 native communities, through stratified probability sampling, determined in base geographical criteria. The universe of study corresponded 2.312 homes (11.352 peoples).

**Results:** The most relevant results are:

**Livelihoods:** The qualification of the human resources in terms of the alphabetism rate is found in 60.8%. The schooling rate stood at in 51.4%. Houses are precarious and overcrowded, assented in ancestral lands. Employment is shortage and poorly paid.

**Food security and nutritional status:** Food comes from forage, the agricultural production, purchase and donations. Access, consume and stability of the food, present variations throughout the year, in wintertime. In terms of evaluation nutritional status (EEN) children less than 5 years old, were found low size for the 26% and the risk of low size 13%. Age group of 6-18 years old, BMI values is adequate for the 59%. The malnutrition by excess

is predominant in adults (51%). For its part, level of food security in homes, measured through the Latin American and Caribbean Food Security Scale (ELCSA), categorized 98% families with children under 18 years old with food insecurity.

**Access and availability of water:** The water supply is diverse; most used are cutwater, community cistern. Lack of water in 92% of homes, especially in winter.

**Resilience:** most of pressing events they face are mainly food scarcity, employs, medical care and medicines.

**Conclusions:** With all displayed can be concluded that indigenous families of sample had high levels of vulnerability of their livelihoods, compromising for consequence food security, health and development of themselves.

**Keywords:** vulnerability of the Livelihoods, Food security, Resilience.

**Further collaborators:**

Edith Arrúa, Sebastián Bruno, Tomas Velázquez, Antonio Ortiz. Consultora Centro de Desarrollo Regional y Medio Ambiente. Paraguay

144/2705

NUTRITION-LED AGRICULTURE: SYNERGIES BETWEEN AGRICULTURAL AND NUTRITION INTERVENTIONS IN SENEGAL

(1)Steinberg, Douglas; (2)Rosenberg, Karl; (3)Crosby, Todd.

(1)MSc. Director of Programs Africa. National Cooperative Business Association. USA; (2)MA. Chief of Party. Yaajeende. National Cooperative Business Association. Senegal; (3)MA. Senior Technical Director. National Cooperative Business Association. USA.

**Background and objectives:** The Yaajeende Agriculture and Nutrition Development Project is a USAID funded initiative implemented since 2011 by NCBA CLUSA and partners. Taking a food systems approach, the project's goal is to improve the economic and nutritional status of the very poor in four rural regions of Senegal. Yaajeende employs a "Nutrition-Led Agriculture" approach, which promotes improved production, trade and local consumption of nutritious foods. Yaajeende also emphasizes institutional capacity building and private sector strengthening to effectively integrate agriculture and nutrition and to contribute to sustainability. These institutions include citizen working groups, mother-to-mother groups, livestock rearing groups, and networks of "community based service providers" who are linked to private sector suppliers. The project is based on a theory of change that posits that mutually supporting interventions of nutrition and agriculture will be more efficacious in improving nutritional status than either component on its own; this theory has largely been confirmed after seven years of field level implementation.

**Methods:** An external mid-term evaluation1 during the fifth year of implementation utilized a mixed-method approach involving a non-experimental quantitative strategy and qualitative techniques. On the quantitative side, a population-based survey
was administered to 2,720 households in treatment and control villages across 19 rural communes. A multi-stage cluster sampling approach was used to select households that participated in the project baseline survey (2011) along with households from 27 new intervention villages.

**Results:** The mid-term evaluation supported the original hypothesis that households benefiting from both project components have improved or suffered less in the context of food insecurity compared to those who benefit from neither or from only one. At least two high order outcomes have shown improvement:

* 7 percentage points decrease (p=0.008) in stunting among beneficiaries.

* Treatment effect of about 2.9 percentage points in poverty reduction in high-intensity areas (but no evidence of synergy in the high-intensity group (p=0.01)).

**Conclusions:** While the outcomes of the study revealed variability across households and regions, Yaajeende's combined effects were generally synergistic across many key indicators, supporting the hypothesis that impacts on poverty and malnutrition are stronger when the agriculture and nutrition interventions are conducted simultaneously with a target population.

**Keywords:** Agriculture, nutrition, poverty, synergy, evaluation.

**Further collaborators:**

Yaajeende is supported by USAID through Cooperative Agreement No. 685-A-00-11-00002-00

144/2726

FORTY YEARS OF INNOVATED INDUSTRIAL BASED AGRI-TECH IN SUSTAINABILITY FOR ZERO FOOD WASTE

Liaqat, Ali.

Liaqat Corp Pvt. Ltd.

**Background and objectives:** Being seed/food industry, funder to small scale farmers since 1975, we were distributor of EU/USA seed companies for Pakistan. Our funding to farmers is at buy-back, suffered losses in agriculture initially, INNOVATED KITCHEN based nutri- research in drying for production lines at sourcing sites of farming/ fruit/vegi/grain markets, factories, infrastructure, seasonal stations etc.

**Methods:** Prior to 1975, we used to manage nutrition losses by manual sun-drying, have developed multiple value added manual to mechanized processing sheets to eradicate spoilage as per sourcing. This type of NUTRITECH gave positive results. In processing of agri-nutrition, a wide range of techniques were developed. In-kitchen processing trials achieved positivity in converting manual processing lines to mechanized, partial drying was experimented to eliminate perishability by mobile drying units, all challenges were resolved scientifically.

**Results:** To reduce nutritional losses, food/ agriculture system was reshaped by introduction of value added multiple intermediate drying technologies. All spoilage was salvaged by technical

drying solutions leading sustainability, developed food/agriculture partnerships for nutritional security. All elaborated processes were applied by sustainable drying technology. Environmental issues were faced technically. Industrial based affordable accessibility is being applied at sourcing sites, to gain nutritional positivity. Our future-based research balanced nutritional values. Female drying encouraged our nutri-productivity. Due to instant check on spoilage by female labour, Nutritional losses are being instantly stopped by our teams.

**Conclusions:** Our qualitative/quantitative INNOVATED drying impacted funding, improved lost NUTRI conditions, delivered field farming productivity, pre/postharvest LOSSES were improved, by value added technologies, focused at loss sourcing.innovated game changing NUTRI technologies facilitated food/ Agri partnerships, clusters has been enhanced in surrounding largely with industrial/future based technologies. Practical researched network has been shared by Agri/NUTRI stakeholders. our 40 years of innovated ind based nutri/ tech is ready to start saving nutritional values by 2017-18, instead of 2050 with partnership of ICN.

**Keywords:** innovated reshaped processing lines, innovated production sheets as per sourcing sites, cost-effective processing lines, sustainability by eradication of losses at sourcing sites, reduction of perishability instantly

**Conflict of Interest Disclosure:** Low income women are integral part of nutritional security as, domestically trained in processing SDGs has been converted to our in-house INNOVATED tech, reshaped EU/USA processing/production lines at less cost of 15 times, with equal outputs, consumer/oriented tech followed by smallholders.

**Further collaborators:**

IAEA/FAO/FOOD IRRADIATION since 1992

Ministry of Defence, Rawalpindi

SKAL Certification (INSTA FOODS) 2004

IFOAM/TIPI/Organic Research EU exclusive representative in Pakistan

WUR/Illinois University requested for the member of cluster team/IAB

144/2772

IMPACT OF SANITIZING AGENTS ON THE MICROBIOLOGICAL AND PHYSICAL-CHEMICAL QUALITY OF CUCUMBERS

**Background and objectives:** The washing step associated with the use of sanitizing solutions is the only one processing step that reduc-

<footnote>(1)Freitas Brilhante de São José, Jackline; (2)Morandi Lepaus, Bárbara;</footnote>

<footnote>(2)Henrique Cesconetto Coswosck, Kaio; (2)Augustinho Giorgette, Mylena; (2)Souza Rocha, Jéssica; (3)Almeida Costa, Luciana.</footnote>

<footnote>(1)PhD. Nutritionist. Departament of Education Integrated Health. Federal University of Espírito Santo. Brazil.; (2)Nutritionist. Departament of Education Integrated Health. Federal University of Espírito Santo., Brazil; (3)MSc. Nutritionist. Departament of Education Integrated Health. Federal University of Espírito Santo. Brazil.</footnote>
es the number of microorganisms, and it is important that the stage not cause losses for the sensorial and nutritional characteristics. Sanitizing is an essential step in assigning greater safety and shelf life to minimally processed products and fresh produce and, as future restrictions on the use of chlorine are desirable, there is a need to evaluate alternative methods. The aim of this study was to evaluate the effectiveness of alternative sanitizers to chlorinated compounds in removing natural contaminants, removal of Salmonella enterica Enteritidis and evaluate the effects on the chemical characteristics of cucumbers.

**Methods:** Treatments with 1 and 2 % acetic acid and 1 and 2 % lactic acid, 3 % hydrogen peroxide, 200 mg/L sodium hypochlorite and 200 mg/L sodium dichloroisocyanurate were evaluated. The control was samples without sanitization. After each treatment, a microbiological analysis was conducted for the samples. The analysis examined the impact of the treatments in reducing aerobic mesophilic bacteria and molds and yeasts as well as Salmonella enterica Enteritidis inoculated on the surface. The values of pH, total titratable acidity, total soluble solids, phenolic compounds, antioxidant capacity were also determined.

**Results:** The reduction of aerobic mesophilic bacteria was between 1.10 – 2.08 log CFU/g in cucumbers. The molds and yeasts contamination was between 0.88 – 1.58 log CFU cucumber samples, respectively. After the sanitization treatments with hydrogen peroxide and 2 % lactic acid reductions of 2.71 log CFU/g and 2.34 log CFU/g, respectively, were achieved. Cucumbers presented no significant difference (p> 0.05) for pH values, total titratable acidity and total soluble solids/total titratable acidity ratio. In the evaluation of the impact of the sanitizers on the total phenolic compounds of cucumber it was observed that there was no significant difference between the non-sanitized and treated samples. This indicates the preservation of the nutritional characteristics of the vegetables after the sanitization treatments.

**Conclusions:** The results of this study show the potential of the proposed strategies to replace chlorinated compounds in the sanitization step of fresh produce.

**Keywords:** Sanitizers, fresh vegetables, Salmonella, quality, safety

**Further collaborators:**

The study was financed by FAPES.

erage consumers, nutritional value is mostly regarded as credence attribute as they can hardly verify this attribute even after purchase (Grunert, 2005). This indicates consumers' need for trust in food before consumption, especially in the context of high involvement. This research explores the role of consumer trust in the case of uncertainty concerning food safety and nutrition in the context of infant formula consumption in urban China.

**Methods:** This is a longitudinal qualitative research based on an initial face-to-face semi-structured in-depth interview with 28 pregnant women living in urban China, and a follow-up interview with the same group of mothers at the time when the babies are about 8-9 months old.

**Results:** For Chinese mothers, infant formula is a high-involve-ment food category in both functional and emotional aspects. In the wake of infant formula incidents in China in the past decade, safety has become the primary concern of infant formula for Chi-nese mothers. As public trust in domestic food regulation system has been damaged by past incidents and not yet rebuilt, Chinese mothers turned to food regulation systems of other countries and utilised interpersonal relationships to get connected with those more trustworthy-perceived food systems, namely, friends or rel-atives living overseas. In terms of the nutritional content, mothers seemed to have neither professional knowledge nor expertise to verify health claims of infant formula products. They tended to rely on word-of-mouth information from trusted acquaintances and brand reputation as cues to decide which brands can be under consideration for further purchase. Asking overseas friends and relatives to purchase infant formula from foreign markets, some Chinese mothers believe that international brands are safe and ad-vanced in providing better nutrition for babies, while some others argue that overseas infant formula may not be perfectly suitable for Chinese babies, yet still, are willing to compromise nutrition needs in order to secure the safety of baby food.

**Conclusions:** In the case of uncertainty concerning food safety and nutrition, trust in food is necessary for consumers to proceed food consumption practice.

**Keywords:** Consumer trust, food safety, infant formula consumption, urban China

144/2793

NUTRITION, SAFETY, AND TRUST: THE CASE OF
INFANT FORMULA CONSUMPTION IN URBAN
CHINA

(1)Gan, Caixia; (2)Conroy, Denise; (3)Lee, Michael.

(1)PhD Candidate. Department of Marketing. The University of Auckland. New Zealand.; (2)Senior Lecture. Department of Marketing. The University of Auckland. New Zealand.; (3)Senior Lecture. Department of Marketing, The University of Auckland, New Zealand.

**Background and objectives:** Nutrition and safety are essential to consumers regarding their food for daily need. Yet for av-

144/2864

DIETARY DIVERSITY AND SCALING UP THE PRO-
DUCTION IRON AND ZINC- RICH YELLOW POTATO-
TOES YELLOW POTATOES IN COLOMBIA

(1)del Castillo, Sara Eloisa; (2)López, Claudia; (3)Mosquera, Teresa.

(1)PhD. Professor. Department of Nutrition. National University of Colombia. Colombia.; (2)Master Student. Nutritionist. Department of Nutrition. National University of Colombia. Colombia.; (3)PhD. Professor. Faculty of Agricultural Sciences. National University of Colombia. Colombia.

**Background and objectives:** Food insecurity among rural Colombian households is high, reaching 90% in some regions. Almost all farmers from the Colombian-Andean region rely on po-
tatoes as their staple food and as their main income source. In this presentation, we discuss an ongoing project in Nariño, a region dependent on potato farming, that has high rates of food insecurity, malnutrition, and nutritional deficiencies, particularly iron and zinc. Our aim is to increase the availability of more nutritious potatoes for Colombian consumers through a strategy that integrates agriculture and nutrition.

**Methods:** We will introduce three varieties of yellow potatoes with better agronomic properties (i.e. higher yields, better resistance to blight) and higher zinc and iron content compared to potatoes currently being grown. These potatoes can provide up to 0,5 mg iron and 0,3 mg zinc per 100g potatoes. These potatoes have potential to impact nutritional status, as the Institute of Medicine recommended dietary allowances for women of reproductive age are 18 mg and 8 mg for iron and zinc, respectively.

**Results:** Potatoes are a staple food for Colombians, therefore the introduction of novel high-mineral potatoes maybe part of a sustainable option to combat micronutrient deficiencies when it is part of a diverse diet, alongside increased consumption of locally produced fruits and vegetables from home gardens. Although the iron and zinc in the novel potato varieties is not as bioavailable as animal-source foods, Colombian consumers do not always have the economic resources to purchase these foods. This strategy therefore, becomes a successful experience of a local agriculture sensitive to the nutritional needs of vulnerable communities of a region or a territory.

**Conclusions:** To date, we conducted a baseline survey and one follow-up survey measuring: the production and consumption of the varieties of yellow potatoes among the families of the project; dietary diversity of project households (dietary diversity score through 24-hour Recall); and monitoring the nutritional situation of children under 5 years of age in project households; This last will be measured through anthropometric measurements such as: weight and height and biochemical measurement such as: iron status (hemoglobin, ferritin, transferrin), zinc and vitamin A.

**Keywords:** Yellow Potatoes, Food Security, Nutrition, Dietary Diversity

**Further collaborators:**

Note this is an abstract for special symposium 144/155 - Research and Scaling Up Nutritionally Sensitive Agricultural Innovations Track 8: Agriculture, Food Science and Safety

Chinese Center for Disease Control and Prevention. China; (³)PhD. Nutritionist. China National Center for Food Safety Risk Assessent. China.; (⁴)PhD. Nutritionist. ILSI Focal Point in China. China.

**Background and objectives:** Since the national food safety standard for complementary supplements was issued in 2008, yingyangbao as a complementary supplement has been widely used in the poverty rural areas, yearly covering 1.27 million children aged 6-24 months. Because the nutrition conditions during the first 1000 days of life is critical for future potential health, it is necessary to develop the products to improve the nutrition status for pregnant and lactating mother, and the associated national food safety standard should be regulated. To develop the food safety national standard for applying complement supplements to pregnant and lactating mothers.

**Methods:** The related international materials were investigated including standards, technology, reporting results for the effectiveness of micronutrient interventions, as well as the nutrition and dietary status of pregnant and lactating mother in China. The CAC standard, WHO guidelines and related standards in China have been compared. The micronutrient exposure was evaluated. In addition, the experts in this research areas attended meetings for discussions, and social opinions were also considered.

**Results:** This standard stipulates the supplement food for pregnant and lactating mothers as special dietary to provide high quality proteins, vitamins and minerals. The maximum of daily portion is 50 g, among which the protein accounts for 18% to 35%. Iron, vitamin A, vitamin D, folic acid, vitamin B12, totally five micronutrient is compulsorily to be added in, the other 14 micronutrients is optional. The daily portion could provide 50% of RNIs of micronutrient. This standard also limits the amount of pollutants, mycotoxin, microorganism, urease and so on.

