researchers and practitioners to identify best use method based on goals, study design, and sample characteristics.

**Keywords:** Dietary assessment, mobile dietary assessment methods, passive dietary assessment methods

144/2200

PREVALENCE OF OVERWEIGHT AND OBESITY AND ITS ASSOCIATION WITH SOCIOGRAPHIC FACTORS AMONG A NATIONAL REPRESENTATIVE SAMPLE OF ECUADORIAN CHILDREN AND ADOLESCENTS

**Background and objectives:** Overweight and obesity during childhood are important risk factors for noncommunicable diseases. We aim to assess the prevalence of overweight and obesity among children and adolescents and its associations with socio-demographic factors in a National representative sample from a middle-income country.

**Methods:** A national representative sample of 2-18 years old children and adolescents from the 2012 Ecuadorian National Health Survey (ENSANUT-ECU) was analyzed. Overweight, and obesity were defined applying the IOTF cut offs. Logistic regression models were set to identify sociodemographic factors (i.e. sex, rurality, geographic region, ethnicity, household income quintile and age) associated with overweight/obesity. The models were adjusted for the cluster design applying the svy command in Stata version 13.0.

**Results:** In total, 24,224 children and adolescents (8.2±5.1 years old) from the four geographic regions in Ecuador (Pacific-Coast, Andean-Region, Amazon-Rainforest and the Galápagos Islands) were included in the analysis. Overweight, obesity and morbid obesity affected 14.5% (95% CI, 13.2-16.4), 3.5% (95% CI, 2.7-4.6), and 2.2% (95% CI, 1.8-2.8) of the studied population. Urban participants were 1.2 times (P=0.001; 95% CI, 1.1-1.3) more likely to be either overweight or obese in comparison with their rural pairs. Similarly, children and adolescents living in households in the higher income quintiles (P<0.001; OR: 1.7; 95% CI, 1.4-2.0) and adolescents (P=0.045; OR: 1.4; 95% CI, 1.0-1.8) were more likely to be either overweight or obese in comparison participants in the lower income quintiles and children respectively. No significant associations were found between overweight and obesity with either sex or geographic region.

**Conclusions:** The reported overweight/obesity prevalence are in line with those reported in the Latin American region. This

health problem seems to affect the whole country and to be predominant among urban and wealthier populations as well as when the population reaches adolescence. Although some actions have been already taken such as such the implementation of traffic light food labels and health promotion programs, more actions are still needed.

**Keywords:** overweight, children, Ecuador, sociodemographic

144/2210

NUTRITIONAL STATUS EVALUATION BY ANTHROPOMETRIC ASSESSMENT OF A GROUP OF WORKERS IN SÃO PAULO CITY, BRASIL

**Background and objectives:** Since the 1970s, Brazil has undergone a reduction of malnutrition associated with an increase in obesity, a process called nutritional transition. The aim of the study was to evaluate the nutritional status of adult workers (19-59 years) of a shopping mall in the city of São Paulo, comparing the anthropometric evaluation data between those with sedentary (S) and non-sedentary (NS) work.

**Methods:** This was a descriptive cross-sectional study with primary data collection of 107 volunteers (64 females; 43 males), who met the inclusion criteria and had signed the informed consent. Data included: Weight; height; arm, waist (WC), wrist and hip circumferences; triceps (TSF), bicipital, subscapular and suprailiac skinfolds, arm muscle circumference (AMC), sum of 4 skinfolds (S4SF) and the indexes BMI, central obesity (CO), waist to hip (WHR) and conicity index (CI). The S4SF was used to estimate the percentage of body fat and the results were compared to the BMI. Nutritional status and cardiovascular risk (CVR) was determined.

**Results:** BMI and WC showed a positive correlation with age in both sexes; 62,8% of men of all ages were overweight (46,5%) or obese versus only 34,4% women (29,7% overweight) irrespective of age differences between sex groups. AMC, TSF and S4SF does not correlate with BMI for neither sexes. For women, WC and WHR identified 18% and 3% of CVR respectively. The CI showed positive correlation with age in both sexes and a good correlation and precocity in the identification of CVR, especially for men. Of women at NS (n=38) and S (n=26) type of work, 68,4% and 57,7% presented with normal BMI respectively, even though in both groups a higher than average fat percentage (HPFM) was observed (NS=81,6%; S=92,3%). Similar results were observed for men (NS=9; S=34), with 66,6% of NS and 94,1% of S presenting HPFM.

<footnote>(1)Andrade Tenesaca, Dolores Susana; (2)Ochoa Avilés, Angelica;</footnote>

<footnote>(3)Freire, Wilma; (1)Andrade Tenesaca, Dolores Susana; (4)Donoso Moscoso, Silvana Patricia.</footnote>

<footnote>(1)MSc. PhD. Department of Biosciences. Faculty of Chemistry Sciences. Cuenca University. Ecuador.; (2)MD. PhD. Department of Biosciences. Faculty of Chemistry Sciences. Cuenca University. Ecuador.; (3)MSc. PhD University San Francisco Quito. Ecuador.; (4)Bioq. MSc. Department of Biosciences. Faculty of Chemistry Sciences. Cuenca University. Ecuador.</footnote>

<footnote>(1)Pieri, Patricia de Campos; (1)Assis, Gustavo Marchese; (1)Forti, Bruno Luis Peixoto; (1)Giori, Fabiana Ferreira; (1)Camargo, Maria Azevedo de; (1)Neves, Lorena Piquini; (1)Brito, Isabella Aguiar de; (2)Freiberg, Clara.</footnote>

<footnote>(1)Undergraduate Student. Nutrition. Universidade São Camilo. Brasil; (2)MSc. Nutricionist. Nutrition Department. Universidade São Camilo. Brasil.</footnote>
**Conclusions:** BMI is an easy method to evaluate nutritional status of populations, but should be associated to other variables chosen in accordance to the ethnic group studied. The type of work might play an important role in the nutritional status and percentage of fat mass, but the present work fail to show it.

**Keywords:** Anthropometric evaluation. Nutritional Status. Cardiovascular risk.

**Further collaborators:**

Júlia Ferreira Marques da Silva, Carolina Lopes Malta, Valkíria Lúcia Santos da Silva

**Conclusions:** It is concluded that walking at PV can be considered as a moderate activity. Even though the CPA code MET values for walking at PV and EV were correct, their use will significantly overestimate the EE.

**Keywords:** Energy expenditure. Physical activity. Daily activities. Nutrition assessment.

144/2212

ENERGY EXPENDITURE OF SELECTED DAILY ACTIVITIES IN ADULTS FROM NITERÓI, RIO DE JANEIRO, BRASIL

(1)Anjos, Luiz Antonio; (2)Mariz, Virginia; (2)Silva, Edimara; (3)Wahrlich, Vivian.

(1)MD, PhD. Professor. Universidade Federal Fluminense,;

(2)Undergraduate student. Laboratório de Avaliação Nutricional e Funcional. Universidade Federal Fluminense.; (3)PhD. Nutritionist. Laboratório de Avaliação Nutricional e Funcional. Universidade Federal Fluminense.

**Background and objectives:** The assessment of the energy expenditure (EE) plays an important role in the assessment of the nutritional status and the treatment strategies of the population. The purpose of the present study was to measure the EE of selected daily activities and to compare the values with the code MET values of the Compendium of Physical Activities (CPA). The activities were: typing, organization of shelves, climb up and down 8 flights of stairs and walk on the treadmill at two self-selected speeds (pleasure, PV and exercise, EV) and PV-0.8.

**Methods:** This is a preliminary analysis of data of 33 adult (≥20y) subjects (25 women) recruited to participate in a larger study aimed to assess total daily EE by various methods. Resting EE (METm) was assessed with the subject sitting during 12'. The EE of each of the selected activities were measured for six minutes and expressed as multiple of METm (MMETm) or estimated MET (METe=3.5mLO2/kg/min). Body mass (BM) and stature (S) were also obtained. Body mass index (BMI) was calculated as BM/S2. Percent body fat (%BF) was measured by DXA.

**Results:** Mean (SD) age and BMI were 26.2 (6.6) and 23.7 (3.7) kg/m². Mean %BF was 32.7 (5.0) and 25.0 (9.3) for women and men, respectively. EE (kcal/min) of organizing shelves, climbing up and down the stairs was 3.0 (1.1), 7.0 (1.5) and 3.7 (1.0), respectively. MMETm was higher than MMETe by approximately 9% for all activities. Organizing shelves and PV-0.8 were classified as moderate activities (≥3 METs) only when METm was used. MMETm was 3.1 (0.6), 3.5 (0.6) and 4.8 (0.9) for PV-0.8 (3.8±0.5), PV (4.6±0.6) and EV (6.1±0.6km/h) and equal to the CPA codes for the last two. However, EE calculated by METe and the CPA codes was significantly greater than measured (mean difference of 0.51±0.69 and 0.65±0.9kcal/min, respectively). Climbing up stairs was the only activity classified as heavy (MMETm=6.9±0.8).

144/2219

REFERENCE INTERVAL FOR METHYLMALONIC ACID IN DRIED BLOOD SPOTS OF YOUNG, ADULT WOMEN TO FACILITATE SCREENING OF VITAMIN B-12 DEFICIENCY IN FIELD SETTINGS

(1)Schroder, Theresa; (2)Quay, Teo; (3)Lamers, Yvonne.

(1)PhD. Nutritionist. Food, Nutrition and Health Program. University of British Columbia. Canada.; (2)MSc. Nutritionist. Food, Nutrition and Health Program. University of British Columbia. Canada; (3)PhD. Professor. Food, Nutrition and Health Program. University of British Columbia. Canada.

**Background and objectives:** Maternal vitamin B-12 (B-12) status in early pregnancy has been inversely associated with impaired fetal development, including neural tube defects, and positively with infant B-12 status. Periconceptional B-12 adequacy is thus critical. Dried blood spots (DBSs) allow for convenient and cost-effective collection of biological samples in field settings. We have developed a method to quantify methylmalonic acid (MMA), the most specific functional B-12 biomarker, in DBSs. The objective was to calculate a reference value of DBS MMA in young adult women suggestive of functional B-12 deficiency.

**Methods:** In a convenience sample of 208 healthy women (19-35 years) living in Vancouver, Canada, DBSs were collected after pricking either middle or index finger. DBS MMA was quantified from an 8-mm spot by liquid chromatography-tandem mass spectrometry; plasma MMA and serum total B-12 and holotranscobalamin concentrations were determined. Dietary B-12 intake was assessed by food frequency questionnaire, and dosage of supplemental B-12 recorded. A reference value was computed from a reference population (mean ± SD age: 26.7±4.2 y), i.e. a subset of women with plasma MMA concentrations <370 nmol/L (92% of study population) and DBS MMA data (n=174), following clinical guidelines (CLSI EP28-A3c).

**Results:** The upper limit (90% CI) of the central 95% reference interval, computed after Box-Cox transformation and removal of 5 outliers (Tukey's test), was 8.9 (8.2-9.6) pmol/8-mm spot. The reference population had a median (IQR) DBS MMA concentration of 5.2 (4.2-6.3) pmol/8-mm spot. DBS MMA concentration was correlated with plasma MMA ($\rho$=0.65; $P<0.0001$) and serum total B-12 ($\rho$=-0.17; $P=0.02$) and holotranscobalamin ($\rho$=-0.22; $P=0.004$) concentrations. The median (IQR) plasma MMA and serum total B-12 and holotranscobalamin concentration of the reference population was 148 (114-185) nmol/L, 278 (200-373) pmol/L, and 66.5 (51.4-87.7) pmol/L respectively; the median (IQR) dietary and total (dietary and supplementary; 30%
supplement user) B-12 intake was 2.7 (1.9-4.0) µg/d and 3.7 (2.4-7.6) µg/d, respectively.

**Conclusions:** This is the first study to present a reference value for elevated DBS MMA computed from a healthy reference population of young adult women. Analysis of DBS MMA has the potential to be a convenient and field-applicable method that facilitates B-12 deficiency screening in reproductive-aged women.

**Keywords:** vitamin B-12 deficiency, methylmalonic acid, dried blood spots, reference interval, periconceptional

**Conclusions:** The decline in dietary quality with time over the month from receipt of SNAP benefits might be mitigated by their allocations on a bimonthly basis. A more frequent distribution could provide a more even food supply and alleviate inconsistencies over time.

**Keywords:** diet quality, food assistance

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REDUCTIONS IN DIET QUALITY WITH TIME IN SINCE BENEFITS IN LOW INCOME WOMEN PARTICIPATING IN THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM IN THE UNITED STATES

(1)Freeland-Graves, Jean; (2)Sangeevi, Namratas.

(1)PhD. Bess Heflin Centennial Professor. Department of Nutritional Sciences. University of Texas at Austin. United States of America.; (2)PhD Candidate. Department of Nutritional Sciences. University of Texas at Austin. United States of America.

**Background and objectives:** The Supplemental Nutrition Assistance Program (SNAP) is the largest food assistance program in the United States, serving approximately 46 million individuals with program benefits. It transfers financial benefits once a month via an electronic card that can be utilized to purchase foods. Within the first 3 days of the month, a spike in food expenditure is noted, followed by redemption of 80% of the benefits within 2 weeks. The objective is to investigate changes in dietary quality in 151 women that occurred in response to fewer financial resources toward the end of the monthly cycle of SNAP benefits.

**Methods:** Subjects were recruited from low-income housing sites and neighborhood centers, informed consent was obtained, and a demographic survey was administered. At 1 week intervals, four more visits were conducted in which the participants completed a food frequency questionnaire (FFQ). It was validated for a reference period of 1 week and consisted of 95 food items, with varying frequency and serving size options. The initial administration of the FFQ was based on timing of the initiation of the monthly program benefit. The indicator of diet quality was the Healthy Eating Index-2010. Scores ranged from 0-100, based on 12 dietary subgroups, with nine adequacy and three moderation components. A mixed linear model was conducted with time as the independent variable, and diet quality and foods as the dependent variables. When significant main effects were detected, Bonferroni adjustments were conducted.

**Results:** Diet quality scores significantly declined as the month progressed, from 57.4 + 0.9 at week 1 to 45.6 + 1.0 at week 4. This was accompanied by a decrease in intakes of fruits, vegetables and dairy, and a higher consumption of whole grains. Total protein foods remained unchanged. Also, fewer home-prepared meals and increased eating outside the home were reported towards the end of the month.

144/2230

EXCESS BODY FAT IN EUTROPHIC ADOLESCENTS AND RISK OF BLOOD PRESSURE CHANGE

(1)de Lucena Ferretti, Roberta; (2)de Pádua Cintra, Isa; (2)Aparecida Zanetti Passos, Maria; (2)Fisberg, Mauro.

(1)PhD Student. MSc. Nutritionist. Federal University of Sao Paulo. Brazil. Department of pediatrics. University of Taubate.; (2)PhD. Nutritionist. Federal University of Sao Paulo. Department of Pediatrics.

**Background and objectives:** The current adolescents lifestyle has collaborated for the body fat accumulation and chronic diseases development, such as hypertension. It is widely known that, in overweight individuals, there is a greater risk of blood pressure change. However, this risk is directly associated with excess body fat, which can occur in eutrophic individuals as well. The main objective of this study is to evaluate eutrophic adolescents body fat and the relation with the risk of development of blood pressure change.

**Methods:** A cross-sectional study that assessed adolescents aged 10 to 17 years old. The collected variables were weight (kg), height (cm) to calculate BMI (kg/m2), and were considered eutrophic adolescents ranked between -1 and +2 z-score of BMI according to the World Health Organization, 2007. To assessment of body fat, were used triceps and subscapular skinfold thickness, according to standard techniques, and body fat percent calculated according to the equations of Slaughter and classified by Lohman. To measurement of blood pressure Measurement protocol was followed, according to the V Brazilian Guidelines on Hypertension. The values of blood pressure were classified according to American Academy of Pediatrics recommendations - The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Crude analysis between excess body fat and the independent variables were performed by univariated logistic regression. The binary regression analysis was used to estimate the values of chance (odds ratio-OR).

**Results:** Among 1774 adolescents assessed, 1123 eutrophic adolescents were selected, and 55.8% (n = 627) were female. The prevalence of excess body fat in eutrophic adolescents, boys and girls, were, respectively, 64.3% e 71.4%. It was verified that the risk of these eutrophic adolescents presenting a change in Sistolic Blood Pressure was 1.43 higher in relation to adolescents who did not present excess body fat (OR: 1.43 (0.98-2.09)), and for Diastolic Blood Pressure, this risk was 2.70 higher [(OR: 2.70 (1.78-4.10)].

**Conclusions:** It is concluded that there is elevated risk of eutrophic adolescents with excess body fat present alterations in
blood pressure, and this outcome is higher for diastolic blood pressure.

**Keywords:** Body fat. Nutricional Status. Eutrophy. Adolescent Blood Pressure

**Further collaborators:**

Roberta de Lucena Ferretti conceived, designed, and implemented the study, collected and interpreted data, wrote and revised the text; Isa de Pádua Cintra helped to implement the study and to write the text; Maria Aparecida Zanetti Passos helped the data collection, helped implement the study, and helped to write the text; Mauro Fisberg was responsible for coordinating original study and contributed to the intellectual content. All authors have sufficiently contributed to the development of this study.

**Conclusions:** Prevalence of overweight and obesity in the studied population (54.62%) is higher than the national average (36.3%). The problem of overweight and obesity is higher in males (57.36%) than in females (52.88%).

High height is very uncommon since no student was reported with this condition, also low height affects 14.36% of this sample, but only 0.73% of them were underweight and 8.03% overweight and obese.

Based on the results, Nutri-Campechada requires a permanent training intervention in the Mediterranean diet and physical activation addressed to the students to improve their nutritional condition.

**Keywords:** Nutrimetry, overweight, obesity, adolescents, nutrition assessment

144/2257

NUTRI-CAMPECHADA 2016: NUTRIMETRY APPLICATION TO HIGH-SCHOOL ADOLESCENTS

(1)Selem Solis, Jorge Enrique; (2)Sandoval-Castellanos, Fernando Jose; (3)Alcocer-Gamboa, Alberto; (4)Hattori-Hara, Mónica.

(1)MPH. Medical Doctor. Tenabo's Health Center. Campeche Ministry of Health. México.; (2)MPH. Medical Doctor. Rector. Instituto Campechano. Mexico.; (3)MSc. Medical Doctor. PIAIOY, Ministry of Education of the Government of Yucatan State. México.; (4)PhD. Psychology. PIAIOY, Ministry of Education of the Government of Yucatan State. México.

**Background and objectives:** Mexico is the world's first place in childhood overweight and obesity, four out of ten Mexican adolescents are overweight or obese and the trend is increasing, that's why Mexico is strongly committed to contributing any element that helps curb this epidemic. The objective of the study was to establish the use of Nutrimetry as an instrument for clinical and epidemiological surveillance of malnutrition as the first part of a program called "Nutri-Campechada" in a sample of high-school adolescents.

**Methods:** Nutrimetry is a tool that combines BMI/age with height/age and generates nutricodes that identify groups of nutritional risk allowing a timely malnutrition prevention. According to WHO z-scores values were assigned, for height/age: z≤-2=1, z≥2=5, or 3 to the rest, and for BMI/age: z≤-1=0, 1≤z<2=6, z≥2=12 or 3 to the rest, values were crossed and 12 codes that combine short, normal and high height with underweight, normal-weight, overweight and obesity were obtained.

**Results:** Data of 822 students of the "Instituto Campechano" between 15 and 18 years of age were evaluated. Weight and height were measured, BMI/age and height/age were calculated, and applying Nutrimetry, risk groups were classified in odd (1/3/5: underweight, 7/9/11: overweight and 13/15/17: obese) and even (4/6/8: normal weight) numbers. Prevalence were: 1 (n=6) 0.73%, 3 (n=29) 3.53%, 5 (n=0) 0.00%, 4 (n=46) 5.60%, 6 (n=292) 35.52%, 8 (n=0) 0.00%, 7 (n=44) 5.35%, 9 (n=222) 27.01%, 11 (n=0) 0.00%, 13 (n=22) 2.68%, 15 (n=161) 19.59%, and 17 (n=0) 0.00%.

144/2286

DEVELOPMENT OF AN INTERACTIVE TECHNOLOGICAL TOOL THAT USE THE LEAP MOTION CONTROLLER, AS A TOOL TO ESTIMATE FOOD PORTION SIZE: A VIABILITY PILOT STUDY

(1)Gutierrez Gomez, Yareni Yunuen; (2)Escarcega Centeno, David Alejandro.

(1)PhD. MSc. Nutritionist. Nutrition Department. School of Medicine and Health Sciences. Tecnologico de Monterrey. Mexico City. Mexico.; (2)PhD. Software Engineering. Computer Department. Engineering School. Tecnologico de Monterrey. Mexico City, Mexico.

**Background and objectives:** Estimation of food portion sizes has been a big challenge in dietary assessment. The aim of this work was to design and develop an interactive technological tool for the estimation of food portions through a virtual reality based on the Leap Motion® controller.

**Methods:** The interactive technological tool development was carried out in three phases: 1) Creation of food portions and photographs. We include 121 food portions sizes (fruits, vegetables, cereals, legumes, animal foods and fats). The food was cooked, weighed and in some cases measured before taking photographs. 2) 3D modeling of food. In this phase the food portion sizes were 3D modeling with the next software: MAYA Autodesk 2016, Autodesk Mbox 2016 and Adobe Photoshop. 3) Software development. To create the functional prototype of the Virtual Reality based in the Leap Motion® controller, we used the Unity software that is used for the creation of videogames.

**Results:** We designed and developed an interactive technological tool for estimation of food portion size based on the Leap Motion controller. Anyone can model with his/her bare hands a food portion size and the software could predict the portion size in grams. The first validation tests showed small differences between the food portion size estimated by the software and the real food portion size (weighed) for some food (watermelon, beans, cottage cheese, shredded coconut, read meat and chicken). The average differences was 8.4 g (SD 12.7 g) for the food mentioned before.
**Conclusions:** The interactive technological software that use the Leap Motion controller developed here, is a promising tool for a better food portion sizes estimation. Further work and investigation is needed in order to improve our development.

**Keywords:** Portion size estimation, dietary assessment, leap motion.

are under the recommended levels in 42% of the women. The goal of 90% of salt containing iodine ≥15ppm at household levels was not achieved. A preventive official plan must be implemented

**Keywords:** micronutrients, deficiency iodine, urine iodine, iodized salt.

**Further collaborators:**

Alejo Ramos. PhD. Medic. Ministry of health. Province of Jujuy. Argentine

144/2300

## LODINE NUTRITIONAL STATUS IN FERTILE AGE WOMEN IN THE PROVINCE OF JUJUY, ARGENTINA

(1)Lopez Linares, Sonia; (2)Lopez Linares, Sonia; (3)Silva Croome, Maria del Carmen.

(1)PhD. Biochemistry. Centro Nacional de Investigaciones Nutricionales-ANLIS; (2)PhD. Biochemistry, Center National of Nutritional Research-ANLIS "Malbrán". Salta. Argentine; (3)PhD. Endocrinology. Hospital Ramos Mejias. Province of Buenos Aires. Argentina.

