nutrition behaviors specifically IYCF practices based on FES find-
ings within a resilience program in the five counties.

**Methods:** Based on FES findings, we designed a SBCC inter-
vention focusing on behavior change, social mobilization and ad-
vocacy around IYCF including inadequate micronutrient intake,
cooking practices and food security. Target was self-help group
members including fathers and grandmothers that were also re-
ceiving a package of other interventions from consortium part-
ners. The community was reached through care groups and radio
listener groups. Talking books were used in areas where there was
no local radio frequency.

**Results:** The FES identified zinc and iron to be the most critical problem nutrients. We reached 5163 households with 6443 children 0-5 years of whom 46% were under 2 years through 230 care-groups and over 100,000 through mass communication on IYCF messages. 170 health workers and 86 CHVs trained on care-group model. Over 20 model vegetable gardens were established. The FES was adopted by MOH as a methodology for identifying IYCF interventions and BCC strategy adopted by Turkana County.

**Conclusions:** FES provides empirical support for evidence based programming of nutrition interventions in resource-constrained populations. Care-groups and radio listener groups were an innovative model through which community members can discuss nutrition related issues. Engagement with government provides for sustained efforts of promoting IYCF behavior change in the region.

**Keywords:** FES, Infant and Young Child Feeding, Behavior Change Communication.

144/1242

TYPE OF NUTRITION FACTS PANEL (NFPS) ON
PACKAGED FOOD PRODUCTS AND THEIR COM-
PREHENSIBILITY BY THE CONSUMERS

(1)Singh, Meenu; (2)Chandorkar, Suneeta.

(1)Post Doctoral Fellow. Division of Nutrition. St. John's Research Institute. St. John's National Academy of Health Sciences. Bangalore 560034. Karnataka. India.; (2)Assistant Professor. Department of Foods and Nutrition. Faculty of Family and Community Sciences. The Maharaja Sayajirao University of Baroda. Vadodara 390002. Gujarat. India.

**Background and objectives:** Nutrition information on the packaged foods aids healthy food choices. However, absence of a uniform style of Nutrition Facts Panel (NFP) on the packaged food leads to lack of comprehensibility of NFPs by the consumers. Therefore, the present study aimed at assessing the comprehensibility of commonly found NFPs on packaged foods.

**Methods:** The study was carried out on 807 consumers aged ≥15 years in Vadodara, Gujarat, India. Each consumer was shown four NFPs, varying in terms of the format and the amount of nutrition information, and their responses were recorded on a pre-tested semi-structured questionnaire. NFP-1 presented nutrients as "per 100g" of the product with fractions of total-fats and

total-carbohydrates. NFP-2 presented nutrients in two tabular formats. One table detailed micronutrients with their significance and second table listed four mandatory nutrients "per 100g" of the product. NFP-3 reported five mandatory nutrients as "per 100g" and "per serving". NFP-4 listed nutrients in two tables. One of the tables had nutrients as "per serving" and "%DV" with five mandatory plus other essential nutrients while the other table presented nutrients as "per 100g". All the NFPs were as per Food Safety Standards Act guidelines (2006).

**Results:** Comprehensibility of four different NFPs commonly found on packaged foods revealed that the best comprehended NFP was NFP-2(82%) followed by NFP-1(67%), NFP-4(55%) and NFP-3(52%). Percent scores on understanding of NFPs were higher among adolescent girls (53%) and adult females (53%) than their male counterparts, 50% and 45% respectively. Fat was considered by most of the consumers (27%) for evaluating NFPs, followed by energy (23%), protein (17%), vitamins (14%) and carbohydrates (13%). "Nutrients of concern" namely, cholesterol, sugar, TFA and sodium were considered by less than 10% of the consumers. Terminologies that were reported difficult to understand on NFPs were units for expression of nutrients, serving size, nutrients like MUFA (24%), TFA (18%) PUFA (24%),etc.

**Conclusions:** With the increase in complexity or the amount of information on NFPs, the difficulty in comprehension also increases. Therefore, there is a need to present NFPs in uniform and simplified format so as to make them easy to understand by the consumers.

**Keywords:** Nutrition facts panel, consumer awareness, packaged foods.

**Further collaborators.**

Meenu Singh and Suneeta Chandorkar.

144/1334

BREAKING FRESH GROUND ON ADOPTING SUS-
TAINABLE DIETS: ASSESSMENT OF USING CON-
SUMER PARTICIPATION TO DEVELOP TOOLS
FOR BRIDGING THE INTENTION-BEHAVIOUR
GAP

(1)Fink, Leonie; (2)Ploeger, Angelika; (3)Strassner, Carola.

(1)PhD Student. Nutritionist. Department of Department of Food
· Nutrition · Facilities. University of Applied Sciences Münster.
Germany.; (2)Prof. Dr. Section of Organic Food Quality and Food
Culture. Faculty of Organic Agricultural Sciences. University of
Kassel. Germany.; (3)Prof. Dr. Department of Food · Nutrition ·
Facilities. FH Münster University of Applied Sciences. Germany.

**Background and objectives:** When trying to adopt sustainable diets, people often deal with the gap between their good intentions and their actual behaviour. Tools are needed which support people's needs during the process of diet adoption. To meet those needs, it might be useful to involve people in the developmental process. Therefore, we conducted six workshops in different cities in Germany from September to December 2016. Our workshop
design provided a combination of creativity supporting techniques. The purpose was to enable all participants to develop ideas contributing to the research question: How can we bridge the intention-behaviour gap regarding the adoption of sustainable diets? Besides the workshop results, it is important to explore the potential of our innovative approach by examining the participants' experience with it. The aim of the subsequent survey among the participants was to examine their assessment of the workshop design in combination with the research question, the applied methods and the suitability for active participation.

**Methods:** We collected the data using seven structured and closed ended questions with a verbalised response scale as one part of an anonymous feedback tool we distributed always after the end of the six workshops. Participants were men and women between the age of 16 and 70 years.

**Results:** The sampling comprised 82 participants of which 63 (76,8%) completed the feedback questionnaires and 19 (23,2%) didn't fill in the questionnaire. Evaluation shows that 61 participants (96,8%) agree that the research question is suitable for exploration within an idea generation workshop and 58 (92,1%) say that therefore a series of local workshops is sensible. Concerning the applied methods, 62 (98,4%) say that they were suitable for the workshop. Only 2 people (3,2%) claimed that the methods were not supporting the creativity for generating ideas. All participants (100%) grant that involving people in this research is reasonable and 58 (92,1%) say that the participation in the developmental process searching for tools can contribute to their successful application later on.

**Conclusions:** Our conclusion from the results is that our methodological approach corresponds to the concept of citizen science. Here we see potential for further contributions to this latest research development.

**Keywords:** Citizen science, consumer input, diet adoption, intention-behaviour gap, sustainable consumption.

**Methods:** Household eating patterns are identified using exploratory factor analysis with 24-hour, 12-food-group dietary recall data from a clustered survey of 740 households in the Far-West region of Nepal. Survey-adjusted OLS and logistic regression is used to assess the relationship of these patterns to anthropometry of an index child in these households, while controlling for food environment and household characteristics. Similar analysis is performed regressing anthropometric indicators on the household dietary diversity score (HDDS), which is associated with dailly per capita caloric availability and is commonly used as a proxy for food security in monitoring impact of development programs.

**Results:** Three consistent patterns emerged: a “diverse,” “energy-dense,” and “typical.” All else equal, the energy-dense pattern (dairy, sugar/sweets, and oils/fats) was positively associated with WAZ (p<.01), WHZ (p<.001), BMIZ (p<.01), and overweight (p<.05) and negatively associated with underweight (p<.01) and wasting (p<.01). The diverse pattern was positively associated with overweight (p<.05), and there was no significant association between anthropometry and the typical pattern. HDDS was moderately correlated with the diverse pattern (r=.56, p<.001) but not the energy-dense (r=.14, p<.05) and typical patterns (r=.13, p<.05). All else equal, HDDS was not significantly associated with any anthropometric measures.

**Conclusions:** Eating patterns derived from limited dietary data may be sufficient to predict child nutritional status, and eating patterns may offer value beyond simple dietary diversity scores—constructed using the same data—in helping to understand context-specific dietary factors influencing growth. In a resource-constrained setting, understanding the relationship between how people eat and nutritional status may be useful in determining areas for programmatic intervention.