**Conclusions:** The standard of “the National food safety standard: Multi-nutrient Supplementary Food for Pregnant and Lactating Women” (GB 31601-2015) was issued in November, 2015, by Health and Family Planning Commission in China, and officially implemented in November, 2016.

**Keywords:** Pregnant women, lactating mothers, first 1000 days of life, nutritional supplements, standard

**Further collaborators:**

Suying Chang. PhD. Nutritionist. United Nations Children's Fund. China.

<footnote>(¹)Huang, Jian; (²)Huo, Junsheng; (³)Sun, Jing; (³)Han, Junhua; (³)Liang, Dong; (²)Wang, Lijuan; (⁴)Chen, Chunming; (⁴)Wang, Yuying; (²)Yang, Zhenyu; (²)Tang, Yanbin.</footnote>

<footnote>(¹)BD. Nutritionist. National Institute for Nutrition and Health. Chinese Center for Disease Control and Prevention. China.; (²)PhD. Nutritionist. National Institute for Nutrition and Health.</footnote>
(1)Lynd, Larry; (2)Lakzadeh, Pardis; (3)Talukder, Aminuzzaman;

(4)Stormer, Ame; (5)Kroeun, Hou; (6)McLean, Judy; (7)Green, Tim.

(1)PhD. Professor. Faculty of Pharmaceutical Sciences. University of British Columbia. Canada.; (2)MSc. Research Analyst.

Broadstreet Health Economics & Outcomes Research. Canada.;

(3)MPH. Country Director. Asia-Pacific Regional Office. Helen Keller International. Cambodia.; (4)PhD. Regional Director. Asia-Pacific Regional Office. Helen Keller International. Cambodia;

(5)MPH. Program Manager. Asia-Pacific Regional Office. Helen Keller International. Cambodia.; (6)PhD. Nutritionist. Senior

Instructor International Nutrition. Department of Food, Nutrition and Health. University of British Columbia. Canada.; (7)PhD.

Affiliate Professor. Discipline of Pediatrics. University of Adelaide.
Principal Nutritionist. Healthy Mothers, Babies & Children Theme.
South Australian Health and Medical Research Institute. South
Australia. Australia.

**Background and objectives:** Background: For over 20 years Helen Keller International has implemented homestead food production (HFP) programs in developing countries to improve the nutritional status of women and children, household food security and income. The HFP model encourages year-round food production through home gardens and animal husbandry. Although, HFP has been successful in increasing household food production, economic assessment of this program has been limited. In order for program implementers to allocate limited resources efficiently, there is a need for a rigorous economic assessment of HFP programs.

Objective: To (1) identify factors associated with household income in rural, Cambodia, (2) to systematically measure and monetize food production from gardens and fishponds, and explore the cost-effectiveness of HFP in Cambodia in a cost-benefit analysis (CBA), using data from a randomized control trial (RCT), (3) explore the sensitivity of the CBA results and alternative scenarios for program implementation.

**Methods:** Factors associated with household income, were examined using a generalized linear mixed model at a univariate and multivariate level. Food production was estimated from multiple longitudinal data sources. The program benefits (food production) were monetized using local village market values, while costs were determined through a micro-costing analysis. A CBA was carried out from the project iii perspective and the net monetary benefit in each study arm was estimated and compared to control households. Lastly, the sensitivity of the CBA results was tested in a one-way sensitivity and scenario analysis.

**Results:** Assessment of baseline household income revealed that in rural Cambodia fishponds and pigs were associated with income. Households in the HFP program produced more food, relative to the control. The results from CBA show that home gardens are a cost-effective HFP intervention. The results from the scenario analysis suggest that the addition of fishponds to gardens may also be cost-effective if implemented outside a RCT.

**Conclusions:** This study has developed tools to systematically measure and monetize food production from HFP, while finding that establishment of home gardens is a cost-effective use of resources.

**Keywords:** Food security, Homestead food production, Cost-benefit analysis

(1)Eyinla, Toluwalope; (2)Maziya-Dixon, Busie; (3)Sanusi, Rasaki.

(1)Dept. of Human Nutrition, UI, Ibadan and International Institute of Tropical Agriculture, Ibadan; (2)(PhD)Food & Nutrition Sciences Laboratory,International Institute of Tropical Agriculture, Ibadan, Nigeria; (3)PhD)(Department of Human Nutrition, University of Ibadan, Ibadan, Nigeria.

**Background and objectives:** Background: Introduction of yellow fleshed cassava has resulted in the production of analogous foods of the white fleshed varieties. With Pro-vitamin A content (especially β-carotene) degrading quickly when subjected to usual traditional processing methods. It is important to understand the possible contribution of these new foods to dietary intake.

Objectives: Evaluation of the β-carotene concentrations in local staples namely eba (Dough cooked from fried cassava granules) and fufu (dough cooked from cassava mash), lafun (Dough cooked from milled chips). Comparing these concentrations with usual dietary intake in women and children and calculate the possible contribution to vitamin A intake

**Methods:** Matured roots of four Cassava varieties (TMS01/1371, TMS07/593, TMS07/539 and NR07/0220) were processed into eba, fufu and lafun. The fresh roots and products were analyzed for their β-carotene contents using HPLC. Mean portion sizes (in grams) of products from white fleshed variety were compared with concentrations in the similar products from yellow cassava varieties to calculate possible contribution to RDA of Vitamin A intake.

**Results:** The β-carotene concentration in eba was highest in TMS01/1371 at 3.79µg/g. In fufu it was the highest in NR07/220 at 5.38µg/g. In lafun it was the highest in NR07/220 at 3.19µg/g. The lowest values were found in TMS07/593 at 0.08 µg/g, 0.85 µg/g and 1.52 µg/g in lafun, fufu and eba respectively. The portion sizes ranged from 236g in eba to 267g in lafun in children while the portion sizes ranged from 225g in fufu to 633g in lafun in women. Contributions to RDA of Vitamin A show that for children fufu can give 18% contribution through NR07/0220 followed by eba giving 11% in TMS01/1371 followed by 8% in fufu from TMS07/0539. In women, eba from TMS01/1371 was highest at 16% followed by NR07/0220 providing 10% from lafun.

**Conclusions:** The varying potential of the varieties is evident. The information can be valuable when questions regarding bioavailability and bioefficacy of these local food products are raised.

**Keywords:** Beta-Carotene, Cassava, Eba, Fufu, Vitamin A
# B-CAROTENE RETENTION IN YELLOW CASSAVA IS NOT ONLY DEPENDENT ON GENOTYPE BUT ALSO ON PROCESSING METHOD

**Background and objectives:** Carotenoid losses in yellow cassava during food processing is of particular interest since pro-vitamin A content (especially β-carotene) degrades quickly when exposed to sunlight or to different forms of processing. It is well known that retention ability is genotype dependent. The study therefore sought to evaluate the retention capacity of β-carotene in recently released cassava varieties when processed into local staples namely Eba (Dough from Cassava granules) and Fufu (dough cooked from cassava mash).

**Methods:** Matured roots of four Cassava varieties (TMS 01/1371, TMS 07/593, TMS 07/539 and NR 07/0220) were harvested and processed into Eba and Fufu. The fresh roots and products were analyzed for their β-carotene contents. Percentage true retention was used to evaluate retention. Precautions were taken to avoid unnecessary carotenoid loss during processing.

**Results:** Beta-carotene content of the fresh roots ranged from 5.32µg – 7.8µg, the processed product, Eba had retention ranging from (0.05% - 16.6%). TMS 01/1371 had the highest retention while TMS 07/539 had the lowest retention. The processed fufu had retention ranging from (6.9% - 24.7%). NR 07/0220 had the highest retention while TMS 07/593 had the lowest retention.

**Conclusions:** The varying retention ability of the varieties is evident. While this is expected, it is observed that some varieties may offer more significant contribution to nutrient intake than others. This can maximize the potential contribution to pro-vitamin A intake and ultimately vitamin A intake for women and children.

**Keywords:** Beta-Carotene, Cassava, Eba, Fufu, Retention

interest in guaranteeing self-sufficiency of food that has remained a priority issue for organizations and governments. The concept today relates food and nutritional security with availability, access, consumption, use and quality and safety of food.

The objective of this investigation was to construct a concept of food and nutritional security from a perspective of complexity.

**Methods:** This research is qualitative of an exploratory, descriptive nature; is a genealogical investigation from bibliographic searches of publications in databases, review of public policy guidelines and action plans proposed in declarations of world food summits from 1974.

Description, interpretation and construction-of-construction were carried out; a systemic and complex hermeneutics of the relations that make up the food-nutritional security network was applied and emerging thoughts were identified.

**Results:** A genealogy of the famines was a source of systemic elements that contribute to the understanding and interpretation of hunger in its historical moments and contexts. Hunger occurs in situations of conflict when the dominated countries lose their autonomy for food supply and this forces them to generate mechanisms to provide a solidarity response by food aid.

A detailed review and identification of the interrelationships in global declarations for the eradication of hunger and Malnutrition, originating from food summits since 1974; their contributions to the conceptual transition of food and nutritional security. Despite the efforts the purpose of reducing the hungry people, is far.

Food-nutritional security of “new time” is the environmental adventure of nurturing life, it is the biological and social relations, the warp of food-nutritional, man-ecosystem in a network of complex relationships in feedback loops between peoples and land, peoples and their ecosystemic and cultural contexts.

It constitutes a framework of knowledge that connects both the natural sciences and the social sciences such as, anthropology and ecology.

**Conclusions:** A critical look that gives way to a perspective from the reorganization of knowledge towards a complex, systemic vision, as a network of networks; Which invites us to interpret the language of discourses in new ways, expanding possibilities of observing and interpreting the transition towards food-nutritional security.

**Keywords:** Food nutritional security; complexity; concept

**Further collaborators:**

Ana Patricia Noguera

# CONCEPT OF FOOD AND NUTRITIONAL SECURITY FROM THE COMPLEXITY

Rodriguez Leyton, Mylene.

Magister, Nutritionist, Research Professor. Nutrition and Dietetics Programan. Metropolitan University of Barranquilla. Colombia.

**Background and objectives:** Food and nutritional security are inherent to life; since the beginning of humanity, there is an

<footnote>(1)Eyinla, Toluwalope; (2)Maziya-Dixon, Busie; (3)Sanusi, Rasaki;</footnote>

<footnote>(4)Alamu, Oladeji.</footnote>

<footnote>(1)MSc.Nutritionist. Dept. of Human Nutrition, UI, Ibadan and International Institute of Tropical Agriculture,Ibadan;</footnote>

<footnote>(2)PhD. Senior Scientist.Food & Nutrition Sciences Laboratory,International Institute of Tropical Agriculture, Ibadan, Nigeria; (3)PhD.Nutritionist.Department of Human Nutrition, University of Ibadan, Ibadan, Nigeria; (4)PhD.Scientist.Food & Nutrition Sciences Laboratory,International Institute of Tropical Agriculture, Ibadan, Nigeria.</footnote>
# N-GLYCOLYLNEURAMINIC ACID LEVELS IN RED MEAT OF 7 ANIMAL SPECIES: GUIDELINE FOR HUMAN CONSUMPTION

(1)Wang, Bing; (2)Jahan, Marefa; (3)Wynn, Peter.

(1)Graham Centre for Agricultural Innovation. Charles Sturt University. Australia; (2)PhD student. Graham Centre for Agricultural Innovation. Charles Sturt University. Australia;

(3)Dr. Graham Centre for Agricultural Innovation. Charles Sturt University. Australia.

**Background and objectives:** Many studies have shown that red meat-derived sialic acid (Sia) N-glycolylneuraminic acid (Neu5Gc) promotes inflammation and cancer progression (1). However red meat are a good natural source of protein and iron. Our aim was to quantify the Neu5Gc, N-acetylneuraminic acid (Neu5Ac) & 2-keto-3-deoxy-D-glycero-D-galactonononic acid (KDN) level in conventional red meat of thigh muscle in cattle, goat, sheep, pig, deer, horse, kangaroo and estimate the level of dietary consumption of the non-human Neu5Gc from different species red meat and its potential for inflammatory diseases.

(1). Samraj AN. A red meat-derived glycan promotes inflam-
mation and cancer progression. Proc Natl Acad Sci U S A. 2015
Jan 13;112(2):542-7

**Methods:** Neu5Ac, Neu5Gc, KDN were determined in the muscle meat of 7 different animal species (n=3) by UHPLC using DMB derivatization.

**Results:** Sia concentration in the red meat of 6 tested animal species varied from Neu5Ac 168~661µg/g protein, Neu5Gc 0~166 µg/g protein; KDN 0~4 µg/g protein and total 207~814 µg/g protein respectively. There was significant difference in concentration of Neu5Gc (P= 0.022), but not for Neu5Ac, KDN and total Sia in the muscle meat of 7 animal species. The predominate form of each family Sia was conjugated including Neu5Ac (70~95%), Neu5Gc (85~99%) and total Sia (55~90%), which is the bioavailable form and can be digested and incorporated into human tissue. Although, KDN concentration was negligible to absent in all animal species muscle meat, free KDN was the predominant form. Neu5Gc concentration in the muscle meat from high to low was in goat, cattle, pig, sheep, horse and deer. Interestingly Kangaroo muscle meats were devoid of any Neu5Gc.

**Conclusions:** The conventional red meat contained the relatively high concentration of bioactive form Neu5Gc, except kangaroo meat that did not contain any Neu5Gc. Therefore kangaroo meat is a much safer source of red meat in terms of Neu5Gc intake. Our new findings may aid in reducing the risk of cancer, cardiovascular and inflammatory diseases among the red meat consumption population by recommending that they choose low Neu5Gc containing meat.

**Keywords:** Neu5Gc, red meat, sialic acid
Track 1: Advances in Nutrition Research

SSS_144/1061

NUTS AND DRIED FRUIT CONSUMPTION AND
HEALTH: NEW INSIGHTS

DRIED FRUIT CONSUMPTION AND OSTEOPOROSIS (BONE HEALTH)

Arjmandi, Bahram.

PhD. RDN. Florida State University. Center for Advancing Exercise and Nutrition Research on Aging. USA.

Osteoporosis is characterized by a loss of bone mass and quality leading to an increased risk of fractures. Postmenopausal women are at the greatest risk of developing osteoporosis.. A search for promising non-pharmacological alternative therapies for osteoporosis is important as medications used for osteoporosis can be associated with side effects and low compliance. Nutrition can reduce the risk of developing osteoporosis and therefore play an important role in bone health. In terms of nutrition, dried plum has been shown to be one of the most efficacious interventions for preventing and reversing bone loss in a rat model of osteoporosis and in postmenopausal women. The purpose of this presentation is to provide an overview of the efficacy of dried plum for preventing and reversing bone loss associated with ovarian hormone deficiency and to highlight possible mechanisms of action. Our follow-up study demonstrated that postmenopausal women taking dried plums during our one year clinical trial conducted five years earlier retained bone mineral density compared to the control. Overall, these findings suggest that dried plum is a promising functional food therapy for postmenopausal bone loss with the potential for a long-lasting bone-protective effect.

**Keyword:** Postmenopausal women, dried fruits, prune, dried plum, osteoporosis

**Conflict of Interest disclosure:** This symposium was sponsored by International Nut and Dried Fruit Council Foundation (Spain)

SSS_144/152

5TH YINI SUMMIT-FERMENTED FOODS AND HEALTH: THE INTERSECTION OF GUT MICROBIOTA AND FERMENTATION MICROBES

THE GUT MICROBIOTA: THE INTERSECTION BETWEEN DIET AND HEALTH?

Donovan, Sharon.

B.S. and Ph.D. Dept Food Science and Human Nutrition, University of Illinois, Urbana, USA.