**Background and objectives:** INTRODUCTION: An iodine deficient diet is cause of hypothyroidism, mental retardation and IDD (iodine deficiency disorders). During pregnancy, iodine requirements increases. Adequate iodine supply must be achieved in preconception. Previous survey reported that pregnant population in Jujuy was iodine deficient.

**OBJECTIVE:** To establish iodine nutritional status in women of childbearing age in the province of Jujuy measuring urinary iodine concentration (UIC) and salt for consumption iodization levels

**Methods:** MATHERIAL AND METHODS: We randomly selected 98 healthy women between 14 and 40 years, living in Jujuy (without thyroid disease, pregnancy or taking iodine containing supplements). After informed consent, urinary casual sample and a household salt sample were obtained. The UIC was quantified by Persulfate method and iodine in salt by qualitative kit. A subsample (n = 77) by titration with thiosulfate. Median and percentiles of UIC were calculated and percentage of salts with adequate low or absent iodine content. We compared UIC of women taking salts of national and regional salts. We considered indicators of sustained IDD elimination if UIC median was between 100 to 199 UImg/l and > 90% of household salt iodine ≥15ppm. Statistic SPSS

**Results:** RESULTS: UIC median: 119 µg/L, range: 12-365 µg/L, distribution: 41.2% < 100ug/L, 52.6% between 100-199 µg/L, 4.1% between 200-299 µg/L and 2.1% > 300 µg/L; percentile 20: 54.4 µg/L, percentile 80: 165 µg/L.

Regional salts were consumed by 71.3%. The Kit detected 84.5% positive iodine and 15.5% without iodine (only detected in regional salts). Iodine content: 22.4 ± 15.39 ppm; 0.0-95.2 ppm range, >15 ppm the 74.0% between 20-40 ppm 61% and 17% without iodine measurable. UIC median was significantly higher in women consuming salt of national origin compared to regional salts (123 ug/L vs 117 ug/L respectively, p = 0.001).

**Conclusions:** CONCLUSIONS: Median urine iodine concentration in this study indicate iodine sufficiency. But iodine levels

144/2316

## NEW DIETARY ASSESSMENT TECHNOLOGY FOR INDIVIDUAL-LEVEL DIETARY DATA COLLECTION IN LOW-INCOME COUNTRIES: THE DEVELOPMENT PROCESS OF INDDEX24

(1)Coates, Jennifer; (2)Colaiezzi, Brooke; (3)Bell, Winnie; (4)Wafa, Sarah;

(5)Prata, Cathleen; (6)Rogers, Beatrice.

(1)PhD. Associate Professor. Tufts University Friedman School of Nutrition Science and Policy. USA.; (2)MSc. Assistant Researcher. Tufts University Friedman School of Nutrition Science and Policy. USA.; (3)MSc. MPH. PhD Candidate and Assistant Researcher. Tufts University Friedman School of Nutrition Science and Policy. USA.; (4)MPH. RD. Assistant Researcher. Tufts University Friedman School of Nutrition Science and Policy. USA.; (5)MPH. Project Manager. Tufts University Friedman School of Nutrition Science and Policy. USA.; (6)PhD. Professor. Tufts University Friedman School of Nutrition Science and Policy. USA.

**Background and objectives:** Large-scale individual-level dietary surveys are infrequently conducted in low-income countries (LICs). Barriers include high resource requirements and limited research infrastructure for dietary assessment. As part of a multi-year effort to scale-up dietary assessment in LICs, the International Dietary Data Expansion (INDDEX) Project is investing in INDDEX24, a novel dietary assessment platform modeled on a multiple pass 24-hour dietary recall (24HR) and targeted to users in LICs. This study presents the systematic process used to identify INDDEX24's technical specifications and the results of preliminary testing carried out Bangladesh and Burkina Faso.

**Methods:** A multi-pronged approach was used to draft the INDDEX24 technical specifications. First, an initial list of technical specifications was drafted by a dietary assessment expert with in-depth knowledge and experience conducting 24HR surveys in LICs. Second, a literature review and qualitative research on existing 24HR platforms were conducted. Third, the INDDEX Project's Technical Advisory Group (TAG) and external technology experts evaluated the feasibility and validity of the technical specifications in terms of their appropriateness in the context of LICs.

**Results:** The INDDEX24 platform consists of a mobile application (app) for data collection and an integrated database website app for housing context-specific information required for processing 24HR data. It contains an interviewer-administered format, offline data collection capability, and is designed to be easily adapted to new contexts. INDDEX24 will also facilitate dietary
data processing by enabling researchers to link their food list to a contextually appropriate food composition database. A beta-version of INDDEX24 was developed and then evaluated by members of the INDDEX Project and TAG. Following revisions to the beta-version, the performance and user experience of a beta version of INDDEX24 was assessed in Bangladesh and Burkina Faso. Researchers in these countries suggested modifications to improve the usability of the platform. Additional in-depth feedback from cognitive debriefing with both survey respondents and enumerators was incorporated.

**Conclusions:** INDDEX24 has been developed by integrating feedback from a broad range of stakeholders and through extensive testing in a range of contexts. The efforts will help ensure INDDEX24 is a high quality, evidence-based tool for dietary assessment researchers in LICs.

**Keywords:** Dietary assessment. Food consumption data. 24-hour dietary recall. Low-income countries.

**Conflict of Interest Disclosure:** This research was conducted as part of the International Dietary Data Expansion (INDDEX) Project, which is implemented by Tufts University's Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy with funding from the Bill & Melinda Gates Foundation. The authors declare no conflicts of interest.

144/2328

## BIG DATA METHODS AND PUPILLARY RESPONSE: CRACKING THE CODE OF DARK ADAPTOMETRY FOR VITAMIN A DEFICIENCY

**Background and objectives:** The World Health Organization estimates that 9.7 million pregnant women exhibit night blindness, a severe form of dark adaptation, due to vitamin A deficiency (VAD). We have developed an innovative digital, quantitative field method leveraging pupillary responsiveness to structured light stimuli to assess functional VAD. Breakthroughs in image analysis and pattern recognition have revealed details of pupillary dynamics of up to 3000 consecutive data points on each subject's pupillary response over a 90 second window among pregnant women in rural Bangladesh.

**Methods:** We conducted an individually randomized, controlled trial among 488 women in late pregnancy in Gaibandha, Bangladesh from April 2015 to May 2016, supplementing half the women with a daily dose of 5,000 IU of vitamin A for 15 days. A blood sample was collected and women were assessed pre-and post-supplementation using a portable field dark adaptometer to record pupillary response to varying light stimuli (-2.9 to 0.1 c/m2). We present results of both conventional statistical analysis and machine learning and image analysis approaches to identify characteristic pupillary dynamic signatures associated with VAD and possibly, specific serum Vitamin A levels.

**Results:** 241 control and 247 supplemented women participated in the trial. Gestational age (28 weeks) and plasma retinol (0.34 ± 0.1µg/mL) levels did not differ between groups at baseline, though we see an intervention effect of increased plasma retinol levels among the supplemented group (difference of +0.03 ± 0.08 versus -0.01 ± 0.08, p=0.002). Pupillary responsiveness was similar across groups at baseline and is being analyzed at follow-up. We have captured 1800-3000 pupillary response diameters on women with an example of early data on an individual participant included at this link (https://tinyurl.com/pupildata) to illustrate the heretofore uncaptured granularity and precision of pupillary dynamics captured in a rural, remote population.

**Conclusions:** We hope to demonstrate the practicality of digital field dark adaptometry as a method for point-of-population vitamin A status determination using the dynamics of pupillary responsiveness. Breakthroughs in mobile computing capacity and analytics continue to improve the feasibility of the method.

**Keywords:** Vitamin A deficiency, dark adaptometry, pupillary response, night blindness,

**Conflict of Interest Disclosure:** The authors have no conflict of interest to declare. Supplements were donated gratis by DSM Limited through the Sight and Life Foundation, but they had no access to the data, and were not involved with the analysis or conclusions reached.

**Further collaborators:**

Maithilee Mitra - Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University

Rezwanul Haque - The JiVitA Project, Johns Hopkins University, Bangladesh.

Rashidul Haque - The JiVitA Project, Johns Hopkins University, Bangladesh.

<footnote>(1)Mehra, Sucheta; (2)Healy, Katie; (3)Shaikh, Saijuddin;</footnote>

<footnote>(4)Soltanianzadeh, Amir; (2)Zeller, Kelsey; (3)Ali, Hasmot; (2)Schulze, Kerry; (2)Wu, Lee; (2)West, Keith; (5)Labrique, Alain Labrique.</footnote>

<footnote>(1)Nutritionist, Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University; (2)Center for Human Nutrition Department of International Health Bloomberg School of Public Health Johns Hopkins University; (3)The JiVitA Project, Johns Hopkins University, Bangladesh.; (4)Masters Student, Department of Bioengineering Innovation, Whiting School of Engineering, Johns Hopkins University; (5)Global Disease Epidemiology and Control, Department of International Health Bloomberg School of Public Health Johns Hopkins University.</footnote>
IODIZATION OF SALT AS SUCCESSFUL STRAT-
EGY, COMBATING IODINE DEFICIENCY DISOR-
DERS (IDD) IN AFGHANISTAN

(1)Aminee, Ahmadwali; (2)Hassam, Wasiullah; (3)Samadi, Khalil.

(1)MD.MPH. Global Alliance for Improved Nutrition. Kabul office. Kabul.Afghanistan; (2)MD. MPH. Global Alliance for Improved Nutrition.Kabul.Afghanistan; (3)MD.Public Nutrition Department of Ministry of Pubic Health.Kabul.Afghanistan.

**Background and objectives:** Iodine Deficiency Disorder (IDD) is serious public health problem among Afghan school aged children and reproductive age women. The Universal Salt Iodization (USI) program as main strategy combating IDD started in 2003 by operating of the first salt iodization factory and became a great success in Afghanistan, currently there are 31 salt iodization factories functioning in 14 out of 34 provinces with the capacity of 5-8 Metric Ton /hour each. The iodization of salt for edible consumption becomes mandatory in 2011 after enactment of national regulation by the government. The objective of this study is to present the success effect of salt iodization program on reduction of iodine deficiency in Afghanistan.

**Methods:** Reviewing the results of two National Nutrition Surveys (NNS) conducted in 2004 and 2013, to assess the impact of USI program, over the reduction of iodine deficiency in the country.

**Results:** According to the NNS 2013 reports, up to 66% of the households all over the country have access to and are using adequately iodized salt (>15 ppm) in the diet, and a significant improvement from 28% reported by the NNS 2004, the report also indicated that the prevalence of iodine deficiency among children 7-11 years and reproductive age women decreased to 29.5 % and 40.7% respectively, remarkable progress from 72% and 75% respectively among the same age groups. The comparisons of two data showing a remarkable iodine deficiency reduction of 35 percentage points (55%), as a result of 10 years successful salt iodization program implementation, furthermore, it will contribute to saving the brine damage and preventing the reduction of 10-15 IQ points of almost 395,000 out of 94, 2000(72% of total live births/year) afghan new-born children each year, causing as iodine deficiency.

**Conclusions:** since there is no any national program influenc-
ing the reduction of iodine deficiency, the salt iodization has been
a successful strategy combating IDD in Afghanistan.

**Keywords:** Iodine Deficiency Disorder ,Brain damage ,10-15
IQ points ,salt iodization

DIET, ANTHROPOMETRY AND GUT PERMEA-
bILITY IN MEXICAN CHILDREN WITH AUTISM
SPECTRUM DISORDERS

(1)Pedroza García, Karina Alejandra; (1)Ronquillo, Dolores; (2)Anaya-Loyola, Miriam Aracely; (2)Rosado, Jorge L.

(1)MD. Facultad de Ciencias Naturales. Universidad Autónoma de Querétaro. México; (2)PhD. Facultad de Ciencias Naturales. Universidad Autónoma de Querétaro. México.

**Background and objectives:** Autistic Spectrum Disorders (ASD) comprise a group of developmental disorders, characterized by deficits in social interaction, communication, and behavioral patterns. Children with ASD may present nutritional challenges, specially as a result of their restrictive behaviors such as selective food intake, increased sensory sensitivity leading to rejection of food, disruptive behavior to specific foods and refusal to accept new foods. Additionally, nutritional status can be affected by gastrointestinal problems that may be related to a leaky gut. The aim of the study was to evaluate diet, anthropometry and intestinal permeability of ASD children and teenagers.

**Methods:** A cross-sectional study was crried out in 22 ASD children and adolescents aged 4 to 18 years from the cities of Aguascalientes and Querétaro, México. Diet was evaluated by means of three 24-hour recalls a food frequency questionnaire. Weight and height were measured by duplicate and BMI was sti- mated and compared with WHO z score. Intestinal permeabili- ty was evaluated by a lactulose/mannitol test and its subsequent measurement in urine by HPLC.

**Results:** At the end of the study it was observed a high prevalence of malnutrition, 18.2% of the participants have low weight for height and 50% have overweight or obesity; the diet was unbalanced with a high content of fat and refined sugar, and a poor consumption of fiber (13.0g ± 5.2), vitamin E, vitamin D, potassium, calcium and zinc. Intestinal permeability was in average 0.01 ± 0.02 and it was adequate in 80% of the sampe.

**Conclusions:** In this study it was found that participants have deficient consumption of some vitamins and minerals, but high ingestión of fat and sugar, and a hight percentage of participants have overweight or obesity, its advisable to develop food coun- seling strategies for children with ASD. In contrast with previous studies, intestinal permeability was adeucate in Mexican children with ASD.

**Keywords:** Autism spectrum disorders, anthropometry, diet, gut permeability.
## ASSOCIATION BETWEEN INDIAN DIABETES RISK SCORE (IDRS) AND NON IDRS COMPONENTS AMONG INDIAN ADULTS

(1) Joshi Reddy, Kejal; (2) Takalkar, Siddhi.

(1) Assistant Professor. Nutrition and Dietetics Department. Symbiosis School of Biomedical Sciences. Symbiosis International University. India; (2) B.Sc., M.Sc. Nutrition and Dietetics Department. Symbiosis School of Biomedical Science. Symbiosis International University. Pune-412115. Maharashtra. India.

**Background and objectives:** Prevalence of Type 2 diabetes is increasing at an alarming rate globally. It is a major risk factor for death and other non-fetal complications. WHO reports that one fifth (19%) of the total diabetics, reside in India (35 million). It is projected that it will increase to 80 million 2030. Indian Diabetes Risk Score is a simple, cost effective tool devised by MDRF to determine high risk individuals at an early stage. There is a need to assess a correlation between the risk score and other modifiable non-IDRS components which can be further focused on to reduce the risk of Diabetes and CHDs in future. Thus, a study with an aim to derive an association between IDRS and Non-IDRS components in urban population of Pune was developed.

**Methods:** A cross-sectional study involved N=185 healthy individuals aged between 20 and 50 years, randomly selected from a free living setting in Pune city. Other than IDRS components (Age, Waist Circumference, physical activity and family history), non IDRS components like anthropometric measurements, dietary data, random blood sugar level (BSL), blood pressure (BP) and lipid profile were also assessed.

**Results:** The findings revealed that 24.9% of the population had high risk of diabetes; where as 33% had moderate risk of diabetes. IDRS showed a significant positive association (p<0.01) with BMI, carbohydrate intake, blood pressure, random BSL, change in appetite and FRS. However, a negative association (p<0.05) was found between IDRS and protein and fat intake, flax seed consumption and nature of physical activity.

**Conclusions:** IDRS and non-IDRS components are strongly associated, which indicates an increased risk of Diabetes, if not modified with due attention. To reduce ever increasing burden of diabetes in the community, it is essential to undertake mass screening program. So that appropriate interventions can be delivered to prolong occurrence of Type 2 diabetes in productive population.

**Keywords:** IDRS, Body Mass Index, Waist Hip ratio, Framingham Risk Score

## SELENIUM PATHWAY GENOTYPES ARE ASSOCIATED WITH COLORECTAL CANCER RISK AND MODIFIED BY SELENIUM STATUS

(1) Hughes, David; (2) Fedirko, Veronika; (3) Méplan, Catherine;

(3) Hesketh, John; (4) Schomburg, Lutz; (5) Jones, Jeb; (6) Hybsier, Sandra;

(6) Riboli, Elio; (7) Jenab (on behalf of EPIC group), Mazda.

(1) PhD. Department of Physiology and Centre for Systems Medicine. Royal College of Surgeons in Ireland. Dublin. Ireland;

(2) PhD. Rollins School of Public Health. Emory University. Atlanta. USA.; (3) PhD. Institute of Cell and Molecular Biosciences. Newcastle University. Newcastle. UK.; (4) PhD. Institute for Experimental Endocrinology. Charité – Medical University. Berlin. Germany.; (5) MSc. Rollins School of Public Health. Emory University. Atlanta. USA.; (6) MD, PhD. School of Public Health. Imperial College London. London. UK.; (7) PhD. Section of Nutrition and Metabolism. International Agency for Research on Cancer. Lyon. France.

**Background and objectives:** Suboptimal intakes of the essential micronutrient selenium (Se) and selenoprotein genetic variation may contribute to colorectal cancer (CRC). Here, we examined the associations of single nucleotide polymorphisms (SNPs) in the Se pathway and their Se status interactions with CRC risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

**Methods:** Using an Illumina Golden gate assay, we simultaneously genotyped all SNPs in 164 Se pathway genes (comprising all 25 selenoprotein genes, selenoprotein biosynthesis / transport genes, and metabolic pathway genes) using 1264 candidate functional and common tagging SNPs. From these assays, 1040 variants in 154 genes were successfully assayed in DNA samples from 1478 CRC case-control pairs matched within EPIC. Multivariate logistic regression was used to determine the association of SNPs in the Se pathway with CRC risk. Pathway and gene based analyses were also performed using the PIGE package Adaptive Rank Truncated test.

**Results:** Genotypes for 144 SNPs in 63 genes were associated with an altered CRC risk. However, none of the associations in the selenoprotein genes remained significant after Benjamini-Hochberg multiple-testing correction, although the Thioredoxin Reductase 1 (TXNRD1) rs11111979 SNP retained significance with gene-wide PACT (P values adjusted for correlated tests) considerations. SNP genotypes in cell-signaling pathway genes (FRZB, SMAD3, and SMAD7) known to be affected by Se intake were also significantly associated with CRC risk after multiple testing adjustments. Additionally, genetic variations were shown to interact with biomarkers of Se status (as assessed by serum Se and Selenoprotein P concentration) to alter CRC risk. Pathway analyses also suggest that SNP only and SNP X Se interactions in selenoprotein, antioxidant, apoptosis and TGF-beta signaling pathways may alter CRC susceptibility risk.

**Conclusions:** Detailed investigation of Se intake levels and metabolism is needed to further explore relevance for CRC
were preschoolers; Age range 1-59 months (average 15.2 m). 7
Days of hospitalization: 7.1 days (2-47 days) At admission, the
prevalence of global malnutrition was 25.8%, acute malnutrition
22.4% and chronic malnutrition 28.8%; Hospital malnutrition:
8.2%. Children with malnutrition were characterized by: low
birth weight, breastfeeding of less than five months, parents with
a monthly family income of a minimum wage, who consulted for
a basic pathology. The association of enteral nutrition use and
weight gain was significant (p = 0.02). No child presented kwashi-
orkor. No deaths were recorded.

**Conclusions:** The prevalence of hospital malnutrition in chil-
dren under five years of age is 8.2% in a referral hospital. It is high-
er in the infants group.

**Keywords:** hospital malnutrition, nutritional status, Infants

144/2397

NUTRITION AND HEALTH MONITORING SYSTEM
DEVELOPMENT IN THE US AFFILIATED PACIFIC:
THE CHILDREN'S HEALTHY LIVING NETWORK

(1)Novotny, Rachel; (2)Techur-Pedro, Angela; (3)Coleman, Patricia;

(⁴)Fialkowski, Marie; (⁵)Wilkens, Lynne; (⁶)Delacruz-Talbert, Elise;

(7)Leon Guerrero, Rachael; (8)Deenik, Jonathan; (9)Tufa, Aifili;

(¹⁰)Greenberg, Joshua.

(¹)PhD. Professor. College of Tropical Agriculture and Human Resources. University of Hawaii a Manoa. Hawaii USA; (²)PhD. Epidemiologist. Pacific Island Health Officers Association. Hawaii. USA; (³)BS. Program Coordinator. Northern Marianas College. Commonwealth of the Northern Marianas. USA; (⁴)PhD. Assistant Professor. College of Tropical Agriculture and Human Resources. University of Hawaii. Hawaii USA; (⁵)DrPH. Specialist. University of Hawaii Cancer Center. Hawaii. USA; (⁶)MPH. Data Coordinator. College of Tropical Agriculture and Human Resources. University of Hawaii. Hawaii.; (⁷)PhD. Professor. College of Natural and Applied Sciences. University of Guam. Guam.; (⁸)PhD. College of Tropical Agriculture and Human Resources. University of Hawaii. Hawaii.; (⁹)MPH. Epidemiologist. Pacific Island Health Officers Association. American Samoa.; (¹⁰)PhD. Professor. School of Natural Resources and Extension. University of Alaska at Fairbanks. Alaska.

**Background and objectives:** The US Affiliated Pacific Islands are underserved by the US national health and nutrition monitoring system. The importance of having reliable anthropometric data was highlighted with the recent Zika virus outbreak in the region, with critical sequelae identified with infant head circumference measurements (microcephaly), and for monitoring obesity in a region with the highest rates of obesity and non-communicable disease in the world. The Children's Healthy Living (CHL) Network has expanded its partnership beyond Colleges and Headstart programs to include Departments of Health, in partnership with the Pacific Island Health Officers Association (PIHOA)(CHL USDA/AFRI Grant#: 2011-68001-30335, Novotny R, PI; PIHOA CDC/NACDD Cooperative Agreement # 1412016, Techur-Pedro

A, PI). The CHL Network aims to develop and maintain a regional
anthropometric monitoring system through partnerships of land
grant colleges and health departments to provide data for deci-
sion-making.

**Methods:** Training, standardization and coordination of research and health program personnel in anthropometric measures were done in 11 jurisdictions, according to protocols developed by CHL and later expanded to 3 age groups: 0-1 y (length, weight, head circumference), 2-10 y (height, weight, waist circumference at the umbilicus), 11+ y (height, weight, waist circumference at the iliac crest)(Li et al. 2015).

**Results:** Each US affiliated Pacific jurisdiction now has at least 1 standardized anthropometric measurer in at least 1 age group. With a core of regional anthropometric measurers in the 2-10 y range (145 height, 154 weight, 109 waist), measurers are now being trained in infant (24 length, 24 weight, 24 head circumference) and adult measures (52 height, 50 weight, 1 waist circumference). Increasing the number of standardized measurers and developing a sustainable anthropometric monitoring system that includes quality assurance is in process for the region.

**Conclusions:** College and health leaders in the US affiliated Pacific region have formed a network to provide on-going training and skill development in order to gather and maintain standardized anthropometric information useful for decision making related to non-communicable and communicable diseases critical to the region.

**Keywords:** Pacific, anthropometry, height, weight, circumferences

144/2407

THE IMPACT OF TASTE PREFERENCES ON MA-
CRONUTRIENT INTAKE

(1)Dikmen, Derya; (1)Inan-Eroglu, Elif; (2)Ozdemir, Aslihan; (2)Madali, Berna; (3)Ellahi, Basma.