**Keywords:** Nepal, diet quality, malnutrition, dietary diversity, eating patterns.

144/1348

ASSESSING THE VALUE OF EATING PATTERNS AS MARKERS OF DIET QUALITY IN A RESOURCE-CONSTRAINED SETTING

O'Hara, Corey.

MS. PhD Candidate. Friedman School of Nutrition Science and Policy. Tufts University. United States of America.

**Background and objectives:** Decades of research have shown that empirically derived eating patterns have substantial power to predict risk for health outcomes, including cardiovascular disease, diabetes, metabolic syndrome, cancers, and a range of plasma biomarkers (Hu 2002; Newby and Tucker 2004; Barbaresko et al. 2013). Rising rates of overweight and obesity in low-income countries have more recently led to use of eating pattern assessment in these contexts, but the approach has been virtually unused in relation to undernutrition. The purpose of this study is to determine the value of this methodology in predicting risk of child malnutrition associated with undernutrition.

144/1564

DOES PEER COUNSELING PROMOTE APPROPRIATE INFANT FEEDING AND BETTER GROWTH IN INFANTS IN URBAN SLUMS IN BANGLADESH?

(1)Ara, Gulshan; (2)Khanam, Mansura; (3)Papri, Nowshin; (4)Kabir, Iqbal; (5)Dibley, Michael.

(1)Public Health Nutritionist, Nutrition and Clinical Services Division, icddr,b; (2)MPH, Nutritionist, Nutrition and Clinical Sciences Division, icddr,b; (3)MPH, Medical Doctor, Nutrition and Clinical Services Division; (4)PhD, Scientist, Bangladesh breastfeeding foundation; (5)MD, Professor, Sydney School of Public Health.

**Background and objectives:** Adequate and age-appropriate nutrition during infancy and early childhood is fundamental for attaining and maintaining the growth and health of children. The objectives of this study is to investigate the association between infant feeding practices, and growth and compared data between control and intervention groups to measure the impact of peer counseling.
**Methods:** A community-based randomized controlled trial was conducted in selected slums of Dhaka, Bangladesh in which 350 mother-infant pairs were randomized to either receive infant feeding counseling (n = 175) or a control group (n = 175) between September 2014 and July 2016. The outcome data were collected at enrollment, following childbirth, and every two months interval up to 12 months. We have created scales to measure infant feeding practices (IFPs) and anthropometry from birth to 12 mo of age to assess the main outcomes of weight and length. Moreover, we created infant feeding scales based on infant feeding recommendations and run linear regression models to determine the effect of intervention.

**Results:** Higher proportion of intervention mothers (89%) reported first hour initiation of breast feeding than control mothers (78%). More than 95% of the neonates in both groups received colostrum. More mothers in the intervention group (n = 136, 73%) were exclusively breastfeeding at 5 months compared to mothers in the control group (n = 124, 27%). Better feeding scale scores were associated (p<0.001) with better weight and length gains during infancy. Infants who were in the 75th percentile of the infant feeding scales found to be significantly less stunted (P<0.05) compared with infants who were in the 25th percentile of these scales at intervention group as well as control group at different follow up period (1, 3, 5, 7, 9 and 12 months).

**Conclusions:** Our results provide the evidence for the effects of peer support on increasing rates and duration of exclusive breastfeeding. Similarly, this study also give a positive support of adhering to current infant feeding recommendations on better nutritional status of infants. Further studies are needed to follow the linear growth of these children during the second year of their life.

**Keywords:** Infant feeding scale, peer counseling, randomized control trial.

**Background and objectives:** Irrigated horticultural production at scale can be a powerful vehicle for income generation in Sub-Saharan Africa; however, there is a need for evidence about how best to integrate nutrition in a scaleable way. This project is unique for two key reasons: 1) it is injecting nutrition (via behavior change communication strategies) into an existing agriculture development project and 2) it is using voice messaging as a delivery mode for nutrition education.

**Methods:** We will leverage a large, funded, cluster-randomized controlled trial (RCT) that evaluates the impact of the PAPSEN-TIPA development project, which disseminates drip-irrigation and improved horticultural technologies to groups of

smallholder farmers in Senegal. One hundred and twenty-four villages in three regions of Senegal are participating in the study (~1275 households). In order to develop the voice messaging intervention we first conducted formative research by conducting focus groups (n=6) with men and women to identify barriers and facilitators to improving infant and young child feeding practices. We combined these findings with baseline results from the larger RCT as well as market surveys.

**Results:** The focus groups found that men were making food purchasing decisions within households, horticulture crops produced were being sold rather than being consumed within the household and that there was an avoidance of feeding infants and young children “heavy” foods (e.g., animal sourced foods). These findings were complemented with the baseline survey data that indicated that 63% of children consumed a minimally diverse diet and consumption of nutrient-rich food groups was generally low. Moreover, 64% of children 6-59 months surveyed were anemic. These findings were subsequently combined to identify the key messages for the intervention, including: consumption of locally available and affordable animal sourced foods, dark leafy greens and vitamin A rich fruits and vegetables along with messaging around consumption of horticulture within the household. Voice messages will be sent to both mothers and fathers in the study in order to ensure buy-in for purchasing nutrient-rich foods.

**Conclusions:** This study has the potential to provide important insight into the effectiveness of using mobile technology to inject nutrition into large-scale agriculture development projects.

**Keywords:** Behavior change communication, infant and young child feeding, nutrition-sensitive interventions.

**Background and objectives:** India is home to ~20% of world's adolescents but of whom ≈19.3% are overweight/obese. This in part is attributed to increasing trend of shift from at-home meals to away-from-home meals. Lack of skills to interpret food label information, which can serve as point-of-purchase guideline for healthy food choice can add to the woes. The present study describes an educational intervention that aimed at improving the food label information skills among urban adolescents (13-15y) in a south Indian City.

<footnote>(1)Saha, Snehasree; (2)Rao, V. Sudershan; (3)Rao, VishnuVardahana;</footnote>

<footnote>(4)Gavaravarapu, M SubbaRao.</footnote>

<footnote>(1)M.Sc. Assistant Professor, Udaynarayanpur Madhabilata Mahavidyalaya, University of Calcutta, Kolkata, India; (2)PhD. Scientist E. food & Drug toxicological research institute. National Institute of Nutrition (Indian Council of Medical Research), India; (3)PhD. Scientist F. Dept of Biostatistics. National Institute of Nutrition (Indian Council of Medical Research), India; (4)PhD. Scientist E. Extension & Training Division. National Institute of Nutrition (Indian Council of Medical Research), India.</footnote>
**Methods:** Firstly, a KAP questionnaire was developed & its content-validity was assessed by a panel of 3 experts. Test-retest reliability was assessed by administering it among 114 participants within a gap of 7-days. Spearman Correlation co-efficient, difficulty and discrimination indices were calculated to accept/reject questions. The questionnaire thus validated was administered among 170 participants to assess the determinants of food label usage by co-relating label use with demographic details, nutrition awareness and perceptions. 'Read-B4-U-Eat' a multi-component education module comprising 3 interactive sessions, animated film, booklet and 9 posters was developed and tested on 116 participants. The impact of educational intervention was assessed by administering KAP questionnaire pre- and post-intervention and observing food choices of 60 participants in a simulated shopping environment. Retention was assessed by interviewing participants' parents (n=30).

**Results:** For validating the questionnaire, Spearman-Correlation was calculated for internal consistency. Following this, patterns and words in the questionnaire were changed to finalize using Difficulty index (range: 0.2-8) and discrimination index (≥0.20). General nutrition awareness, specific health claims and perceived weight status were identified as major determinants of food label use. Read-B4-U-Eat module significantly (p<0.05) increased knowledge on manufacturing-date, ingredients, nutrient-panel and quality-symbols & checking of sodium declaration in snacks. After the intervention, use of label information to read fat-content (100%), ingredients, calorie, sugar and protein was increased. Reading date-of-manufacture and best-before-date, quality-symbols also improved notably. Parents (24 of 30) informed that their children's label reading skills retained after 3 months.

**Conclusions:**

This study was one of the first attempts to equip adolescents to use food label information in India. This can be scaled up for integration in school curricula.