Over the past decade, our understanding of the composition of the gut microbiota has been advanced through the use of next generation sequencing approaches. More than 50 bacterial phyla have been detected in the human gut but, the gut microbiota are dominated by ~1000 microbial species belonging to the Bacteroidetes and the Firmicutes phyla. These microbes encode a substantially larger number of genes than the human host and interact with the host through specific receptors on gut epithelial, neural and immune cells as well as through the production of hormones and metabolites that signal to the host to influence health and disease. Studies in germ-free animals have shown that the gut microbiota are essential for normal gastrointestinal, immune, metabolic and cognitive development and function. Clinical and epidemiological studies have linked an imbalance of the normal gut microbiota, or dysbiosis, to gastrointestinal conditions such as inflammatory bowel disease and irritable bowel syndrome, as well as extra-intestinal diseases such as obesity, type 2 diabetes, and atopy. There is broad interest in better understanding how microbial dysbiosis is associated with non-communicable diseases as well as to develop strategies to manipulate the gut microbiota to improve health outcomes through diet. Two common approaches are the provision fermentable substrates (fibers and prebiotics) or live microbes (probiotics). Probiotics can be administered as supplements of single or multiple microbial species or by consumption of fermented foods containing live microbial species, such as yogurt. This presentation will focus on how dietary intake impacts the gut microbiome and the potential benefits of probiotics on the gut microbiome and disease.

**Keywords:** Gut microbiota, non-communicable diseases, diet, probiotics

**Conflict of Interest disclosure:** Dr. Donovan serves as co-Chair of the Yogurt in Nutrition Initiative (YINI) and received travel support and an honorarium to present at the IUNS meeting.
# YOGURT INTAKE AND PREVENTION OF CARDIOMETABOLIC DISEASES: THE ROLE OF FERMENTATION PRODUCTS

Marette, Andre.

Ph.D. Biochemist. Cardiology axis of Laval Hospital, Department of Medicine. Laval University. Quebec. Canada.

A healthy dietary pattern has been identified as a pillar for the prevention of weight gain and cardiometabolic diseases (CMD). A growing body of evidence suggests that yogurt consumption is linked to healthy dietary patterns, lifestyles and reduced risk of CMD, particularly type 2 diabetes (T2D). However, to date, there have been few to no randomized clinical trials (RCT) investigating yogurt intake in relation to cardiometabolic clinical outcomes. Furthermore, there has been little attempt to clarify the mechanisms that underlie the potential beneficial effects of yogurt consumption on CMD. Yogurt is a nutrient dense dairy food and has been suggested to lower weight gain and prevent CMD by contributing to intakes of protein, calcium, bioactive lipids and several other micronutrients. In this presentation we will focus on recent evidence that dietary proteins are key regulators of immunometabolic factors and the gut microbiota. In addition, fermentation with bacterial strains generates bioactive peptides from dairy proteins resulting in a potentially greater beneficial effect of yogurt on metabolic health compared with non-fermented dairy products such as milk. I will outline potential mechanisms that can underlie the inverse associations between yogurt intake and incidence of CMD and that are related to its bacterial constituents and bioactive peptides released during fermentation and compared with other fermented or non-fermented dairy products. A review of current gaps and challenges in identifying such mechanisms, and a perspective on future research needs that are necessary to validate the proposed role of yogurt in protecting against CMD will also be provided.

**Keywords:** Yogurt, proteins, fermentation, peptides, gut microbiota, health benefits

**Conflict of Interest disclosure:** Grants from and consulting for Danone Nutricia Research, Thetis Pharma, Consulting for Valbiotis.

# IMPROVING YOUR DIET WITH FERMENTED FOODS: HARMONIZING DIETARY GUIDELINES INCLUDING FERMENTED MILKS

Salminen, Seppo.

Professor, Director, Faculty of Medicine, Functional Foods Forum, University of Turku, 20014 Turku, Finland.

Microbes are an essential part of our environment and food. Beneficial microbes derive mainly from fermented foods which have a long history of safe use The species Lactobacillus has been defined as the 5th most important factor for human evolution due

to the importance of lactobacilli in food fermentation and health promotion by strengthening intestinal mucosal barrier. Yogurt is defined as milk fermented with Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus (Codex Standard Number 243/2003) with the organisms viable through the shelf-life.

Yogurt and fermented milks are a significant sources of viable bacteria and fermentation products which enhance nutritional quality and palatability of milk and provide metabolites, enzymes (eg. lactase) and flavor components. In Europe, only one health claim has been approved for beneficial microbes: yogurt improves the handling of lactose. Five EU member states have national nutrition guidelines or recommendations that include either probiotics or yogurt with live bacteria. A recent report demonstrates that yogurt is recommended as a good source of nutrients in many countries (14 EU member states recommend yogurt as a recommended part of local diet and nutrition). Five of them explicitly mention probiotic beneficial effects and four give examples of probiotic bacteria. Several physiological effects of probiotics are well established. Yogurt and yogurt with probiotics, have benefits to humans: yogurt is easily digestible with live microbes. The inclusion of yogurt in food based dietary guidelines has been suggested and knowledge on health benefits suggest opportunities for evidence-based dietary guidelines with yogurt and yogurt with probiotic bacteria.

**Keywords:** Dietary guidelines, fermented foods, fermented milks

**Conflict of Interest disclosure:** Prof Salminen serves as member of the Yogurt in Nutrition Initiative (YINI) and received travel support and an honorarium to present at the IUNS meeting

# HEALTH BENEFITS OF FERMENTED DAIRY FOODS: MICROBIOTA AND BEYOND

Hutkins, Robert.

Ph.D. Microbiologist. Department of Food Science and Technology. University of Nebraska. USA.

Increased consumption of yogurt, kefir, and other fermented dairy products has been driven, in part, by the health benefits these products are thought to confer. For example, epidemiological studies have shown that yogurt consumption is generally associated with reduced risks of type 2 diabetes (T2D), metabolic syndrome, and heart disease, and improved weight management. Although these products are good sources of protein, calcium, and other nutrients, the live microorganisms present in these products are now considered responsible for many of these health benefits. Included are the yogurt starter culture organisms, Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus, as well as strains of Bifidobacterium and Lactobacillus added specifically for their probiotic properties. The physiological mechanisms by which these microbes interact with the gut microbiota and contribute health benefits are now the subject of considerable interest. One major topic of research for establishing a role for these
organisms is the well-known phenomenon of colonization resistance. Specifically, the healthy human gastrointestinal tract contains a diverse, complex, and stable microbiota that is resistant to colonization by exogenous microorganisms. These could include pathogenic organisms as well as bifidobacteria and lactobacilli that are added to fermented milk products as probiotics. Nonetheless, clinical studies have reported several health benefits from yogurt consumption for several conditions. Among the most well established effect is the role of yogurt bacteria on improving lactose digestion in individuals with lactose maldigestion, mediated via in vivo expression of the lactose-hydrolyzing enzyme β-galactosidase. However, clinical evidence has also emerged showing that consumption of yogurt containing probiotics also improves both intestinal and extra-intestinal health. Examples include infectious diarrhea, respiratory infections, and improved immune and anti-inflammatory response. More recently, the effect of probiotics and probiotic yogurts on behavior and the microbiota-gut-brain axis has become an active area of research.

**Keywords:** Yogurt, probiotics, gut microbiota, health benefits

**Conflict of Interest disclosure:** Partner, Synbiotic Solutions; Grants from Mead Johnson Nutrition; Consulting with Danone, Prenexus; Board of Directors, ISAPP

SSS_144/1012

# CHRONONUTRITION: CHRONOBIOLOGY INFLUENCE ON FOOD INTAKE AND METABOLIC HEALTH

## AN INTRODUCTION TO CHRONONUTRITION: IS WHEN YOU EAT AS IMPORTANT AS WHAT YOU EAT?

Escobar, Carolina.

PhD. Research Professor. Department of Anatomy. Faculty of Medicine. Universidad Nacional Autónoma de México. México.

In the last 20 years the role of the time of food ingestion has shown to be a main factor for metabolic balance and weight gain. Why the time? How does this influence energy balance?

Research in chronobiology using experimental animals as well as clinical studies have evidenced that the efficiency and the response of organs involved in digestion and nutrient metabolism varies along the 24 hours. This confers a dynamic and economic system that increases the metabolic activity during hours when individuals are expected to be awake and lowers this activity in order to save energy during rest and seep hours. The circadian system transmits time signals and coordinates all involved organs so that they can give high or low orchestrated responses. The main entraining signal from the environment to the circadian system is the light-dark cycle, however the cycles of feeding-fasting have proven to be powerful time signals for several organs and brain systems that coordinate metabolism.

Recent research indicates that ingesting food at the time when the circadian system indicates a sleep stage elicits conflicting en-

training signals and disrupts the expression of circadian rhythms. Also ingesting food at the wrong time has a bad metabolic outcome favoring the development of overweight, and metabolic syndrome. This condition is promoted by night-work, jet-lag and “social” jet-lag, affecting a wide proportion of individuals.

In my conference I will present experimental studies where the mechanisms linking the circadian system with the metabolic outcome is discussed. The relevance of feeding patterns, will be discussed in the context of different experimental models for night-work, jet-lag and social jet-lag, and their consequence on body weight and indicators for metabolic syndrome. The impact of a disrupted feeding pattern on the circadian system will also be discussed. The main message is that the time of food ingestion can disrupt the circadian system and that a homeostatic condition can only be achieved when the time of feeding is orchestrated with the temporal signals for sleep and wakefulness given by the circadian clock.

Data presented have been supported by CONACYT 239403 and DGAPA-PAPIIT IG200417.

**Keywords:** Circadian rhythms, obesity, night-work, chrononutrition, metabolism

**Further collaborators:** Prof. Ruud M Buijs, Instituto de Investigaciones Biomédicas, UNAM

Natali Guerrero Vargas PhD, Faculty of Medicine UNAM

Roberto Salgado Delgado PhD, Universidad Autónoma de San Luis Potosí

Sofía Morán Flores, PhD. Instituto Nacional de Medicina Genómica

Estefania Espitia Bautista, Faculty of Medicine UNAM

Mario Velasco Ramos, Instituto Nacional de Cardiología

Cinthya Córdoba Manilla, Faculty of Medicine UNAM

**Conflict of Interest disclosure:** This symposium was sponsored by Kellogg Nutrition & Health Institute

# THE HUMAN CIRCADIAN TIMING SYSTEM AND ITS INFLUENCE ON METABOLIC PROCESSES

Scheer, Frank.

Brigham and Women's Hospital and Harvard Medical School. USA.

Obesity and diabetes have obtained epidemic proportions and contribute significantly to cardiovascular disease and mortality. Most research and clinical attention has focused on the importance of what we eat and how much we exercise in these developments. However, in recent years it has become clear that also other modern life style changes such as the timing of food intake, of physical activity and of sleep importantly impact metabolism and cardiovascular risk factors. This presentation will focus on the role of the endogenous circadian system, and its interaction with a disturbed timing of the behavioral/environmental sleep/wake, rest/active, fasting/feeding, and dark/light cycles on cardiometabolic function. For example, the circadian system and circadian misalignment (i.e., the misalignment between the circadian system and the
behavioral/environmental cycle) influence glucose metabolism, energy expenditure, food intake, weight regulation, inflammation, and cardiovascular function in humans. These new observations provide possible mechanistic evidence for the adverse cardiometabolic effects observed with shift work, late night snacking, and circadian-related gene variants. Given the high prevalence of sleep restriction, sleep disorders, and shift work, as well as the increasing rate of diabetes and obesity, there is an urgent need to increase our understanding of the impact of sleep, circadian rhythm, and their disturbances on cardiometabolic function and disease. The objectives of my talk will be to (a) discuss the effects of the human circadian system and circadian misalignment on glucose control, metabolism, inflammation, and cardiovascular function; (b) present data on the effect of melatonin and its interaction with type 2 diabetes risk variant MTNR1B on glucose control; and (c) discuss the evidence for the importance of not just what you eat, but also of when you eat for health and disease.

**Keywords:** Circadian misalignment, circadian rhythms, metabolism, glucose, weight regulation

**Conflict of Interest disclosure:** Speaker fees from Bayer Healthcare, Sentara Healthcare, and Kellogg's.

nificant increases in retroperitoneal and epidydimal adipose tissue masses (172% and 61%, respectively), adipocytes size (28%), and circulating triglycerides (39%) were also detected. Daily patterns of food and water intake were abolished under ChrA. In contrast, ChrD had no effect on body weight. Wheel-running, housing of animals in groups, and restriction of food availability to hours of darkness prevented abnormal increase in body weight under ChrA. Our findings suggest that the observed alterations under ChrA may arise either from a direct effect of circadian disruption on metabolism, from desynchronization between feeding and metabolic rhythms, or both. Direction of shifts, timing of feeding episodes, and other reinforcing signals deeply affect the outcome of metabolic function under CJL. Such features should be taken into account in further studies of shift working or other disrupting schedules in humans.

**Keywords:** Circadian rhythms; Desynchronization; Metabolism

**Conflict of Interest disclosure:** This symposium was sponsored by Kellogg Nutrition & Health Institute

## CHRONIC FORCED CIRCADIAN DESYNCHRONIZATION AFFECTS LOCOMOTOR ACTIVITY, BODY WEIGHT AND METABOLISM IN MICE

Circadian rhythms control our daily activities; indeed, circadian disruption in animal models and humans has a profound effect on our behavior and physiology. Chronic desynchronization results in changes in mood, immune and endocrine variables (among many others) and even susceptibility to disease. In addition, metabolic functions are synchronized by the circadian clock setting daily patterns of food intake, nutrient delivery, and behavioral activity.

We have developed a murine model of chronic circadian desynchronization and found that it induces significant changes in locomotor behavior, resulting in two independent bouts of daily activity (i.e., internal desynchronization). Moreover, we studied the impact of chronic jet-lag (CJL) on metabolism, and tested manipulations aimed to overcome potential alterations.

We recorded weight gain in C57Bl/6 mice under chronic 6 h advances or delays of the light–dark cycle every 2 days (ChrA and ChrD, respectively). Indeed, ChrA, but not ChrD, induced forced desynchronization of locomotor activity rhythms in mice. Body weight was rapidly increased under ChrA, with animals tripling the mean weight gain observed in controls by day 10, and doubling it by day 30 (6% vs. 2%, and 15% vs. 7%, respectively).

<footnote>(1) Golombek, Diego; (2) Casiraghi, Leandro; (3) Alzamendi, Ana;</footnote>

<footnote>(3) Giovambattista, Andres; (1) Chiesa, Juan Jose.</footnote>

<footnote>(1) National University of Quilmes. National Research Council (CONICET). Argentina.; (2) National University of Quilmes. Argentina.; (3) Unidad de Neuroendocrinologia, IMBICE (CONICET-CICPBA). Argentina.</footnote>
## Track 2: Nutrition Through Life Course

SSS_144/1015

### MICRONUTRIENTS FOR OPTIMUM HEALTH

#### VITAMINS AND MINERALS DEFICIENCIES: THEIR ROLE IN CHRONIC NON COMMUNICABLE DISEASES

Katz, Mónica.

Dr. Favaloro University. Buenos Aires. Argentina.

Micronutrients are essential to sustain life and for optimal physiological functions. Hidden hunger is a global health issue. Micronutrients deficits coexist. It presents with no clinical symptoms but can interfere with an optimal health and lead to several chronic diseases. Micronutrients intervene in immunity, inflammation, oxidative damage, are cofactors and coenzymes in several metabolic pathways, modulate genomic stability processes, act as glycation inhibitors, anti oxidants and have a protective effect on bone health, diabetes mellitus and cardiovascular disease. Suboptimal levels of micronutrients are associated with metabolic anomalies that can be prevented: molecular damage associated to aging, repair failure caused by chemical and physical changes like cross linking, advanced glycation end products (AGEs), free radicals (oxidative damage) and changes in the cellular / matrix structure / function. There are many risk groups for developing vitamin and mineral deficiencies: women, pregnant women, people who carry out diets for medical or cosmetic reasons, athletes, dancers, older adults, vegans, bariatric patients, and even lonely people. In fact each adult can suffer during the course of his life from any deficiency because modern diet patterns in general show a low correlation with the current dietary guidelines recommendations. Food consumption is a biomarker of diet quality and a strong determinant of health disease processes. There is an association between consumption of specific food or nutrients with increased risk or a protective effect for developing chronic diseases like obesity, type 2 diabetes, and osteoporosis. Aging process is inevitable. But the damage can be maintained at a sub patogenic level to prevent chronic diseases. The treatment of vitamin and mineral deficiencies is one of the most extraordinary development-related scientific advances of recent years. Probably no other public health strategy available today offers an opportunity to improve lives and accelerate development at such a low cost and in such a short time. Eliminating hidden hunger will not be easy. Challenges lie ahead. Much still needs to be done to ensure that people around the world gain access to nutrient-rich foods and diversified diets. Meanwhile two other strategies are at reach: fortifying foods and multivitamin-mineral supplementation.