(¹)PhD, Nutrition and Dietetics Department, Hacettepe University, Turkey; (²)MSc, Nutrition and Dietetics Department, Hacettepe University, Turkey; (³)Prof, PhD, Faculty of Health and Social Care, University of Chester, United Kingdom.

**Background and objectives:** Recent evidence has suggested that there are multiple links between taste preferences and food choices and the amount of food consumed. In this study, we aimed to investigate whether there is an impact of taste preference on macronutrient consumption in healthy adults.

**Methods:** This study compromised 46 adults aged between 18-40. Socio-demographic characteristics and anthropometric measurements of the individuals were taken by dietitians. Participants' 24 hour food recall was also taken for determining the nutrient intakes by specialized dietitians. The results were evaluated by the statistical program SPSS.

**Results:** The great majority of participants reported that they like sweet taste (93.5%). Participants 69.6 % like soury taste and 60.9 % salt taste. Because umami taste is a new taste for consumers, it was found that 50.0% of the participants did not have an idea
about the taste of umami and 28.3% disliked it. The mean energy intake of the participants was 2038.4 ± 678.34 kkal. According to the participants' 24-hour food recalls, the average percentage of energy from carbohydrate, fat and protein intake were 47.9 ± 9.31%, 37.2 ± 8.66% and 14.9 ± 3.50% respectively. The fat intake of the participants who like sweet taste (37.%) was higher than non-likers of the sweet taste (26.3%) (p=0.02). Also participants who like bitter taste fat intake were higher than non-likers of bitter taste (p>0.05). Fat intake levels were lower who likes mostly soury and salty taste when compared to sweet and bitter taste likers. Daily protein intake of the salty (p>0.05) and soury taste (p<0.05) likers were higher than the sweet and bitter taste likers. The participants like salty taste daily protein intake were 5 g higher than the non-likers salty taste (p>0.05).

**Conclusions:** There was a relation between fat, protein intake of the participants with taste preferences. There are evidence on oral and pharyngeal recognition of the nutrients is proposed as a mechanism for regulating nutrient intake. Further experimental studies need to investigate the taste preference and its affect on nutrient intake.

**Keywords:** taste, nutrient intake, food choice

144/2426

## USE OF COMPUTER VISION TECHNIQUES FOR AUTOMATIC FOOD CLASSIFICATION BY SIZE

**Background and objectives:** Computer vision (VC) techniques are a novel tool for the food and nutrition area. The classification of foods according to size using VC techniques would allow the estimation of portion sizes and grams, optimize the evaluators time and reduce subjectivity, but research in this area is still incipient. Therefore, we set out to develop an automatic and reproducible method of food classification by size.

**Methods:** To evaluate the method we used oranges, which are much consumed and are available in the local market. We measured the dimensions (greater diameter) of the oranges with a caliber and weighed each one of them, later we classified them in: small, medium and large. We created a closed environment to obtain high quality images, and developed a program that takes the obtained images as input data and we applied VC techniques which includes image processing, segmentation, extraction of characteristics and classification using the algorithm KNN. Finally we estimated the sensitivity and specificity of the results obtained through the program.

**Results:** We obtained photographs of 207 oranges (124 used for training of the program (60%) and 83 for the corresponding

tests of the same (40%)), the average greater diameter according to the measurements of the expert was 69.1 ± 4.4 millimeters and the obtained from the program was 68.9 ± 4.1. The Pearson correlation showed r = 0.68 (p <0.001). The average difference between the expert and the program measurements was 0.20 ± 3.4 (p> 0.05). After 100 training with random assignment of oranges in the ratio of 60% to 40%, the program had a sensitivity and specificity equal to 1.0.

**Conclusions:** The proposed method could provide assistance to nutrition professionals in the process of estimating the size of foods and consequently portions and grams. The database of images and physical measurements generated would enable more studies in the area.

**Keywords:** Computer vision, Food, food classifications

144/2428

## IDENTIFYING DIETARY STRATEGIES TO IMPROVE NUTRIENT ADEQUACY AMONG ETHIOPIAN INFANTS AND YOUNG CHILDREN USING LINEAR MODELLING

**Background and objectives:** Optimal Infant and Young Child Feeding practices are crucial for child survival but lack guidance from local food-based dietary guidelines, that incorporate fortified products, to ensure nutrient adequacy in Ethiopia.

**Methods:** Based on data from the Ethiopian National Food Consumption Survey, linear programming (LP, Optifood) was used to identify nutrients lacking in local diets of young children (6-8, 9-11 and 12-23 months) and to formulate realistic Food Based Dietary Recommendations (FBDR) for improved nutrient adequacy in four regions by comparing alternative approaches of local complementary foods, micronutrient powders (MNPs), Small quantity Lipid based Nutrient Supplement (Sq-LNS) and combinations of these.

**Results:** Optimised local diets provided inadequate zinc in all regions and age groups, inadequate iron for infants < 1 year of age

<footnote>(1)Miranda, Juan Carlos; (2)Gonzalez Cespedes, Laura Elizabeth;</footnote>

<footnote>(3)Aguilar Rabito, Ana Carolina; (4)Vázquez Noguera, José Luís;</footnote>

<footnote>(4)Legal Ayala, Horacio.</footnote>

<footnote>(1)Facultad Politécnica. Universidad Nacional de Asunción; (2)San Lorenzo; (3)Department of Nutrition Research. Facultad de Ciencias Químicas. Universidad Nacional de Asunción; (4)Facultad de Politécnica. Universidad Nacional de Asunción.</footnote>

<footnote>(1)Samuel, Aregash; (2)Osendarp, Saskia; (3)Ferguson, Elaine;</footnote>

<footnote>(4)Borgonjen, Karin; (5)Alvarado, Brenda M.; (6)Neufeld, Lynnette M.;</footnote>

<footnote>(7)Adish, Abdul Aziz; (8)Kebebe, Amha; (9)Weuhler, Sara; (10)Brouwer, Ingeborg.</footnote>

<footnote>(1)Msc. Nutritionist. Division fo Human Nutrition. Wageningen University. The Netherlands. Ethiopian Public Health Institute. Addis Ababa. Ethiopia.; (2)PhD. Nutritionist. Division of Human Nutrition. Wageningen University. The Netherlands. Micronutrient Initiative. Canada.; (3)PhD. London School of Health and Tropical Medicin. United Kingdom; (4)Bsc. Research Dietician. Division of Human Nutrition. Wageningen University. The Netherlands.;</footnote>

<footnote>(5)MSc. Division of Human Nutrition. Wageningen University. The Netherlands; (6)PhD. Global Alliance for Nutrition. Geneva. Switserland; (7)Micronutrient Initiative. Addis Ababa. Ethiopia;</footnote>

<footnote>(8)Ethiopian Public Health Institute. Addis Ababa. Ethiopia;</footnote>

<footnote>(9)Micronutrient Initiative. Canada.; (10)PhD. Nutritionist. Division of Human Nutrition. Wageningen University. The Netherlands.</footnote>
in all regions, and inadequate calcium, niacin, thiamin, folate, vit-
tamin B12 and B6 in some regions and age-groups, but not in all.
The set of regional FBDRs were significantly different for the four
regions thus development of one general national FBDRs will be a
challenge. Promoting a more diverse diet such as increasing veg-
etables, legumes and animal source food consumption improves
nutrient profile of the diet to a certain extent. Nevertheless even
after the FBDRs; some nutrient intakes remain suboptimal.

**Conclusions:** The best nutritional option to solve the nutri-
ent gaps identified is a combination of regional FBDRs with MNP
supplementation. It is important to emphasize that MNP should
not replace the feeding recommendations, but should be promot-
ed in addition to these FBDRs together with breast-feeding on de-
mand during the first two years of age.

**Keywords:** Complementary food, Optifood analysis, food based dietary recommendations, problem nutrients, young children.

144/2431

NUTRITIONAL STATUS BY GENDER, AGE RANGE,
SEL AND REGION AMONG ARGENTINE POPULA-
TION. RESULTS OF ELANS STUDY

(1)Guajardo, Viviana Beatriz; (2)Favieri, Andrea Lorena; (3)Nogueira Previdelli, Agatha; (4)Gerardi, Alejandro; (5)Gómez Salas, Georgina;

(6)Fisberg, Mauro; (7)Kovalskys, Irina.

(1)BSc. Psychologist. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina; (2)BSc. Nutritionist. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina; (3)PhD. Professor. Faculdade de Ciências Biológicas e da Saúde. Universidade São Judas Tadeu São Paulo. Brazil; (4)BSc. Sociologist. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina; (5)MSc. Professor. Departamento de Bioquímica. Escuela de Medicina. Universidad de Costa Rica. Costa Rica; (6)MD. Instituto Pensi. Fundação Jose Luiz Egydio Setubal. Hospital Infantil Sabara. São Paulo. Brazil PhD. Professor. Departamento de Pediatria. Universidade Federal de São Paulo. São Paulo. Brazil; (7)MD. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina.

**Background and objectives:** Obesity's comorbidities are the major cause of morbidity and less quality of life in adult population all over the world. The aim of this study was to evaluate the prevalence of overweight (OW), obesity (OB) and underweight (UW) in a representative sample population of Argentina.

**Methods:** Data were obtained from 1266 Argentines par-
ticipating in The Latin American Health and Nutrition Study
(ELANS), a multicenter study of a nationally representative ran-
domized sample of urban population of 8 LA countries between
November 2014 and July 2015. The sample had a multistage de-
sign stratified by geographical location (6 regions), age (15-65 y),
gender and Socio Economic Level (SEL). A standard study pro-
tocol was designed to evaluate 6 anthropometric measurements
including weight and height. A questionnaire to classify SEL was

administered. Sample expansion factors were calculated and de-
scriptive statistical data analysis was performed with SPSS Sta-
tistics 20.

**Results:** Overall OW, OB and UW prevalence were 32.2%, 23.2% and 4.9% respectively. Analyzing by gender, up to 20 years of age, the prevalence of OW including OB was higher for men, but OB prevalence was higher for woman between 35 and 49 y (32.1% vs. 23.3%). On the other hand, the prevalence of UW, up to 20 years old, was higher for women (12.4% for 20-34 y). Comparing by SEL (high, medium and low) OW including OB prevalence was 61.8%, 57.4% and 52.7% respectively, while the highest prevalence of UW (5.7%) was observed on low SEL population. Analyzing by region the prevalence of OW including OB was higher for men in Buenos Aires Metropolitan Area, Cuyo and South regions (65.2%, 72.8%, 65.2%), while for women was higher in Pampeana, Northwest and Northeast regions (58.5%, 56.8%, 55.7%). South region had the highest prevalence of OW including OB (63.1%) while Pampeana region had the highest prevalence of UW (8.1%).

**Conclusions:** More than 50% of the Argentine population is above the BMI considered healthy. Minimal differences were found between genders and regions but a special public health consideration should be centered in the trans-generational tracking of adiposity in woman.

**Keywords:** Nutritional Status, Argentine population, multi-center study

**Conflict of Interest Disclosure:** The ELANS is supported by a scientific grant from the Coca Cola Company and support from the Instituto Pensi / Hospital Infantil Sabara, International Life Science Institute of Argentina, Universidad de Costa Rica, Pontificia Universidad Católica de Chile, Pontificia Universidad Javeriana, Universidad Central de Venezuela (CENDES-UCV)/ Fundación Bengoa, Universidad San Francisco de Quito, and Instituto de Investigación Nutricional de Peru. The funders had no role in study design, data collection and analysis, the decision to publish, or the preparation of this manuscript.

**Further collaborators:**
on behalf of the ELANS Study Group
# REPORTED DIETARY INTAKE: ANALYSIS OF CALCIUM USUAL INTAKE AMONG ARGENTINE POPULATION. RESULTS FROM ELANS STUDY

(¹)Guajardo, Viviana Beatriz; (²)Favieri, Andrea Lorena; (³)Nogueira Previdelli, Agatha; (⁴)Gerardi, Alejandro; (⁵)Gómez Salas, Georgina; (⁶)Fisberg, Mauro; (⁷)Kovalskys, Irina.

(¹)BSc. Psychologist. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina; (²)BSc. Nutritionist. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina; (³)PhD. Professor. Faculdade de Ciências Biológicas e da Saúde. Universidade São Judas Tadeu São Paulo. Brazil; (⁴)BSc. Sociologist. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina; (⁵)MSc. Professor. Departamento de Bioquímica. Escuela de Medicina. Universidad de Costa Rica. Costa Rica; (⁶)MD. Instituto Pensi. Fundação Jose Luiz Egydio Setubal. Hospital Infantil Sabara. São Paulo. Brazil PhD. Professor. Departamento de Pediatria. Universidade Federal de São Paulo. São Paulo. Brazil; (⁷)MD. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina.

**Background and objectives:** The consumption of calcium is associated both with the prevention of many diseases and also with quality of life (1). This study aimed to identify the adequacy of calcium intake among Argentine population.

(1) Mueller, N. T., & Appel, L. J. (2017). Attributing Death to Diet: Precision Counts. Jama, 317(9), 908-909.

**Methods:** Data were obtained from 1266 Argentines participating in Latin American Health and Nutrition Study (ELANS), a multicenter study of a nationally representative randomized sample of urban population of 8 LA countries, developed between November 2014 and July 2015. The sample by country had a multistage design stratified by region, age (15-65 y), gender and SEL. A standard study protocol was designed to evaluate nutritional intake assessed by two 24-hour recalls, analyzed with the Nutrition Data System for Research (NDS-R) from Minnesota University, after a standardization process between local food and NDS-R database. Calcium usual intake was estimated with the Multiple Source Method (MSM) statistic package (https://nugo.dife.de/msm) and adequacy estimated in comparisons with Recommended Dietary Allowances (RDA) (IOM standards). Sample expansion factors were calculated and descriptive statistical data analysis was performed with SPSS Statistics 20.

**Results:** Median of usual consumption of the whole sample was 777 and 689 mg/day in men and women respectively. Both female adolescents and women above 50 consume a median of 50% of RDAs: 646.1 and 655,4 mg/day respectively, adding that 99% and 98,5% of the population of those groups of ages were below recommendations. Although the RDA decreases at 20-49 y, the prevalence of inadequate usual intake was 90.9%-86.9%. Younger males (15-19) and older ones (50-65) consume more calcium than women of same ages (855.7 mg/day and 746,7 respectively) but, the prevalence of inadequate usual intake was 94.4% and 90.3% respectively, for equal RDAs.

**Conclusions:** The prevalence of inadequate usual intake of calcium for Argentine population, at every age range and gender is very high. These results reinforce the importance of public health programs focused on increasing calcium consumption and implementing micronutrients fortification specially in women.

**Keywords:** Calcium, inadequate usual intake, Argentinian population, multicenter study.

**Conflict of Interest Disclosure:** The ELANS is supported by a scientific grant from the Coca Cola Company and support from the Instituto Pensi / Hospital Infantil Sabara, International Life Science Institute of Argentina, Universidad de Costa Rica, Pontificia Universidad Católica de Chile, Pontificia Universidad Javeriana, Universidad Central de Venezuela (CENDES-UCV)/ Fundación Bengoa, Universidad San Francisco de Quito, and Instituto de Investigación Nutricional de Peru. The funders had no role in study design, data collection and analysis, the decision to publish, or the preparation of this manuscript

**Further collaborators:**

on behalf of the ELANS Study Group

# CHARACTERISTICS OF THE DIET IN THE ARGENTINE POPULATION. RESULTS OF ELANS STUDY

(¹)Favieri, Andrea Lorena; (²)Guajardo, Viviana Beatriz; (³)Nogueira Previdelli, Agatha; (⁴)Gerardi, Alejandro; (⁵)Gómez Salas, Georgina; (⁶)Fisberg, Mauro; (⁷)Kovalskys, Irina.

(¹)BSc. Nutritionist. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina; (²)BSc. Psychologist. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina; (³)PhD. Professor. Faculdade de Ciências Biológicas e da Saúde. Universidade São Judas Tadeu São Paulo. Brazil; (⁴)BSc. Sociologist. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina; (⁵)MSc. Professor. Departamento de Bioquímica. Escuela de Medicina. Universidad de Costa Rica. Costa Rica; (⁶)MD. Instituto Pensi. Fundação Jose Luiz Egydio Setubal. Hospital Infantil Sabara. São Paulo. Brazil PhD. Professor. Departamento de Pediatria. Universidade Federal de São Paulo. São Paulo. Brazil; (⁷)MD. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina.

**Background and objectives:** The diet is determinant in the development of chronic diseases. The aim of this study was to assess energy intake (EI) and macronutrients intake (MI) and distribution (MD) of the Argentine population

**Methods:** Data from 1266 Argentine people (15-65 y) participating in the Latin American Health and Nutrition Study (ELANS), a multicenter study developed in urban areas of 8 LA countries. Intake was assessed by two face to face 24-hour recalls (November 2014-July 2015), and processed by the software Nutritional Data System for Research (NDS-R). Daily intake was analyzed by age, gender, socioeconomic level (SEL) and region (Buenos Aires Metropolitan Area, Cuyo, Pampeana, Northwest,
Northeast and South). The median values of EI and MI and percentages of MD were calculated. Sample expansion factors were calculated and descriptive statistical data analysis was performed with SPSS 20.

**Results:** The median of EI was 2154 kcal/day (2434 kcal/day in men and 1911 kcal/day in women). The MI was 271 g/day of carbohydrates, 85 g/day of protein and 78 g/day of fat (51%, 16% and 33% of EI respectively). Saturated fats accounted for 11.5%, monounsaturated fat 10.3% and polyunsaturated fat 7.7% of EI. The cholesterol intake was 375 mg/day. The added sugar was 15% of the EI. It was observed that EI decreased inversely with age (2667 kcal/day in men aged 15 to 19 years and 1712 kcal/day in women between 50 and 65 years), EI values showed no differences by SEL. In men, differences were found in MD: high SEL men increased proportion of fats and proteins (35% and 17% respectively) in comparison with low SEL men (32 and 15%). EI was not different due to a compensation effect of CHO. By region, EI ranged from 1994 kcal/day in the Pampeana region to 2307 kcal/day in the Northwest. No significant differences were found in MD by age.

**Conclusions:** In Argentina, population diet showed high levels of critical nutrients as saturated fats, cholesterol, and added sugars, all related to cardiovascular disease and metabolic syndrome. Differences by region and by SEL were found and should be taken into account by public health stakeholders.

**Keywords:** Energy intake, macronutrients, Argentine population, multicenter study.

**Conflict of Interest Disclosure:** The ELANS is supported by a scientific grant from the Coca Cola Company and support from the Instituto Pensi / Hospital Infantil Sabara, International Life Science Institute of Argentina, Universidad de Costa Rica, Pontificia Universidad Católica de Chile, Pontificia Universidad Javeriana, Universidad Central de Venezuela (CENDES-UCV)/ Fundación Bengoa, Universidad San Francisco de Quito, and Instituto de Investigación Nutricional de Peru. The funders had no role in study design, data collection and analysis, the decision to publish, or the preparation of this manuscript.

**Further collaborators:** on behalf of the ELANS Study Group

fat distribution. In this regard, a new index, called the Lipid Accumulation Product (LAP), has been proposed. The aim of this study was to compare LAP and BMI measurements and to determine cutoff point values for LAP and BMI in apparently healthy Brazilian adults men.

**Methods:** A cross-sectional study was conducted with 130 apparently healthy Brazilian adults men (20-59 years). Anthropometric data, including weight, height and waist circumference, were determined. Triglycerides were determined by enzymatic colorimetric method. The lipid accumulation product was calculated as (waist circumference [cm] - 65) × (triglycerides concentration [mM]). Percentage of body fat mass was obtained by Tetrapolar Bioelectrical Impedance Analysis. It was considered as cutoff point for elevated percentage of body fat mass values ≥ 25%. The statistical analysis consisted in construction of ROC curves (Receiver Operating Characteristic Curve) and was carried out using Medcalc version 12.7.

**Results:** A strong correlation was found between BMI and percentage of body fat mass (r=0.71; p<0.001). BMI and LAP also showed a strong correlation (r=0.67; p<0.001), as well as, LAP and percentage of body fat mass (r=0.69; p<0.001). According to these results, the ROC curve analysis showed accuracy for BMI (AUC=0.886±0.057) and for LAP (AUC=0.823±0.068) regarding the discriminatory ability for detect elevated percentage of body fat mass. The cutoff point value of 39.3 cm.mmol/L for LAP provided a sensitivity of 73.3% (95% CI: 44.9-92.0%) and specificity of 81.7% (95% CI: 73.4-88.3). Whereas, the cutoff point value of 27.1 kg/m2 for BMI provided a sensitivity of 86.7% (95% CI: 59.5-98.0) and specificity was 88.7% (95% CI: 81.4-93.8%).

**Conclusions:** The LAP may be an alternative to measure adiposity; however, the BMI is a simple, inexpensive and reliable tool that showed great ability in discriminating elevated values of percentage of body fat mass in apparently healthy Brazilian adults men.

**Keywords:** Adiposity. Body Mass Index. Lipid accumulation product. Obesity.

**Background and objectives:** Obesity (defined as an excess accumulation of body fat) is a complex multifactorial condition that has reached epidemic proportions. The Body Mass Index (BMI) is the most commonly used indicator to assess obesity. This indicator evaluates generalized obesity, but does not measure body

<footnote>(1)de Carvalho Vidigal, Fernanda; (2)Enriqueta Frandsen Paez de Lima Rosado, Lina.</footnote>

<footnote>(1)PhD in Nutrition Science. Professor of Nutrition. Faculty of Nutrition. Universidade Federal de Alfenas. Brazil.; (2)PhD in Nutrition. Nutritionist. Brazil.</footnote>
# ANTHROPOMETRY AND THE MEAL PATTERNS AMONG UNIVERSITY STUDENTS IN KENITRA CITY, MOROCCO

(1)madane, salwa; (2)Sbaibi, Rachid; (2)Aboussaleh, Youssef.

(1)PhD.Laboratory of Nutrition Health and Environment.
Department of Biology. Faculty of Sciences. University Ibn Tofail.
Kénitra. Morocco; (2)PhD. Nutritionist. Laboratory of Nutrition
Health and Environment. Department of Biology. Faculty of
Sciences. University Ibn Tofail.Kénitra. Morocco.

**Background and objectives:** Morocco, in full economic, social and cultural transition, experiencing urbanization increasingly greater causing changes in lifestyle and dietary habits. The objective of this study was to evaluate nutritional status by Anthropometry and determines the meal patterns of university students in Kenitra city, Morocco.

**Methods:** The anthropometric survey was conducted on 150 university students with average age (24.15years ± 4.6). Body Mass Index (BMI) was adopted to evaluate nutritional status by Anthropometry. A self-administered questionnaire was used to collect data about sociodemographic features of the students and their families, as well as meal habits of students.