**Keywords:** Food label, adolescents, educational intervention.

titude of non-Igbo bank workers to local dishes in Abia State and influencing factors.

**Methods:** Validated and pretested questionnaire was used to obtain data on the demographics, dietary adaptation and attitude to local dishes and influencing factors from 236 non-Igbo indigenes working in various banks and residing in two commercial cities in Abia State. Dietary adaptation was assessed using a Likert scale rating of 10 different local dishes ranging from "Being aware of the dishes" to "Ability to prepare, consume and enjoy the dishes frequently". Attitude was assessed using 12 questions on a 5 point scale rating ranging from "Strongly agree" to "Strongly disagree". Factors influencing dietary adaptation were assessed using 5 point scale rating of 11 questions ranging from "Affected much" to "Never affected". Pearson's correlation was used to determine the relationship between respondents' demographics, dietary adaptation and attitude to local dishes. IBM SPSS Statistics (version 20) was used to analyze the data and significance judged at P<0.05.

**Results:** Demographic result showed that 18% of the bankers have Igbo mothers, 52% have resided in the State for less than 2 years while 38% have lived in another Igbo speaking State but for less than 2 years (58%). Majority (79%) of the bankers moderately adapted to the local dishes while 35% showed positive attitude to local dishes. Dietary adaptation score positively correlated with having Igbo mother, duration of residence in Abia (P<0.01) and in another Igbo speaking State (P<0.05). Only duration of residence in the State positively (P<0.01) correlated with attitude. Dietary adaptation also positively (P<0.01) correlated with attitude to local dishes. Preconceived myths and fallacies were factors that most affected the level of dietary adaption.

**Conclusions:** Dietary adaptation and attitude towards local dishes among non-Igbo indigenes working and residing in Abia State improved with duration of residence in the State but were limited by preconceived myths and fallacies.

**Keywords:** Dietary adaptation, Attitude, Local dishes, Non-Igbo indigenes, Bank.

144/1793

DIETARY ADAPTATION AND ATTITUDE TO LOCAL DISHES AMONG NON-IGBO INDIGENES WORKING IN BANKS AND RESIDING IN TWO COMMERCIAL CITIES IN ABIA STATE. NIGERIA

**Background and objectives:** Adapting to local dishes by non-indigenes may be influenced by demographics, education and income as well as exposure and access to host culture and cultural norms. This study aims to determine the dietary adaption and at-

144/1855

NUTRITION EDUCATION PRACTICES IN HEALTH TEACHERS FROM SHANGHAI K-12 SCHOOLS: THE CURRENT SITUATION, BARRIERS AND WILLINGNESS

**Background and objectives:** To investigate the current situation of health teachers performing nutrition education in Shanghai K-12 schools, and to determine the barriers and willingness of teaching nutrition in the classroom.

**Methods:** A total of 904 health teachers from Shanghai K-12 schools was invited to fill out a Wechat-based questionnaire by

<footnote>(1)Nkwoala, Chiaka Charles; (2)Mark, Olachi Pleasure;</footnote>

<footnote>(2)Okwarachukwu, Elochukwu Stanley.</footnote>

<footnote>(1)MSc.Community Nutritionist. Department of Human Nutrition And Dietetics. Michael Okpara University of Agriculture. Umudike. Abia State. Nigeria; (2)BSc. Human Nutrition And Dietetics. Department Of Human Nutrition And Dietetics. Michael Okpara University Of Agriculture. Umudike. Abia State. Nigeria.</footnote>

<footnote>(1)Chen, Bo; (2)Li, Fang; (1)Dong, Ruihua; (2)Chen, Jingsi; (2)Yuan, Yaqun;</footnote>

<footnote>(1)Liu, Qipei; (1)He, Gengsheng.</footnote>

<footnote>(1)PhD. Department of Nutrition and Food Health. Fudan University. China; (2)MS. Department of Nutrition and Food Health. Fudan University. China.</footnote>
investigating the current situation of teaching nutrition in the classroom, the barriers and resources of performing nutrition education, and the wiliness of performing future education on nutrition. The questionnaire were self-designed and validated. Logistic analysis was used to identify the factors influencing the education practices and willingness.

**Results:** There are 722 (84.29%) health teachers currently teaching nutrition in the classroom. Among them, 532 (73.68%) teachers spent less than 1 hour to teach the class. Among the 182 teachers who did not teaching nutrition, 57 (31.32%) reporting that nutrition was not a required course by the school, 69 (37.91) reporting of willing to teach but lack of knowledge, and 17 (9.34) reporting of willing to teach but lack of support. There are 735 teachers willing to develop a future nutrition course, and 762 teachers willing to teach nutrition in other ways. Using the logistic models to identify the factors influencing whether or not teachers were currently teaching nutrition in the classroom, gender, age, school type, level of concerning about nutrition, and the level of received background on nutrition background were identified as significant factors. Using the logistic models to identify the factors influencing whether or not teachers were willing the teach future lessons on nutrition, location, school type, level of concerning about nutrition, and currently teaching nutrition lessons were identified as significant factors.

**Conclusions:** Nutrition education in Shanghai K-12 schools is not sufficient.

**Keywords:** Nutrition education, K-12 schools, teachers, barriers, willingness.

144/2014

NUTRITION STATUS AND FEEDING PRACTICES
AMONG ORPHANED CHILDREN IN MEXICO

(¹)Nieto, Claudia; (²)Maafs Rodríguez, Ana Gabriela.

(¹)Nutritionist, MSc. Life Sciences Department. Instituto Tecnológico y de Estudios Superiores de Monterrey. Mexico;

(²)Nutritionist, M. Ed. Life Sciences Department. Instituto Tecnológico y de Estudios Superiores de Monterrey. Mexico.

**Background and objectives:** Children in abandonment have become an increasing problem in Mexico. According to the National Institute of Statistics and Geography (INEGI) there are 30 thousand children living in orphanages. Children and adolescents institutionalized in orphanages are exposed to greater risks of poor nutrition and health. The aim of this study was to explore the nutrition status and feeding practices among this vulnerable population.

**Methods:** Quantative: This is a mixed methods study. Quantitative data was taken from (n=24) institutionalized children (<9 years old). Trained personnel measured the children using standardized procedures. Nutrition status of children were categorized according to the World Health Organization criteria. Qualitative: Fieldworkers (n=20) who worked at the orphanage and collected the data, were interviewed to explore their perceived barriers to better food practices.

The interviews were read line by line and then coded. Transcriptions were analyzed using the MAXQDA software.

**Results:** Quantative: Stunting was prevalent among children (n=11, 45.8%), whereas overweight and obesity had a lower prevalence (n= 2, 8.3%). Qualitative: Three main themes arose from the analysis: 1) Poor hygiene methods: participants reported lack of hygiene in the kitchen and food wasting. "It is quite hard to manage that amount of food with reduced space and hardly any kitchen staff to help out..." 2) Caregiver's attitude/situation: most of the caregivers felt observed; therefore, they might not have acted as usual. "We had everything, from very willing nurses to others very conservative with their methods" and 3) Perceived need for a multidisciplinary approach: Most of the participants reported that there was a generalized need for nutritionist and psychologist to be involved in the caring of the children. "Most of the children need psychological support due to their vulnerable situation".

**Conclusions:** Results showed that most of the institutionalized children are stunted (this situation might come from previous abandonment situation); furthermore, feeding practices and hygiene methods could be improved. Data showed that there is generalized call for a multidisciplinary approach. Government should be encouraged to improve the nutrition of orphan children around the country.

**Keywords:** Nutrition status, feeding practices, orphaned children.

144/2159

STRESSORS AND COPING STRATEGIES OF INFANT AND YOUNG CHILD FEEDING PRACTICES
IN RWANDA: PERCEPTIONS OF MOTHERS, FATHERS, GRANDMOTHERS AND COMMUNITY HEALTH WORKERS

(¹)Ahishakiye, Jeanine; (²)Bouwman, Laura; (³)Brouwer, Ingeborg;

(⁴)Matsiko, Eric; (⁵)Koelen, Maria.