**Keywords:** Hidden Hunger, Aging, Chronic Diseases.

**Conflict of Interest disclosure:** Dr. Monica Katz has an agreement with Bayer SA, a manufacturer of multivitamins

### STATUS AND NUTRITIONAL GAPS IN ARGENTINA: UPDATED EVIDENCE

Britos, Sergio.

University of Buenos Aires. Buenos Aires. Argentina.

The first National Nutrition Survey in Argentina was conducted eleven years ago; the study represented a complete diagnosis of the prevalence of different forms of malnutrition, children and women dietary patterns and insufficient intake or excess of different nutrients. After the survey, only studies with a more limited representation have been carried out. The three editions of the National Risk Factors Survey (ENFR), included indicators about food patterns and anthropometric measures in the adult population, and reported a high prevalence of overweight and obesity (57,6%) and low intakes of nutrient rich foods.

A dietary pattern with low intakes of high nutrient-dense foods combined with high consumption of high caloric density ones is associated with the development of obesity, especially if accompanied with low caloric expenditure patterns.

The analysis of these aspects of diet quality has been the focus of our studies in the last seven years, through two lines of research: we analyzed the food gaps of general population, measuring each food group consumption against the recommendation of dietary guidelines and expert organizations (WHO). We also described the nutritional gaps, both in the local market available foods and in the consumption pattern of the population. The nutritional gap is the difference between the nutrient profile of nutrients to limit or to promote and its standard values developed from nutrient density recommendations.

In general population (2012) the most significant gaps for low consumption were in vegetables, fruits and grains and whole grains (average -66%); Also in dairy products (-39%) and on the other hand excesses gaps were described in sugars, flour, bakery and very refined cereals and meats (in all cases above 50%). When nutrient profile was applied to foods, the main nutritional gaps were found in sweetened beverages, sweets, processed meats and cheese.

The results on food gaps for deficits were also analyzed in another study, in this case a representative national survey in a sample of 1000 adults over 18 years old (2015). Only 17% of the population reported they reached the recommended consumption of three or more groups of food guides simultaneously.

Both lines of research allow us to conclude that the high prevalence of overweight in children and adults in Argentina is accompanied by malnutrition caused by inadequate intakes of essential nutrients due to low consumption of their food sources.

Based on this background, we will present model scenarios oriented to calculate the improvement in diet quality (NRFI and NutriScore methods) in children and adults through different mix of increase in the consumption of essential nutrients food source and decrease in nutrients to limit ones.

**Keywords:** Nutritional quality, food guides, micronutrients.

**Conflict of Interest disclosure:** Sergio Britos has an agreement with Bayer SA, a manufacturer of multivitamin
# VITAMIN D AND IMMUNE FUNCTION

Gombart, Adrian.

PhD. Linus Pauling Institute. Department of Biochemistry and Biophysics. Oregon State University. United States of America.

Inadequate levels of vitamin D due to deficiency and insufficiency are a global health issue for over one billion individuals. This includes regions of North and South America, Africa, Europe, Australia and Asia where one would assume that sun exposure is sufficient for efficient cutaneous vitamin D synthesis. The modern lifestyle of many populations limits synthesis via UVB exposure due to extended time spent indoors and the use of topical sunscreens. Older individuals are particularly prone to low vitamin D serum levels as cutaneous synthesis is less efficient due to age related changes of the skin and their reduced levels of outdoor activity. Insufficient vitamin D levels are associated with poor bone health, impaired muscle function, cardiovascular disease, cancer, autoimmune disorders and infectious diseases. Since the early 19th century, both environmental (i.e. sunlight) and dietary sources (cod liver) of vitamin D were identified as treatments for tuberculosis. The discovery that vitamin D induces antimicrobial peptide gene expression and the expression of other genes involved in immune function has greatly renewed interest in the ability of vitamin D-containing supplements to improve immune function by raising overall serum levels. The importance of vitamin D throughout the course of infection from the initial exposure to the pathogen through the resolution of tissue damage and inflammation indicates that individuals need to maintain adequate levels of vitamin D for an optimal immune response against both bacterial and viral infections. The prevalence of vitamin D deficiency both globally and in the Latin American region is strongly associated with increased risk for respiratory tract infections in adults and children. Several studies indicate that vitamin D deficiency may contribute to increased severity and duration of infection. Research findings support a role for vitamin D in immunity and protection against respiratory tract infections. A very recent systematic review and meta-analysis of individual participant data from randomized controlled trials showed that vitamin D supplementation protected against acute respiratory tract infection overall. Those patients that were severely deficient and started taking supplemental vitamin D daily or weekly benefited the most over those who received bolus doses. While many observational studies link low vitamin D levels and respiratory tract infections and numerous trials show that supplementing with vitamin D can lower one's risk of getting a respiratory infection, the results are mixed. Carefully designed studies to address supplementation dosing intervals and levels, and protective serum vitamin D levels will help determine if taking vitamin D supplements can protect against respiratory tract infections.

**Keywords:** Vitamin D. immune. deficiency. infection. respiratory

**Conflict of Interest disclosure:** Paid consultant for Bayer Consumer Health AG

# Track 3: Public Health Nutrition and Environment

SSS_144/1045

## ROLE OF MICRONUTRIENTS FOR PUBLIC HEALTH

### THE ROLE OF MICRONUTRIENTS FOR PUBLIC HEALTH

Eggersdorfer, Manfred.

DSM, Nutrition Science & Advocacy. Switzerland.

According to the World Health Organization (WHO), "in almost every country, the proportion of people aged over 60 years is growing faster than any other age group. This population aging can be considered as a success story for public health policies and for socioeconomic development, but it also challenges society to adapt, to maximize the health of people." Life-long health promotion, with an emphasis on the fundamental role of nutrition and essential micronutrients to reduce risk of chronic disease, can prevent or delay the onset of non-communicable diseases, such as heart disease, diabetes, osteoporosis, Alzheimer disease, and others. Nutrition is recognized as being an important factor in optimal health throughout the life course and the United Nations declared the Decade of Action on Nutrition.

Nutrition is a complex topic in itself, and so are its fields of application. Nevertheless, a significant scientific and medical consensus exists as to the importance of an appropriate level of micronutrient intake throughout the life course to foster health, and prevent the onset of diseases. A balanced diet rich in fruits and vegetables can provide the essential micronutrients according recommendations; however, a major part of the population does not follow or achieve the recommendations. Food fortification and the use of supplements are proven, cost efficient and safe ways for an adequate intake of essential micronutrients. To increase the recognition of the importance of micronutrient interventions, policy makers, health insurers and other stakeholders should give a healthy diet, including the use of supplements, a higher priority. The health benefits of fortification or supplementation with micronutrients are evident; examples on health and reduction of health care costs will be presented.

Subsequent to these lectures the DSM Nutritional Sciences Award will be presented, whereas the award 2017 is dedicated to Human Nutrition, with special emphasis on vitamins, carotenoids, polyunsaturated fatty acids, enzymes, pre- and probiotics and naturally occurring bioactive compounds. Scientists from all parts of the world, who have made major contributions to fundamental or applied research in this field, were nominated for the award. An international judging committee has reviewed the nominations and select the winner. We are pleased to welcome the winner for a keynote lecture, followed by an award ceremonial and reception.

**Keyword:** Micronutrients, public health, healthy aging, health economy
**Conflict of Interest disclosure:** This symposium was sponsored by DSM Nutritional Products (Switzerland)

**Further collaborators:** DSM Nutritional Sciences Awards Program

SSS_144/153

EATING PATTERNS AND DIETARY INTAKE OF INFANTS, TODDLERS AND CHILDREN: INSIGHTS FROM CROSS-COUNTRY ANALYSIS

INTRODUCTION TO FITS AND KNHS: METHODOLOGICAL CHALLENGES IN DIETARY INTAKE COLLECTION AMONG INFANTS, TODDLERS AND CHILDREN IN AUSTRALIA, CHINA, MEXICO, RUSSIA AND THE US

(1)Eldridge, Alison; (2)Afeiche Zehil, Myriam; (3)Denney, Liya;

(4)Jacquier, Emma; (2)Kassis, Amira; (2)Mathias, Kevin; (2)Semenova, Iaroslava; (5)van der Horst, Klazine; (3)Wang, Dantong.

(1)PhD, RD. Expert Scientist. Institute of Nutritional Science. Nestle Research Center. Lausanne. Switzerland.; (2)PhD. Scientist. Institute of Nutritional Science. Nestlé Research Center. Lausanne. Switzerland.; (3)PhD. Senior Scientist. Institute of Nutritional Science. Nestlé Research Center. Lausanne. Switzerland.; (4)PhD. Country Lead Scientist USA. Institute of Nutritional Science. Nestlé Research Center. Lausanne. Switzerland.; (5)PhD. Group Leader Dietary Intake. Institute of Nutritional Science. Nestlé Research Center. Lausanne. Switzerland.

**Background and objectives:** The Feeding Infants and Toddlers Study (FITS) and the Kids Nutrition and Health Study (KNHS) are large-scale cross-sectional surveys designed to explore nutrient intakes, food sources of nutrients, eating patterns and key behaviors related to energy intake and expenditure in infants and children in different countries around the world.

**Methods:** In each country, dietary intake is assessed using trained interviewers and multiple-pass 24-hr recalls on one or more days. The FITS and KNHS use data from national nutrition and health surveys when available, but when data do not exist for our age groups of interest, we collect data using similar methods. To date, a common analysis approach has been applied across data from the following countries: Australia, China, Mexico, Russia and the United States (US).

**Results:** Although many countries that conduct national nutrition surveys employ 24-hr recalls for individual-level intake estimations, other aspects of the survey methodology differ considerably. Some do not collect intake information on infants or young children. Food composition tables vary, limiting accurate intake estimates to only a few nutrients in some places. Different countries use different age classifications and different food grouping schemes, making comparisons across countries more difficult. Not all surveys record details about the meals or times when foods are

consumed. As much as possible, the FITS and KNHS have standardized reporting of age categories and food groupings so comparisons can be made. In addition, we have imputed missing values to complete data sets for nutrients of interest. When national survey data did not include the age categories needed, we have supported primary data collection to fill gaps in knowledge.

**Conclusions:** This presentation provides an overview of the individual studies and country data that comprise the current FITS and KNHS. The following presentations in this symposium will cover important nutritional issues in diets of infants, toddlers and children, including complementary feeding practices, intakes of total and added sugars, and the role of snacking in the diets of children.

**Keywords:** Dietary intake, child nutrition, survey

**Conflict of Interest disclosure:** All authors are employed by NESTEC, SA (Nestlé Research Center in Lausanne, Switzerland). Funding for these studies was provided by NESTEC.

COMPLEMENTARY FEEDING AND THE TRANSITION TO FOODS OF THE FAMILY TABLE IN CHINA, MEXICO, RUSSIA AND US

(1)Denney, Liya; (2)Afeiche Zehil, Myriam; (2)Semenova, Iaroslava.

(1)PhD. Senior Scientist. Institute of Nutritional Science. Nestlé Research Center, Lausanne. Switzerland.; (2)PhD. Scientist. Institute of Nutritional Science. Nestlé Research Center, Lausanne. Switzerland.

**Background and objectives:** Timely introduction of appropriate complementary foods is essential for optimal growth and development of infants and young children. The aim of this study is to describe and compare complementary feeding practices in four culturally diverse regions represented by China, Mexico, Russia and the United States (US).

**Methods:** Dietary intake data on infants and toddlers aged 6-23 months in China, Mexico and US were from the Maternal Infant Nutrition Growth (MING) study 2012 (n=906), the Mexico National Health and Nutrition Survey 2012 (ENSANUT) (n=767) and the Feeding Infants and Toddlers Study 2008 (FITS) (n=1430) respectively. Dietary intake data on infants and toddlers aged 7-23 months in Russia were from the Russian National Nutrition Survey 2013 (n=3294). In each study, trained interviewers collected 24-hour dietary recalls from parents or caregivers on behalf of their children. The percentage of infants and toddlers consuming foods from specific food groups and the average amount consumed (per capita) was estimated and presented for 3 age groups.

**Results:** The percentage of infants consuming breast milk was generally low, ranging between 33-58% at 6-8 months and 33-43% at 9-11 months. Several large differences in complementary food consumption were observed. In China, cow's milk consumption was very low whereas infant formula/growing-up milk was highly consumed (270-317g/d). Rice was a main grain consumed at all ages. In Mexico, infant cereal consumption was low, while a substantial amount of cow's milk was consumed before 12 months of
age. Sugar sweetened beverages were highly consumed in all age
groups and the amount increased significantly with age (64-219g/
d). In Russia, infant cereal consumption was low whereas white
potatoes were highly consumed as a vegetable. Consumption of
sugar sweetened beverages in Russia appeared to be the highest
(114-242g/d) across the 4 countries. In the US, consumption of
vegetable and fruit baby foods resulted in higher overall vegetable
and fruit intakes among infants compared with other countries.
However, vegetable consumption was significantly reduced after
12 months of age. 100% fruit juice was a main beverage and highly
consumed at all ages.

**Conclusions:** In this study, early feeding of relatively high amounts of empty calorie foods, such as sugar sweetened beverages and sweets and high consumption of low-nutrient dense food such as rice or white potatoes was observed. This compromises intakes of more nutritious foods such as vegetables and fortified infant cereals. In addition, early introduction of cow's milk was found in Mexico. These findings provide culture-specific and food based information for healthcare professionals to understand the improvement needs in their country and offer more targeted guidance on complementary feeding practices.

**Keywords:** Complementary feeding; China; Mexico; Russia; US

**Conflict of Interest disclosure:** This symposium was sponsored by Nestlé Research Center (Switzerland)

## INTAKE OF TOTAL AND ADDED SUGARS AMONG CHILDREN IN AUSTRALIA, CHINA, MEXICO, RUSSIA AND US

(1)Eldridge, Alison; (2)Afeiche Zehil, Myriam; (3)Shaheen Koyratty, Bibi Nadia; (4)Wang, Dantong; (2)Semenova, Iaroslava; (2)Mathias, Kevin; (5)Jacquier, Emma; (4)Lê, Kim-Anne.

(1)PhD, RD. Expert Scientist. Institute of Nutritional Science. Nestlé Research Center. Lausanne. Switzerland.; (2)PhD. Scientist. Institute of Nutritional Science. Nestlé Research Center. Lausanne. Switzerland.; (3)MS. Student. Epidemiology and Environmental Health. The State University of New York at Buffalo. USA.; (4)PhD. Senior Scientist. Institute of Nutritional Science. Nestlé Research Center. Lausanne. Switzerland.; (5)PhD. Country Lead Scientist USA. Institute of Nutritional Science. Nestlé Research Center. Lausanne. Switzerland.

**Background and objectives:** Sugar consumption is high across the world. However, it is unclear to which proportion added sugars contribute to total sugars, and how intakes differ across geographies. Targets to limit consumption have been set by various national and international organizations. The aim of this study was to assess differences in intakes of total- and added sugars in 4-13y old children in China, Mexico, the US, Australia, and Russia. The secondary aim was to identify main sources of total- and added sugars in the diets of these children.

**Methods:** Secondary data analysis was conducted using the 2011 China Health and Nutrition Survey, 2012 Mexican National

Health and Nutrition Survey, 2009-2012 US National Health and Nutrition Examination Survey, 2011-12 Australian National Nutrition and Physical Activity Survey, and the 2013 Russian National Nutrition Survey. Total- and added sugar intakes were calculated using the US Food Patterns Equivalents Database for China, Mexico, and the US; and using the respective national food composition databases for Australia and Russia.

**Results:** US children had the highest mean intakes of added sugar (76g/d), followed by Russian (68g/d), Australian (59g/d), Mexican (55g/d), and Chinese (9g/d) children. Intakes of total sugars followed a somewhat similar order, with Russian children having a mean intake of 127g/d, followed by US children with 124g/d, Australian children with 121g/d, Mexican children with 92g/d, and Chinese children with 26g/d. The top food sources of total sugar in China were fruits and vegetables, contributing to 42% of intake among Chinese children. Beverages (such as sugar-sweetened beverages, fruit drinks, and milk-based beverages) were the top sources of total sugar in other countries, contributing to 50% (Mexico), 44% (US), 33% (Australia), and 33% (Russia) of the total sugar in diets of children in these countries.

**Conclusions:** Despite very distinct geographies and cultures, it appears that in all countries studied except China, beverages are the major source of total sugar intakes. This strengthens the need to have global public health and industry efforts towards this specific product category, as it is a high contributor to sugar intakes in children in many countries.