**Results:** The finding showed an average Height of subject (1,64m ± 0,1 cm), the mean weight was (60.9 kg ± 10.7 kg); the mean of IMC (22.36+3.5); stunting (10%), thinness (9.3%), a risk of overweight (16%) and obesity (1.3%). About 73.7% of students eat three meals per day (70,7% for breakfast, 87,7% for lunch and 62,7% for diner). Snacks were eaten daily by 60 % of students. The majority drinks at breakfast tea (39.3%), coffee (13.3%) and eat Bread, cheese and olive oil (53. 3%).At the lunch, students eat bread (84%) with Tajine of meat (39%) and fruits (71.3%). At the dinner, most students eat bread)66.7%( and the pasta or tajine with meat (48%). 68.7% hydrate daily (1.7L per day),62% consume daily fruits and vegetable.

**Conclusions:** Students practice meals based on cereals. Interventions are needed to promote healthy eating habits among students.

**Keywords:** Anthropometry, nutritional status, meal patterns, university students, Morocco

**Background and objectives:** Obesity has a great impact on health, due to its complications. Anthropometric measures are able to identify the upper-body subcutaneous fat accumulation, such as neck circumference (NC), which presents a strong correlation with adiposity. The objectives of this study was to evaluate the prevalence of adult and elderly patients hospitalized with excess adiposity through NC, and verify the correlation of NC with BMI (Body Mass Index) in these patients.

**Methods:** A cross-sectional study, with secondary data from a hospital in the city of Taubate, Sao Paulo, which evaluated hospitalized adults and elderly, among February 2015 and May 2016. The variables analyzed were weight, height, BMI, NC, sex and age. For classification of nutritional status, the cutoff points proposed by the World Health Organization (1995), for adults and Lipschitz for the elderly (1994), were used. The cutoff points for elevated NC were 37 and 34 cm, for men and women, respectively. Data analysis was performed using descriptive statistics. Pearson's correlation test was performed to verify the correlation between NC and BMI.

**Results:** Among 628 patients selected, 579 were the final sample, of which 53.88% (n = 312) were female. The mean age, for the female and male sex was 66.2 ± 15.78 and 63.48 ± 13.88, respectively. It was verified that 76% of the female patients and 67.4% of the male patients presented elevated NC. Considering the groups of patients with and without overweight by BMI, 65.82% and 34.17% of the women, 64.44% and 35.55% of the men presented elevated NC, respectively. There was a strong correlation between NC and BMI for males (r = 0.85) and female (r = 0.90).

**Conclusions:** It was concluded that there was high correlation between NC and BMI for both sexes, and higher prevalence of overweight women who presented elevated NC. In relation to the non-overweight patients, there was a higher prevalence of males for this outcome.

**Keywords:** Neck Circumference, Anthropometry, Excess Adiposity, Hospitalized Patients.

**Further collaborators:**

Adriana Aparecida da Silva Alvarenga helped to implement the study and to write the text; Adriana Lisboa Mendes Roman helped the data collection, helped implement the study, and helped to write the text; Roberta de Lucena Ferretti conceived, designed, and implemented the study, collected and interpreted data, wrote and revised the text was responsible for coordinating original study and contributed to the intellectual content. All authors have sufficiently contributed to the development of this study.

# NECK CIRCUMFERENCE TO IDENTIFY EXCESS ADIPOSITY IN HOSPITALIZED PATIENTS

(1)Aparecida da Silva Alvarenga, Adriana; (1)Mendes Lisboa, Adriana;

(2)de Lucena Ferretti, Roberta.

(1)Nutritionist. University of Taubate. University Hospital of Taubate. Sao Paulo. Brazil; (2)PhD student. MD. Federal University of Sao Paulo. Department of Pediatrics. University of Taubate. Sao Paulo. Brazil.

# UNDERREPORTING OF ENERGY INTAKE IN A PROBABILITY SAMPLE OF THE BRAZILIAN ADULT POPULATION

Anjos, Luiz Antonio.

MD, PhD. Professor. Universidade Federal Fluminense.

**Background and objectives:** Energy intake (EI) is an important measure in detailed nutritional assessment in clinical and re-
search settings. However, there has been recent strong criticism on the self-reported methods used to obtain EI in populations, which yield low, unexplained, and sometimes unusable, values primarily in women and obese. The EI/basal metabolic rate (BMR) ratio has been suggested to provide clues on who underreports EI. In 2008, EI was obtained in a probability sample of the Brazilian 10y+ population by a 24h dietary recall (24HDR). This study reports the relationship between EI and BMR of the sub-sample of Brazilian adults (≥20y) in an attempt to quantify the level of EI underreporting.

**Methods:** Data from 25949 subjects (14052 women) aged 20-104y were used in the analysis. BMR was estimated by two set of equations: 1) the Schofield equations using body mass and stature (SCHO) suggested to be used internationally by FAO/WHO and 2) equations developed in a probability sample of the adult population of Niterói, a urban area in the Metropolitan area of Rio de Janeiro, Brazil (BRA). The latter equations have been validated in adults from the same town. EI/BMR of 1.53 was used as the cutoff to identify underreporting. The values were weighted to represent the Brazilian adult population.

**Results:** Overall mean (95%CI) EI was 1728.6 (1719.3;1737.9) kcal/day, being higher in men (1941.4, 1926.4;1956.5) than in women (1521.6, 1510.9;1532.2) kcal/day. Estimated BMR by the SCHO equations (1523.6, 1520.6;1526.5kcal/day) was significantly higher than the BRA equations (1259.5, 1257.0;1262.0kcal/day). Mean EI/BMR ratio varied from 1.06 to 1.21 depending on age and sex when the SCHO equations were used and between 1.26 and 1.48 with the BRA equations. EI underreporting varied from 78 to 88% when using the SCHO equations and 59 to 74% when the BRA equations were used. Using the latter equations, underreporting was 64% and 69% in all men and women, respectively.

**Conclusions:** EI assessed by a 24hDR is underestimated by more than 60% of the Brazilian adult population. Caution is warranted when using 24hDR to estimate EI in adults in Brazil.

**Keywords:** Nutrition Assessment, Basal metabolism, Adults, Diet.

ger, satiety and binge eating scale scores on caloric estimation in healthy subjects.

**Methods:** This study was conducted with 46 healthy volunteers in Ankara, Turkey. Anthropometric measurements, body compositions were examined. Binge eating scale was evaluated on participants to identify the risk of binge eating disorder. Moreover, 24-hour recall food records were taken from subjects. To determine the effect of hunger and satiety situations on caloric estimations of some specific foods, a protocol was developed. Participants were asked to estimate the energy content of the foods in hunger and satiety status.

**Results:** The mean age of subjects was 22,9±4,4, and mean BMI was 22,5±2,6 kg/m2. According to Binge Eating Scale, 84,8% of participants' binge eating scores were low. Non-binging subjects estimated calorie content of CHO-based foods eg. green beans, chocolate, potato chips, and fried potatoes lower when they were hungry (p<0,05). Subjects who had moderate binge eating scores estimated calorie content of apple higher when they are satiated (p<0,05) when compared with hunger situation. According to data obtained from food records, 60,9% of subjects consumed higher energy from CHO. Estimations on calorie contents of CHO content foods apple, bread, and fried potatoes of these subjects were statistically different in hunger and satiety conditions (p<0,05).

**Conclusions:** This study shows that there is a significant association between hunger status and caloric estimations. Especially carbohydrate consumption affects predictions about foods that contain more carbohydrate. Further studies are required to investigate the relation between binge eating, carbohydrate consumption and caloric estimations.

**Keywords:** hunger, satiety, binge eating, caloric estimation

**Background and objectives:** Estimation of calories in foods is crucial in the maintenance of body weight and energy regulation. Binge eating is defined as eating an unusually large amount of food in a short period and experiencing a loss-of-control over eating. In this study, we aimed to investigate the effects of hun-

<footnote>(1) Ozdemir, Aslihan; (2) Madali, Berna; (3) Dikmen, Derya; (4) Inan-Eroglu, Elif; (5) Ellahi, Basma.</footnote>

<footnote>(1) MSc, Nutrition and Dietetics Department, Hacettepe University, Turkey; (2) MSc, Nutrition and Dietetics Department, Hacettepe University, Turkey; (3) PhD, Nutrition and Dietetics Department, Hacettepe University, Turkey; (4) PhD, Nutrition and Dietetics Department, Hacettepe University, Turkey; (5) PhD, Faculty of Health and Social Care, University of Chester, United Kingdom.</footnote>
# ACCURACY AND RELIABILITY OF A LOW-COST, HANDHELD 3D IMAGING SYSTEM FOR CHILD ANTHROPOMETRY

(1)Conkle, Joel; (2)Ramakrishnan, Usha; (2)Suchdev, Parminder S.;

(3)Alexander, Eugene; (2)Martorell, Reynaldo.

(1)MPH, Doctoral Program in Nutrition and Health Sciences. Laney Graduate School. Emory University, USA; (2)PhD. Hubert Department of Global Health. Rollins School of Public Health. Doctoral Program in Nutrition and Health Sciences. Laney Graduate School. Emory University. Atlanta, GA, USA; (3)Body Surface Translations, Inc.

**Background and objectives:** Body measurement, or anthropometry, is used to assess child growth and body composition. Anthropometry is used in clinical settings to identify and manage malnutrition, and in national surveys to guide nutrition programs. The usefulness of anthropometry however is undermined by poor measurement quality, which has led to calls for improved quality and/or new approaches. We evaluated the potential of a three-dimensional (3D) imaging system to replace the current gold standard of non-digital, manual measurements for child stature (length or height), head circumference (HC) and mid-upper arm circumference (MUAC).

**Methods:** Five trained anthropometrists measured 474 apparently healthy children 0-5 years of age in Atlanta, USA from September 2016 to February 2017. For manual measurements, we followed training and measurement techniques used to develop the 2006 WHO Growth Standards. Anthropometrists took 3D scans of children using an iPad Air® with Occipital Structure Sensor and custom software developed by Body Surface Translations. We analyzed the quality of manual measurements using the 2006 WHO Growth Standards to calculate z-scores and define biological plausibility. We evaluated the accuracy of scan-derived measurements against manual measurements using average bias and Bland-Altman Plots; for reliability, we calculated intra- and inter-observer Technical Error of Measurement (TEM) and Coefficient of Reliability.

**Results:** 99.8% of manual measurements were biologically plausible, and the z-score standard deviations (SD) were close to 1.0 for all anthropometric indices, ranging from 0.92 for weight-for-height to 1.07 for height-for-age. Z-score variances among children under 2 years did not differ from those 2 or more based on Levene's Test. Inter- and intra-observer TEM was below 0.35 cm for all manual measurements. We are still analyzing the accuracy and reliability of scan-derived measurements.

**Conclusions:** We collected high quality manual anthropometry. If accurate and reliable, 3D imaging could help to improve the efficiency, precision and accuracy of child anthropometry. Expensive 3D imaging systems are already used in the garment industry for adult anthropometry. The 3D scanner and associated software we used in this study are low-cost, mobile and can handle movement; possibly extending the use of 3D imaging for diagnostic purposes.

**Keywords:** anthropometry; 3D; imaging; accuracy; reliability

**Conflict of Interest Disclosure:** The Bill and Melinda Gates Foundation funded the study. Dr. Eugene Alexander is employed by BST, Inc. All other authors do not have affiliations with or financial involvement with any organization or entity with a financial interest in the subject matter or materials discussed in the manuscript.

# THE PILOT KOREAN KEY FOODS BASED ON DIET CONSUMPTION

(1)Chang, Moon Jeong; (2)Shim, Jee Seon; (1)Lee, Jung Sug; (3)Kim, Hye Young; (4)Lee, Hyun Sook; (5)Kim, Ki Nam.

(1)PhD. Department of Food and Nutrition. Kookmin University. Republic of Korea.; (2)PhD. Medical College. Yonsei University. Republic of Korea.; (3)PhD. Department of Food and Nutrition. Yongin University. Republic of Korea.; (4)PhD. Department of Food and Nutrition. Dongseo University. Republic of Korea.; (5)PhD. Department of Food and Nutrition. Daejeon University. Republic of Korea.

**Background and objectives:** This study was performed to develop the Key Foods approach to select foods for nutrient analysis of up-to-date National Food Nutrient Composition Database. The primary objective of nutrient composition database in Korea is to provide the information to represent the nutrients consumed by Korean population, especially the nutrient profile for each food identified as important in the food consumption. The Key Food approach assists database system to prioritize foods that contribute significant amounts of nutrients of public health interest to the diet.

**Methods:** The Key Foods approach used 16 nutrients and energy (Key Nutrients) of public health significance identified in the intake data from Korea National Health and Nutrition Examination Survey (KNHANES) 2013-2014. The recipe file from KNHANES containing the list of ingredients and their amounts was used to identify the Key Foods. At first, foods list that contributed to the intake of each nutrient was selected using recipe code from raw data of KNHANES. Then, we determined foods that contributed the most to intake across all key nutrients. After selecting foods list, Key Foods were identified as those food components that contribute up to 85% of any one nutrient of Key Nutrients.

**Results:** From this procedure, 570 primary Key Foods were aggregated, which account for approximately 90.5% of the contribution of the nutrient consumption for the Korean diet. 456 Key foods were identified after further refinement procedure to insure that we have a representative list of what Korean eat by considering some foods that are not widely consumed by the Korean population.

**Conclusions:** This Key Foods list will be used for updating and revising the National Food Nutrient Composition Database from 2017 and concentrating resources for food composition analysis in Korea. We expect the updating database will give representative data for researchers, etc.
(This research was supported by a grant (16162MFDS087) from Ministry of Food and Drug Safety in 2016)

**Keywords:** Key Nutrients, Key Foods approach, KNHANES, Food Nutrient Composition database

**Keywords:** Brazilian Nut; Brazil nut; Body Composition; Obesity.
**Further collaborators:** Fundação de Amparo para Pesquisa do Estado de São Paulo (FAPESP)

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## BRAZILIAN NUT INTAKE HAS NO INFLUENCE ON BODY COMPOSITION IN OBESE WOMEN

(1)Biude Silva Duarte, Graziela; (2)Zavarize Reis, Bruna; (3)Cercato, Cintia;

(4)Macedo Rogero, Marcelo; (5)Maria Franciscato Cozzolino, Silvia.

(1)MSc. Nutritionist. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Science. University of São Paulo; (2)MSc. Nutritionist. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Science. University of São Paulo.; (3)PhD. Department of Endocrinology. Faculty of Medicine. University of São Paulo.; (4)PhD. Nutritionist. Department of Nutrition. School of Public Health. University of São Paulo; (5)PhD. Nutritionist. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Science. University of São Paulo.

**Background and objectives:** Nuts are considered to have an optimal energy density and a good source of lipids, especially unsaturated fatty acids. One Brazilian nut provides approximately 35,3kcal and 3,24g of total lipids, mainly monounsaturated fatty acids. The daily consumption of this food has been associated with the improvement of lipid profile and risk reduction of cardiovascular diseases. However, there is a concern about the possible effects of the daily intake of nuts on weight gain. Thus, the aim of this study was to investigate the effects of Brazilian nuts (Bertholletia excelsa H.B.K.) intake on body composition of obese women.

**Methods:** We enrolled 72 obese women recruited in the outpatient clinic of endocrinology from Clinics Hospital of São Paulo, Brazil. They were randomly assigned to either ingestion of Brazil nuts (BN) group or control (CO) group and they were followed up for 2 months. Participants of the treatment group consumed one Brazilian nut daily and the control group avoided the intake of any food containing the nut for the same period of time. On baseline and after two months of follow-up were assessed weight and height for the calculation of body mass index (BMI), waist circumference (WC) and percentage of body fat (%BF). Repeated measures ANOVA analyses were performed using SPSS 18.0 software to evaluate the effect of supplementation time with Brazilian nuts on the variables mentioned above.

**Results:** Twenty-nine participants of the treated group (BN) and twenty-six of the control group (CO) completed the trial. The mean age of BN and CO group was 40,3±9,0 and 39,4±9,5 (P=0,714) respectively. For BN and CO groups, no significant differences were observed for weight (ΔAfter-Before= -0,50) (ΔAfter-Before= 0,20) (P=0,723), BMI (ΔAfter-Before= -0,10) (ΔAfter-Before=0,10) (P=0,784), WC (ΔAfter-Before= -1,10) (ΔAfter-Before= 2,50) (P=0,111) and %BF (ΔAfter-Before= 0,30) (ΔAfter-Before= -0,10) (P=0,587).

**Conclusions:** The data show that Brazilian nut consumption for two months has no effect on the body composition of obese women.

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## A MODEL FOR DIGITALIZATION OF THE NUTRITION JOURNEY – CASE INSIGHTS FROM THE NUTRIDIA APP DEVELOPMENT FOR CANCER PATIENT COUNSELLING

(1)Mikkelsen, Bent Egberg; (1)Mikkelsen, Bent Egberg; (2)Clausen, Katja Serup; (3)Holst, Mette.

(1)PhD. Professor. Department of Clinical Medicine. Captive Foodscape Studies. Aalborg University. Copenhagen. Denmark.; (2)MSc. Department of Civilengineering. Aalborg University. Denmark; (3)PhD. Center for Nutrition and Bowel Disease. Department of Gastroenterology. Aalborg University Hospital & Department of Clinical Medicine, Aalborg University. Denmark.

**Background and objectives:** Shared decision making is relevant to nutrition counselling for patients who have diminished food intake, and suffer from cancer and therapy related riskfactors. Shared decision making however requires the patient to be well informed, and the professional to have access to updated information on the patients foodintake and riskfactors as nausea, mouth-problems i.e. So far nutritional apps seem to have been inspired more by experience economy than by nutrition science. The objective of NutriDia was to digitalize the nutrition counselling in a transparent and beneficial manner for the client while at the same time making the most of the expert knowledge of nutritionists and app developers, in order to enhance shared decision making for the individualised nutrition plan.

**Methods:** Development was set in the University Hospital Nutrition Centre with a professional app developer as partner and with university scientific team as evaluators. Evaluation performed observation and interviews with patients and professionals in consecutive app intermezzo's. The "sprint" concept from Agile software development was adopted. It defines principles for software development under which user requirements are specified and solutions are returned through efforts of a multidisciplinary team. It is adaptive and aims at early delivery and continuous improvement to secure flexible and rapid response to user wishes. Two versions were developed – one for the counsellors and one for patients supporting the dialogue in the presence of both patient and counselor.

**Results:** Patients took high interest in the patient APP that ended up user friendly to a large group of cancer patients, regardless of age and diagnose. Professionals were in general in agreement that the professional future will be “app’tized” and patient focused. For both groups early and instructed introduction was viewed as important. For both groups the visual appearance and straightforwardness of the app was found essential to user loyalty. Professionals however found it difficult that the software under the development did not “speak” with other clinical software, and has to be opened separately.
**Conclusions:** The sprinted mode of working involving clients, practitioners and developers in an evidence based environment is a useful method for future nutrition app'tisation.

**Keywords:** Digitalization, Nutrition Counselling, Nutridia, Cancer Patients

**Further collaborators:**

Last author: Rasmussen. HH. PhD. Center for Nutrition and Bowel Disease. Department of Gastroenterology. Aalborg University Hospital & Department of Clinical Medicine, Aalborg University. Denmark.

The NutriDia program i supported by the National Board of Health Denmark

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# MAN OR MACHINE - A REVIEW OF SMART ICT ASSISTED REALTIME DIETARY ASSESSMENT TECHNOLOGIES (RDAT) FOR AUTOMATED DIETARY DATA ASSESSMENT

Mikkelsen, Bent Egberg.

PhD. Professor. Department of Clinical Medicine. Captive Foodscape Studies. Aalborg University. Copenhagen. Denmark.

**Background and objectives:** Data collection in dietary intake studies using traditional methods is costly and time consuming. As a result ICT assisted measurement of dietary behavior has attracted interest from the nutrition research community and a number of groups across the world has through different trajectories tried to reduce the workload related to determining food intake. The aim of the study it to present an overview of smart ICT assisted devices for automated dietary data assessment - here referred to as Realtime Dietary Assessment Technologies (RDAT).

**Methods:** A literature search was conducted using the key words ICT assisted, app, devices, technology assisted automated, dietary data, food intake, assessment collection. In order to exclude ICT based solutions only replacing paper based methods with screen based ones, the study used as inclusion criteria was that methods should be based on < 1 hardware component. In addition, a network search was carried out based on snowballing technique in which known authors, research groups and technology acronyms was used as search terms. Only technologies that was reported scientifically was included. The search identified 8 technologies that was analyzed further

**Results:** The literature search identified the following Realtime Dietary Assessment Technologies (RDAT): eButton, Dietary intake Monitoring System (DIMS), Splendid, Smart Meal, Mandometer Technology and Technology Assisted Dietary Assessment (TADA). The review showed that the following specialized hardware based components was used in order to automatize the recognition of types and amounts of food: scales, jawbone motion, fork motion, imaging, picture recognition, spectrophotometry, Near InfraRed (NIR) technology and Near Field Communication (NFC).

**Conclusions:** The technologies identified all minimizes human involvement and involve novel combinations of various tech-

nology-solutions. All technologies are based on combinations of "intake signals" and uses a mix of different intake proxies. They include measuring jawbone and or fork movement as proxies, measuring chewing noise, measuring weight of plated food, math-based algorithms for automated or semi automated pictures recognition and artificial intelligence based recognition. The technologies are currently undergoing validation and feasibility studies. We conclude that more interdisciplinary research involving both nutritionists and digital media scientists is needed as well as more cooperation and knowledge sharing between involved research groups.

**Keywords:** Nutritional Assessment, Realtime Dietary Assessment Technologies, RDAT, automated dietary data assessment, ICT assisted food intake dietary data collection

**Further collaborators:** The author wish to acknowledge the dVices4food and the Richfields program

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# NUTRITIONAL PROFILE OF JIU JITSU FIGHTERS AND ANALYSIS OF ITS KNOWLEDGE REGARDING DIET GRACIE

(1)Auler, Flavia; (2)Macedo, Ana Carolina Gonçalves de; (2)Meucci, Nayara Ramos.

(1)PhD. Nutricionist. Pontifical University Catholic of Paraná; (2)Nutricionist. Pontifical University Catholic of Paraná. Argentina.

**Background and objectives:** The Gracie Diet, created by Carlos Gracie (precursors of Brazilian jiu-jitsu), has as main objective to maintain a slightly alkaline blood pH through food combinations divided into groups in order to prevent chemical reactions harmful to the organism. Thus, the objective was to analyze body composition and diet under the principles of the Gracie Diet in jiu-jitsu fighters.

**Methods:** A cross-sectional field study with a descriptive analysis and a quantitative approach involving jiu-jitsu fighters, only men between 18 and 29 years of age, enrolled in a state competition, excluding those classified as obese by BMI (WHO, 1997). Data collection was based on individual interview about personal details, food and knowledge of the Gracie Diet. The anthropometric assessment was carried out by GC% arising from Guedes protocol (2010) with Fleck classification (1983) and Wilmore (1983) and BMI (WHO, 1997).

**Results:** Information of 69 fighters were collected, and 84% had excess body fat and 51% overweight and 80% did not conform to the recommendations of the Food Guide for the Brazilian Population (BRAZIL, 2005). As for the Gracie Diet, 67% claimed to know it, but only one fighter followed. Most followed principles as washing hands before meals (88%), at bedtime drink water (59%), not to consume alcohol (56%) and 10% non-mixed grains and / or starches together. The dietary maneuvers were used by 30% of the fighters, and supplements by 46%, of which, 44% under nutritionist prescription.
**Conclusions:** In view of these results, it was concluded that the majority of the study participants did not present a body composition comparable to the established standards for the sports modality and did not conform to the recommendations of the Brazilian Population Food Guide. A greater number of connoisseurs and followers of the Gracie Diet was expected, as this is widely known in the midst of martial arts. Therefore, it is believed that there is a disinterest of the fighters or lack of knowledge related to diet, and an urgent need to raise awareness about the role of nutritional guidance in sports performance, so that there is performance allied to health.