(¹)MSc. Human Nutrition and Dietetics Department.University of Rwanda. Rwanda; (²)PhD.Health and Society Chair Group. Wageningen University. The Netherlands.; (³)PhD. Nutrition and Health over the life course chair group. Wageningen University. The Netherlands.; (⁴)MSc.Human Nutrition and Dietetics Department.University of Rwanda. Rwanda.; (⁵)Professor, PhD. Health and Society Chair Group. Wageningen University. The Netherlands.

**Background and objectives:** Background: Chronic malnutrition is an unabated public health priority in Rwanda with an unacceptable high stunting prevalence of 38% among under-five year olds. Although exclusive breastfeeding is a social norm and widely practiced, only 18% of children aged 6-23 months are fed in accordance with the recommendation for infant and young children feeding practices, contributing to these high rates.

**Aim:** This study investigated the everyday challenges towards appropriate infant and young child feeding practices (IYCFP) experienced by community members in poor resource, rural setting of the Muhanga District in Rwanda and how they engage resources.
es and strategies to deal with these challenges by use of a salutogenic, solution-oriented approach.

**Methods:** 16 Focus group discussions were held with mothers, fathers, grandmothers and community health workers (CHWs) in Muhanga district (144 participants in total). The discussions were recorded, transcribed verbatim and thematically analyzed using Atlas.ti software.

**Results:** Two main themes emerged from the data. Firstly, a discourse on optimal practices that reflects the knowledge about and efforts to align with recommendations on proper IYCFP. Second, a discourse on impeded mother-child interaction involved challenges hindering optimal practices and the applied resources and strategies. A number of challenges emerged as impeding appropriate IYCFP being mainly poverty, gender imbalance (laborious women's work and limited support from partner) and seasonal fluctuations. Required resources included time-availability, attentiveness, responsiveness and resources specific to optimal complementary feeding such as availability of proper foods, money, and home-grown food. Strategies to cope with the challenges involved family and social support from CHWs and health facility staff, financial support through casual labor, mothers saving and lending groups and kitchen gardens.

**Conclusions:** Conclusion: Determinants of IYCFP are beyond food practices and embedded in everyday-life situations (mother's workload, social support at family and community levels, financial resources available at family level, mothers' knowledge about appropriate IYCFP). Hence, strategies to improve child nutrition should also go beyond food related practices and consider the multidimensional nature of IYCF in the everyday reality of those living in impoverished situations.

**Keywords:** Infant and young child feeding practices, breastfeeding, stressors, salutogenesis, coping strategies

## COMMUNITY VIDEO: AN ADAPTABLE AND EFFECTIVE TOOL FOR NUTRITION SOCIAL AND BEHAVIOR CHANGE

**Background and objectives:** Community video is an innovative social and behavior change communication (SBCC) tool that can be harnessed to promote maternal, infant, and young child nutrition (MIYCN), hygiene, and nutrition-sensitive agriculture practices. The USAID-funded Strengthening Partnerships, Results: **Methods:** Formative research is crucial for adapting this community-centered model, allowing implementers to better understand the nutrition context, as well as influencers and determinants of key behaviors, and to prioritize behaviors for video top-

ics. Local extension agents or community volunteers are trained on MIYCN, hygiene, and nutrition-sensitive agriculture (in some contexts) as well as on video production for select team members. SPRING works with local partners and teams to create videos addressing priority behaviors and determinants featuring "early adopters" of improved practices. After production teams pretest and finalize videos, they are shown in community peer groups using portable pico projectors, followed by facilitated discussions.

**Results:** A feasibility study conducted in India in 2013 found the approach to be promising, with good community engagement and interest as well as anecdotal evidence of behavior change. Evaluations in Niger and Burkina Faso found the approach to be an effective and cost-effective SBCC approach. An evaluation of the pilot program in Niger found that households that have handwashing stations with water and soap increased from 73.8% at baseline to 96.2% only 3-4 months after exposure to videos on handwashing. The program's cost per beneficiary reached was approximately US$16.19 per person, projected to be US$3.73 once the program is taken to scale. The approach has been successfully adapted for a number of contexts and local partnership models, and a focus on capacity-building for local production teams has strengthened the sustainability of the approach.

**Conclusions:** Community video is a promising SBCC approach for promoting nutrition-specific MIYCN and hygiene as well as nutrition-sensitive agriculture practices. The approach provides implementers and communities with a flexible tool to create participatory, context-specific, and sustainable nutrition-related SBCC programs.

**Keywords:** SBCC, nutrition, MIYCN, nutrition-sensitive agriculture, ICT.

**Further collaborators.**

Marjolein Moreaux. MSc. SPRING Project. Save the Children. Belgium.

Philip Moses. MPH. SPRING Project. JSI Research and Training Institute, Inc. USA.

Leanne Dougherty. MPH. SPRING Project. John Snow, Inc. USA.

Avinash Upadhyay. BA. PG Diploma. Digital Green. India.

## ASSESSMENT OF A CASCADE TRAINING APPROACH FOR NUTRITION: LESSONS LEARNT FOR E-LEARNING IN GUATEMALA

**Background and objectives:** The Diplomado course, developed in 2014, focused on training on maternal infant and young

<footnote>(1) Cunningham, Sarah; (2) Granger, Kristina; (3) Koniz-Booher, Peggy;</footnote>

<footnote>(4) Moses, Philip.</footnote>

<footnote>(1) BS. SPRING Project. JSI Research and Training Institute, Inc. USA;</footnote>

<footnote>(2) MPH. SPRING Project. The Manoff Group. USA.; (3) MPS. SPRING Project. JSI Research & Training Institute, Inc. USA.; (4) MPH. SPRING Project. JSI Research and Training Institute, Inc. USA.</footnote>

<footnote>(1) Palmieri, Mireya; (2) Kavle, Justine; (3) Fischer, Maggie; (4) Gomez, Leonel.</footnote>

<footnote>(1) Msc. Independent Consultant.; (2) PhD. Senior Nutrition Advisor. Maternal Newborn Child Health and Nutrition Division. Maternal and Child Survival Program (MCSP) / PATH. Washington DC. USA.; (3) MPH. Chief of Party. Maternal and Child Survival Program (MCSP)/ Save the Children. Guatemala City. Guatemala.; (4) MD. Technical Director. Maternal and Child Survival Program (MCSP)/ Jhpiego. Guatemala City. Guatemala.</footnote>
child nutrition for various cadres of health providers, including auxiliary nurses and nurses. In 2015, ~ 600 health providers were trained in eight modules related to Essential Nutrition Actions. Central and district levels viewed the course as a core training tool for nutrition. To date, no assessment of training methodologies for nutrition have been conducted in the country - which can inform on training strategies needed at the national and subnational levels. The key objectives of this assessment are to ascertain the strengths and areas of improvement of the Diplomado course, as well as examine the value added of the cascade training as a training methodology and the potential to adapt the course for e-learning to other health content, beyond nutrition.

**Methods:** This mixed methods assessment included 8 focus group discussions (FGDs) with health providers, 32 in-depth interviews (IDIs) with health providers and 8 FGDs with facilitators which were carried out in three areas of western Guatemala. In addition, 15 IDIs with key stakeholders involved in the design and/or implementation of the course were conducted. Following transcriptions of recordings for FGDs and IDIs, key emergent themes and sub-themes were coded. Quantitative post-tests were analyzed by topic. A review of key official documents and supporting materials was also carried out.

**Results:** The course demonstrated improved health providers' knowledge in key nutrition areas. Areas of improvement identified by health providers and facilitators included greater time allotment for content learning, and real-time learning at health facilities, in areas such as growth monitoring and interpretation. Implementing routine supportive supervision and mentoring were recognized needs for translation of skills to achieve improvements in quality of health services. Adaptation of the course through the development of additional health modules, on topics such as family planning and greater awareness of stunting at community level were cited as important.

**Conclusions:** The Diplomado course has potential for further expansion and adaptation to other areas, through an e-learning platform.

**Keywords:** Capacity building, nutrition, e-learning, health providers, health.

**Conflict of Interest Disclosure:** One of the authors, M. Fischer, aided in supporting the implementation of the Diplomado course. The author aided in providing input to the recommendations, though did not partake in collection of data, analyses or design of the assessment.