**Keywords:** Total sugars, added sugars, children, food sources

**Conflict of Interest disclosure:** All authors except Bibi Nadia Shaheen Koyratty are employees of NESTEC, SA (Nestlé Research Center). This study was funded by NESTEC.

## THE ROLE OF SNACKING IN THE DIETS OF CHILDREN IN AUSTRALIA, CHINA, MEXICO AND US

(1)Jacquier, Emma; (2)Afeiche Zehil, Myriam; (2)Mathias, Kevin;

(3)Wang, Dantong.

(1)PhD. Country Lead Scientist. USA. Institute of Nutritional Science. Nestlé Research Center. Lausanne. Switzerland.; (2)PhD. Scientist. Institute of Nutritional Science. Nestlé Research Center. Lausanne. Switzerland.; (3)PhD. Senior Scientist. Institute of Nutritional Science. Nestlé Research Center. Lausanne. Switzerland.

**Background and objectives:** Eating between main meals or “snacking” is becoming more prevalent world-wide. Eating patterns and snacking behaviors are strongly influenced by culture. Our objective is to evaluate the similarities and differences in snacking habits among children from Australia, China, Mexico and the US.

**Methods:** National survey data were used for the comparisons across countries, including the National Nutrition Survey 2011-12 (Australia), the China Health and Nutrition Survey 2011 (China), the Mexican National Health and Nutrition Survey 2012 (ENSA-NUT; Mexico), the Feeding Infants and Toddlers Study 2016 (US)
and National Health and Nutrition Examination Survey 2009-2012 (NHANES; US). Trained interviewers collected 24-hr dietary recalls from parents or caregivers (for younger children) or from the children themselves. Snacking occasions were either defined by the participants (China, Mexico, US) or by time of day of consumption between meals (Australia).

**Results:** Snacking frequency varied widely across countries, with only 11.4% of 4-8y and 7.5% of 9-13y consuming snacks in China, in contrast to 98.9% of Australian children 2-16y consuming snacks. Snacking prevalence was intermediate in Mexico with 69.3% of 4-8y and 66.7% of 9-13y consuming snacks on any given day. The frequency of snacking in the US approached Australia (96.6% and 94.8% for 4-8y and 9-13y, respectively). FITS 2016 data demonstrated that snacking patterns appear in the toddler/preschool years, stabilizing to provide approximately 25% of energy from snacks from 3y. US children continued to get 25% of energy from snacks from 4-13y. Snacks contributed 11.4% of daily energy for Chinese 4-8y olds and only 7.5% for 9-13y. In Mexico, snacks contributed 15.2% of energy for 4-8y and 14.9% in 9-13y. In contrast, 33.6% of daily energy came from snacks among children in Australia. Foods consumed during snacks also varied widely: Chinese children most frequently consumed fruits and dairy; Mexican children preferred salty snacks, candy, and fruit; children in the US consumed milk and sweet bakery (mostly cookies); and children in Australia consumed fruit/vegetable juices or drinks and bread or rolls.

**Conclusions:** Despite differences in survey methodology, a common analysis approach provided valuable insights into snacking behaviors around the world. Snacking habits and foods consumed as snacks are important contributors to energy in the diets of children, but amounts and foods consumed vary considerably among the countries studied. In addition, we found that many of the foods typically consumed as snacks are needed to help children meet dietary recommendations, but there is still room for improvement in many snacking choices for children.

**Keywords:** Snacking, children, dietary intake.

**Conflict of Interest disclosure:** All authors are employed by NESTEC, SA (Nestlé Research Center). Funding for these studies was provided by NESTEC.

evolves from a more traditional model. Busy parents struggle to balance work and family life, resulting in less time to prepare and share mealtimes together as a family, and less time to enjoy quality moments together.

Across the world, the incidence and prevalence of overweight and obesity are reaching alarming levels. A growing body of evidence indicates that the family environment plays an integral role in children's and adolescents' weight status and unhealthy weight-related behaviours.

Childhood is a formative period for the development of children's healthy eating habits; consequently, it is a crucial time to build the most optimal foundations for positive and sustainable health behaviours.

The home environment is a critical source of positive influence, with the family having a great impact upon the shaping of children's first choice foods, therefore a family-centred approach is of crucial importance.

Danone Institute International (DII) gathered experts (dietitians, nutritionists, pediatricians, psychologists, sociologists, and public health professionals) to work together in collecting data, to develop a unique perspective on the topic.

It clearly emerged that to positively impact children's healthy eating, it is essential to shift the emphasis from "what we eat" to "how we eat".

Three key levers, supported by a strong body of evidence, all related to the family, have been identified, which all have a special emphasis on the pleasure of eating: Positive parenting, Eating together and a Healthy home food environment.

With three distinguished experts in the field, this symposium aims to share a consensus on key recommendations, by identifying relevant and innovative strategies to support families in making positive decisions for nurturing healthy eating in children.

**Keywords:** Healthy eating habits, children, eating together, healthy home food environment, food parenting

**Conflict of Interest disclosure:** This symposium was sponsored by Danone Institute International (France)

SSS_144/149

# THE ROLE OF FAMILY/PARENTS IN NURTURING HEALTHY EATING HABITS IN CHILDREN

## THE ROLE OF FAMILIES IN NURTURING HEALTHY EATING HABITS IN CHILDREN

Goulet, Olivier.

MD, PhD. Necker Enfants Malades Hospital. University Paris Descartes. President of the Danone Institute International. France.

With the increasing development of a 'global' world, many social, economic and cultural issues arise as the family structure

## PARENTAL SOCIALIZATION OF HEALTHY EATING HABITS AMONG CHILDREN

Hughes, Sheryl.

PhD. Developmental Psychologist. USDA ARS Children's Nutrition Research Center. Baylor College of Medicine. Houston. Texas. USA.

Developmental theory posits that parents socialize their children by encouraging them to internalize the goals and values that parents deem important. The goal of most parents is that, by early adulthood, their children will be making appropriate choices in their daily lives. When it comes to healthy eating, the parenting environment remains the first and most fundamental context in which children's eating behaviors are socialized. Child eating socialization is characterized by at least three broad areas of food parenting: 1) coercive control, 2) structure, and 3) autonomy
support. Food parenting used by parents of young children may
not be appropriate for older children and adolescents. During a
child's early years, more guidance is needed as parents teach chil-
dren basic eating skills, promote appropriate food preferences,
and support child eating self-regulation. During the elementary
school years, when children experience a wider range of food en-
vironments, parents change their behaviors to more developmen-
tally appropriate practices to promote healthy eating in children.
During adolescence, parents continue to guide eating behaviors
by supporting autonomy in their children with the hope that the
youth will internalize the norms and values accepted within the
extended family.

A recent literature review highlighted the food parenting prac-
tices that either foster or hinder the development of healthy eating
habits in children. In younger children (preschool through kinder-
garten), the use of coercive control is common. Collectively, co-
ercive control strategies with young children have been shown to
be related to higher consumption of unhealthy foods. In contrast,
the use of structure (i.e., monitoring) and autonomy support (i.e.,
encouragement and praise) were shown to be related to healthier
child eating habits. In elementary school aged children, the use of
coercive control continued to be seen; however, the use of these
food parenting practices with child food intake appeared to show
little impact on intake. Structured activities (availability, accessi-
bility, and modeling) were associated with healthier eating in this
age group. It was expected that autonomy promotion (i.e., mode-
ling, encouragement and praise) would be used extensively with
older children and adolescents. However, our literature review did
not show the use of these practices—at least in the empirical stud-
ies we located. We will critically review the evidence supporting
associations between coercive control, structure, autonomy sup-
port, and child food intake in these age groups. In addition, we will
point to gaps in the literature and discuss where future research
should be targeted.

**Keywords:** Food parenting, healthy eating habits, autonomy support, structure, control

**Conflict of Interest disclosure:** I received speaker fees from Danone Institute International for this presentation

**Further collaborators:** Thomas G. Power

IMPROVING CHILDREN'S EATING HABITS THROUGH EATING TOGETHER

Haines, Jess.

Department of Family Relations and Applied Nutrition.
University of Guelph. Guelph. Canada.

Eating together is generally regarded as a child having a
planned meal with at least one parent. While the frequency of
eating together varies by geographic region, research suggests
that the number of meals that children report eating with their
families has been declining over the past four decades. Numer-
ous observational studies have found that eating together has a
positive sustained impact on children's dietary intake. This may

because foods eaten together as a family are healthier than those
consumed alone or outside of the home or the time spent together
as a family allows parents an opportunity to model healthful di-
tary intake and eating patterns. Observational research has also
found that regularly eating meals together is associated with lower
risk of obesity among children and adolescents. As a result of these
findings, the American Academy of Pediatrics and the European
Society for Pediatric Gastroenterology, Hepatology and Nutrition
recommends that families should regularly eat meals together as
part of childhood obesity prevention strategies. One key limitation
of these findings from observational studies is that families who
eat meals together may differ from those who do not eat together
on characteristics, such as family functioning or level of chaos in
the home, which may influence child diet and weight outcomes.
Failing to appropriately account for these potential confounders
may result in biased estimates of the impact of eating together. To
address this limitation of observational research, researchers have
begun to design and test interventions to increase the frequency of
families eating together. The focus of this presentation is to criti-
cally review the observational and intervention research on eating
together. We will present key research findings on the associations
between eating together and children's behavioural and health
outcomes. We will also discuss results from existing intervention
studies and their implications for future intervention efforts.

**Keywords:** Eating together, family meals, healthy eating, obe-
sity prevention, children

**Conflict of Interest disclosure:** I have received speaker fees from Danone Institute International for this presentation.

HOW TO CREATE A HEALTHY HOME FOOD ENVI-
RONMENT

Lytle, Leslie.

PhD. Professor. Departments of Health Behavior and Nutrition.
Gillings School of Global Public Health. University of North
Carolina at Chapel Hill. North Carolina. USA.

The home food environment is the most proximal influence
over youth eating behaviors and has a strong influence on the ha-
bituation of food practices that continue into adulthood. The home
environment includes both physical and social factors that youth
are exposed to. The physical environment includes the availability
of and accessibility to foods in the home. The provision of healthy
foods available at home and parental role modeling of healthful
eating habits increases the likelihood that youth in the family will
be willing to eat and enjoy a greater variety of healthy foods. Re-
search suggests that not only is it important for families to provide
healthy foods to their children but it is also important to help teach
children how to be more intentional about what, when, where and
how they eat. The social environment includes myriad factors that
youth are exposed to by observing and interacting with the adults
and other children living in the home. This social environment
includes role modeling by parents and other household members,
family rules around eating and meal time, and cues and reinforce-
ments for eating behavior. Creating a healthy home food environ-
ment requires a consideration of how to positively impact both the
physical and social environments of homes. Using this framework,
this session will discuss the interventions that have been tested to
positively influence the home food environment and the best prac-
tices that have emerged from the empirical literature to date. We
will also discuss the potential for future intervention efforts.

**Keywords:** Home food environment, family-based interven-
tions, obesity prevention healthy eating habits

**Conflict of Interest disclosure:** I received speaker fees from Danone Institute International for this presentation.

SSS_144/1010

MINDFUL EATING APPLIED TO SNACKING: A BEHAVIORAL APPROACH SUPPORTED BY RECENT SCIENTIFIC FINDINGS (DRAFT)

SNACKING IN DIFFERENT PARTS OF THE WORLD: A MARKER OF DIETARY ANARCHY OR A USEFUL CONTRIBUTOR TO DIET QUALITY AND WEIGHT CONTROL?

Bellisle, France.

Nutritional Epidemiology. University Paris 13. France.

The present “epidemic” of obesity has been attributed to a
growing trend for snacking (Murakami, 2015). Dietary surveys in
various parts of the world reveal that “snacks” (eating occasions at
other moments than main meals) do bring a significant amount
of energy and nutrients to the daily diet. Even in countries where
the traditional pattern of three “main meals” is maintained, most
individuals snack at least once daily. One daily snack is frequent
in France (mostly at the occasion of the traditional afternoon
“goûter”) but up to 8 or 12 habitual daily snacks have been report-
ed in Scandinavian countries (Bellisle, 2014; Lund, 2014). In the
USA, snacks have increased in frequency over the last decades and
three or more snacks a day now bring over 23% of the daily energy
in men and women (Kant, 2015). Snacks can represent between
4% (China) and more than 50% (Finland) of daily energy intake
(Lund, 2014; Duffey, 2014). Clearly, the important contribution
from snacks to the daily intake can affect body weight control
and quality of the diet. A review of the abundant literature about
snacking reveals at least two contrasting pictures (Bellisle, 2014;
Hess, 2016). In many studies, snacking is presented in a favorable
way, highlighting its contribution to the daily intake of valuable
micronutrients and the flexibility it confers to adjust the daily en-
ergy intake to fluctuating energy needs. By contrast, other reports
view snacking as a source of excessive energy intake, facilitating
weight gain, with little contribution to the quality of the diet (1).
The potential value of snacking is obviously modulated by the se-
lection of good nutritional quality foods, but also by other types of
factors, for example: eating in the absence of hunger in response
to external non-physiological cues, irregular as opposed to regular

snacking, snacking while watching television or screen. Evidence
exists that paying attention to the act of eating facilitates both sa-
tiation and satiety, perhaps by optimizing the sensory experience
of ingestion and facilitating the memory processes that contrib-
ute to inhibiting further eating. The regularity of snacks can make
them small “meals” that occur predictably in the daily schedule.
The French “goûter” ingested by all children and many adults in
the middle of the afternoon not only allows them to cope with
the very long time interval between lunch and dinner, but gener-
ates the physiological responses usually triggered by regular meals.
Physiological cues typically present at the outset of a “main” meal
(among which a small decline in glycemia) are also present at the
beginning of a regular “goûter”, preparing the organism to respond
to the nutrient load. Such physiological responses are not present
when snacking is triggered by external cues in the absence of hun-
ger. The potential beneficial effects of snacking (intake of valua-
ble micronutrients, facilitated adjustment of intake to needs) take
place when snacking is a regular, mindful eating event as opposed
to an irregular, externally triggered, impulsive behavior.

**Keywords:** Snack, energy intake, diet quality, weight control, mindfulness

**Conflict of Interest disclosure:** The author is a member of scientific advisory councils for Cereal Partners Worldwide, European Food Information Council, General Mills, Nomad Foods, CreaBio, International Sweeteners Association, and European Fruit Juice Association. Over the last 5 years, she has received honoraria and travel grants from: American Beverage Association, International Life Science Institute, Mondelez, Tate & Lyle.

EATING MINDFULLY AS A SUSTAINABLE
HEALTHY BEHAVIOR: THEORY AND EVIDENCE

Kristeller, Jean.

Indiana State University. USA.

Mindful eating is a unique way of relating to the many food
choices we face every day. Our minds and our bodies can provide
us much wisdom, not only to eat in a more healthy and flexible
way, without dieting, but also to enjoy our food more – not less.
Although snacking is often identified as an undesirable aspect of
food intake, evidence suggests that regular meals can be supple-
mented by snacks within healthy parameters, particularly in re-
gard to quantity, but also related to quality of foods chosen. One of
the challenges of highly restrictive diet programs, which generally
curtail virtually all commercially available snack foods is that little
awareness is developed regarding how to eat such foods in a more
balanced, limited but sustainable way.

This presentation will provide an introduction to the basic
elements of the Mindfulness-Based Eating Awareness Training
(MB-EAT) program, including a brief introduction to the theo-
ry of mindfulness meditation and the mindful eating experienc-
es used in the program (Kristeller, 2016; Kristeller & Wolever, in
press). Core goals within the MB-EAT program, a structured 12
session manualized intervention, include heightening interocep-
tive awareness of physical hunger, taste, and fullness; heightening
awareness of non-nutritive cues for eating, including thoughts
and feelings, and external triggers such as the presence of food,
and social pressure; and mindful use of nutritional information.
Heightening awareness of taste satisfaction and taste satiety (sens-
sory-specific satiety) is a core element throughout. Multiple eat-
ing awareness exercises occur across the program, including use
of snack foods such as high energy dense foods, and participants'
personally preferred snack foods. Rather than restricting these
foods, which often results in rebound overeating, the message is
to consider how to obtain maximal pleasure from smaller, rather
than larger, quantities, and to make more mindful choices to re-
flect caloric and health needs. At the same time, healthier foods
are also presented as important alternatives, but again, in a bal-
anced rather than exclusive way.