**Keywords:** Jiu jitsu, nutrition, body composition, anthropology, Gracie Diet.

the most balanced diets in terms of macronutrients. Vegetarians exhibited lower estimated prevalence of inadequacies for micronutrient such as antioxidant vitamins (e.g.: for vitamin E, 28.9% for vegetarian women <55y vs. 41.6 in meat eaters) while vegan exhibited higher estimated prevalence of inadequacies for some nutrients in particular vitamin B12 (69.9% in men and 83.4% in women <55y), compared to meat eaters.

**Conclusions:** Our study highlighted that vegetarian and vegan diets may overall allow reaching nutritional recommendations. Although such diets may be culturally difficult to accept, at least in some subgroups, well-planned vegetarian dietary patterns could be considered as sustainable diets including potential health benefits and a lower environmental impact.

**Keywords:** vegetarians, vegans, diet, sociodemographic characteristics, dietary nutrient inadequacy

144/2560

COMPARISON OF SOCIODEMOGRAPHIC AND NUTRITIONAL CHARACTERISTICS BETWEEN VEGETARIANS, VEGANS AND MEAT EATERS FROM THE NUTRINET-SANTÉ STUDY

(1)Allès, Benjamin; (2)Baudry, Julia; (2)Méjean, Caroline; (2)Touvier, Mathilde; (2)Péneau, Sandrine; (3)Hercberg, Serge; (2)Kesse-Guyot, Emmanuelle.

(1)Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, Université Paris 13, COMUE Sorbonne Paris Cité, Bobigny. France.; (2)PhD. Université Paris 13.Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche en Epidémiologie et Statistiques. Inserm (U1153), Inra (U1125), Cnam. France; (3)Prof. MD. Université Paris 13.Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche en Epidémiologie et Statistiques. Inserm (U1153), Inra (U1125), Cnam. France.

**Background and objectives:** Vegetarian and vegan diets are a growing trend in many western countries. Epidemiological evidence suggesting that such diets may help in maintaining a good health is rising. However, dietary and sociodemographic characteristics of vegetarian and vegan consumers are not well known. The aim of this cross-sectional study was to describe sociodemographic and nutritional characteristics of vegetarians and vegans adults, compared to meat-eaters, from the French NutriNet-Santé study.

**Methods:** Participants were classified into 3 diet groups based on self-reported information: 90,664 meat eaters, 2,370 vegetarians and 789 vegans. Dietary data were collected using repeated 24 h dietary records. Multivariable polytomic logistic regression models were perfomed to assess the association between the sociodemographic characteristics and type of diet. The prevalence of nutrient intake inadequacy was estimated, by sex, age and type of diet categories.

**Results:** Compared with meat eaters, vegetarians were more likely to be highly educated, and unlike vegans had lower education level. Vegetarians and vegans substituted animal protein dense products by higher consumption of plant protein dense products (e.g.: soy based products such as tofu or legumes). Vegans had

144/2571

VITAMIN D VALUES IN SERUM IN RELATION TO THE NUTRITIONAL STATUS AND LIFE HABITS IN A GROUP OF HEALTHY VOLUNTEERS FROM MEDELLÍN, COLOMBIA

(1)Giraldo Giraldo, Nubia; (2)Idárraga, Yelithza; (2)Ramirez, Carolina;

(3)Restrepo Moreno, Angela; (3)Cano, Luz Elena; (4)Mejía, Susana.

(1)MSc. Epidemiologist. Escuela de Nutrición y Dietética. Universidad de Antioquia. Medellín.; (2)Nutrition Student. Escuela de Nutrición y Dietética. Universidad de Antioquia. Colombia;

(3)PhD. Grupo de Micología médica y Experimental Corporacion para Investigaciones Biológicas (CIB). Colombia; (4)MsC. Grupo de Micología médica y Experimental Corporacion para Investigaciones Biológicas (CIB). Colombia.

**Background and objectives:** Vitamin D serum values depend mainly of its synthesis after solar light exposition and alternatively, from the ingestion of food rich in this vitamin. Factors such as age, skin pigmentation, use of anti sun-protecting agents, lenght of light exposition also influence its synthesis.

To determine Vitamin D serum values and explore their relation with the nutritional status and life habits in a group of healthy volunteers from the city of Medellín, Colombia

**Methods:** A cross sectional study was carried out in a group of 53 healthy volunteers. Data pertaining sociodemographic, anthropometric and life habits were collected. Vitamin D serum values were determined by means of the High Efficiency Liquid Chromatography (HPLC) technique with ultraviolet detection. To quantify Vitamin D intake we used frequency of ingesta, evaluated the nutritional status, took anthropometric mesasurements and determined the skin prototype by means of the Fitzpatrick and Von Luschan scales. In order to explore the relationship among the nutritional status, the life habits and certain socio-demographic conditions such as vitamin D serum classification, the Chi square test was used. Correlations among vitamin D serum values and certain quantitative variables were measured by the Spearman r test.

**Results:** Women predominated in this study, 79,2%, with 41,5% of them belonging to social strata 3. Median age was 32
years, the predominating skin phenotype was IV (49,1%), the most subjects (72,2%) used sun blockers once a day. The mean vitamin D ingesta was 191,7±142,0 UI day and mean lenght of light exposition was 36±28 minutes/day. According to the Body Mass Index (BMI), 39,6% were either overweight or obese. Deficient or insufficient vitamin D serum values were found in 67,9%. Age was found to be the only variable that showed an inverse correlation with Vitamin D deficient or insufficient values (r=-0,279; p=0,43).

**Conclusions:** The proportion of healthy volunteers that showed deficient or insufficient vitamin D values was very high. Vitamin D intake was lower than recommended. No relationship was found among the nutritional status and life habits with these values. Age was found to be the only factor that showed a negative correlation.

**Keywords:** Vitamin D, serum values, nutritional status, intake

144/2598

## INTRA-INDIVIDUAL DIFFERENCES IN PLASMA FERRITIN CONCENTRATION IN RELATION TO INFLAMMATION OBSERVED DURING A SHORT-TERM LONGITUDINAL STUDY ARE SIMILAR TO CROSS-SECTIONAL INTER-INDIVIDUAL DIFFERENCES

(1)Wessells, K. Ryan; (2)Peerson, Janet M.; (3)Hess, Sonja; (4)Rouamba, Noel; (5)Ouédraogo, Jean Bosco; (6)Brown, Ken.

(1)PhD. Assistant Project Scientist. Program in International and Community Nutrition. Department of Nutrition. University of California, Davis. USA; (2)MSc. Statistician. Program in International and Community Nutrition. Department of Nutrition. University of California, Davis. USA; (3)PhD. Associate Research Nutritionist. Program in International and Community Nutrition. Department of Nutrition. University of California, Davis. USA; (4)MD. Researcher. Regional directorate for the West, National Research Institute in Health Sciences, Bobo-Dioulasso, Burkina Faso.; (5)MD. PhD. Director of Research. Regional directorate for the West, National Research Institute in Health Sciences, Bobo-Dioulasso, Burkina Faso.; (6)MD. Senior Program Officer. Bill & Melinda Gates Foundation. USA. Distinguished Professor. Program in International and Community Nutrition. Department of Nutrition. University of California, Davis. USA.

**Background and objectives:** Cross-sectional (CS) surveys indicate that individuals with acute inflammation have higher plasma ferritin (pF) concentrations than those without, possibly due to either inflammation-induced increases in pF or a heightened risk of inflammation among individuals with higher iron status. To determine the validity of adjusting pF for inflammation using CS data, we assessed the effects of short-term changes in inflammation status on pF, based on the assumption that body iron stores were unlikely to change during the study period.

**Methods:** Two blood samples were obtained 21d apart from 451 asymptomatic 6-23mo Burkinabé children; plasma was analyzed for ferritin, C-reactive protein (CRP) and alpha-1-acid glycoprotein (AGP). Inflammation was defined as CRP>5mg/L and/or AGP>1g/L. Additionally, a regression correction (RC) approach was used to adjust pF to a presumably healthy reference point within the study population (10th percentile CRP/AGP concentrations). Cross-sectional RCs were estimated from a naïve regression model which treated observations from the same children as independent. Longitudinal RCs, to estimate effects of intra-individual changes in CRP/AGP were estimated from structural equation models, accounting for repeated measures.

**Results:** pF was significantly greater in children with inflammation (44.9±2.9µg/L) than those without (13.6±1.0µg/L; P<0.0001). Similarly, pF differed intra-individually in longitudinal models, based on changes in inflammation status (with inflammation: 37.0±3.2µg/L vs. without: 15.3±1.2µg/L; P<0.0001). The RC approach from CS models over-adjusted slightly for the effects of inflammation on pF compared to longitudinal models (P<0.001); adjusted pF were 9.5±0.3µg/L and 10.5±0.4µg/L, respectively, vs. unadjusted 25.0±1.0µg/L. The estimated prevalence of iron deficiency (pF<12µg/L) was comparable between CS and longitudinal models (61.0% and 56.5%, respectively vs. unadjusted, 27.7%).

**Conclusions:** In this population, pF changed intra-individually in relation to inflammation. Cross-sectional RC models tended to over-adjust for the effects of inflammation on pF compared to longitudinal models, suggesting that pre-illness iron status was slightly higher in those with inflammation than those without, or that adjustments did not capture the full effect of inflammation. However, estimated mean pF and prevalence of iron deficiency were similar, especially when compared to unadjusted values, suggesting that CS adjustments are valid for survey data collection and programmatic decisions in comparable populations.

**Keywords:** ferritin, regression correction, iron deficiency, inflammation

144/2609

## IRON AND VITAMIN C INTAKE IN SCHOOL-AGE CHILDREN IN POLAND

Stos, Katarzyna; Oltarzewski, Maciej; Glowala, Aneta; Ziolkowska, Izabela; Jarosz, Mirosław; Krygier, Bogumiła.

National Food and Nutrition Institute, Warsaw, Poland.

**Background and objectives:** Iron is required for oxygen transport, electron transfer, oxidase activities and energy metabolism. The main components of the body that contain iron are erythrocyte haemoglobin and muscle myoglobin, liver ferritin, and haem and non-haem enzymes.

One of the main factors that increase the absorption of non-heme iron is vitamin C. Vitamin C has also a number of biochemical and physiological functions in the body. There is still ongoing problem of not sufficient iron and vitamin C intake in Poland. The aim of the study was to assess the iron and vitamin C content in daily diets of Polish school-age children.

**Methods:** The study was carried out between 2006 and 2011 among 981 girls and boys aged 9-13 years with the use of one-day
dietary recall method. The data on iron and vitamin C content in food products were based on the National Food Composition Database. The results of iron and vitamin C intake were compared to the Estimated Average Requirements (EAR).

**Results:** The median total daily iron intake in the group of pupils was 7.7 mg and ranged from 7.3 mg (girls) to 7.9 mg (boys). The comparison of individual iron intake to EAR values showed that 38.6% diets were below EAR. The main sources of iron in pupils' diets were cereal products (31.4%), vegetables and fruits (21.1%) and meat and meat products (11.1%). The median total daily vitamin C intake in the group of studied pupils was 46.0 mg and ranged from 43.7 mg (boys) to 48.8 mg (girls). In comparison to EAR, the 46.9% of diets were below EAR. The main sources of vitamin C in pupils' diets were juices (27.1%), vegetables and pulses (25.6%) and potatoes and their products (23.3%).

**Conclusions:** The study showed that many diets of school children aged 9-13 years in Poland were low in iron and vitamin C in relation to the requirements.

**Keywords:** iron, vitamin C, intake, girls, boys

cholesterol, HDL-cholesterol level, albumin and hemoglobin significantly lower (all p less than 0.05). Forns index value, aspartataminotransferase, alaninaminotransferase, and gamma-glutamyl transpeptidase were statistically significantly higher in patients with denutrition (all p less than 0.05). The average concentrations of pro-inflammatory cytokines (TNF-α, IL-6) were higher in patients with denutrition. Multivariate analysis identified two independent risk factors for denutrition: mean duration of CHC (odds ratio [OR] = 1.3; 95% confidence interval [CI] = 1.03-2.4), and Forns index (OR = 1.2; 95% CI = 1.02-2.5).

**Conclusions:** The results of this study demonstrated that patients with chronic hepatitis C associated denutrition in a high percentage. Nutritional screening using both clinical and especially biochemical methods is necessary in this population.

**Keywords:** chronic hepatitis C, denutrition, nutritional risk index, instant nutritional assessment score

**Conflict of Interest Disclosure:** This study was supported by the Romanian National Authority for Scientific Research as a part of the PNCDI 2 program DIADIPOHEP 41-008/2007.

144/2610

NUTRITIONAL STATUS IN PATIENTS WITH CHRONIC HEPATITIS C

(1)Rusu, Emilia; (2)e, Georgiana; (3)Dragut, Ramona Maria; (2)Cursaru, Raluca; (4)Rusu, Florin; (5)Ateia, Simona; (6)Popescu Valceanu, Horatiu Cristian; (3)Jinga, Mariana; (2)Dragomir, Andreea Diana; (3)Radulian, Gabriela.

(1)MD. PhD. Carol Davila University of Medicine and Farmacy. Bucharest. Romania; (2)MD. PhD student. University of Medicine and Farmacy "Carol Davila". Bucharest. Romania.; (3)MD. PhD. University of Medicine and Farmacy "Carol Davila". Bucharest. Romania.; (4)MD. PhD. Emergency Military Hospital "Carol Davila". Bucharest, Romania.; (5)MD. PhD. Medas. Bucharest. Romania.; (6)MD. PhD. Bucharest. Romania.

**Background and objectives:** The objective of the study was to assess nutritional status in patients with chronic hepatitis C (CHC) by different methods and to evaluate the risk factors for denutrition in this population.

**Methods:** This observational study, held in three medical centers from Bucharest, Romania, included 173 patients. We followed anthropometric indices and biochemical parameters for each patient. Clinical and biological assessment of nutritional status was performed using body mass index (BMI), nutritional risk index (NRI) and instant nutritional assessment score (INA). Each patient completed Mini Nutritional Assessment (MNA). We also recorded a denutrition combined score. We considered patients to be malnourished according to the combined score if any score indicated denutrition. Hepatic fibrosis was assessed using Forns index.

**Results:** The mean average age was 54.14±9.1 years. The mean duration of CHC was 7.21±3.23 years. Using the combined score, denutrition was present in 17 patients (9.8%). Patients with denutrition had weight, body mass index, waist circumference, total

144/2642

PREVALENCE OF MALNUTRITION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

(1)Canicoba, Marisa; (2)Colon, Carolina; (2)Spiazzì, Renata; (2)Milano, Claudia.

(1)Nutritionist. Department of Nutrition and Division of Gastroenterology. Hospital Nacional "Prof. A. Posadas". El Palomar. Provincia de Buenos Aires. Argentina; (2)MD. Department of Nutrition and Division of Gastroenterology. Hospital Nacional "Prof. A. Posadas". El Palomar. Provincia de Buenos Aires. Argentina.

**Background and objectives:** Inflammatory bowel disease (IBD) including ulcerative colitis (UC), Crohn's disease (CD) and inclasificable colitis(IC). Patients with IBD are at risk of malnutrition (MN), the nutritional assessment plays a crucial role in the practice of care of patients with IBD. The aim was to determine prevalence of MN in patients with IBD

**Methods:** Analyzed data from a cohort of patients with clinical and histopathological diagnosis of IBD treated at the Division of Gastroenterology, with a multidisciplinary care model, from January 2013 to March 2017. Nutritional assessment were calculated in each, consisted of anthropometric measurements of body mass index (BMI) and Subjective Global Assessment (SGA) as a systematic method of integrating nutritional history data, gastrointestinal symptoms and physical examination, 3 diagnoses were obtained: A. eunutrids, B. at risk or moderate malnutrition and C. severe malnutrition. To determine the clinical activity of CD, the Harvey-Bradshaw index was used and for the UC the modified Truelove-Witts index

**Results:** 151 patients with IBD were included: median age was 44, 32 (±16, 9) year, 56, 4% female, 30.2% had CD, 66, 9% UC and 2, 9% IC, year diagnosis median 6 year (1- 43).
Treuth, Pate, Puyau, Mattocks), while Evenson equation was add-
ed for prediction of activity intensity, making 6 equations in total.
The accuracy of accelerometer energy prediction was assessed by
comparing measured and predicted values, using the paired t-test.
Based on their METs, activities were classified as sedentary, light,
moderate or vigorous. The intensity classification accuracy was
evaluated with k statistics and ROC-Curve.

**Results:** For activities of lying down, watching TV and reading, Freedson / Trost and Treuth equations were accurate in predicting energy expenditure. Regarding Pate equation, it was accurate for vacuuming and slow treadmill walking energy prediction. Puyau predictive equation was inaccurate in all activities, while Mattocks' equation was accurate in all treadmill walking activities. Concerning activity intensity classification accuracy, Pate equation had the best performance across the 4 intensities (κ = 0.72), while the remaining equations had low accuracy (κ = 0.14~0.37). In case of the sedentary activities, all equations had a good prediction accuracy (ROC-AUC = 0.83-0.89), while in light activities, Pate equation had an excellent accuracy (ROC-AUC = 0.91). For moderate activities, all equations showed a poor performance whereas in vigorous activities, Pate equation had an excellent prediction accuracy (ROC-AUC = 0.94).

**Conclusions:** In conclusion, no equation was accurate in predicting energy expenditure across all assessed activities in children athletes. For activity intensity classification, Pate equation had the best prediction accuracy.

**Keywords:** Energy expenditure, accelerometer, Children, Athlete.

nathic surgery (December 2013 to March 2016). Data collection was performed a week before surgery and 10, 40, and 90 days post operatory (PO). BMI (kg/m2) was estimated with the equation: weight (kg)/height (m)2, and classified in: < 18.5, underweight; 18.5-24.9, eutrophic; 25.0-29.9, overweight; and >30.0, obesity. Statistical analysis was performed with Chi-Square test and Student t-test for independent samples, with a confidence interval of 95%.

**Results:** Mean age was 29.42±8.72 years, 56.5% (n=39) of the patients were women, and 56.5% (n=39) were monomaxillary surgeries. In the preoperative period, 51.30% (n=20) and 43.30% (n=13) of the patients submitted to mono and bimaxillary, respectively, were eutrophics, and 90 days PO 61.50% (n=24) and 46.70% (n=14) of the patients submitted to mono or bimaxillary, respectively, were eutrophics. There were no difference between BMI classification in mono and bimaxillary before (p=0.551) and after surgery (p>0.05). BMI before monomaxillary was similar to bimaxillary surgery (24.84±4.23 and 26.11±4.52, respectively, p=0.237,). At 10, 40 and 90 days PO, BMI were also similar to mono and bimaxillary surgery (PO10: 23.94±4.16 and 24.97±4.41, respectively; PO40: 23.86±3.96 and 24.65±4.37, respectively; PO90: 24.34±4.00 and 24.85±4.19, respectively; p>0.05).

**Conclusions:** BMI are similar to mono and bimaxillar in pre and postoperative periods. BMI alone is not enough to predict body composition, and BMI classification is unable to verify fast and small weight variations.

**Keywords:** Orthognathic surgery. Nutritional status. Nutrition assessment. Body Mass Index.

144/2681

BODY MASS INDEX OF PATIENTS WITH DENTOFACIAL DEFORMITIES BEFORE AND AFTER MONO AND BIMAXILLARY ORTHOGNATHIC SURGERY

(1)Thieme, Rubia Daniela; (2)Silva Benato, Leonardo; (3)Oliveira Carlos, Ligia; (4)Madalozzo Schieferdecker, Maria Eliana; (5)Rebellato, Nelson.

(1)MSc. Nutritionist. Nutrition Department. Universidade Positivo. Brazil.; (2)Master of Science student. Oral and Maxillofacial Maxillofacial Surgeon. Odontology Department. Universidade Federal do Paraná. Brazil.; (3)MSc. Nutritionist. Nutrition Department. Universidade Federal do Paraná. Brazil.; (4)PhD. Nutritionist. Nutrition Department. Universidade Federal do Paraná. Brazil.; (5)PhD. Oral and Maxillofacial surgeon. Odontology Department. Universidade Federal do Paraná. Brazil.

**Background and objectives:** Orthognathic surgery is a treatment for patients with dentofacial deformity. After surgical procedure, diet restriction is recommended and, consequently, weight loss is common. The objective was to compare Body Mass Index (BMI) of patients with dentofacial deformities before and after mono and bimaxillary orthognathic surgery.

**Methods:** Prospective clinical study with 69 adults with dentofacial deformity submitted to mono or bimaxillary orthog-

144/2693

DIETARY INTAKE AND SOURCES OF ADDED SUGAR AMONG BRAZILIAN POPULATION: RESULTS FROM ELANS/EBANS STUDY

(1)Fisberg, Mauro; (2)Nogueira Previdelli, Agatha; (3)Gómez Salas, Georgina; (4)Guajardo, Viviana Beatriz; (5)Zalcman Zimberg, Ioná; (6)Kovalskys, Irina.

(1)1 MD. Instituto Pensi. Fundação Jose Luiz Egydio Setubal. Hospital Infantil Sabara. São Paulo. Brazil 2 PhD. Professor. Departamento de Pediatria. Universidade Federal de São Paulo. São Paulo. Brazil; (2)PhD. Professor. Faculdade de Ciências Biológicas e da Saúde. Universidade São Judas Tadeu São Paulo. Brazil; (3)MSc. Professor. Departamento de Bioquímica. Escuela de Medicina. Universidad de Costa Rica. Costa Rica; (4)Bs. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina; (5)PhD. Departamento de Psicobiologia. Universidade Federal de São Paulo. São Paulo. Brazil; (6)MD. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina.

**Background and objectives:** Added sugar (AS) intake is highly associated with the epidemic of overweight and obesity. This study aimed to identify the dietary intake and sources of AS among Brazilian population.
**Methods:** Latin American Health and Nutrition Study (ELANS) is a multicenter study developed in urban areas of 8 Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. Data were obtained from 2,000 Brazilians (15-65 y.o) participating in EBANS (Brazilian Health and Nutrition Study). Two 24-hour recall were used to identify the intake of AS and the major food items accounting for AS, using the weighed-proportions formula developed by Block (1985) in which the relative contribution (RC) of a given food item/food group is defined as: $RC=[(Total AS grams from a food item x 100)/Total AS grams from all food items]$. Median intake and sources of AS were performed by age group, gender, socioeconomic level (SES) and nutritional status.

**Results:** Median AS and AS percentage of energy intake were 52.4g/day and 12.6%, respectively. More than 63% of the subjects had %energy from AS >10%. Comparison of median AS intake (g/day) between age groups, nutritional status and SES showed that the highest intake was found among male adolescents, obese male and high SES. Carbonated soft drinks accounted for the highest contribution of AS intake in whole sample, providing from 26.8% to 40.1% of total AS intake. Infusions were the second main source, except for adolescents that had cookies and cakes as the second contributor of AS intake. Sugar-sweetened beverages (SSBs) represented 68% of total AS intake among Brazilians, based on gender it was 69.2% for male and 57.5% for female.