**Background and objectives:** Malnutrition in young children of Ethiopia is mainly related to poor quality and quantity of complementary foods, which are thin cereal gruels lacking in animal-sources. One egg a day is recommended but accessibility is low. By age of 12 months, need for calcium (Ca) goes up dramatically. An eggshell contains ~2 grams Ca. The objective was to evaluate effects of promoting egg and eggshell powder (ESP) consumption on nutritional status of children of 6-24 months.

**Methods:** A cluster, randomized, controlled trial was conducted in Halaba in 2016 for 6 months, following Intervention (127) and Control (128) children, 6-12 months old. Caregivers were counselled on feeding children with egg and ESP and on safe homestead poultry husbandry. Chicken gift ceremony was conducted in intervention kebeles. Children received two egg-laying local chickens; caretakers promised not to sell or share eggs nor chickens, and to maintain two or more chickens.

**Results:** Within one month, 83% of children had ≥3 hens; this increased to 93% by endline. Average egg consumption by children increased from ≤2 to 17 eggs/month; control children remained at 2 eggs/month. Eggshell use was accepted. Most children in the intervention group consumed ESP mixed in hardboiled egg. There were more underweight (-2SD WAZ) and stunted (-2SD HAZ) children in the Control group with 28% and 36% than in the intervention group with 20% and 25%, respectively. Underweight was reduced by 15% in the Intervention arm while a slightly increasing pattern was observed in the control group. Stunting increased in both groups with similar trend; however severe stunting rate (-3SD HAZ) was increased at a slower rate in the Intervention group. Hemoglobin <11.0 g/dl was more prevalent in the Control group (22%) than in the Intervention (16.5%) but decreased in both groups at the same rate.

**Conclusions:** The effect of increased egg and ESP consumption was seen as reduction of underweight but not stunting. Benefits of increased egg and eggshell consumption on intake, however, may have been offset by having free-range chickens corralled in homes each night, with potential to negatively affect children's health.

**Keywords:** Malnutrition, hemoglobin, stunting, poultry, calcium.

**Conflict of Interest Disclosure:** Funding from One Health, University of Saskatchewan

<footnote>(1)Whiting, Susan; (2)Omer, Anteneh; (2)Mulualem, Demmelash;</footnote>

<footnote>(3)Classen, Hank; (4)Vatanparast, Hassan.</footnote>

<footnote>(1)PhD. College of Pharmacy and Nutrition. University of Saskatchewan. Canada; (2)MSc. School of Nutrition, Food Science and Technology, Hawassa University. Ethiopia; (3)PhD. Animal and Poultry Sciences. University of Saskatchewan. Canada; (4)MD. PhD. College of Pharmacy and Nutrition. School of Public Health. University of Saskatchewan. Canada.</footnote>
# PROCESS EVALUATION OF THE CLUSTER RANDOMIZED CONTROLLED TRIAL ACTIVITAL- A SCHOOL-BASED HEALTH PROMOTION INTERVENTION

(1)Ochoa, Angelica; (2)Ochoa Avilés, Angelica; (3)Verstraeten, Roosmarijn; (4)Andrade Tenesaca, Dolores Susana; (5)Andrade Muñoz, Diana Jesús; (6)Ramírez Jimbo, Patricia Liliana; (7)Donoso Moscoso, Silvana Patricia; (8)Kolsteren, Patrick.

(1)MD. PhD. Department of Biosciences. Faculty of Chemistry Sciences. Cuenca University. Ecuador.; (2)MSc. PhD. Consultant. Ghent-Belgium; (3)MSc. PhD. Department of Biosciences. Faculty of Chemistry Sciences. Cuenca University. Ecuador.; (4)Eng. MSc. Department of Biosciences. Faculty of Chemistry Sciences. Cuenca University. Ecuador.; (5)Bioq. MSc. Department of Biosciences. Faculty of Chemistry Sciences. Cuenca University. Ecuador.; (6)MSc, PhD. Department of Food Safety and Food Quality. Ghent University-Belgium.

**Background and objectives:** Process evaluations (PE) of behavioral interventions can help to understand pathways of change and assess the opportunities to implement the intervention in real practice. In Ecuador, the school-based health intervention ACTIVITAL was effective in decreasing adolescents intake of added sugar and unhealthy competitive food items as well as in decreasing waist circumference. We report the PE of the ACTIVITAL.

**Methods:** The trial involved 10 intervention and 10 control schools and was conducted among 1430 adolescents (12-14 years old). Interventions strategies involved the implementation of interactive healthy eating classes with adolescents, healthy eating workshops with parents and canteen staff, and social events. A full pre-specified PE was performed to document the implementation of the ACTIVITAL intervention. Reach, dose, fidelity and barriers of the intervention were evaluated. Data collection comprised observations, face-to-face interviews and questionnaires, applied to adolescents, parents, teachers and school staff.

**Results:** ACTIVITAL was implemented in all the schools, 46% of the school teachers delivered the classes themselves (the remaining classes were implemented by external teachers). Students received 94% of the planned classes, and, teachers were motivated in 89% of them. The teachers demonstrated sufficient knowledge in 88% of the classes and their students enjoyed 93% of the delivered classes. All the parental workshops were implemented and all but one school participated in the school canteens workshops. All the parental and canteen workshops were delivered by experienced staff and the attendants showed a positive attitude, but parental reach was low (15%). Most of the adolescents enjoyed the social events. The main barriers were the difficulty to include the program in the school curriculum, the voluntary participation of the school teachers, lack of time to perform the classes, poor parental reach, difficulties to change the food and portion sizes served by the canteens staff and persistence of an adverse nutritional environment outside the school.

**Conclusions:** In general, the ACTIVITAL intervention was well implemented and its content was well received by the included au-

diences. Future programs should: incorporate the activities in the school curriculum, deal with poor parental participation and promote changes in the canteens by means of new formative research.

**Keywords:** RCT, diet, school, Ecuador, process evaluation.

# ANTENATAL NUTRITION BEHAVIOUR CHANGE COMMUNICATION: CHANGE IN BIRTHWEIGHT IN RURAL BANGLADESH

(1)Chowdhury, Morseda; (2)Dibley, Michael J.; (3)Alam, Ashraful;

(4)Raynes-Greenow, Camille.

(1)PhD candidate. School of Public Health. The University of Sydney. Australia.; (2)Professor. Global Public Health Nutrition. School of Public Health. The University of Sydney. Australia.

(3)Postdoctoral Research Associate. International Public Health. School of Public Health. The University of Sydney. Australia.

(4)NHMRC Career Development Fellow. Sydney Medical School. School of Public Health. The University of Sydney. Australia.

**Background and objectives:** Historically Bangladeshi diet lacks diversity, heavily dependent on carbohydrates, mostly rice, contributing up to 86% of the total energy intake. Bangladesh observed a sluggish improvement in the nutritional status of women over the last decade. Almost a quarter (24.75%) of pregnant women are moderately malnourished and more than half of them (59.50%) are anemic. Rural pregnant women consume 1464 (±416) kcal energy per day, which is far below the recommended daily allowance. As a result, mothers deliver babies whose birthweight falls below the normal cut off level.

**Methods:** We conducted a cluster randomised controlled trial in one rural district of Bangladesh, where treatment was randomly allocated among 900 pregnant women selected from 36 clusters in equal proportion. Community health workers visited all pregnant women in both groups once in every month from conception till delivery and provided 'balanced plate nutrition education' to intervention group only. The outcome was difference in mean birthweight & low birthweight (LBW) rate. Socio-demographic data was collected on enrolment and outcome was measured within 72 hours after birth.

**Results:** The mean birthweight in the intervention group was 124g greater than that in the comparison group (2.86kg vs 2.74kg; P<0.001). The prevalence of LBW babies was 9.4% in the intervention group and 22.1% in the comparison group (P<0.001). Multivariate analysis revealed that the risk of LBW was 2.78 times lower in the intervention group than in the comparison group (P<0.001) when adjusted for other variables in the model taking cluster effect into account.

**Conclusions:** Balanced plate nutrition education targeted to bring about changes in dietary behaviour with focus to meal balanced in energy and quality can improve birthweight of infants in situation where LBW is a major problem.