The presentation will review research evidence from several NIH-funded clinical trials, application to a range of clinical populations, including those with binge eating disorder (Kristeller, Sheets, & Wolever, 2013; Kristeller & Wolever, 2011), type II diabetes (Miller, Kristeller, et al., 2012; 2014), and obesity-related eating patterns (Daubenmier, Moran, Kristeller et al., 2016). Our research to date suggests that individuals can bring compulsive overeating under control, improve emotional regulation related to eating, and decrease weight, and that improvement across a range of variables is associated directly with amount of mindfulness practice. The implications of this approach for helping individuals create a more balanced, sustainable, yet flexible relationship to eating and food, will be discussed.

**Keywords:** Mindful eating; MB-EAT; sensory-specific satiety; binge eating disorder; weight loss.

**Conflict of Interest disclosure:** This symposium was spon-
sored by Mondelez International (USA)

HOW MINDFULNESS CAN BENEFIT TO SNACK-
ING?

Cornil, Yann.

Sauder School of Business. University of British Columbia.
Canada.

The growing trend for snacking among children and adults
over the past forty years has been potentially identified as one of
the factors contributing to the obesity epidemic. Because of the
type of food being consumed (high in calorie, sugar and fat), but
also the timing of consumption (between meals) and the mode of
consumptions (for instance, while watching TV), a habit of snack-
ing represents a challenge for energy balance and body weight
control. By contrast, evidence exists that “mindfulness” can bene-
fit to snacking. Mindfulness typically increases consumers’ aware-
ness of and responsiveness to internal signals of satiety, but it also
increases food enjoyment and savoring. It can thus decrease the
occurrence of impulse-based or mindless snacking episodes, but
also promote more qualitative snacking with the aim to appreciate
the sensory quality of snacks rather than satisfying an appetitive
impulse.

We know that satiety is only marginally influenced by the actu-
al quantity of energy being ingested, and is largely driven by a vast
array of cognitive factors, including consumption norms, visual
perception of food quantity, and monitoring of eating (Cornil
2017). Hence, behavioral research has shown how purposeful
changes in food marketing and environments can promote pos-
itive eating behaviors like mindful snacking, and more general-
ly decrease food intake without reducing satiety or satisfaction
(Chandon and Wansink 2012; Wansink and Chandon 2014). Small
changes in package shape and dinnerware size can have a large
impact on consumers' perception of food volumes, and therefore
increase the perceived (but not the actual) amount of food being
eaten (Krishna 2006; Van Ittersum and Wansink 2012). Size labels
(for instance, labeling the same portion size "large" rather than
"normal") and assortment sizes (for instance, adding an "extra
large" or an "extra small" option in the choice set) influence con-
sumption norms, and can thereby impact the satiating power of a
snack for the same actual quantity (Aydinoglu and Krishna 2011;
Sharpe, Staelin, and Huber 2008). Also, subtle cues can encourage
better monitoring of eating and limit mindless eating sequences,
leading to faster satiation—for instance, inserting potato chips of
different colors at regular intervals in a tube of chips as a way to
“segment” consumption (Geier, Wansink, and Rozin 2012).

Growing research inspired by mindfulness techniques has also
shown that encouraging consumers to focus on the sensory char-
acteristics of foods can increase eating enjoyment while reducing
calorie intake (Tapper 2017). This is because a higher sensory focus
increases awareness of and responsiveness to satiation cues, and in
particular to “sensory-specific satiety”, which predicts that the first
few bites of a food are the most pleasurable, then pleasure declines
with each subsequent bite. Hence, positioning a snack food as a
way to emphasize its multisensory qualities (taste, aromas, tex-
ture) can increase the appeal of smaller portion sizes (Cornil and
Chandon 2016). This shows that mindfulness techniques applied
to foods can be a viable alternative to health warnings in order to
encourage consumers to snack more healthily, while preserving—
and even enhancing—the pleasure of eating.

**Keywords:** Mindfulness, snacking, portion size, satiety

**Conflict of Interest disclosure:** Yann Cornil has received funding from the Social Sciences and Humanities Research Council of Canada, from the University of British Columbia, from INSEAD, and from Institut Benjamin Delessert for his research.
STUDY OF THE CONTRIBUTIONS IN BREAD RELATED TO THE CONTRIBUTION OF FORTIFICATION LEVEL OF IRON IN WHEAT FLOUR

(1)López, Ximena; (2)Geria, Rodrigo; (3)Salazar, Karen; (3)Arqueros, Valeria; (3)Gonzalez, Miluzka; (3)Benavides, Clara; (3)Trejo, Maricela.

(1)Master en Ciencia y tecnología de los Alimentos. Universidad de Valencia. España.; (2)Ingeniero Químico; (3)Ingeniero en Alimentos.

Flour Fortification is a very old Public Health Program in Latin America, even beginning in Chile in 1958, after the countries of North America. Although some countries have joined just a few years ago, there are already 33 countries in the Region that are fortifying wheat, corn and rice flour. Mostly wheat and corn flour are subscribed as Public Fortification programs and are monitored by the Ministries of Health of each country.

The objective of this work is to have a vision of the levels of iron found in the bread from Flour Fortification. This work will be carried out in five countries: Mexico, Ecuador, Peru, Argentina and Chile, where 180 samples will be obtained from typical high-consumption bread that is sold in bulk in the most populated and representative urban sectors of the capital area.

Once the bread samples were obtained, the iron tracer was selected as an indicator that the flour used was fortified. The analytical determination of Iron used is by Atomic Absorption Spectroscopy. A methodology based on the Official Method A.O.A.C. 999.10. In this way, we wish to show in a very simple way, what is the actual benefit of iron and establish what its contribution means on the health of people.

**Keywords:** Food fortification; iron deficiency; public health; Monitoring

**Conflict of Interest disclosure:** This symposium was sponsored by Granotec Foundation (Chile)

EPIDEMIOLOGY OF MICRONUTRIENT DEFICIENCY IN LATIN AMERICA, PUBLIC HEALTH SIGNIFICANCE

Morán, Javier.

Catholic University of Murcia (UCAM). Spain.

We reviewed at this conference the epidemiology of micronu-
trient deficiency in Latin America with special reference to the
iron deficiency and how these deficiencies have a great impact in
terms of public health.

We also review the interest of the fortification of new food ma-
trices that allow the fortification to be carried out to all the popu-
lation and particularly to children and adolescents.

**Keywords:** Food fortification; iron deficiency; public health
**Conflict of Interest disclosure:** This symposium was spon-
sored by Granotec Foundation (Chile)

NUTRIENT PROFILING STRATEGIES IN LATIN AMERICA AND ITS INFLUENCE ON THE CONTROL OF MICRONUTRIENT DEFICIENCY

(1)Gil, Ángel; (2)Soto-Méndez, María José.

(1)PhD. Prof. Department of Biochemistry and Molecular Biology. Institute of Nutrition and Food Technology. Centre of Biomedical Research. University of Granada. CIBERobn. Spain.; (2)Ph.D. Scientific Coordinator. Fundacion Iberoamericana de Nutrición. Granada. Spain.

The increasing of overweight and the obesity epidemic, in addition to the increase of diet-related non-communicable diseases, are among the main consequences of dietary changes, in conjunction with the physical inactivity of the populations.

Within the context of interest of the Latin American countries,
already affected by obesity and non-communicable chronic diseas-
es, but still experiencing the problems of undernutrition and micro-
nutrient deficiencies, governments and regional organizations have
promoted actions of generating comprehensible, suitable, accurate
and standardized information on the content of food products in
order to allow the consumer to make healthier choices, promoting
the consumption of more complete foods; all these actions can be
reached by implementing Nutrient Profiling models.

The definition of Nutrient Profiling was proposed by the WHO in 2015 as “the science of classifying or ranking foods according to their nutritional composition for reasons related to preventing disease and promoting health”.

There are nutrients classified as of public health relevance, some of them because of their harmful effects and high consumption (e.g. total fat, saturated fatty acids, trans fatty acids, sugars and sodium), and others for their positive effects on health but not reaching the daily recommendations (e.g. dietary fiber, unsaturated fatty acids, vitamins and minerals [vitamin D, iron, calcium, zinc, potassium]).

One of the first approaches of Nutrient Profiling was the reg-
ulation of claims; now the use has extended to other actions, for
example, nutritional education conducted by health professionals,
and be a guideline for consumers and assist them to make “health-
ier” decisions against a wide variety of products offered in the
market, nutrient profiling strategies have also increased privately
and publicly to establish industrial food labeling using graphs or
representative symbols (logos) on the products to communicate
nutritional information to the consumer or to label products as
“healthy” food.

Several countries in Latin America, such is the case of Mexico,
Costa Rica, The Caribbean, Ecuador, Peru, Bolivia, Brazil, Argen-
tina and Chile, have developed initiatives that involve the use of
Nutrient Profiling, as recent as 2016 a regional model of Nutrient
Profiling was generated by the Pan-American Health Organiza-
tion to be taken as basis for local policies in different countries.
Whether the nutrient profiling would be positively adapted by the countries taking into account the relevance of food groups, their role in the diet and the contribution of the nutrients to the overall diet of a population or a particular group within a population is an arising question.

The creation of nutrient profiling should respond to a systematic, transparent and logic methodological process, ideally agreed between the different sectors of each country or region involved (governmental organizations, public bodies, food industry and consumers' organizations). The proper use of Nutrient Profiling could lead to the Latin American consumers to select products that let them reach their micronutrient requirements and promote a more balanced diet.

**Keywords:** Nutrient Profiling, Public health. Nutrient information. Nutritional claims.

**Conflict of Interest disclosure:** The present symposium has been sponsored by Granotec

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UNITED FOR HEALTHIER KIDS: A PROGRAM TO HELP PARENTS ESTABLISH HEALTHIER EATING AND LIFESTYLE HABITS

UNITED FOR HEALTHIER KIDS PROGRAM EXPERIENCE- IS IT ON TRACK TO ACHIEVE ITS GOALS: COUNTRY EXPERIENCES FROM PAKISTAN AND MEXICO

Das, Jai.

MD. Senior Instructor. Division of Women and Child Health. Aga Khan University. Karachi. Pakistan.

The multi-level United for Healthier Kids program (U4HK), initiated and catalyzed by Nestlé, is intended to provide families with children under 12 years with new tools to inspire and enable dietary and behavioral change and focused on six behaviors. It was launched in countries around the world with each country choosing the behaviors and activities that apt to the local context. We will discuss two country examples of Mexico and Pakistan to gauge the success of U4HK so far. Both the countries vary in the burden of malnutrition as Mexico has one of the highest prevalence of childhood overweight and obesity, while Pakistan has one of the highest prevalence of childhood undernutrition and stunting.

Mexico was the first country to launch U4HK and chose four behaviors including ‘Manage Portions’, ‘Choose Nutritious Foods and Varied Options’, ‘Choose to Drink Water’ and ‘Feed your Baby Like a Baby’ and ‘Move More, Sit Less. Multiple partnerships were developed with the Ministry of Health, Ministry of Education, Kimberly Clark and Televisa and multiple communication channels were used to create awareness and reach large segments of the population, including digital media, mass media by broadcasting a reality show. Pakistan focused on three behaviors including

'Choose to drink water', 'Move more sit less' and 'Choose nutritious & varied options'. It utilized various channels to communicate the selected messages including digital media, mass media and school platforms and engaged celebrities to endorse the messages.

It was intended to measure the success of the program at three levels - Reach, Engage, and Impact. Initial evaluation from these two countries suggest that U4HK has been successful in reaching and engaging with its target population as in Mexico, digital media generated more than 13.5 million exposures with sufficient engagement rates and Pakistan showed greater awareness amongst mothers regarding the behaviors. A study on purchase and consumption of food patterns in Mexican families with children under 12 years suggested increase purchase and use in the healthy basket and a decrease of the unhealthy basket, with greater increase in consumption of fruits and vegetables.

U4HK is a comprehensive program designed to help parents establish healthier eating and lifestyle habits for their kids. Its strength of forming partnerships and using multiple communication channels has been effective to broaden its exposure and reach a large target audience. U4HK will also aid global understanding to design, implement and evaluate multipronged approaches to changing behaviors.

**Keywords:** U4HK, undernutrition, obesity, dietary behaviors

**Conflict of Interest disclosure:** JD is a member of the Scientific Advisory Board for United for Healthier Kids.

BEHAVIOUR CHANGE PROGRAMS DRIVING HEALTHIER DIETS AND LIFESTYLES: WHAT DO WE KNOW?

French, Jeff.

PhD. Visiting Professor. Brighton University. Brighton. United Kingdom.

In this presentation a summary of what we currently know about how to design programmes aimed at influencing healthy diets and related lifestyle issues such as exercise will be presented. The presentation will cover what we know about the design characteristics of successful programmes including how they should be established, developed managed and evaluated. The presentation will be illustrated using examples of both success and failure from around the world. The presentation will also explore the role of different intervention ‘Types’ and ‘Forms’ and how these different approaches can be integrated into an effective and efficient programme mix.

**Keywords:** Social Marketing, diet, lifestyle, behavior change

**Conflict of Interest disclosure:** JF is a member of the Scientific Advisory Board for U4HK
# UNITED FOR HEALTHIER KIDS: A PROGRAM TO HELP PARENTS ESTABLISH HEALTHIER EATING AND LIFESTYLE HABITS

Prentice, Andrew M.

PhD. FMedSci. MRC Unit The Gambia and London School of Hygiene & Tropical Medicine.

Malnutrition in all its forms threatens the health and development of hundreds of millions of children worldwide. The prevalence of stunting and underweight is gradually declining as many countries pass through the economic transition. But the decline in undernutrition is being more than offset by a global rise in childhood overweight and obesity that heralds a future explosion in nutrition-related non-communicable diseases.

There are numerous societal and environmental drivers of the growing obesity pandemic that will require cross-sectoral approaches if they are to be reversed. Many parents lack awareness of the importance of their children maintaining a healthy body weight through appropriate diets and exercise and, even if concerned by their child's weight status may lack the life skills to implement effective change within the family.

United for Healthy Kids (U4HK) is an international programme that sets out to empower families to live a healthier lifestyle. The programme offers advice, training and participatory strategies to help parents effect healthy change in six core skills: Manage Portions; Choose Nutritious and Varied Options; Choose to Drink Water; Enjoy Meals Together; Feed Your Baby Like a Baby; and Move More, Sit Less.

U4HK represents a new model of private-public engagement that seeks to mobilise multiple governmental, non-governmental and private agencies to maximise its reach and impact. Country-specific implementation of the programme utilises the core suite of evidence-based skills but tailored to local needs. Innovative use of social media platforms provides a powerful tool for dissemination and reinforcement of key messages, interactive engagement with families and evaluation of impact.

U4HK has so far been implemented in 13 countries and has reached over 150m participants.

**Keywords:** Malnutrition, stunting, overweight, obesity, behavior change

**Conflict of Interest disclosure:** AMP is a member of the Scientific Advisory Board for U4HK

# FROM PPP TO PPE: A NEW OPPORTUNITY FOR ENGAGEMENT

Drewnowski, Adam.

Center for Public Health Nutrition, University of Washington, USA.

Multi-sectoral initiatives involving private industry are increasingly viewed as a necessary step to improve both diet quality and population health. Public private partnerships (PPPs) have

addressed a number of global nutrition challenges, ranging from biofortification and fortification to the promotion of more nutrient-rich diets and healthier lifestyles. The Food and Agriculture Organization (FAO) and the World Food Program (WFP) look to industry partners to improve the quality of the global food supply.

The traditional role of the private sector has been to provide technical assistance, knowledge transfer, and financial support for activities ranging from preventing hunger to promoting optimum health. Companies have used PPPs to alleviate hunger, promote food security, or help develop microenterprises or small businesses. Often, those activities were led by policymakers, local health jurisdictions, or international agencies, with industry assuming a secondary role.

The multi-sectoral U4HK program was created in direct response to calls by international agencies for more engagement by private companies to address the double burden of malnutrition in low and middle income countries (LMIC). Its development was consistent with the published principles on creating PPPs to address complex public health nutrition issues. The challenges, risks and benefits of PPPs have been set out in influential past work, notably by Kraak et al. (2011). While preserving those principles, the U4HK program represents a novel type of private-public engagement (PPE), distinct from the traditional PPP structure. A central feature of PPE is that the private sector takes the leading role in bringing together multiple actors, including families, schools, communities, policymakers, the media, and NGOs. Here, the rapid growth of social media has made it possible to reach families directly with messages about optimum diets and child health.

The U4HK protocols followed standard principles, such as having a clearly defined and achievable goals, clear statements of work, rules, and responsibilities, as well as an evaluation component. Details of U4HK design and implementation will be presented in this symposium.