**Conclusions:** Brazilians are consuming AS above the level recommended by the World Health Organization (10%). The main source of AS was SSBs independent of gender, age group, SES and BMI status. This results reinforce the importance of reducing sugar content in manufactured foods. However product reformulation alone may not be enough, public health programs should also focus on strategies that reduce the quantity and frequency of others sources of AS, such as homemade drinks, cakes, cookies and desserts.

**Keywords:** Food source, Added sugar, Brazilian population, multicenter study.

**Conflict of Interest Disclosure:** The ELANS is supported by a scientific grant from the Coca Cola Company and support from the Instituto Pensi / Hospital Infantil Sabara, International Life Science Institute of Argentina, Universidad de Costa Rica, Pontificia Universidad Católica de Chile, Pontificia Universidad Javeriana, Universidad Central de Venezuela (CENDES-UCV)/ Fundación Bengoa, Universidad San Francisco de Quito, and Instituto de Investigación Nutricional de Peru. The funders had no role in study design, data collection and analysis, the decision to publish, or the preparation of this manuscript.

**Further collaborators:** On behalf of ELANS Study Group

(1)Piedra, Fiorela; (2)Chinnock, Anne; (3)Gómez Salas, Georgina.

(1)Bch. Nutritionist. School of Nutrition. University of Costa Rica.;

(2)PhD. Nutritionists. School of Nutrition. University of Costa Rica; (3)MSc. Nutritionist. Department of Biochemistry. School of Medicine. University of Costa Rica.

**Background and objectives:** Several cross-sectional studies have shown an inverse relationship between dietary calcium intake and both body mass index (BMI) and waist circumference. Possible mechanisms for such associations include increased fcal fat excretion, changes in adipocyte metabolism and increased thermogenesis. The aim of this study was to investigate the asso ciation between total dietary calcium, body mass index and waist circumference in Costa Rican population living in urban areas during the period between 2014-2015 as part of the Latin Ameri can Study of Nutrition and Heath (ELANS).

**Methods:** Data were obtained from 798 subjects from urban Costa Rican population, between the ages of 15 and 65 partici pating in ELANS, a multicentric study developed in urban areas of Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. Food intake assessment included two 24-hour recall (Multiple Pass Method), from non-consecutives days and processed by the software Nutritional Data System for Research (NDS-R). Calcium usual intake was estimated with the Multiple Source Method (MSM) statistic package (https://nugo.dife.de/ msm). Anthropometric measurements were obtained and BMI and BMI-for-age percentiles were calculated. Population was di vided into tertiles according to dietary calcium consumption, and association with nutritional status were analyzed. Logistic regres sion was use to calculate the probability of having excess weight or waist circumference above recommendation.

**Results:** The probability of having excess weight (≥24.9 kg/ m2) was 39% less for those in the second tertile of calcium intake, and 55% less for those in the highest tertile of calcium intake. The risk of having a waist circumference above the recommendation (men ≥102 cm; woman ≥ 88 cm) was 34% less for the second ter tile and 42% less for the higher tertile of calcium intake.

**Conclusions:** Evidence suggests that a low dietary calcium in- take increase the probability to have excess weight and waist cir cumference above recommendations in urban Costa Rican pop ulation.

**Keywords:** calcium intake; excess weight; waist circumfer- ence; Costa Rica

**Conflict of Interest Disclosure:** The ELANS is supported by a scientific grant from the Coca Cola Company and support from the Instituto Pensi / Hospital Infantil Sabara, International Life Science Institute of Argentina, Universidad de Costa Rica, Pontificia Universidad Católica de Chile, Pontificia Universidad
Javeriana, Universidad Central de Venezuela (CENDES-UCV)/
Fundación Bengoa, Universidad San Francisco de Quito, and In-
stituto de Investigación Nutricional de Peru. The funders had no
role in study design, data collection and analysis, the decision to
publish, or the preparation of this manuscript.

**Further collaborators:** on behalf of ELANS Study Group

(1)Liria Domínguez, María Reyna; (2)Pareja, Rossina Pareja.

(1)PhD Nutritionist. Instituto de Investigación Nutricional. Peru.;

(2)MSc Nutritionist. Instituto de Investigación Nutricional. Peru.

**Background and objectives:** Evaluation of energy and nutri-
ent consumption allows identifying possible nutritional deficien-
cies and/or excesses. The aim of this study is to assess the adequacy
of energy and nutrients intake by sex in Peruvian population.

**Methods:** The ELANS (Latin American Health and Nutrition Study) is a transversal study conducted in 8 Latin America countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela), in adolescents and adults (1113 peruvians, 15 to 65 years old). We obtained usual intake (Multiple Source Method) of energy, macro and micronutrients through two 24 hour dietary recall in non-consecutive days. Estimated average requirement (EAR) were used to determine the percentage of adequacy to recommendations. For energy adequacy, basal energy expenditure-BEE was calculated according to age, sex and physical activity level-PAL proposed by Gerrior et al (2006), using results from the long IPAQ. We used mean difference test for continuous variables and chi2 Fisher's exact to assess difference by sex at 95% confidence level.

**Results:** The energy adequacy was 95% for men vs 105% for women (p<=0.000). The percentages of energy coming from macronutrients by sex were: protein 15% vs 15% (p=0.159), fat 22% vs 23% (p<=0.000) and carbohydrates 64% vs 62% (p<=0.000), for men and women respectively. Adequacy for micronutrient intake: calcium was 57% vs 52% (p<=0.000), iron was 136% vs 72% (p<0.000), vitamin A was 109% vs 131% (p<0.000) and vitamin C was 151% vs 168% (p=0.002). Percentages of population that showed insufficient macronutrients intake were: 28% for fat (men: 35% vs women: 23%, p<0.000), in contrast to the 35% that consumed more carbohydrates than recommended (men: 41%, women 29%, p<0.000). Micronutrients with the highest percentages of insufficient intake were: calcium (97%, men: 97% vs women 98%, p=0.083) and iron (97%, men: 15% vs women 83%, p<0.000).

**Conclusions:** While energy consumption does not appear to be a problem in the Peruvian population, the adequacy of fats were low while carbohydrates high, the micronutrients with greater inadequacy were calcium and iron. Given the nutritional problems in the country: micronutrient deficiencies and high carbohydrate

intake, strategies that cover both problems at the same time are
required.

**Keywords:** Energy, macronutrient, micronutrient, adequacy

**Conflict of Interest Disclosure:** The ELANS is supported by a scientific grant from the Coca Cola Company and support from the Instituto Pensi/Hospital Infantil Sabara, International Life Science Institute of Argentina, Universidad de Costa Rica, Pontificia Universidad Católica de Chile, Pontificia Universidad Javeriana, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Universidad San Francisco de Quito, and Instituto de Investigación Nutricional de Peru. The funders had no role in study design, data collection and analysis, the decision to publish, or the preparation of this manuscript.

**Further collaborators:**

Instituto Pensi/Hospital Infantil Sabara, International Life Sci-
ence Institute of Argentina, Universidad de Costa Rica, Pontificia
Universidad Católica de Chile, Pontificia Universidad Javeriana,
Universidad Central de Venezuela (CENDES-UCV)/Fundación
Bengoa, Universidad San Francisco de Quito, and Instituto de In-
vestigación Nutricional de Peru.

(1)Yukiko, Oe; (2)Toshinao, Goda.

(1)phD. Institute of Health Longevity Science and Nutrition, Watami Corporation, Ltd, Japan; (2)phD. School of Food and Nutritional Sciences, University of Shizuoka, Japan.

**Background and objectives:** Most of elderly who requires nursing care has chronic disease, and due to a diminished food intake and physical activity, they tend to show decreased skeletal muscle mass. As a result, there is a great increase in the risk of fall and malnutrition in the elderly. Malnutrition is known to worsen the prognosis after infection and delay healing of disease in the elderly due to decreased immune function.

**Methods:** We have examined the associations between nutri-
tion status and blood biochemical parameters, the degree of inde-
pendence in dementia elderly's activity of daily living, the nursing
care levels, and the form of food in 1,823 elderly persons aged 61-
106 y (average 86.7 y) who lives in nursing care facilities were ana-
lyzed using Spearman's rank correlation coefficient analysis and
steel-dwass test.

**Results:** The percentages of the elderly at risk of malnutri-
tion according to GNRI (Geriatric Nutritional Risk Index) were
67.0% for men and 66.2% for women. The GNRI scores tended
to be lower according to an increase in the nursing care level. In
elderly men, the GNRI scores were remarkably lower in the groups
categorized as nursing care levels 4 and higher than those in nurs-
ing care level 3 or lower. In elderly women, the GNRI scores were
greatly decreased in the groups categorized as nursing care levels 2 and higher. The lower the degree of independence in dementia elderly's activity of daily living was, the lower the GNRI, and the GNRI scores of the groups categorized IIIa and over were significantly lower than those categorized as of IIb or under. The GNRI scores were associated with the provided form of food, according to the transition from regular to liquid form.

**Conclusions:** The results of this study suggest that the nutrition status of elderly who requires nursing care in nursing homes was associated with the degree of independence in dementia elderly's activity of daily living, the nursing care level, and the form of food, and it may be attributable to a decrease in physical function required for activity of daily living.

**Keywords:** Geriatric Nutritional Risk Index, elderly, malnutrition, Nursing care Facilities

144/2753

COMPARISON OF NUTRITIONAL STATUS Y PERINATAL OUTCOMES BETWEEN IMMIGRANT AND CHILEAN PREGNANT WOMEN WHO ATTENDED THEIR DELIVERY AT SAN BORJA ARRIARAN HOSPITAL IN THE YEAR 2015

**Background and objectives:** The migration in Chile increased by 28% between the years 2012 and 2015. As there are no studies in the country that describe the pre-pregnancy nutritional status (NS) and perinatal outcomes of immigrant (GI) versus Chilean (GI) pregnant women, the objective of this study was to compare the NS and to analyze its association with maternal and newborn pathologies in GNI versus GI who attended their delivery at the Hospital Clínico San Borja Arriarán (2015).

**Methods:** A comparative study carried out at 1,078 GI and 1,520 GNI. The data were obtained from: 1. the clinical records 2. The health agenda and a survey made to the pregnant woman. The variables studied were NS (underweight, normal, obesity and overweight) determined by Atalah standard; Gestational diabetes (GD), preeclampsia (PE), intrauterine growth retardation (IUGR) and preterm birth (PTB). Data were presented as prevalences and compared with CHI2 test. Crude and adjusted (by sociodemographic, obstetric and of maternal diseases variables) logistic

regression models were performed to evaluate the association between NS and maternal and newborn pathologies.

**Results:** The GNI had significantly more likely to have obesity 3.0 [2.4 - 3.8] and overweight 1.7 [1.4 - 2.1] at the beginning of gestation than GI, in relation to have a normal nutritional status (50% GI and 34% In GNI, p <0.001), with no differences in the risk of underweight 1.1 [0.8 -1.5]. GI had a higher prevalence of anemia than GNI (12.6% vs 7.7, p <0.001). On the other hand, the GNI had higher prevalences of GD (8.7% vs 4.4%, p <0.001) and preeclampsia (8.3% vs 4.9%, p <0.05) than GI, while their children had a higher prevalence of PTB (14.0% vs. 6.6%, p <0.001) and IUGR (6.9% vs. 3.7%, p <0.001) than GI. Crude and adjusted logistic regression models showed that GD was associated with maternal obesity and overweight; PE was associated with obesity; while maternal underweight was associated with IUGR.

**Conclusions:** The GNI presented higher prevalences of obesity, DG, PE, IUGR and PTB than GI. Obesity was associated with DG and PE and the latter with PTB.

**Keywords:** Migration, Immigrant, Pregnant women, Nutritional status, Obesity.

144/2757

SERUM VITAMIN B12 LEVELS IN PATIENTS WITH TYPE 2 DIABETES TREATED WITH METFORMIN

**Background and objectives:** According to all guidelines, metformin is the frontline treatment and the most prescribed drug for type 2 diabetic patients, that can be associated with other oral medication or insulin. Treatment with metformin may lead to a decreased absorption of vitamin B12. The purpose of this study is to evaluate serum vitamin B12 levels in patients with type 2 diabetes, treated chronically with metformin.

**Methods:** We evaluated 119 patients with type 2 diabetes, aged 33-86 years, who underwent annual periodic evaluation at our center. Patients provided their socio-professional and medical history, their history of diabetes treatment and supplements taking. We obtained anthropometric data: weight, height, abdom-

<footnote>(1)Ortiz, Jovita; (2)Díaz, Marcela; (3)Quiroz, Jael; (3)Pavez, Joselyn;</footnote>

<footnote>(3)Carroza, Begoña; (4)Binfa, Lorena; (4)Araya B, Marcela.</footnote>

<footnote>(1)MsC. Midwifery. Department of Women's and Newborn Health Promotion. School of Midwifery. Faculty of Medicine. University of Chile. Santiago. Chile; (2)MsC. Midwifery. Department of Women's and Newborn Health Promotion. School of Midwifery. Faculty of Medicine. University of Chile. Santiago. Chile;</footnote>

<footnote>(3)Midwifery. Department of Women's and Newborn Health Promotion. School of Midwifery. Faculty of Medicine. University of Chile. Santiago. Chile; (4)PhD,MPH. Midwifery. Department of Women's and Newborn Health Promotion. School of Midwifery. Faculty of Medicine. University of Chile. Santiago. Chile.</footnote>

<footnote>(1)Gherasim, Andreea; (2)Mihalache, Laura; (3)Nita, Otilia; (4)Oprescu, Andrei Catalin; (5)Gavril, Radu Sebastian; (5)Mitu, Ovidiu; (6)Burlui, Alexandra Maria; (3)Arhire, Lidia Iuliana.</footnote>

<footnote>(1)MD. PhD student. I Medical Department.; (2)MD, PhD. II Medical Department. "Grigore T Popa" University of Medicine and Pharmacy. "St. Spiridon" Clinical Emergency Hospital. Iasi. Romania; (3)MD.PhD. II Medical Department. "Grigore T Popa" University of Medicine and Pharmacy. "St. Spiridon" Clinical Emergency Hospital. Iasi. Romania; (4)MD.PhD student. "Grigore T Popa" University of Medicine and Pharmacy. "St. Spiridon" Clinical Emergency Hospital. Iasi. Romania; (5)MD.PhD. I Medical Department. "Grigore T Popa" University of Medicine and Pharmacy. "St. Spiridon" Clinical Emergency Hospital. Iasi. Romania; (6)MD.PhD student. II Medical Department. "Grigore T Popa" University of Medicine and Pharmacy. Clinical Rehabilitation Hospital. Iasi. Romania.</footnote>
inal circumference (AC), body mass index (BMI), blood pressure, measured vitamin B12 serum levels and performed biochemical analyses regarding the metabolic control of diabetes. B12 vitamin deficiency was defined at serum levels below 193 pg/ml. Descriptive statistics provided frequencies, means, standard deviations and medians. Anova and Mann-Whitney U tests were used to analyze the differences between the variables.

**Results:** Of the 119 enrolled patients, the 87 treated with metformin for at least six months had a higher mean BMI (32.9 kg/m2 vs. 29.2 kg/m2, $p = .001$), a higher mean AC (99 cm vs 108 cm, $p = .001$) and a lower mean vitamin B12 serum level (352.28 pg/ml vs 450.09 pg/ml, $p = .016$). 12 patients (13.8%) on metformin had values below the lower limit of vitamin B12, compared to 3.1% from those on other treatments. No statistically significant differences were found regarding treatment duration and control, nor the dose of metformin. No evidence was found to support the diagnosis of anemia. In the metformin patients, taking supplements containing B12 was associated with a reduction in the prevalence of B12 deficiency, however, those taking supplements had an average of the B12 levels of 472.50 pg/ml vs 329.22 pg/ml, $p = .05$.

**Conclusions:** Our results found 13.8% of the patients treated with metformin had a vitamin B12 deficiency. We recommend periodic evaluation of the level of vitamin B12 for patients receiving chronic metformin treatment. B12 supplementation may be protective against B12 deficiency.

**Keywords:** B12 vitamin, type 2 diabetes, metformin

144/2775

ASSESSMENT OF FOOD CONSUMPTION AND NUTRIENT INTAKE OF OUTPATIENTS WITH CHRONIC DISEASES AT A UNIVERSITY FEDERAL HOSPITAL IN RIO DE JANEIRO

(1)Duas, Juliana Furtado; (2)Leão, Leila Sicupira Carneiro de Souza;

(3)Silva, Renata de Souza; (4)Pereira, Alessandra Pereira; (2)de Aquino, Luana Azevedo; (2)Santos, Claudia Roberta Bocca.

(1)PhD, Professor, Departamento of Applied Nutrition, Nutrition School, Rio de Janeiro Federal State University, Brazil; (2)PhD, Professor, Departamento of Nutrition and Public Health, Nutrition School, Rio de Janeiro Federal State University, Brazil;

(3)Nutrition Student, Departamento of Nutrition and Public Health, Nutrition School, Rio de Janeiro Federal State University, Brazil; (4)Professor, UNIRIO, Rio de Janeiro, Brazil.

**Background and objectives:** The assessment of food consumption is often carried out to develop and implement nutritional advice. Due to the high prevalence of chronic diseases and its relation with nutrient intake, the objective of this study was to assess food consumption and nutrient intake of patients with chronic diseases.

**Methods:** During the consultation, two nutritional questionnaires were applied (non-consecutive two days 24 hour and food frequency) in 45 outpatients from February 2016 to April 2017. Daily food consumption, and quantity of energy, macro and micronutrients related to chronic diseases were estimated. Socio-economic and anthropometric information were also collected.

**Results:** Most respondents (85%) were female, 67% were 50 years or older (58,8 ± 12,1 years), 40% were white, 36% had 4 to 7 years of study, and 82% presented more than one chronic disease. Obesity was observed in 45%, Hypertension in 62%, and Diabetes in 54%. Soft drinks (11%) and sweets (20%) daily consumption were significant; fruits (60%), vegetables (37%), beans (47%) and milk (64%) consumption were considered insufficient. Elevated salt consumption was observed in 13% of individuals. Average energy intake was 1400±420,2 kcal, protein 20,2±6,6%, carbohydrate 52,3±13,8%, lipids 27,5±10,6%. It was observed high prevalence of inadequate nutrient intake for vitamin D (72,2%) and calcium (95,5%) and expressive prevalence for vitamin C (42,8%) and zinc (18,4%).

**Conclusions:** Food consumption and nutrient intake in this group of outpatients with chronic diseases was considered not healthy and preoccupant due to expressive presence of simple sugars and salt as well as insufficient amount of fiber and micronutrients such as calcium and zinc, and vitamins C and D.

**Keywords:** food frequency; anthropometry; vitamin D; Calcium; vitamin C;

144/2787

IS NECK CIRCUMFERENCE A GOOD INDICATOR TO IDENTIFY MUSCLE WASTING IN CHILDREN AND ADOLESCENTS WITH MALIGNANT NEOPLASMS?

(1)Lucena Ferretti, Roberta; (2)Santos Maia-Lemos, Priscila; (3)Jaloretto Teixeira Guedes, Karen; (4)Maria Monteiro Caran, Eliana.

(1)PhD Student, MSc. Nutritionist. Federal University of Sao Paulo. University of Taubate. Sao Paulo. Brazil.; (2)PhD, MSc. Nutritionist. Federal University of Sao Paulo. Sao Paulo. Brazil.; (3)Nutritionist. Federal University of Sao Paulo. Sao Paulo. Brazil.; (4)PhD, MSc. Doctor. Federal University of Sao Paulo. Sao Paulo. Brazil.

**Background and objectives:** Children and adolescents with malignant neoplasms may present muscle wasting early, and this finding may be underestimated when only the Body Mass Index is considered, due to the various metabolic changes, and the side effects caused by antineoplastic therapy. It has been considered in the literature that even Arm Muscle Area (AMA) or Calf Circumference (CC) present strong correlation with muscle mass stores. Neck circumference (NC) is a measure of easy gauging and applicability in clinical practice. The main objective of this study was to verify if there is a correlation between NC with AMA and CC.

**Methods:** A cross-sectional study that assessed children and adolescents from 0 to 20 years old with malignant neoplasms at a Pediatric Oncology Specialized Institute between October 2015 and March 2017. Measurements of NC and CC were evaluated, all performed by trained evaluators, following anthropometric techniques standardized by the literature, besides middle upper arm
circumference and triceps skinfold (to calculate AMA). For sta-
tistical analysis, Pearson's correlation and one-way ANOVA were
used, with significance level p<0.05.

**Results:** Among the 1656 assessments, 56.9% (n=943) were male. The mean age, for male and female were 9.0 ± 5.8 and 8.5 ± 5.4, respectively. The median NC, AMA and CC, for male and female were 28.4 ± 4.62 vs 27.4 ± 3.84 cm; 21.2 ± 12.47 vs 21.6 ± 10.1 cm2; 26.0 ± 7.16 vs 26.8 ± 8.58 cm, respectively. Significant differences were observed between sexes in AMA (p=0,017) and NC (p=0,000). It was also observed that there were no significant difference for CC (p=0,064), considering sexes. The correlation between NC with AMA and CC was positive, very strong and sig- nificant (r=0.9 vs r=0.8; p=0,000) respectively.

**Conclusions:** It is concluded that NC has a strong correlation with AMA and CC, being a promising indicator to identify muscle wasting in children and adolescents with malignant neoplasms.

**Keywords:** Malignant Neoplasms. Neck Circumference. Muscle Wasting. Children. Adolescent.

**Further collaborators:**

Roberta de Lucena Ferretti conceived, designed, and imple-
mented the study, collected and interpreted data, wrote and re-
vised the text; Priscila Santos Maia-Lemos helped to implement
the study and to write the text; Karen Jaloretto Teixeira Guedes
helped the data collection, helped implement the study, and helped
to write the text; Eliana Maria Monteiro Caran contributed to the
intellectual content. All authors have sufficiently contributed to
the development of this study.

calculated based on food composition tables and nutritional in-
formation from manufacturers. The classification of macronutri-
ents was made according to the current guidelines of the Brazilian
Society of Diabetes and the calories were obtained by adding the
nutrients multiplied by their respective caloric values. The energy
density (ED) of the meals was calculated by two methods: the first
(M1) considered all foods and caloric liquids, the second (M2) ex-
cluded all liquids except milk and both were evaluated according
to the American Institute for Cancer Research (2007).

**Results:** From M1 to M2, a reduction in calories and an in-
crease in ED were observed due to the absence of caloric liquids.
However, both were found to be adequate on almost all days, ex-
cept for dinner on the third day and breakfast on the fourth, that
presented values higher than the reference, by both methods. Re-
garding the macronutrients, the hyperlipidic distribution of the
third day and the predominance of adequate values on the other
days are emphasized. Pizza was served for dinner at the third day.
Possibly, the presence of fruits and vegetables in the main meals
contributed to this suitability and all participants were encouraged
to consume it daily by stimulating healthy eating.