**Keywords:** Birthweight, nutrition education, pregnant woman.
# DESIGNING AN INTEGRATED AGRICULTURE AND NUTRITION INTERVENTION TO IMPROVE MATERNAL AND CHILD NUTRITION IN RURAL BANGLADESH: A FORMATIVE RESEARCH

**Background and objectives:** Despite remarkable progress in agriculture over the past three decades in Bangladesh, food and nutrition insecurity among the poor is common. Several parallel interventions in agriculture and nutrition exist that lack integration. This paper presents the formative research findings of a study that assesses the feasibility of an intervention that integrates agriculture and nutrition behavior change with financial incentives, to improve maternal and child nutrition among disadvantaged families.

**Methods:** We conducted qualitative exploration and stakeholder consultation. i) In-depth interviews with mothers of <5 children in very poor households, and their husbands; ii) Key-informant interviews with agriculture extension workers, local shop keepers and mobile banking operators; 3) Focus Groups with opinion leaders and elderly women. We also organized stakeholder meetings that was attended by nutrition researchers, activists and program managers from the government and non-governmental organizations. We finalized the intervention design, including the sites, based on the feedback from the formative research findings and the stakeholders.

**Results:** The families widely practiced home gardening irrelevant of land ownership. Seasonal vegetables are the dominant foods produced in the homestead. Some families raised hens and ducks. The households produced these foods for their own consumption. Gardening and poultry raising were found to be solely women's activities. Respondents reported small size of the homestead and seasonal flooding for home gardening, and lack of medical care for poultry as the main barriers. Respondents knew about mobile banking ('BKash'), although none of them experienced using it. The women received gardening information from their neighbors and relatives. Seeds were provided by the neighbors, NGOs, and often purchased from local agro-dealers. The stakeholders suggested that the Agriculture Extension Workers might only be involved as trainers of counselors because their current job description does not include home visits. They identified voice message as more suitable than text message, and stressed on weekly reminders.

**Conclusions:** This formative research informed the design of a feasibility study that will guide the design of an integrated agriculture-nutrition intervention, which will be implemented and evaluated at a larger scale in the future.

**Keywords:** This formative research informed the design of a feasibility study that will guide the design of an integrated agriculture-nutrition intervention, which will be implemented and evaluated at a larger scale in the future.

# DETERMINANTS OF ADHERENCE TO MICRO-NUTRIENT POWDERS AMONG CHILDREN 6-11 MONTHS OF AGE IN RURAL ETHIOPIA

**Background and objectives:** Micronutrient powders (MNPs) is a promising approach to improve micronutrients intakes of children in Ethiopia where malnutrition remains a public health concern. Adherence is a key element to reach successful implementation of delivering micronutrients to children. Identifying adherence and factors associated with adherence is essential to evaluate the effectiveness of MNPs and to provide necessary information for future MNP program implementation in Ethiopia.

**Methods:** A total of 1193 children aged 6-11 months were provided with MNPs during a seven-month intervention. Adherence and determinants of adherence were assessed monthly through the mothers. Adherence was measured by counting the number of MNPs sachets used, and determinants were assessed using a Knowledge, Attitude, and Practice (KAP) questionnaire. Adherence was defined in two ways: adherence based on distribution scheme and adherence based on instructions. Generalized Estimating Equation (GEE) analysis was performed to examine factors that determine adherence.

**Results:** Adherence fluctuated over time, with an average of 58% for adherence to distribution and 28% for adherence to instruction. On average, children consumed 95 out of total 120 sachets provided during the study. Each month, >80% of mothers reported that the child liked MNPs and > 90% responded that MNPs were easy to use. The factors of MNPs found easy to use, child liked MNPs, support from surrounding people and mother's age >25 years were positively associated with adherence of mothers to give MNPs to their children. Meanwhile, a far distance from home to the health post, knowledge of MNP correct use, perceiving negative effects and living in South Nation, Nationalities and People Region (SNNPR) had negative associations with adherence.

<footnote>(¹)Alam, Ashraful; (²)Bokshi, Anowarul; (³)ARA, GULSHAN; (⁴)Li, Mu;</footnote>

<footnote>(²)McConchie, Robyn; (⁵)Khanam, Mansura; (⁶)Dibley, Michael.</footnote>

<footnote>(¹)PhD. Research Fellow. Sydney School of Public Health. University of Sydney. Sydney. Australia.; (²)PhD. Agriculturist. Sydney Institute of Agriculture. University of Sydney. Australia.; (³)MSc. International Centre for Diarrhoeal Disease Research Bangladesh. Bangladesh.;</footnote>

<footnote>(⁴)PhD. Sydney School of Publeac Health. Univeristy of Sydney. Australia.; (⁵)MSc. International Centre for Diarrhoeal Disease Research Bangladesh. Bangladesh.; (⁶)MBBS. MPH. Sydney School of Publeac Health. Univeristy of Sydney. Australia.</footnote>

<footnote>(¹)Samuel, Aregash; (²)Putri Pamungkas, Nindya; (³)Brouwer, Ingeborg; (⁴)Adish, Abdul Aziz; (⁵)Kebebe, Amha; (⁶)Osendarp, Saskia.</footnote>

<footnote>(¹)MSc. Nutritionist. Division fo Human Nutrition. Wageningen University. The Netherlands. Ethiopian Public Health Institute. Addis Ababa. Ethiopia.; (²)BSc. Nutritionist. Division of Human Nutrition. Wageningen University. The Netherlands.; (³)PhD. Nutritionist. Division of Human Nutrition. Wageningen University. The Netherlands.; (⁴)PhD. Deputy Regional Director. Micronutrient Initiative. Addis Ababa. Ethiopia; (⁵)PhD. Director General. Ethiopian Public Health Institute. Addis Ababa. Ethiopia; (⁶)PhD. Nutritionist. Division of Human Nutrition. Wageningen University. The Netherlands. Micronutrient Initiative. Canada.</footnote>
**Conclusions:** Despite an overall low adherence, the average 95 sachets of MNPs consumed over the study were reasonably good. MNPs were also well accepted by both mothers and children. It suggests that the MNP program has potential to be expanded, by taking into account the factors that positively and negatively determine adherence.

**Keywords:** Micronutrient powders, adherence, young children, Ethiopia.

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## FOOD AND NUTRITION LITERACY (FNLIT) IS ASSOCIATED WITH DIETARY HABITS IN CHILDREN

(1)Omidvar, Nasrin; (2)Doustmohammadian, Aazam; (3)Keshavarz Mohammadi, Nastaran; (4)Amini, Maryam; (5)Abdollahi, Morteza;

(6)Eini-Zinab, Hassan.

(1)PhD. Professor. Department of Community Nutrition. Faculty of Nutrition and Food Technology. Shahid Beheshti University of Medical Sciences; (2)MSc. Nutritionist. Department of Community Nutrition. National Nutrition and Food Technology Research Institute. and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences; (3)PhD. Health Promotion. School of Public Health. Shahid Beheshti University of Medical Sciences.; (4)PhD. Nutritionist. Department of Nutrition Research. National Nutrition and Food Technology Research Institute. and Faculty of Nutrition Sciences and Food Technology. Shahid Beheshti University of Medical Sciences.; (5)MD. MPH. Community Medicine. Department of Nutrition Research. National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology. Shahid Beheshti University of Medical Sciences.; (6)PhD. Sociology. Department of Community Nutrition. National Nutrition and Food Technology Research Institute. and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences.

**Background and objectives:** Food and nutrition literacy may be the underlying factor that protects nutritional quality during transitions. This study evaluates the association between Food and Nutrition Literacy (FNLIT) and dietary habits of elementary school children in Tehran, Iran.

**Methods:** This cross-sectional study was undertaken on 803 students (419 boys and 384 girls) aged 10–12 years from 44 elementary schools in Tehran city. Demographic and socio-economic characteristics were collected through interviewing students and their mothers and/or caregivers. Food and nutrition literacy (FNLIT) was measured by a locally designed and validated self-administered questionnaire consisted of 46 items in 7 subscales. Dietary habits over the last 7 days were assessed by a questionnaire. The multinomial adjusted Odds ratios of food and nutrition literacy for dietary habits were analysed.