**Keywords:** Public-private partnership (PPP); Private-public engagement (PPE); Social marketing

**Conflict of Interest disclosure:** AD is a member of the Scientific Advisory Board for U4HK and a member of the Nestlé Nutrition Council. He has received grants, contracts, and honoraria from public agencies, private industry, private foundations, and commodity groups for projects involving nutrient profiling, diet quality assessments, and health outcomes.

# THE SIX HEALTHIER HABITS TARGETED IN UNITED FOR HEALTHIER KIDS

Rolls, Barbara.

PhD. Professor in Nutritional Sciences. Department of Nutritional Sciences. The Pennsylvania State University. Pennsylvania. USA.

United for Healthier Kids (U4HK) aims to create a social movement through social media platforms that target parents and carers of children up to 12 years of age. A panel of global, independent experts with different expertise in public health, behavioural psychology and nutrition, and with different geographical backgrounds advised U4HK on a framework of six healthier habits.
its to target. These are ‘Manage Portions’, ‘Choose Nutritious and Varied Options’, ‘Choose to Drink Water’, ‘Enjoy Meals Together’, ‘Feed Your Baby Like a Baby’, and ‘Move More, Sit Less’. The habits were chosen based on in-depth evaluation of scientific evidence and were framed to affect a change in behaviours that could help minimize the risk of childhood obesity and under-nutrition. Each country in which U4HK is introduced chooses which of the six behaviours will receive the most attention. The choices depend on and are tailored to the local context and the specific nutritional needs, health priorities, and available resources at each country location. Thus far, countries have chosen to activate up to 3 to 5 of the healthier habits. All countries have included ‘Choose Nutritious and Varied Options’ and ‘Choose to Drink Water’. In this presentation, the science behind several habits and the varied ways they have been adapted and implemented by different countries will be discussed.

**Keywords:** Habits, dietary behaviors, under-nutrition, obesity

**Conflict of Interest disclosure:** BR is a member of the advisory board for United for Healthier Kids

SSS_144/1027

# NUTRIENTS AND BEYOND NUTRIENTS: SOCIAL, CULTURAL, AND ENVIRONMENTAL DRIVERS OF FOOD CHOICES GLOBALLY

## WHEN IS CHOICE AN OPTION?

Fischler, Claude.

PhD. Interdisciplinary Institute for Contemporary Anthropology (IIAC). EHESS/CNRS,.

Choice has become an omnipresent notion in nutrition and public health literature as well as in lay parlance. Consumers are told, or read in the media, that their choices of foods are detrimental to their health. They are repeatedly reminded that they have to make the right choices, i.e. the healthy choices.

Choice goes hand in hand with decision. An influential 2008 paper stated that 2.4 million deaths in 2000 can be attributed to personal decisions and could have been avoided if readily available alternative choices were made. In the paper, diet was one of the prominent sets of personal decisions involved.

The Oxford Dictionary defines decision as a conclusion or resolution reached after consideration. Using choice and decision to denote behavior implies assuming some degree of deliberation and/or intention. Assumed intentionality and free will make individual subjects the essential link in the causal chain. This in turn easily leads to holding them as solely responsible for their prediction.

Meanwhile, in recent decades, various disciplines, particularly in the social sciences (e.g. history, anthropology, sociology, social psychology), have shown that one of the most striking features of human eating is that it is an essentially social activity. In most societies, not just those labeled traditional, eating is performed

collectively. It is regulated by a body of rules (etiquette) adjusting individual behavior to fundamental principles of solidarity, hierarchy, morality, propriety. Children are socialized into these rules on the occasion of meals. In more traditional societies, lone eating is stigmatized and the very notion of likes, dislikes and aversions, particularly about staple foods, is irrelevant or non-existent: to that extent, choice is simply not an option.

For several decades, in contemporary, affluent societies, individual autonomy has enjoyed ever increasing recognition in most areas of life, including eating. But even in those individualistic cultures most daily eating unfolds according to an implicit, cultural script, and social interactions can, according to context, both inhibit or stimulate food intake. Moreover, degree of individualization as well as appreciation of choice are shown to vary considerably, including across Western cultures.

The unfounded assumption that food is just another form of consumption and that what people eat essentially depends on free will, choices and decisions is not just a cause for repeated failure in nutrition education and public health campaigns. There is some indication that it helps make the problem worse by promoting anxiety, confusion and aberrant dieting.

It is urgent to integrate into nutrition the wide, cross-disciplinary spectrum of knowledge relevant to the understanding of the human omnivore's eating behavior and complex relationship to food.

**Keywords:** Food selection, food habits, social and cultural determinants, individualization

**Conflict of Interest disclosure:** CF has received funding from public agencies and private or semi-private sector to investigate structure and evolution of food and eating patterns.

## TASTE RULES FOR KIDS

Orlet Fisher, Jennifer.

PhD. Professor of Social and Behavioral Sciences. Associate Director. Center for Obesity Research and Education. Temple University. USA.

Early childhood is considered to be a critical period for establishing healthful eating habits. At the same time, many of the poor dietary patterns seen among adults begin to emerge early in life. It has long been appreciated that taste plays a central role in shaping children's food preference and is rooted in biology. Preferences for sweet and savory tastes as well as rejection of bitter and sour tastes are seen well before children experience the first tastes of solid or complementary foods. From this perspective, children's love of sweets and dislike of vegetables seem a foregone conclusion. To what extent does taste actually rule when it comes to food choices among young children? While taste (and more recently temperament) predisposes children to readily prefer certain types of foods over others, the trajectory of food acceptance is fundamentally driven by experience that starts in early development. Children show the capacity to learn to accept a wide variety of foods in their diets, including vegetables which are neither particularly sweet nor energy-dense. Thus, the rules of taste are less deterministic
and more pliable than often perceived by parents and other adults who routinely feed young children. What are the essential rules for promoting acceptance of healthful food choices? Context is everything. Familiarity is one of the most fundamental dimensions of food preferences: children eat what they like and like what they know. A large body of evidence demonstrates that repeated exposure promotes liking via the accumulation of positive experiences around eating—both social and biological. Practices of caregivers, along with the broader socioeconomic environment, set the stage for these experiences. Caregivers determine which foods will become familiar to children, exhibit like and dislike of foods that children learn to model, and use practices that shape children's food preferences and choice. Children's preferences for sweets, for instance, are not only rooted in taste biology but are also socially reinforced by the use of such foods as treats, rewards, and celebration. Social context not only shapes children's understanding what and how much to eat, but also the time of day when eating should occur (e.g. snacks), the way foods are prepared and paired at a given eating occasion (e.g. a meat and a vegetable at meals), and salient qualities of those foods (e.g. healthy, treats). Practices around feeding children, in turn, reflect conditions of the local environment (e.g. availability and cost) as well as norms, values, and behaviors of family, community, and culture. For instance, snacking and eating sweets between meals is normative among US children, but uncommon in other countries. Collectively, these observations suggest that taste rules are universal but are not destiny for food choice among children. Rather, children's choices are rooted in the accumulation of day-to-day experiences—at the family table, in the school cafeteria, eating with their grandparents—and the multi-faceted social contexts in which those experiences occur. Repeated exposure to healthful foods in positive social contexts is the key rule for promoting healthful dietary patterns in early childhood.

**Keywords:** Children, taste, preference, acceptance, repeated exposure

**Conflict of Interest disclosure:** Sponsored by General Mills

## COST AND CONVENIENCE IN FOOD CHOICE

Drewnowski, Adam.

Center for Public Health Nutrition. University of Washington.
USA.

There is more to eating than nutrient consumption. There is more to non-communicable diseases than nutrient excess. Studies in nutritional epidemiology have tried to convince us that a single food, nutrient, or dietary ingredient could be linked to a specific health outcome, after adjusting for multiple covariates. Typically, socioeconomic variables were adjusted for, and thus removed from consideration, in order to show us the “true” relation between dietary components and health. As nutrition has come to embrace the social sciences, it has become clear that it is impossible to separate the food from the person and the person from society. The current trend is to analyze total food patterns, rather than nutrients, and their likely impact on health and well-being.

Indeed, recent dietary advice in the US has focused on total diets, with a focus on the USDA-style, Mediterranean style, DASH, and vegetarian food patterns. More attention is being paid to social inequities and to the socioeconomic determinants of both diets and health. The “new nutrition” science draws on insights from allied disciplined to illustrate the dynamics of food decision making across the world. Any attempts to improve dietary behaviors in target populations must be respectful of both cultural and social boundaries and economic constraints.

People with one type of dietary pattern may differ in several unobserved ways from people with another dietary pattern. In marketing studies, taste, cost, convenience, health, and variety are recognized as the key drivers of food choice, along with the food environment and socioeconomic status. Yet the monetary cost of diets and the geography of food retail and food consumption patterns have not yet entered mainstream nutritional epidemiology. First, linking dietary intakes from 24h recalls, food records, or food frequency questionnaires with retail prices (per 100g, edible portion) allows for the estimation of diet costs at the individual level. The monetary costs of foods is effectively treated as another nutrient vector; cost calculations follow the same principles as calculations of diets' energy or vitamin content. This procedure has permitted new studies on the relation between diet quality, diet cost and health outcome. Not surprisingly, higher diet cost was associated with better long term health outcomes.

Second, geo-location of dietary intakes data opens the door to new studies in spatial nutritional epidemiology. We have developed microsimulation modeling tools to map food related attitudes, diet quality and even obesity rates at the unprecedented census block level. Geo-positioning trackers have been used to map shopping patterns. Again, socioeconomic variables predicted the relative consumption of sugary drinks versus salad in Seattle King County. Dietary choices appeared to be driven by economics.

Within cities and countries, and across the world, there are dramatic social disparities in diet quality. This talk will consider how geography and economics influence food choice, and ultimately health. There are also opportunities to extend these procedures across regions and globally.

**Keywords:** Spatial epidemiology, food prices, diet costs, economics, geo-location

**Conflict of Interest disclosure:** Conflict of Interest disclosure: AD has received grants, contracts, and honoraria from public agencies, private industry, private foundations, and commodity groups for projects involving nutrient profiling, diet quality assessments, and health outcomes.
# Track 4: Nutrition and Management of Diseases

SSS_144/129

## STEVIA: AN ALLY TO SUPPORT NUTRITION AND HEALTH

### HEALTH AND WELLNESS OF STEVIA

Ayoob, Keith.

EdD, RD. Nutritionist. Associate Professor of Pediatrics. Albert Einstein College of Medicine. New York City. United States of America.

According to the latest WHO report, an estimated 422 million adults were living with diabetes in 2014, compared to 108 million in 1980. Now, one in twelve adults around the world has diabetes. In addition, the prevalence of overweight and obesity is one of the most serious health challenges of the century. Worldwide obesity has doubled since 1980 with almost two billion adults 18 years and older being overweight, of that, more than 600 million being obese.

Global policy guidelines have called for healthier lifestyles in general, for adults and children, and more specifically for reductions in calories and sugar consumption. Global and national health organizations recommend reducing added sugar to less than 10% of calories, with the WHO recommending aiming for less than 5% of total calories from added sugar. Achieving this is nearly unrealistic without the use of low- and zero-calorie sweeteners.

Stevia, being calorie-free, is part of the solution towards sugar reduction and weight management while providing sweet taste and it is a relevant option for a healthy lifestyle and for the diabetic population. Stevia leaf extracts have key health and wellness benefits due to their zero contribution to caloric intake. Emerging evidence suggests stevia may have a unique role in helping diabetics manage blood glucose levels. Additionally, stevia is plant-derived, providing an option for diabetics and others who prefer a naturally sourced zero-calorie sweetener.

**Keywords:** Diabetes, sugar reduction, obesity, overweight, stevia

**Conflict of Interest disclosure:** This symposium was sponsored by International Stevia Council (ISC) & Calorie Control Council (CCC) (Belgium)

### GLOBAL DEMAND FOR STEVIA AND STEVIA LA-BELLING WORLDWIDE

Scardigli, Maria Teresa.

Executive Director. International Stevia Council.

Increased consumer interest in calorie-reduced products combined with a stronger than ever call for natural products has boost-

ed the demand for high purity stevia extracts. In the last 3 years stevia has become a mass volume natural sweetening ingredient and has been heavily endorsed by core brands at the worldwide level: this trend is expected to continue in the future. Such development positively impacts all the players in the stevia value chain, including stevia leaf growers and will benefit many regional economies, such as in the Latin American region. Depending on the region, product labeling requirements vary slightly but the ability to use the word "natural" or "naturally occurring" in advertising materials varies more widely. The presentation aims at giving an overview of the global demand for stevia as well as an overview of the differences in labeling across several regions of the world.

**Keywords:** Stevia. Sweetening ingredient. Calorie-reduced products. Latin American region. Labeling.

**Conflict of Interest disclosure:** This symposium was sponsored by International Stevia Council (ISC) & Calorie Control Council (CCC) (Belgium)

### OVERVIEW OF STEVIA APPROVALS BY THE GLOBAL SAFETY AUTHORITIES

Roberts, Ashley.

Intertek Scientific and regulatory Consultancy.

The presentation will review and evaluate the extensive research conducted to demonstrate the safety of high purity stevia extracts and how in particular the metabolic profile for the various glycosides including those conjugated with glucose, rhamnose and xylose permit the bridging of toxicological studies conducted with stevioside and rebaudioside A to all glycosides present within the leaf. The presentation will focus on the derivation of the ADI particularly by JECFA, which has been adopted on an International basis and the current global regulatory status taking in to account various estimated exposure paradigms, within different demographic populations. In addition to the evaluation of the steviol glycosides present within the leaf, new technologies are continuously being developed including those associated with a) enzyme modified glycosides, b) bioconversion and, c) steviol glycosides from genetically modified yeast. The presentation will therefore look briefly at the differences in production processes and provide a summary of the current international regulatory status of these materials.

**Keywords:** Stevia, Glycosides, regulatory

**Conflict of Interest disclosure:** This symposium was sponsored by International Stevia Council (ISC) & Calorie Control Council (CCC) (Belgium)
APPLICATION AND INNOVATION IN STEVIA AND
TASTE DEVELOPMENT

Fry, John.

Director. Connect Consulting. UK.

This presentation focusses on technological advances in un-
derstanding sensory properties of leaf-derived steviol glycosides.
The objectives were to investigate the taste relationships of simple
combinations of pure glycosides and to develop a predictive meth-
odology to assist the formulation of leaf-based ingredients of im-
proved performance. Such advances aim to satisfy expectations of
global consumers for sugar reduction through zero-calorie sweet-
eners with sugar-like taste.

Intensive sensory investigations of purified individual glycosides allowed the creation of concentration-response curves for sweetness, bitterness and the licorice side-taste. Glycosides were then examined in pairs, looking for synergy in sweetness or suppression of undesirable tastes. Where beneficial responses were found, these pairs were supplemented further with single glycosides to create ternary and quaternary mixtures.

The data from these interactions allowed mathematical mod-
elling of their taste relationships. The models, in turn, indicated
unsuspected combinations of glycosides with potentially superior
taste performance. The model combinations were then created on
a laboratory scale and checked by taste panel for quality.

This approach resulted in a number of novel glycoside mix-
tures, including minor glycosides, that maximised sweetness while
minimizing unwanted side-tastes. Key to this success were critical
concentrations of rebaudiosides A, B, D and, surprisingly, stevio-
side.

With this knowledge, natural leaf extracts of different compo-
sition could be selected and blended to produce ingredient-grade
materials of outstanding taste. The performance of these leaf ex-
tracts, verified in consumer products, allows greater degrees of
sugar reduction (70%+) than earlier types, such as those based
on about 80% rebaudioside A content. The latter were limited to
about 30-50% sugar reduction in a 10% sucrose equivalent sweet-
ness intensity beverage.

Keywords: Stevia, innovation, synergism, taste, sensory

**Conflict of Interest disclosure:** The author is an external consultant to Cargill Inc.

**Further collaborators:** Anne Brockhoff. Technische Universität München § German Institute of Human Nutrition Potsdam-Rehbrücke

Ting Carlson, Nicole Cuellar-Kingston, Hanna Drake, Nicole Falk, Brian Guthrie, Betsy Jones, Nathan Knutson, Paula Krogmann, Allison Leibovich, Tim Lindgren, Tommy Mao, Melinda Montgomery, Kris Mortenson, Michael Mortenson, Ravi Nana, Andrew Ohmes, Wade Schmelzer, Sean Smith, Paige Ties, Christopher Tyler, Nese Yurttas. (Cargill Inc.Consultant, Calorie Control Council)

Caroline Hellfritsch, Thomas Hofmann. (German Institute of Human Nutrition Potsdam-Rehbrücke)

Wolfgang Meyerhof, Frauke Stähler. (Technische Universität München)

NON-NUTRIENT PHYTOCHEMICALS &
NON-COMMUNICABLE DISEASES

Li, Duo.