**Conclusions:** Most meals during the 37th Summer Camp were adequate for the campers, highlighting the importance of consuming a variety of fresh foods including fruits and vegetables.

**Keywords:** Diabetes type 1. Diabetes education. Summer Camps.

144/2792

ENERGY DENSITY AND NUTRITIONAL ADEQUA-
CY IN DIET OF CHILDREN AND ADOLESCENTS IN
A SUMMER CAMP, 2017

**Background and objectives:** Diabetes type 1 (DM1) results from cell-mediated autoimmune destruction of pancreatic B-cells. Its treatment includes insulin therapy, meal planning and physical activity. Educational measures are fundamental to reach the best metabolic control and the Summer Camps for Diabetic Youngster can contribute for the instruction of these measures. The aim of this work was to analyze the diet offered to participants of Summer Camps with DM1 of the 2017 season.

**Methods:** The 37th season of the 2017 Summer Camps was held in Sapucaí Mirim, a city of Minas Gerais, Brazil, for six days. The menu was elaborated by nutritionists for the 81 participants with DM1, from 8 to 16 years old, considering the educational play activities during the season. The nutritional value of the meals was

144/2794

ELEVATED NECK CIRCUMFERENCE IN PATIENTS
WITH TYPE 2 DIABETES MELLITUS

**Background and objectives:** Type 2 Diabetes Mellitus (DM2) has a great impact on public health due to its complications. Anthropometric measures are able to predict nutritional status and excess adiposity, such as neck circumference (NC). The main objective of this study was to evaluate the prevalence of excess adiposity considering Body Mass Index (BMI) and NC, and verify its correlation.

**Methods:** A cross-sectional study that evaluated adults and elderly patients, above 20 years old, with diagnosis of DM2 in a hospital in Taubate, Sao Paulo, from June 2015 to May 2016. The data collected were weight, height, body mass index (BMI), NC, sex, age, diagnosis of Type 2 Diabetes Mellitus. For classification of nutritional status, the cut-off points proposed by the World Health Organization (WHO) for adults and Lipschitz for the elderly were

<footnote>(1)Garcia Peloggia de Castro, Adriana; (2)Castelo Branco, Fernanda;</footnote>

<footnote>(3)Gomes Rodrigues, Carolina; (4)Ferreira Giori, Fabiana; (4)Rogerio Otaga, Luis.</footnote>

<footnote>(1)PhD. Nutritionist. Curso de Nutrição. Centro Universitário São Camilo. Brazil; (2)BSc. Nutricionist. ADJ Diabetes Brasil. Brazil;</footnote>

<footnote>(3)BSc. Nutricionist. Brazil; (4)Student. Centro Universitário São Camilo. Brazil.</footnote>

<footnote>(1)Pereira da Silva, Caroline; (2)Ortiz da Silva, Ronaldo; (3)Lisboa Mendes Roman, Adriana; (3)Aparecida Silva Alvarenga, Adriana;</footnote>

<footnote>(4)Lucena Ferretti, Roberta.</footnote>

<footnote>(1)Nutritionist. University of Taubate. Sao Paulo. Brazil.;</footnote>

<footnote>(2)Nutritionist. University of Taubate. University Hospital of Taubate. Sao Paulo. Brazil; (3)Nutritionist. University of Taubate. University Hospital of Taubate. Sao Paulo. Brazil.; (4)PhD Student. MSc. Nutritionist. Federal University of Sao Paulo. University of Taubate. Sao Paulo. Brazil.</footnote>
used. The cut-off points of NC used to identify excess adiposity were 34 and 37 cm, for female and male respectively. Data analysis was performed using descriptive statistics. The correlation between NC and BMI was determined by the Pearson's correlation, with significant value p<0.05.

**Results:** Among the 175 patients with DM2 evaluated, 52,57% (N=92) were male. The mean age, for female and male were 67.73 ± 14.71 vs 67.71 ± 14.67, respectively. There was high prevalence of excess adiposity, considering BMI, even in adults (60%) or in elderly patients (78.52%). Regarding to the NC, it was verified that 62.5% of the adults and 75.5% of the elderly showed elevated NC. There was a positive, moderate, and significant correlation between NC and BMI for the female and male sex (r = 0.52 vs 0.61, p<0,05).

**Conclusions:** It is concluded that the majority of adult and elderly patients with DM2 presented excess adiposity according to BMI and NC. There was a moderate correlation between NC and BMI for the female and male sex. NC is a measure of easy gauging and applicability in clinical practice, especially with hospitalized patients.

**Keywords:** Neck Circumference. Nutritional Status. Body Mass Index. Type 2 Diabetes Mellitus. Hospitalized patients

**Further collaborators:**

Caroline Pereira da Silva, Ronaldo Ortiz da Silva, Adriana Lisboa Mendes Roman and Adriana Aparecida da Silva Alvarenga helped to implement the study and data collection. Roberta de Lucena Ferretti conceived, designed, and implemented the study, collected and interpreted data, wrote and revised the text was responsible for coordinating original study and contributed to the intellectual content. All authors have sufficiently contributed to the development of this study.

displaying served food in plates, based on Regular Hospital meals to give it content validity. Relative weights were determined for different domains (portion estimation: absolute/relative and nutritional content: qualitative/quantitative) and a dichotomy checklist were established for test correction. Test was designed to be performed by observing photographs of served food on a computer and completing the results on printed paper grids. Pilot test with Registered Dietitians (RD) experts was performed for internal consistency. Discriminative validity was assessed by “known groups” comparison technique between RD as a reference group, and novice (N) and intermediate (I) students. Man Whitney test was applied.

**Results:** Test was performed between Dec 2014 and Dec 2015. RD (n: 27), N (n: 30) and I (n: 73). Students performed the test without qualification conditioning. Cronbach's Alpha was 0.70 in the RD. Between RD and N there was a significant difference in total score (p<.000) with median = 57% (86.7% - 38.8%) and 39.9% (50.8% 22, 9%) respectively. Difference between RD vs. I (p<.000) and I vs. N (p<.000) could also be observed.

**Conclusions:** Test's reliability was acceptable in reference population (RD) and proved discriminative validity when comparing extremes groups (RD vs. S). This result would support construct's contents and the way they were measured.

Photography is an available easy to use and unexpensive resource. Knowing its strengths and weaknesses, contextualizing and developing skills in food management is possible. This Test could be useful in grade level students as a diagnostic, learning and reflection-oriented instrument for improvement. It is necessary to continue with the validation process and to determine when the students become competent.

**Keywords:** Dietary intake - Competencies - Educational Assessment -

144/2798

OBJECTIVE STRUCTURED TEST TO EVALUATE FOOD INTAKE ASSESSMENT SKILLS ON NUTRITION & DIETETIC STUDENTS

**Background and objectives:** An important requirement for health professions education is to develop a framework integrating theory and practice for professional competencies' achievement. Evaluating Competencies requires valid and reliable instruments. The aim of this study was to design a Test for nutrition & dietetic students (S) to evaluate Food Intake Assessment Skills (FIAS) and to initiate the validation process by determining internal consistency and discriminative capacity.

**Methods:** A construct was defined including dimensions attributable to FIAS. Test's Cases were represented by photographs

144/2814

COMPARISON OF PREDICTIVE EQUATIONS OF LEAN MASS IN WOMEN

**Background and objectives:** Adequate lean mass (LM) measurement is important since it is a predictor of functional capacity, daily activities, morbidity and mortality. Therefore, the aim of the present study was to evaluate which predictive equation estimates correctly the LM of women.

**Methods:** Eighty-one women with 19 to 81 years were recruited. The anthropometric variables evaluated were body weight, height, waist circumference and skin folds (bicipital, tricipital, subscapular and suprailiac). The LM was assessed by dual energy X-ray absorptiometry.

<footnote>(1)Guastavino, Paula; (2)Lema, Silvia; (3)García Diéguez, Marcelo.</footnote>

<footnote>(1)MSc. Nutritionist. School of Nutrition. Salvador University. Bs. As. Argentina.; (2)PhD. Nutritionist. School of Nutrition. Buenos Aires. University. Argentina; (3)MSc. MD. Graduate School. University Institute of the Italian Hospital. Buenos Aires. Argentina.</footnote>

<footnote>(1)Nahas, Paula; (1)De Paula, Andressa; (1)De Branco, Flávia; (2)Rossato, Luana; (3)Orsatti, Fábio; (4)De Oliveira, Erick.</footnote>

<footnote>(1)Nutritionist. School of Medicine. Federal University of Uberlandia (UFU). Brazil.; (2)MSc. Nutritionist. School of Medicine. Federal University of Uberlandia (UFU). Brazil.; (3)PhD. Physical educator. Department of Sport Sciences. Federal University of Triangulo Mineiro (UFTM). Brazil.; (4)PhD. Nutritionist. School of Medicine. Federal University of Uberlandia (UFU). Brazil.</footnote>
gy x-ray absorptiometry scanning (DXA) and was also estimated using the predictive equations: Hume I and Hume II; Salamat et al. and Kulkarni et al. I and Kulkarni II. ANOVA one-way and Tukey's post-hoc test was performed to compare the values of LM measured by DXA and estimated by equations. Pearson's correlation was performed to verify the correlation of LM quantified by equations and DXA. Bland-Altman analysis evaluated the percentage of underestimation and overestimation of the equations.

**Results:** It was observed that Salamat et al and Kulkarni II equations resulted in the same values of LM as measured by DXA (36.62±4.47; 38.86±5.67 and 36.59±4.56, respectively). The equations of Hume I and Kulkarni I estimated higher values (41.71±5.23 and 46.29±6.47, respectively), while Hume II lower values (19.72±4.00) of LM than that quantified by DXA. Hume I, Salamat et al., Kulkarni I, Kulkarni II and Hume II equations showed a positive correlation with LM values of DXA (r=0.89; r=0.69; r=0.87; r=0.89, and r=0.81, respectively). In the Bland-Altman analysis it was observed that Salamat and Kulkarni II equations overestimated in the LM 0.12% and 5.75%, respectively. Additionally, it was observed that the Hume I and Kulkarni I overestimated the LM in 13.07% and 23.22%, respectively and Hume II equation underestimated in 60.77%.

**Conclusions:** The equations that presented better prediction of LM were Salamat and Kulkarni II, but it should be used in clinical practice with caution.

**Keywords:** Lean Mass, Predictive equations, DXA

144/2815

MUSCLE WASTING AND NUTRIENT INTAKE ASSESSMENT OF PATIENTS HOSPITALIZED WITH PRESSURE INJURY UNDER ORAL AND ENTERAL NUTRITIONAL THERAPY

(1)Diniz Camargo, Marcela Aparecida; (1)Mourão, Letícia; (2)Gonçalves Camargo, Isabela; (3)de Lucena Ferretti, Roberta.

(1)Nutritionist. University of Taubate. University Hospital of Taubate. Sao Paulo. Brazil; (2)Nutritionist. University of Taubate. University Hospital of Taubate. Sao Paulo. Brazil.; (3)PhD Student. MSc. Nutritionist. Federal University of Sao Paulo. University of Taubate. Sao Paulo. Brazil.

**Background and objectives:** Inadequate nutrients intake for hospitalized patients is of paramount importance and it is related to complications in the clinical setting, higher mortality rate, higher costs and length of hospitalization, and the occurrence of pressure injury (PI). The main objective of this study was to evaluate the muscle wasting and nutrient intake of adult and elderly patients hospitalized with PI under oral and enteral nutritional therapy.

**Methods:** A cross-sectional study was carried out with adult and elderly patients above 20 years old in a hospital in Taubate, Sao Paulo, with PI under oral or enteral nutrition therapy between February and June 2016. To assessment of muscle wasting, Calf Circumference measure was evaluated, considering cutoff point

below 31 cm to this outcome. To evaluate the nutrient intake were considered type of nutritional therapy used. For patients under Oral Nutrition Therapy, percentage of food acceptance and a food composition table (TACO) were used to calculate nutrition intake while for patients under Enteral Nutritional Therapy, a total amount of diet infused, according to the formula used, were considered. Regarding evaluation of nutrients intake (vitamin A, E, C, selenium, zinc) was considered as reference the Estimated Average Requirement (EAR) proposed by the Dietary Reference Intakes (DRIS) developed by the Foods and Nutrition Board/Institute of Medicine of the United States. Descriptive statistics were used to analyze the data.

**Results:** Among the 29 patients evaluated, 72.41% were male. It was verified that 58.6% of the patients presented muscle wasting. In relation to nutrients intake, 55.17% presented vitamin C intake above, 41.37% below and 3.44% within EAR values; 86.20% presented vitamin E intake above, 10.34% below, and 3.44% within EAR; Regarding to vitamin A, 68.96% presented above, 33.42% below and 3.44% within EAR; 55.17% presented selenium intake above EAR, 31.03% below and 13.79% within EAR; 82.75% of the patients had zinc intake above, and 17.24% below EAR.

**Conclusions:** It was concluded that the majority of patients presented muscle wasting, and there was predominance of patients with higher intake than EAR for vitamins C, E, A, zinc and selenium.

**Keywords:** Pressure Injury. Muscle Wasting. Nutrient Intake. Patients Hospitalized.

**Further collaborators:**

Marcela Aparecida Diniz Camargo, Letícia Mourão, Isabela Gonçalves Camargo helped to implement the study and data collection. Roberta de Lucena Ferretti conceived, designed, and implemented the study, collected and interpreted data, wrote and revised the text was responsible for coordinating original study and contributed to the intellectual content. All authors have sufficiently contributed to the development of this study.

144/2830

PREVALENCE OF MALNUTRITION IN HOSPITALIZED PATIENTS WITH PRESSURE INJURY

(1)Mourão, Letícia; (1)Camargo Gonçalves, Isabela; (2)Diniz Camargo, Marcela Aparecida; (2)de Souza da Cruz, Francine; (2)Moura dos Santos Botan, Gabriela; (3)de Lucena Ferretti, Roberta.

(1)Nutritionist. University of Taubate. University Hospital of Taubate. Sao Paulo. Brazil; (2)Nutritionist. University of Taubate. University Hospital of Taubate. Sao Paulo. Brazil.; (3)PhD Student. MSc. Nutritionist. Federal University of Sao Paulo. University of Taubate. Sao Paulo. Brazil.

**Background and objectives:** The hospitalized patients, especially malnourished, are likely to develop Pressure Injury (PI). Early identification of risk situations in nutritional diagnosis allows adequate planning of actions for prevention and treatment of diseases. The main objective of this study was to identify the prevalence of malnutrition in adult and elderly hospitalized patients with PI.
**Methods:** A cross-sectional study that evaluated adult and elderly above 20 years old in a hospital in Taubate, Sao Paulo, between February and June 2016. To nutritional status assessment, the measure of Calf Circumference was obtained (cutoff value below 31 cm to identify malnutrition). The Braden scale was used to identify the risk, hight and moderate, to development of another PI. C Reactive Protein (CRP) values were obtained from patient's chart to assess inflammation status (reference value above or equal 0.5 mg/dL to identify inflammation). Statistical Descriptives were used to analyse the data.

**Results:** Among the 40 patients evaluated, 62.5% were male. The mean age were 65.8 ± 16.12 and 68.0 ± 15.88 years, for female and male sex, respectively. Regarding nutritional status, 62.5% of the patients were malnourished. It was verified that 87.5% had one PI and 12.5% developed two PI, and the highest percentage of lesions found in the sacral region (69%). In relation to the risk assessment for the development of PI, 55% of patients were at high risk and the remainder 45% presented moderate risk. Considering the patients classified as having moderate and high risk of another PI development, 61.11% and 63.63% were malnourished, respectively. Regarding CRP levels, 97.5% of the patients presented high values.

**Conclusions:** It is concluded that 65.5% of the patients presented malnutrition, being propitious to the development of new PI and worse clinical outcomes.

**Keywords:** Pressure Injury. Malnutrition. Calf Circumference. Patients Hospitalized

**Further collaborators:** Letícia Mourão, Isabela Gonçalves Camargo, Marcela Aparecida Diniz Camargo, Francine de Souza da Cruz and Gabriela Moura Santos Botan helped to implement the study and data collection. Roberta de Lucena Ferretti conceived, designed, and implemented the study, collected and interpreted data, wrote and revised the text was responsible for coordinating original study and contributed to the intellectual content. All authors have sufficiently contributed to the development of this study.

evidence on the efficacy of MNPs in improving Zn status among moderately malnourished children is scarce. the study aimed at establishing bioequivalence of MNPs to conventional fortification in improving Zn status of moderately malnourished children in Thika Informal settlements, Kenya.

**Methods:** In a cluster randomized trial, twelve villages were randomized to four study groups. Three experimental groups received different formulations of MNPs added to CSB; multiple micronutrients (MMN) containing Zn (CSB-sprinkle-MMNZn), MMN without Zn (CSB-sprinkle-MMN) and Zn singly (CSB-sprinkle-Zn). The control group received conventionally Zn-fortified CSB containing MMN. CSB was prepared centrally in the participating villages and enrolled children fed daily. Dietary intake was assessed using 24-hour recall. Enrolled children underwent physical examination and anthropometric measurements. Serum Zn levels were determined pre-post intervention. Daily consumption of CSB was monitored for a period of six months. Sample size was calculated to show bioequivalence within ±20% limit. A total of 346 children (MUAC ≥11.5 - <12.5cm) were enrolled; CSB-sprinkle-MMNZn (N=84), CSB-sprinkle-MMN (N=88), CSB-sprinkle-Zn (N=93) and control group (N=81). Analysis was by intention-to-treat.

**Results:** At baseline, 64.2% of the children were Zn deficient, Zn intake was sub-optimal for 95.7% of children. A mixed effects linear regression was used to model pre-post change in serum Zn levels, adjusting for age, sex and socio-economic status. Compared to control group, the change was significantly lower for CSB-sprinkle-MMN (β=-20.0µg/dL; 95% CI: -26.5, -13.5) and significantly higher for CSB-sprinkle-MMNZn (β=5.9 µg/dL; 95% CI: 0.5, 11.3). No significant difference was observed between CSB-sprinkle-ZN and control group (β=-2.1; 95% CI: -8.3; 4.2). Conventional fortification was not bioequivalent to MNPs in improving serum Zn levels (t-tests 95% CI: -2.2; 8.9 p>0.05).

**Conclusions:** MNPs were more effective in improving Zn status of malnourished children compared to conventional fortification and are therefore recommended in fortification programmes.

**Keywords:** Malnutrition, Zinc, Deficiency, Micronutrient Powders

**Background and objectives:** Corn Soy Blend (CSB) is the standard protocol of treating malnourished children. CSB however, has poor micronutrient bioavailability and may result into poor outcomes during nutrition recovery of the children. Micronutrient powders (MNPs) have a potential to improve micronutrient nutrition. Zinc(Zn) is an essential micronutrient for immune-protection, growth and sensory development. Scientific

**Background and objectives:** Systemic arterial hypertension (SAH) is the leading cause of cardiovascular disease in adults and the

<footnote>(1)Juliana, Kiio; (2)Sophie, Ochola; (3)Ruth, Nduati; (2)Elizabeth, Kuria.</footnote>

<footnote>(1)University of Nairobi. Kenya.; (2)PhD. Department of Food. Nutrition and Dietetics. Kenyatta University. Kenya.; (3)MBChB. MMed. MPH. Department of Paediatrics. University of Nairobi. Kenya.</footnote>

<footnote>(1)de Souza da Cruz, Francine; (1)Moura dos Santos Botan, Gabriela;</footnote>

<footnote>(2)Nunes Novais Calisto, Ariane; (2)Resende de Aguiar, Livia; (3)de Lucena Ferretti, Roberta.</footnote>

<footnote>(1)Nutritionist. University of Taubate. University Hospital of Taubate. Sao Paulo. Brazil; (2)Nutritionist. University of Taubate. University Hospital of Taubate. Sao Paulo. Brazil.; (3)PhD Student. MSc. Nutritionist. Federal University of Sao Paulo. University of Taubate. Sao Paulo. Brazil.</footnote>
elderly, according to the World Health Organization, and may worsen the clinical picture of hospitalized patients. Excess weight is strongly associated with elevated blood pressure. The main objective of this study was to evaluate the nutritional status of hypertensive adult and elderly patients admitted to a hospital in Taubate, São Paulo.

**Methods:** A cross-sectional study that evaluated adults and elderly patients diagnosed with hypertension, aged over 20 years, at a Hospital in Taubate, São Paulo, between February 2015 and May 2016. The variables evaluated were sex, age, weight and height for the calculation of body mass index (BMI). Nutritional status classification was made through World Health Organization criteria for adults, and Lipschitz criteria for the elderly, considering as parameter BMI. For statistical analysis, the t-test for independent samples and one-way ANOVA were used, with a Tukey post hoc analysis, with a significance value p <0.05.

**Results:** Among the 176 patients evaluated, 63% (n = 111) were female. The median age for the female and male sex was 65.3 ± 11.3 and 67.4 ± 13.1, respectively. There was a significant difference between the sexes (p <0.05). With data analysis, 63% (n = 71) of women were overweight, 27.9% (n = 31) presented eutrophy and the others were underweight. Regarding the males, 61% (n = 40) were overweight, 30.7% (n = 20) presented eutrophy and the others were underweight, and this difference was observed among all groups, through post hoc analysis (p <0.001).

**Conclusions:** It is concluded that there is a high prevalence of overweight in hypertensive adults and elderly, and this outcome was higher to female sex. This is considered an injury to the hypertensive patient, and intervention measures are necessary to reduce excess adiposity.

**Keywords:** Systemic Arterial Hypertension. Nutrition Status. Overweight. Body Mass Index. Hospitalized Patients.

**Further collaborators:**

Francine de Souza da Cruz, Gabriela Moura dos Santos Botan, Ariane Nunes Novais Calisto and Livia Resende de Aguiar helped to implement the study and data collection. Roberta de Lucena Ferretti conceived, designed, and implemented the study, collected and interpreted data, wrote and revised the text was responsible for coordinating original study and contributed to the intellectual content. All authors have sufficiently contributed to the development of this study.

**Background and objectives:** Patients with cancer submitted to radiotherapy (RxT) often undergo prolonged fasting, which may favor the development of malnutrition. The objectives of this study were to identify the fasting time performed by patients submitted to RxT under sedation and to verify nutritional status evolution in three moments.

**Methods:** A longitudinal study that assessed children with malignant neoplasms, aged 2 to 8 years old, at a Specialized Institute of Pediatric Oncology, Sao Paulo, from July 2015 to September 2016. Data were collected in three moments, Pre, During ans Post RxT. Weight, height/length were analyzed, to calculate the Body Mass Index (BMI). Measures of middle upper arm circumference and skinfold triciptal were obtained to calculate Arm Muscle Area (AMA). Nutritional Status was assessed through z-score of BMI, according to World Health Organization recommendation. Patients were divided into two groups, A (fasting up to 14hours) and B (above 14 hours). Δ BMI z-score were calculated (variation of BMI z-score among three moments).