**Results:** High level of FNLIT cognitive domain were negatively associated with breakfast skipping (1-2 times a week; OR= 0.32, CI=0.17-0.60), eating lunch less than 7 days a week (neve

er/1-2 times a week; OR= 0.40, CI=0.17-0.93, 3-6 times a week; OR= 0.45, CI=0.25-0.80) and eating dinner less than 7 days a week (never/1-2 times a week; OR= 0.32, CI=0.17-0.68). Also, negative relation between high FNLIT scores in skill domain and breakfast skipping was observed (3-6 times a week; OR= 0.33, CI=0.13-0.78). FNLIT skill domain had an evident positive relation with frequency of eating honey/jam (never eating; OR=0.44, CI=0.21-0.92; eating 1-2 times a week; OR=0.33, CI=0.14-0.76) and never eating sweet snacks (OR=2.84, CI=1.07-7.49). High FNLIT cognitive domain was contributed to never eating sausage/hamburger (OR=2.20, CI=1.01-4.83) and never eating salty snacks, (OR=2.82, CI=1.21-6.54).

**Conclusions:** Our findings highlighted the association between food and nutrition knowledge, skills and capacities and dietary behaviors. This evidence suggests that food and nutrition literacy can play an important role to facilitate healthy dietary behaviors of children. In addition, more emphasis in the development of skills in food and nutrition literacy is essential.

**Keywords:** Nutrition literacy, dietary habits, school age children, Iran.

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## COMMON MATERNAL FEEDING BEHAVIORS IN INFANT FEEDING DIFFICULTIES – RESPONSIVE OR COERCIVE?

(1)Machado, Rachel; (2)Mellisse Tosatti, Abykeyla; (3)Malzyner, Gabriela; (4)Maximino, Priscila Maximino; (5)de Cássia Ramos, Cláudia; (6)Bozzini, Ana Beatriz; (7)Ribeiro, Letícia; (8)Fisberg, Mauro.

(1)MSc. Nutritionist. Centro de Dificuldades alimentares. Instituto PENSI/Hospital Infantil Sabará/ Fundação José Luiz Egydio Setúbal. Brazil.; (2)BSc. Nutritionist. Centro de Dificuldades Alimentares. Instituto PENSI/Hospital Infantil Sabará/ Fundação José Luiz Egydio Setúbal. Brazil.; (3)MSc. Psychologist. Centro de Dificuldades Alimentares. Instituto PENSI/Hospital Infantil Sabará/ Fundação José Luiz Egydio Setúbal. Brazil.; (4)MSc. Nutritionist. Centro de Dificuldades Alimentares. Instituto PENSI/Hospital Infantil Sabará/ Fundação José Luiz Egydio Setúbal. Brazil.; (5)BSc. Speech Therapist. Centro de Dificuldades Alimentares. Instituto PENSI/Hospital Infantil Sabará/ Fundação José Luiz Egydio Setúbal. Brazil.; (6)MD. Pediatrician. Centro de Dificuldades Alimentares. Instituto PENSI/Hospital Infantil Sabará/ Fundação José Luiz Egydio Setúbal. Brazil.; (7)BSc. Nutricionist. Centro de Dificuldades Alimentares. Instituto PENSI/Hospital Infantil Sabará/ Fundação José Luiz Egydio Setúbal. Brazil.; (8)PhD. Pediatrician. Centro de Dificuldades Alimentares. Instituto PENSI/Hospital Infantil Sabará/ Fundação José Luiz Egydio Setúbal. Brazil.

**Background and objectives:** Given the positive influence of responsive caregiving on dietary habits in childhood, to raise awareness of caregivers regarding their feeding behaviors is crucial in multiprofessional care on infant feeding. Objectives: Identification of most common responsive and nonresponsive feeding
practices in mothers of children with feeding complaints, as well as to seek associations between practices and caregivers' profile.

**Methods:** Cross-sectional study with 77 children under 18 years old, with complaints of feeding difficulties. Data were collected during interviews with mothers: children's age, gender, duration of exclusive breastfeeding, presence of organic disease, dynamics of bottle use (normal/prolonged bottle feeding), self-feeding practices and posture at meals (adequate / inadequate), use of appropriate feeding equipment; basic maternal demographic information (parity and level of education), feeding style (according to Hughes et al 2005), presence of coercive feeding, frequency and characteristics of family meals. ANOVA test, Chi-Squared test and binary logistic regression were used, with significance level at 5%.

**Results:** Results a: The nonresponsive profile predominated among mothers (76.2%, with the Authoritarian style being the most prevalent - 39.7%). The responsive profile ('authoritative' style) was characterized by absence of coercive feeding, stimulation of self-feeding practices, use of appropriate feeding equipment and meal environment, with interaction at meals. Nonresponsive profile ('authoritarian', 'indulgent' and 'negligent' styles combined) consisted of both inadequate environment and posture at meals, use of distraction and coercive feeding, lack of shared meals, and disregard for children's hunger signals. The habit of sharing meals with children was associated with mothers' profile, and considered a protection factor against nonresponsive care (OR 0.23; 95% CI 0.06-0.88). Both Authoritarian (p = 0.000) and indulgent mothers (p = 0.007) breastfed exclusively for longer periods of time when compared to negligent ones. There was a higher level of interaction with children in "responsive" parental style (OR 0.056; p = 0.01) compared to non-responsive styles combined.

**Conclusions:** Results highlight the need for educational interventions focused on caregivers' behaviors in families with feeding complaints.

**Keywords:** Responsive caregiving, motherhood, feeding practices, feeding difficulties, feeding complaints.

**Conflict of Interest Disclosure:**

• The PI of the project (Mauro Fisberg) conferences in events such as – Abbott, CPW, EMS, Danone, Nestlé, Nutrociencia, PICME, Sanofi, Wyeth; scientific board member of Danone Institute International, Danone Research, Mondelez. Supports research projects at Abbott, CNPq, Coca-Cola, CPW, Danone Institute International, Danone Research, Fapesp, Fap Unifesp, Nestlé.

• Authors have no participation in food, nutrition or pharmaceutical companies, and there is no influence of any company in any of the projects, conferences or publications conducted.

(1)Doustmohammadian, Aazam; (2)Omidvar, Nasrin; (3)Keshavarz Mohammadi, Nastaran; (4)Amini, Maryam; (5)Eini-Zinab, Hassan; (6)Abdollahi, Morteza; (7)Amirhamidi, Zeinab; (8)esfandiari, Saeed.

(1)PhD Candidate in Nutrition. Department of Community Nutrition. National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology. Shahid Beheshti University of Medical Sciences, Tehran. Iran.; (2)PhD.Nutritionist. Department of Community Nutrition. National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology. Shahid Beheshti University of Medical Sciences, Tehran. Iran.; (3)PhD. Health Education and Health Promotion. School of Public Health. Shahid Beheshti University of Medical Sciences. Tehran. Iran.; (4)PhD. Nutritionist. Department of Nutrition Research. National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology. Shahid Beheshti University of Medical Sciences. Tehran. Iran.; (5)PhD. Sociologist. Department of Community Nutrition. National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology. Shahid Beheshti University of Medical Sciences, Tehran. Iran.; (6)PhD Depart of Nutrition Research. National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology. Shahid Beheshti University of Medical Sciences, Tehran. Iran.; (7)MSc in Nutrition. Department of Community Nutrition. National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology. Shahid Beheshti University of Medical Sciences, Tehran. Iran.

**Background and objectives:** One of the most important personal skills to enable individuals to control the predictors of their health is food and nutrition literacy. Food and nutrition literacy like health literacy should be conceptualized as an asset and a protective factor. This study aimed to measure food and nutrition literacy and its predictive factors among urban 10-12 year-old children in Iran.

**Methods:** This cross-sectional study was undertaken on 803 students (419 boys and 384 girls) aged 10–12 years from 44 elementary schools in Tehran city, Iran. Food and nutrition literacy (FNLIT) was measured by a locally designed and validated questionnaire consisted of 46 items in 7 subscales. Adjusted binary regression logistic was used to assess the extent to which various independent covariates may predict low food and nutrition literacy as dichotomized outcome variables.