Qingdao University. China.

Malnutrition is sharply decreased, and over or imbalanced nu-
trition and lifestyle related disorders are dramatically increased
during past two decades globally. Food and medicine arise from the
similar origins. In the early era, people experienced sickness, diar-
rhea, unconsciousness, even death due to ingestion of poisonous
plants, while some ailments were alleviated or relieved after eating
certain plants. Over time, we have learnt to identify and classify
plants based on their characteristic features, as well as developed
knowledge about herbal medicines. During the past century, sci-
entists have isolated and identified thousands of compounds from
natural sources, and exploited their usage and the relationships
between these compounds and their molecular mechanisms. Nu-
merous preparations of natural products are commercially avail-
able on the market worldwide. Substantial functional foods and
nutraceuticals have been developed such as omega-3 fatty acid,
flavonoids and isoflavones, isothiocyanates, carotenoids, dietary
fiber, probiotics, prebiotics, phytosterols, polyphenols, alkaloids,
terpenoids, saponinoids, polysaccharides, peptides, curcumin,
parthenolide, cucurbitacins, 1,8-cineole, pseudopterosins, cate-
chins, capsaicin, conjugated linoleic acid, fucoxanthin, soy isofla-
vone, glabridin, astaxanthin and cyaniding-3-glucoside, lyprinol,
bromelain, marine sponge natural products and Boswellia serrata
gum resin etc. They are widely used to adjunctive prevent and treat
lifestyle-related continually increasing non-communicable diseas-
es such as diabetes, cardiovascular diseases, cancers, mental disor-
ders, senile dementias, body weight control etc.. However, some
functions are need to be confirmed by randomised controlled clin-
ical trial, and detailed mechanism need to be explored.

**Conflict of Interest disclosure:** This symposium was sponsored by Sunwins Commodity Sales Co., Ltd & Qingdao University (China)

XANTHINE OXIDASE INHIBITORY CONSTITUENTS
OF CELERY SEEDS

(1)Chen, Jijun; (2)Yang, Tong-Hua; (3)Lu, Chen-Jie; (3)Lu, Cheng-Qian.

(1)Prof. State Key Laboratory of Phytochemistry and Plant
Resources in West China. Kunming Institute of Botany. Chinese
Academy of Sciences. China.; (2)State Key Laboratory of
Phytochemistry and Plant Resources in West China. Kunming
Institute of Botany. Chinese Academy of Sciences. China.;

(3)Beijing Sunwins Commodity Sales Co. Ltd.. China.

Apium graveolens is a well known herb of family apiaceae. The
seeds, i.e. celery seeds are used as flavoring agents and as an an-
ti-rheumatic formulation and showed significant effects on arthrit-
ic pain relief, for treating rheumatic conditions and gout. Accord-
ing to our bioassay, the 50% ethanol extract of celery seeds showed
moderate inhibitory activity on XOD. To clarify its active constit-
uents, the extract was further separated to provide two flavone
glycosides named graveobioside A (1) and luteolin-7-O-β-D-glu-
coside (2) elucidated by MS/MS and NMR techniques. Graveo-
bioside A and luteolin-7-O-β-D-glucoside possessed potent ac-
tivities against XOD with IC50 values of 287.17±2.3 and 77.36 ±
4.70 µg/mL, respectively. To further investigate inhibitory activity
of graveobioside A on XOD, three types of animal models were
established to evaluate its effects in mice. The effect of graveobio-
side A on potassium oxonate-induced hyperuricemia in mice was
determined. The results indicated that the serum uric acid level in
each dose group of graveobioside A (20 mg/kg10 mg/kg and 5 mg/
kg) significantly was reduced than that of hyperuricemic group
(P<0.01);In addition, the middle and high dose groups of graveo-
bioside A could obviously inhibit XOD activity in serum(P<0.05).
Then carrageen-induced mice paw edema model was employed
for the anti-inflammatory activity of graveobioside A. The result
showed each dose group of graveobioside A possessed most activ-
ities against inflammation. The rat acute feet swelling induced by
sodium urate was often used to test compounds effects on gouty
arthritis. The middle and high dose group of graveobioside A had
significant activity compared to the model group (P<0.01). There-
fore, graveobioside A had potential activity to treat gout and gouty
arthritis

**Conflict of Interest disclosure:** This symposium was spon-
sored by Sunwins Commodity Sales Co., Ltd & Qingdao Univer-
sity (China)

NON-COMMUNICABLE DISEASES AND ITS PRE-
VENTION IN CHINA

(1)Ma, Guan-Sheng; (2)Zhang, Na.

(1)PhD.Department of Nutrition and Food Hygiene. School of Public Health. Peking University. China.; (2)National Institute for Nutrition and Health. Chinese Center for Disease Control and Prevention. China.

Along with the rapid development of social and economic,
transitions in diseases pattern has been changed from infectious
diseases to the non-communicable diseases (NCDs). In 2012, the
mortality rate of NCDs among Chinese residents was 533/100 000,
accounting for 86.6% of the total deaths. Cardio-cerebrovascular
disease, cancer and chronic respiratory disease were the main cause
of death, accounting for 79.4% of total deaths. The prevalence of
overweight and obesity in adults aged 18 and over were 30.1% and
11.9%, respectively, while that for children aged 6~17 year olds
were 9.6% and 6.4%, respectively. The prevalence of hypertension
in adults aged 18 and over was 25.2% and the prevalence of diabe-
tes was 9.7%. According to the results of the national cancer regis-
tration in 2013 in China, the incidence of cancer was 235/100 000.
It is indicated that unhealthy lifestyle including unhealthy dietary

pattern, smoking, excessive drinking, inadequate physical activ-
ity and the extension of sedentary time, and psychosocial stress
was the main risk factors for the epidemic of NCDs. The epidemic
of NCDs brings serious burden to economy. In 2003, the direct
economic burden of five major chronic diseases (coronary heart
disease, stroke, hypertension, cancer and diabetes) was 151.422
billion RMB; in 2010, the direct economic burden of five major
chronic diseases was 211.436 billion RMB, accounting for 10.6% of
the total health expenditure. It is estimated that the cost of cardio-
vascular disease, cancer, chronic respiratory disease, diabetes, and
mental health will total 191 trillion RMB for the period 2012-2030.
The preventive interventions of NCDs are highly cost-beneficial.
Economic analysis showed that the comprehensive intervention,
dietary intervention and physical activity intervention for obesity
could avoid the loss of productivity equivalent to 314144.8 RMB,
31738.6 RMB, and 16391.6 RMB, respectively; and medical ex-
penses equivalent to 37448.1 RMB, 3357.0 RMB, and 2486.0 RMB,
respectively. In order to control the epidemic of NCDs, the Action
Plan of control and prevention of NCDs has been issued in 2012.
The Action Plan of Health China 2030 has been launched in 2016.
The cost-effective and cost-beneficial measures have been identi-
fied and implemented.

**Keywords:** Non-communicable diseases; Risk behavioral factors; Economic burden; Prevention and control

**Conflict of Interest disclosure:** This symposium was spon-
sored by Sunwins Commodity Sales Co., Ltd & Qingdao Univer-
sity (China)

OMICS BASED STUDY ON N-3 PUFA IN THE PRE-
VENTION AND TREATMENT OF TYPE 2 DIABETES
IN ASIAN

(1)Zheng, Jusheng; (2)Li, Duo.

(1)Career Development Fellow. University of Cambridge,; (2)PhD.
Professor. Department of Food Science and Nutrition. Zhejiang
University. China.

**Background and Objectives:** The interaction of genomics and metabolomics with omega-3 fatty acids among the Asian type 2 diabetic patients is not clear. We aimed to investigate the interaction between genes and omega-3 fatty acids for type 2 diabetes risk and for glycemic traits among type 2 diabetic patients. In addition, we aimed to examine the response of metabolomics profiles to omega-3 fatty acid intervention.

**Methods:** We conducted a case-control study involving 622 type 2 diabetic patients and 293 healthy controls, and a double-blinded randomized controlled trial among 185 type 2 diabetic patients for omega-3 supplements over 6 months. Among these participants, we genotypes several type 2 diabetes-related genetic variants to examine the interaction between omega-3 fatty acids and these genetic variants for type 2 diabetes in the case-control study and for glycemic traits in the trial. In addition, we examine the effect of omega-3 fatty acid intervention on the metabolomics profiles in a subset of the patients.
**Results:** In the case-control study, we found significant inter-action between a genetic risk score generated from 9 type 2 diabetes-related genetic variants, with the inverse association between erythrocyte alpha-linolenic acid and type 2 diabetes only observed in those with low genetic risk. In addition, PEPD variant interacts with total erythrocyte omega-3 fatty acids for type 2 diabetes risk, with the genetic risk of PEPD variant being abolished in high omega-3 fatty acid group. In the randomised trial, we did not detect similar gene-fatty acid interaction pattern as in the case-control study. In the metabolomics analyses of the trial, we identified a most significant biomarker of omega-3 fatty acid supplements: 3-carboxy-4-methyl-5-propyl-2-furanpropanoate, a furan fatty acid metabolite. Change of this metabolite is positively correlated with change of serum eicosapentaenoic acid and docosahexaenoic acid, but negatively correlated with change of serum triglycerides.

**Conclusions:** Both genomics and metabolomics approaches could help advance our understanding about the role of omega-3 fatty acids in type 2 diabetes prevention and treatment.

**Conflict of Interest disclosure:** This symposium was sponsored by Sunwins Commodity Sales Co., Ltd & Qingdao University (China)

# Track 5: Nutrients and Nutritional Assessment

SSS_144/1033

## EARLY DETECTION OF MALNUTRITION IN THE FACILITY AND COMMUNITY SETTING FOR IMPROVED HEALTH AND ECONOMIC OUTCOMES

### IMPROVING HEALTH OUTCOMES: EARLY DETECTION OF MALNUTRITION UTILIZING VALIDATED TOOLS

Correia, Isabel.

MD, PhD. Universidade Federal de Minas Gerais. Brazil.

**Background and Objectives:** Effective implementation of nutrition care plays a key role in achieving improved patient outcomes. Malnutrition negatively affects the patient evolution in terms of higher morbidity, mortality, re-admissions, prolonged hospitalizations and costs. Increased medical awareness regarding the impact of nutritional status on patient outcomes is essential. Malnourished patients cost more than patients with similar diseases who are well-nourished, demonstrating an independent and additive effect of malnutrition on negative outcomes. When malnutrition is identified and interventions are implemented, use of medical care and resulting costs decrease. Therefore, early use of screening and assessment tools (at hospital admission) to identify risk factors, establish a diagnosis of malnutrition and enable effective treatment is fundamental to provide the highest quality of care and improve patient outcomes. Methods: An estimated 30-50% of hospitalized adult patients are malnourished in the U.S. and internationally based on a combination of malnutrition screening and assessment studies. Yet, research indicates that the diagnosis/identification rate remains low with only 3.2% of adult patients are discharged with an International Classification of Diseases, Ninth Revision (ICD-9) malnutrition diagnostic code. Screening and assessment are different processes, the former should identify risk factors and the latter provides diagnosis. Both serve essential roles in creating a inter-disciplinary patient care plan. Results: A triangulation of indices is necessary to determine nutrition status. Weight loss in the last six months and decreased food intake are included in many of the various tools. Both are simple, easily available, do not require use of additional devices, can be provided by the patient or any member of the family and are related to morbidity and mortality in different populations. There are more sophisticated measurements including computed tomography and functional tools, particularly in cancer units, that when available can be added to increase accuracy. Conclusions: Dissemination and implementation of simple, validated tools that can be utilized in a variety of global healthcare settings, to early and accurately assess risk for and identify the presence of malnutrition is fundamental to improving patient and system level health outcomes.
**Keywords:** Health outcomes, malnutrition, screening, assessment. K

**Conflict of Interest disclosure:** Abbott Nutrition, Baxter Nutrition, Fresenius Kabi, Danone Nutrition, Nestlé Nutrition

**Conflict of Interest disclosure:** This work was funded by Abbott Nutrition.

**Further collaborators:** Organization for Health Excellence (OES) - Colombia.

# CREATING A REPLICABLE MODEL OF NUTRITION CARE EXCELLENCE IN THE CLINICAL SETTING

Pinzon Espitia, Olga Lucia.

Nutritionist. PhD Candidate. National University of Colombia. Méderi. Colombia.

**Background and Objectives:** Optimal quality of care is a must for all healthcare institutions across the world. Nutritional care processes must be a priority for hospitals, thus supporting their implementation in clinical outcomes. This is why the conception of nutritional care processes allows hospitalized patients experiencing superior results.

Considering the current approach of healthcare models, it is of utmost important to generate strategies that allow healthcare systems improve their process performance by integrating nutritional management into their patients' clinical care. A comprehensive model responds to the nutritional needs of hospitalized patients under the superior concept of generating value.

**Objective:** To develop a model of hospital nutritional care that allows minimizing malnutrition related risks, optimizing care processes and improving clinical outcomes of hospitalized patients.

**Methods:** A systematic review of literature on hospital nutritional care models informed the construction of a new nutritional model in 2016, which was consulted and validated with feedback from 10 participating hospitals.

**Results:** Publications related to nutritional quality standards have focused on methods of measuring the activities of nutrition processes, thus making it necessary to propose a model of easy duplication and validation in different scenarios of clinical practice. The model aims to promote good practices for clinics delivering nutritional interventions based on set criteria of excellence. Using existing literature on nutritional care models for inpatients and subsequent fieldwork, four lines of patient care plans were proposed: 1. Identification of nutritional risk; 2. Intervention and follow-up; 3. Exchange doors: path of patient care to ensure continuity of treatment; and 4. Education and generation of culture of nutritional care to the patient, caregiver, family and organization.

Quality standards were established to demonstrate the applicability of the model considering the need for organizations to evaluate the impact on their clinical results, inform the construction of models aimed at being differentiators through creation of value for the patients, and lead organizations to be centers focused on excellence.

**Conclusions:** The construction of the new model of care allows the achievement of processes of healthcare of superior value in order to bring hospital nutrition to sites of relevance previously not considered.

**Keywords:** Nutrition Therapy, Quality of Health Care.

# REDUCING THE ECONOMIC BURDEN OF DISEASE-ASSOCIATED MALNUTRITION THROUGH TARGETED INTERVENTIONS ACROSS THE CONTINUUM OF CARE

Sriram, Krishnan

Abbott Nutrition. Chicago. IL. USA.

**Background and objectives:** Disease-associated malnutrition costs health care systems across the globe billions of US dollars annually. This is a result of the direct and indirect costs associated primarily with higher rates of health care resource utilization by malnourished patients compared to their well-nourished counterparts. Nutrition interventions can be effective in terms of alleviating the burden of malnutrition and improving patient outcomes. Increasingly more real-world, pragmatic study designs such as quality improvement programs (QIPs) are used to study nutrition care improvements for malnourished patients across the continuum of care.

Objectives of the presentation include 1) brief overview of economic burden of disease-associated malnutrition; 2) review studies implementing effective research methods used to study nutrition interventions and their impact on patient health and economic outcomes; and 3) discuss key pragmatic studies targeting inpatients and community-dwelling malnourished adults.

**Methods:** Review of real-world, pragmatic research studies implemented in both US and ex-US countries aiming to assess the impact of nutrition-focused interventions on health and economic outcomes of malnourished hospitalized patients and community-dwelling adults.

**Results:** Report the results of different pragmatic research studies assessing the effectiveness of nutrition interventions on patient outcomes including significant reductions in 30-day unplanned readmissions, hospital length of stay, and health care costs.

**Conclusions:** Unplanned 30-day readmissions, length of stay, and healthcare costs among malnourished inpatients and community-dwelling adults can be significantly decreased through nutrition-focused pragmatic programs that include comprehensive screening of patients for malnutrition, prompt administration of oral nutrition supplements, and education of malnourished patients in both hospital and community settings. Real-world, pragmatic study designs are effective methods of generating data that can inform effective decision making in the optimization of nutrition care for malnourished adults across the continuum of care.

**Keywords:** Economic burden, malnutrition, oral nutritional supplements, pragmatic designs, outcomes research/QIP

**Conflict of Interest disclosure:** Abbott Nutrition Employee