**Results:** Among the 19 patients assessed, 57.8% were male. In group A (n=11), during 3 moments, there was 9%(1st),9%(2nd),9%(3rd) of leanness, respectively, 82%(1st), 82%(2nd) and 91%(3rd) of eutrophy and 9%(1st), 9%(2nd) and 0%(3rd) of obesity. Regarding to AMA percentile<5, there were 9%, 9% and 18% of patients, respectively. In group B (n=8), in 3 moments were observed 0%(1st),12.5%(2nd),12.5%(3rd) of leanness, respectively,100%(1st), 87.5%(2nd), 87.5%(3rd) of eutrophy. Regarding to AMA below adequate there were, in 3 moments,12.5%, 12.5% and 37.5%, respectively. Weight loss was present in 47.5%, 73.5% and 52.6% in three moments, respectively. Regarding to the Δ BMI z-score, there was a greater variation for worsening of the BMI z-score, for group B (Δ BMI z-score=0.8) while Group A Δ BMI z-score=0.4.

**Conclusions:** It is concluded that the mean fasting time exceeded the recommendations of ACERTO project. Nutritional Status was predominantly eutrophic with AMA within normal range, however, there was weight loss (larger decrease of the BMI z-score) in a large part of the sample, being this endpoint higher in the group of patients who underwent longer fasting.

**Keywords:** Nutritional Status. Malignant Neoplasms. Children. Radiotherapy. Fasting Time.

**Further collaborators:** Adriana Garófolo, Priscila dos Santos Maia-Lemos and Roberta de Lucena Ferretti helped to implement the study interpreted data, wrote and revised the text. Karen Jalo-

<footnote>(1) Jaloretto Teixeira Guedes, Karen; (2) de Lucena Ferretti, Roberta;</footnote>

<footnote>(3) dos Santos maia-Lemos, Priscila; (3) Garófolo, Adriana.</footnote>

<footnote>(1)Nutritionist. Federal University of Sao Paulo. Brazil; (2)PhD student. MSc. Nutritionist. Federal University of Sao Paulo. Sao Paulo. Brazil.; (3)PhD. MSc. Nutritionist. Federal University of Sao Paulo. Sao Paulo. Brazil.</footnote>
retto Teixeira Guedes conceived, designed, and implemented the study, collected and interpreted data, wrote and revised the text was responsible for coordinating original study and contributed to the intellectual content. All authors have sufficiently contributed to the development of this study.

144/2862

ASSESSMENT OF NUTRITIONAL STATUS, COM-
PARATIVE STUDY. CONCORDANCE BETWEEN
MULTIFREQUENCY, MONOFREQUENCY BIO-
ELECTRICAL IMPEDANCE ANALYSIS AND AN-
THROPOMETRY

(1)Venczel, Analía Verónica; (2)Cristina, Monica; (2)Yuma, María;

(2)Aragona, Hilda Susana; (3)Posadas Martines, Lourdes; (3)Perez,

Lucía; (3)Giunta, Diego; (2)Gutt, Susana.

(1)Nutritionist. Internal Medicine Service. Italian Hospital of Buenos Aires. Argentina; (2)Nutrition Section - Internal Medicine Service - Italian Hospital of Buenos Aires. Argentina; (3)Clinical Research Section - Internal Medicine Service - Italian Hospital of Buenos Aires.

**Background and objectives:** To determine the nutritional health of an individual, we used nutritional assessment with anthropometric techniques and bioelectrical impedance analysis (BIA), two of the field methods most used for their easy application, good reproducibility and low cost.

We aimed to establish the concordance between two cohorts
who were assessed by anthropometry and BIA.

**Methods:** We included 2871 patients between 18 and 90 years old in two cohorts of patients according to availability of bioimpedance equipment (2013-2015). Nutritional status was assessed by monofrequency BIA, multifrequency BIA and anthropometry with 4 skinfold thickness measurement. The Bland and Altman method was used to evaluate concordance between groups.

**Results:** 1168 studies were performed by BIA monofrequency, 69% (n = 807) female. Mean age 41 years (DS 15), mean BMI of 30 kg / m2 (DS 8). Mean % of body fat measured was 33.12% (DS 11), mean % of body fat measured by anthropometry was 34.3% (DS 10).

1703 multifrequency bioimpedance were performed, 70%
(1187) female. Mean age was 44 years (DS 16) and mean BMI 30.5
(DS 7.7). Mean % of body fat was 37.7 (SD 11), mean % of body fat
measured by anthropometry was 35.3 SD (12).

Bland-Altman comparison Limits of agreement ( -11.587 to 9.317)

Mean difference: -1.135 (CI -1.335 to -0.936) Range: 4.750 to 55.550

Pitman's Test of difference in variance: r =0.411, n = 2638, p =0.000

The limits of agreement were broad. At highest fat percentage averages there were difference in means between methods. This variability is not consistent across the graph.

**Conclusions:** Body composition assessment estimates by BIA monofrequency, multifrequency and skinfold method were different especially at greater body fat, concluding that these methods are not interchangeable

**Keywords:** Bioelectrical impedance analysis (BIA)

144/2863

CORRELATION OF VISCERAL FAT LEVEL WITH
WAIST CIRCUMFERENCE IN PATIENTS WITH
NORMAL WEIGHT

(1)Gutt, Susana; (1)Cristina, Monica; (1)Yuma, María; (1)Aragona, Hilda Susana; (1)Schraier, Silvio; (2)Posadas Martines, Lourdes; (2)Perez, Lucía; (2)Giunta, Diego; (1)Venczel, Analía Verónica.

(1)Nutrition Section - Internal Medicine Service - Italian Hospital of Buenos Aires. Argentina; (2)Clinical Research Section - Internal Medicine Service - Italian Hospital of Buenos Aires.

**Background and objectives:** The aim of assessing nutritional status is to determine the general health of a patient from a nutritional point of view. Anthropometric techniques and bioelectrical impedance analysis (BIA) are two of the most widely used field methods due to their easy application, good reproducibility and low cost.

Knowing the size of visceral compartment allow us to predict
metabolic risks.

We aimed to correlate visceral fat level with waist circumfer-
ence in patients with normal weight.

**Methods:** We analyzed data from retrospective studies of patients undergoing nutritional assessment in the period 2015 by multifrequency BIA according to medical criteria. Anthropometry with 4 skinfold thickness and waist measurement was evaluated. The Spearman method was used to evaluate correlation between groups.

**Results:** 1470 multifrequency bioelectrical impedance were performed. 19% (281) patient with normal weight 72% (202) female, Media BMI 22.4 kg/m2, 22% (44) of female population had a % of total body fat ≥ 35% and a 25% (50) had visceral fat higher than normal limit.

28% (79) were male, Media BMI 22,1 kg/m2, 5,1% (4) had a
total body fat ≥ 25%.

Global Rho spearman = 0.38 p 0.0000. By groups Female Rho spearman 0.64 p 0.000 and Male Rho spearman 0.73 p 0.0000

The Clinical Research and Bioethics Committee of the Hospital Italiano de Buenos Aires approved the study.

**Conclusions:** In all patients evaluated a weak linear relationship can be seen, concluding that waist circumference should not be used as a single method for an estimate of visceral fat in normal weight patient probably because it does not take into account height.

The visceral fat size was independent of anthropometric in-
dicators of adiposity such as BMI and waist circumference. Data
analyzed by sex, evidenced an increased correlation in women.

**Keywords:** Bioelectrical impedance analysis (BIA)
## PREVALENCE OF MANLNUTRITION IN ENRICH PROGRAM SITES OF BANGLADESH, KENYA, MYANMAR, PAKISTAN AND TANZANIA

(1)Tolossa, Asrat; (2)Thomas, Abena; (3)Gillespie, Melanie; (4)Sellen, Daniel.

(1)MD, MPH, Chief of Party. ENRICH Program. World Vision Canada. Canada; (2)Grant Manager/DME advisor. ENRICH Program. World Vision Canada. Canada; (3)DME Team Lead. World Vision Canada. Canada; (4)Prof. Director The Joannah and Brian Lawson Centre for Child Nutrition. University of Toronto. Canada.

**Background and objectives:** ENRICH is a Maternal Newborn and Child Health and Nutrition program funded by the Government of Canada and implemented in Bangladesh, Pakistan, Myanmar, Kenya and Tanzania. ENRICH will use nutrition pathway to reduce U5M by strengthening health systems and improving basic nutrition and nutrition sensitive services and addressing nutrition-related causes such as: poor breastfeeding, stunting, wasting, and vitamin A and zinc deficiencies (Lancet, 2013). One of the strategies is promotion of production and consumption of biofortified micronutrient-rich crops which help to reduce vitamin A deficiency and improved iron status among CU5

**Methods:** The anthropometric nutrition assessment was done as part of baseline household survey of the ENRICH program. The sample size for each country was estimated using ENA for SMART software. A proportional stratified multi-stage cluster method was used to select respondents. Ethical approval was secured from University of Toronto and from the concerned authorities at country level. Anthropometric measurements were done among 6-59 months old children.

**Results:** Prevalence of stunting was 31.0% in Bangladesh, 33.1% in Kenya, 31.5% in Tanzania, 44.6% in Pakistan, and Myanmar 39%. The prevalence of wasting was 6.5%, 5.3%, 4.9%, 10.2% and 7.0% in Bangladesh, Kenya, Tanzania, Pakistan and Myanmar respectively. Under weight prevalence was also 20.8%, 17.8%, 15.3%, 29.7% and 28.2% in the same order. Poor infant and young child feeding practices, food insecurity and poor access to nutrition and health services were found to be some of the contributing factors. The proportion of severely food insecure households ranged from 11% to 32.3% among the five countries.

**Conclusions:** Malnutrition is a serious public health problem in ENRICH project sites of the implementing countries. Chronic food insecurity and poor infant and young child feeding practices are some of the factors contributing to the high level of malnutrition. Integrated nutrition specific and sensitive interventions which are effective in reaching the poor are required to address critical underlying determinants of malnutrition. Assessment of other local determinants of poor feeding practices and tailored interventions can also play a central role in preventing undernutrition.

**Keywords:** Stunting, Wasting, Underweight, Undernutrition

**Further collaborators:**

- Egerton University- Kenya. Aga-khan University- Pakistan. BRAC University- Bangladesh. ENTAF - Tanzania. World Vision East Asia Region - Myanmar.

## THYROGLOBULIN IN CHILDREN WITH LONG-TERM EXPOSURE OF IODINE EXCESS

(1)Zhang, Wanqi; (2)Chen, Wen; (2)Wang, Wei; (3)Hao, Yunmeng; (3)Wu, Yalan; (4)Bian, Jiancao; (2)Lin, Laixiang; (2)Tan, Long; (3)Shen, Jun;

(4)Wang, Xiaoming.

(1)Public Health College, Tianjin Medical University; (2)PhD. Department of Food nutrition and hygiene, Tianjin Medical University, Tianjin, China; (3)MD. Department of Food nutrition and hygiene, Tianjin Medical University, Tianjin, China; (4)The Shandong Institute for Endemic Disease Control and Research, Shandong, China.

**Background and objectives:** This study investigated thyroglobulin (Tg) concentrations in children with long-term exposure of iodine excess from water.

**Methods:** In a multi-stage cross-sectional survey, we collected, on two nonconsecutive days, two 24-h urine samples and determined 24-h urinary iodine excretion (24-h UIE, µg/d) and then calculated habitual daily iodine intake. Tg of children was detected.

**Results:** In this study, 2034 children had Tg measured including 1001 boys and 1033 girls. The water iodine content in this study was 181 µg/L (67.1-403) µg/L. The habitual daily iodine intake of children was 298 µg/d (188-436) µg/d. The median Tg concentration of children was 16.0 µg/L (9.8-26.1) µg/L in this study, and 237 (12%) children had Tg>40 µg/L while 85 (4.2%) children had Tg<4 µg/L. Tg was not associated with iodine intake concentrations up to the threshold value of 120 µg/d. When the iodine intake concentration was >120 µg/d, Tg was associated with increased iodine intake (β: 0.5; 95% CI: 0.4, 0.6; P<0.001). Taking iodine intake of 100-149 µg/d as the reference, logistic regression analysis for the association between iodine intake and Tg>40 µg/L, indicating that children from iodine intake range of ≥600 had higher risk of TGR compared to iodine intake of 100-149 µg/d (OR: 2.4 95% CI: 1.2, 4.9; P=0.018) while no differences were observed in other iodine intake ranges.

**Conclusions:** Tg concentrations of children who were exposed to high iodine intake were higher, however, the risk of Tg>40µg/L was not different among different iodine intake levels.

**Keywords:** Children, thyroglobulin (Tg), iodine excess

**Further collaborators:**

Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA, USA (Elizabeth N Pearce, MD); the Human Nutrition Laboratory, Swiss Federal Institute of Technology, Zurich, Switzerland (Michael B Zimmermann, PhD)
# DETERMINATION OF IODINE CONTENT BY ICP-MS FOR IODINE BALANCE STUDY

Zhang, Wanqi; Cui, Tingkai; Shen, Jun; Pan, Ziyun; Tan, Long.

Department of Nutrition and Food Hygiene. School of Public Health. Tianjin Medical University. Tianjin. China.

**Background and objectives:** Iodine balance study on adults, neonates, pregnant and lactating women is essential to provide strong evidence for Dietary Reference Intakes (DRIs. Thus iodine content in a host of food, water, table salt, urine, breast milk and feces samples need to be analysed. Meanwhile demand for assessment of iodine content in serum and saliva samples is increasing due to the rising awareness of iodine status. Inductively Coupled Plasma Mass Spectrometry (ICP-MS) prevails in determining elements, including iodine, as its rapidity, low detection limits and minimal sample amount needed for analysis. This study aims to develop a fast, simple, and cheep method to determine iodine concentration in massive samples for iodine balance study and iodine status survey or evaluation.

**Methods:** Weigh 0.2g shredded food or feces samples and digest with 4.8mL 1% tetramethylammonium hydroxide (TMAH) in 5mL eppendof (EP) tube at 90°C for 24h, then transfer 0.5mL supernatant into 2mL EP tube after centrifuge at 3000 rpm for 15min, dilute with 1.5mL ultra-purified (UP) water, and finally centrifuge at 12000 rpm for 5min. Transfer 0.25mL breast milk samples into 5mL EP tube while with 2.75mL 0.5% ammonia at 90°C for 3h, then centrifuge at 3000 rpm for 15min and transfer 0.5mL supernatant into 2mL EP tube followed by diluted with 1.0mL UP water. Driking water, salt, serum, urine, and saliva samples are directly diluted with 7mmol/L ammonia. The final solution can be injected into ICP-MS for iodine analysing.

**Results:** The precision (RSD: 2.65%-8.85%) and recovery rate (88.08%-115.04%) of the method for assessment of above samples were satisfactory.

**Conclusions:** These sample treatments make iodine determination in a large number of samples fast, simple and cheep and it can be used for iodine status survey or evaluation, especially for iodine balance study.

**Keywords:** Iodine; determination; ICP-MS

# NEW INSIGHTS INTO THE PANDEMIC OF LOW VITAMIN "D" LEVELS AND ITS ASSOCIATION WITH SEMEN QUALITY AND HORMONAL LEVELS IN FERTILE AND INFERTILE MALE SUBJECTS

(1)Ciccone, Inari; (2)Pariz, Juliana; (3)Costa, Elaine; (4)Hallak, Jorge.

(1)MS Student. Androscience. Faculdade de Medicina da Universidade de São Paulo.; (2)PhD Student. Biomedical. Androscience. University of Sao Paulo Medical School FMUSP. Brazil; (3)Associate Professor of Endocrinology. Division of Endocrinology. Hospital das Clínicas of University of São Paulo. Brazil; (4)PhD. Andrologist. Associate Professor Of Urology. Department of Pathology. University of Sao Paulo Medical School. Androscience. Brazil.

**Background and objectives:** Vitamin D is a versatile signaling molecule, that targets also male reproductive organs, in addition to effects on bone, calcium and phosphate homeostasis. Accumulating evidence from animal and human studies suggests that it is involved in reproduction metabolism. Objective: To evaluate the influence of vitamin D status on semen quality and hormonal profile in male fertility and infertility.

**Methods:** We evaluated 100 men (aged 18 to 50 y.o.) from a private medical clinic. Infertility (n=70) and fertility (n=30) groups. According to vitamin D level status all of them were classified in sufficient (group 1 - 25OHvitD ≥ 30ng/ml), insufficient (group 2 - 25OHvitD from 21 to 29ng/ml) and deficient (group 3 - 25OHvitD ≤20ng/ml). Blood samples were collected to analyze serum vitamin D, LH, FSH, estradiol, total and free testosterone, prolactin and SHBG levels. Semen was analyzed according to WHO guidelines, strict criteria and sperm functional tests were performed (ROS, CK, beads). In addition, karyotype, frequency of varicocele, smoking, alcohol ingestion, and body composition were considered. Statistical analysis was performed by SPSS program version 19.0 (SPSS Inc., Chicago, IL). T-test was used for unpaired samples for statistical analysis. Statistical significance was considered with P value < 0.05.

**Results:** According to vitamin D status, patient distribution was: Infertile: group 1 - 28.5% (20/70), group 2 - 43% (30/70) and group 3 - 28,5% (20/70). Fertile: group 1 - 34% (10/30), group 2 - 40% (12/30) and group 3 - 26% (8/30). Sperm motility was significantly lower in group 3 in comparison to group 1 in infertile patients. Regarding fertile men, we found higher sperm volume in group 3 than the group 1, a significant reduction of sperm concentration and worse morphology by strict criteria in group 3 in comparison to group 1. Hormonal levels were similar in all vitamin D groups.

**Conclusions:** Our results demonstrated that sufficient vitamin D levels has a positive influence on spermatogenesis and semen quality, suggesting that vitamin D replacement should highly be concerned on male fertility treatment and that low vitamin D have reached epidemic proportions in industrialized cities.

**Keywords:** Nutrition and Male infertility. Male fertility treatment. 25OHvitaminD deficiency.

**Further collaborators:** Financial support: Androscience and CNPQ
# EVALUATION OF HEMOGLOBIN MEASUREMENT TOOLS FOR CHILD ANEMIA SCREENING IN RWANDA

(1)Parker, Megan E Parker; (2)Han, Zhen; (3)Abu-Haydar, Elizabeth;

(4)Matsiko, Eric; (5)Iyakaremye, Damien; (5)Tuyisenge, Lisine;

(6)Magaret, Amalia; (7)Lyambabaje, Alexandre.

(1)PATH; (2)BSc, PhD. Nutrition Innovation, PATH. USA.; (3)BSc, MPH. Devices & Tools, PATH. USA; (4)BSc, MSc. Human Nutrition and Dietetics Department, University of Rwanda, Kigali, Rwanda; (5)BSc, MD, MSc. Pediatrics. Centre Hospitalier Universitaire de Kigali, Kigali, Rwanda; (6)BSc, MSc, PhD. Departments of Lab Medicine and Biostatistics, University of Washington, Seattle, WA; (7)BSc, MSc, PhD. Mathematics and Applications. University of Rwanda, Kigali, Rwanda.

**Background and objectives:** Blood hemoglobin (Hb) level is a common indicator for diagnosing anemia and is often determined through laboratory analysis of a venous or capillary blood sample. Drawing blood samples, however, poses challenges in young children, increases the risk of infection and disease transmission, and is sometimes unacceptable to caregivers. One alternative to laboratory-based methods is use of the handheld HemoCue® Hb 201+ device, which requires a finger prick and wicking of blood into a pretreated cuvette for analysis. This wicking method is commonly used in clinic and community settings, but an alternative HemoCue® gravity method is being investigated for improved accuracy. Further, recent developments in noninvasive technologies could provide an accurate, rapid, safe, point-of-care option for Hb estimation while addressing some limitations of current tools, but the performance of these devices has not been assessed in low-resource settings. This study evaluated the performance of two HemoCue® Hb 201+ blood sampling methods and a noninvasive device (Pronto® with DCI-mini™ sensors) in a Rwandan pediatric outpatient clinic.

**Methods:** Reference Hb values were determined in 132 children 6 to 59 months of age by using a standard hematology analyzer (Sysmex KN21). 66 children were tested using the HemoCue® wicking method and 66 were tested using the HemoCue® gravity methods. 112 of the children had successful Hb readings with Pronto® DCI-mini™. Statistical analysis was used to assess the level of bias generated by each method and the key drivers of bias.

**Results:** The HemoCue® gravity method was the least biased compared with the HemoCue® wicking method and the Pronto® with DCI-mini™ sensors. The biases of the HemoCue® wicking and Pronto® DCI-mini™ methods were inversely related to the Sysmex KN21 results. Both HemoCue® sampling methods correctly classified patients' anemic status at or above 80%, while the Pronto® DCI-mini™ device had a correct classification rate of only 69%.

**Conclusions:** The HemoCue® gravity method was more accurate than the traditional HemoCue® wicking method in this study, but its accuracy and operational feasibility should be confirmed by future studies. The Pronto® DCI-mini™ devices showed considerable promise but require further improvements in sensitivity and specificity before wider adoption.

**Keywords:** Hemoglobin. HemoCue®, Noninvasive Device, Rwanda, Children

# DETERMINATION CONTENTS OF THE DIGESTIBLE INDISPENSABLE AMINO ACIDS (DIAAS) OF NINE KINDS OF GRAIN CEREAL USING RAT MODEL

(1)Han, Fei; (1)Han, Fei; (2)Han, Fenli; (3)Chen, Xi; (3)Song, Ge; (4)Fan, Liuping.

(1)PhD. Nutritionist. Academy of State Administration of Grain. P.R.China; (2)Master. Food College. Jiang Nan University. P.R.China; (3)Master. Academy of State Administration of Grain. P.R.China; (4)PhD. Nutritionist. Food College. Jiang Nan University. P.R.China.

**Background and objectives:** Recently, for the grains, most of the researches are mainly focus on the antioxidation, prevention of chronic diseases and processed food as well as its nutritional compositions. However, there are few researches about the grain amino acid in vivo digestibility and formula design with digestible indispensable amino acid (DIAA) of grains. This research studies the contents of the digestible indispensable amino acids (DIAAS) of the nine typical grain cereals from different provinces in China.

**Methods:** The research has been made on the impacts of the protein sources in such nine kinds of grains on the apparent, true ileal amino acid digestibility and DIAA using rat model. To prepare diets using 9 grains for atmospheric pressure cooked that meet the nutritional needs of rats according to NRC requirements.

**Results:** The results showing that the average total apparent ileal amino acid digestibility values in the whole wheat and coix groups are significantly higher than other grain groups (P < 0.05) and the ileal true amino acid digestibility and ileal apparent amino acid digestibility values are characterized by a basically consistent trend; the available lysine digestibility is highest in the whole wheat and millet groups but lowest in the tartary buckwheat group and there is no significant difference in others groups (P > 0.05). Moreover, the research has been made on the ileal DIAA and available lysine contents of the protein sources in different grains, with the results showing that the digestible lysine contents in the oats and rice groups are higher than the millet, foxtail millet, coix and whole wheat groups but lower than the common and tartary buckwheat groups (P < 0.05) and the amino acids in legumins are more easily digestible than that in prolamins.

**Conclusions:** The nutritional value of the 9 grains was further evaluated by digestible indispensable amino acid score (DIAAS), the order were as follows: buckwheat group>tartary buckwheat group>oat group>brown rice group>polished rice group>whole wheat group>coix group>millet group>proco-millet group.

**Keywords:** grain cereals; protein; digestible indispensable amino acids (DIAAS)