**Results:** Approximately 11.6% of students had low total food and nutrition literacy score. The majority (68.8%) of students had high scores in cognitive domain but was poor in skill domain (%2.6). The most important predictive factor of low total food and nutrition literacy was lower level of maternal education (OR=0.29, CI=0.09-0.87). The most important predictive factor of low nutritional health knowledge were father age in 30-40 year-
old compared with younger fathers (OR=0.12, CI=0.02-0.57) and Azeri ethnicity (OR=3.4, CI=1.35-8.71). Girls compared to boys (OR=0.30, CI=0.15-0.59) and students in 6th grade compared with those in 5th grade (OR=0.51, CI=0.28-0.93) had higher level of food choice literacy. Other predictive factors of low food choice literacy were lower mother education level (OR=0.16, CI=0.04-0.56) and younger age of mothers (OR=0.45, CI=0.21-0.96). Girls had lower level of critical food and nutrition literacy than boys (OR=1.57, CI=1.14-2.15). Probability of low critical literacy in latter-birth children was higher than first-birth children (OR=1.50, CI=1.00-2.25). The students whose fathers' were older (≥ 46 years old) had better level of critical literacy (OR=0.56, CI=0.33-0.94).

**Conclusions:** Findings showed that despite desirable scores in cognitive domain, different aspects of food and nutrition literacy skills in primary school students are quite low. In planning future programs to promote food and nutrition literacy, more emphasis on skill development, considering socio-demographic predictors is recommended.

**Keywords:** Food and nutrition literacy, socio-demographic predictors, elementary school children, Iran

increased and customers were re-exposed to the healthy option more places. Sales data were collected pre/post test by canteen staff according to a protocol agreed with management canteens.

**Results:** The results showed that significantly more students chose the healthy snacks when measured follow up after the intervention compared to baseline before. Sales of the unhealthy snacks did not change significantly.

**Conclusions:** If students at vocational schools are to opt out unhealthy snacks and replace them with healthy alternatives, consideration should be given both to increase the exposure of healthy snacks and simultaneously undertake similar actions in the unhealthy snacks, for example by removing them or placing them less visibly in the canteen. Rethinking choice dynamics in self service food lay-outs through easy to implement minor changes seems to be able to change uptake of healthy options. More research is needed to explore effects and potentials of changing food choice architectures.

**Keywords:** Nudging, healthy eating, choice architecture, food environment, self service catering.

**Further collaborators:** the study was supported through a grant from Danish Heart Association

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EASIER TO CHANGE ENVIRONMENTS THAN TO CHANGE BEHAVIOR? RETHINKING FOOD CHOICE DYNAMICS INCREASE SALES OF HEALTHY SNACKS AMONG YOUNG PEOPLE IN VOCATIONAL SCHOOL CANTEENS

(1)Mikkelsen, Bent Egberg; (2)Romani, Annette Quinto.

(1)PhD. Professor. Department of Clinical Medicine. Captive Foodscape Studies. Aalborg University. Copenhagen. Denmark;

(2)PhD. Department of Sociology, Aalborg University.

**Background and objectives:** Improving the dietary patterns of young people in a healthier direction is of considerable societal concern. Traditional approaches rest on the assumption that information an education can facilitate such change. However, studies have shown that such approaches tends to benefit those already complying with official nutritional advice whereas the socially less advantaged tends to benefit less. As a result, there is an increasing interest in interventions targeting the environment. According to dual process behavioral psychology changes in the environmental design - often referred to as nudgings - holds the potential to influence the consumer to make healthier decisions. The aim of this study was to examine if influencing food choice dynamics by slightly altering the choice architecture by relocating and re-exposing the healthy option could increase sales of healthy snacks among young people in vocational school canteens.

**Methods:** A healthy eating intervention was developed for young people in canteens of 13 vocational schools. The subjects attending is mainly young men between 16 and 19 years of age. A healthy snack pack not previously offered was developed. The intervention targeted the access to healthy snacks using 2 environmental change strategies. Salience of the healthy snack pack was

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ILLEGAL COMMERCIAL SALES OF INFANT FOR-MULA AND INFANT PRODUCTS IN RIO DE JA-NEIRO CITY, BRAZIL

(1)Boccolini, Cristiano Siqueira Boccolini; (2)Couto de Oliveira, Maria Inês; (3)Afonso Bertoldo, Lucilene; (4)Borges da Silva, Karine; (5)Priscila Nunes Rodrigues, Gloria.

(1)PhD, Institute of Scientific and Technological Communication and Information for Health. Fiocruz. Brazil; (2)PhD. MEB. Universidade Federal Fluminense. Brazil; (3)PhD candidate. PPGICS. ICICT. Fiocruz. Brazil; (4)MsC. PPGSC. MEB. UFF. Brazil; (5)PPGSC. MEB. UFF. Brazil.

**Background and objectives:** The International Code of Marketing of Breast-milk Substitutes was decreed in 1981 by WHO in response to general breastfeeding decline observed trough the World. The aim of this document was to incentivize countries to introduce advertisement codes and legislation in order to protecting breastfeeding against predatory industry marketing strategies. In Brazil, the "International Code" was implemented as national regulation in 1988 and became a national law in 2006, named "Norma Brasileira de Comercialização de Alimentos para Lactentes e Crianças de Primeira Infância, Bicos, Chupetas e Mamadeiras" (NBCAL), in which, among other measures, infant formula, baby bottles and pacifiers cannot have special sales when commercialized. However, a NGO named International Baby Food Action Network has been reporting several marketing violations all over Brazil. The aim of this study was to evaluate commercial sale of infant formula and products related to baby feeding.

**Methods:** Cross-sectional study representative of Rio de Janeiro city's South-Zone, Brazil, a region with population from all
social classes, where a sample of 60% of stores that commercialize products in the scope of NBCAL were evaluated between March and April, 2017 (n=195). All commercialized products not allowed to have special sales were considered: Infant Formulas (IFO), Infant Formulas for Special Needs (IFO_SN) and baby bottles, pacifiers and nipple protection shells (BBPN).

**Results:** Among 195 stores evaluated, 68.4% were pharmacies, 23.7% supermarkets and 7.9% department stores. Among those, 83.6% commercialized IFO, 63.6% IFO_SN and 74.3% BBPN, and 22.3% had illegal commercial sales. Considering stores that commercialized IFO's (n=163), 14.7% had illegal sales; among those commercializing IFO_SN's (n=124), 11.3% violated the NBCAL law; and considering BBPN's commercialization (n=145), 11.7% stores had illegal sales.

**Conclusions:** The high prevalence of illegal commercial sales of infant formulas, baby bottles, pacifiers and nipple protection shells, with violations ranging from special exposition to individual discounts, suggests the need of reinforced vigilance by the governmental agencies. The disrespect of stores and infant food companies with the NBCAL law may be jeopardizing the family ability to choose the best way to feed their babies.

**Keywords:** Marketing. Breastfeeding. Infant Formula. Pacifier

**Results:** The university community devotes its free time: to use electrical appliances (internet of 1 to 3 hours / day), to social networks, to eat and to sleep (5 to 8 hours); Teachers and students report that they generally nap, do not attend cultural events organized by the university and do not use sports facilities; 27.2% were overweight, 7% some degree of obesity, with a higher prevalence in the age group of 20-29 years; In the category student predominated male sex and 1.8% underweight in the female

**Conclusions:** The University population does not have a healthy lifestyle, not making good use of their free time, with important percentage of high weight.

**Keywords:** Free time, university, usual activities.

**Further collaborators.**

Nayhelli Gutiérrez Castañón

144/2593

FREE TIME, RECREATION AND ITS RELATIONSHIP WITH THE NUTRITIONAL STATE BY BODY MASS INDEX, IN UNIVERSITY POPULATION

(1)Hernández Juan, Patricia; (2)Hernández Juan, Patricia; (3)Bezares, Vidalma del Rosario Sarmiento; (3)Solís López, Magnolia; (4)León Gonzaléz, Juan Marcos; (5)Bezares Parada, Alma Cristina; (6)Pascacio González, María del Rocío.

(1)PhD. Instituto de Estudios Universitarios; (2)PhD. Full Time Research Professor (PITC) IEU; (3)PhD. Full Time Research Professor (PITC) UNICACH; (4)Nutritionist, Full Time Research Professor (PITC) UNICACH; (5)Nutritionist UNICACH; (6)Nutritionist, Professor (PITC) UNICACH.

**Background and objectives:** Free time is not currently used for activities that fully benefit the health of the individual. Health involves working productively and actively in social life. The objective of the research was to determine the habitual activities in leisure time and recreation, relating it to the nutritional state of the UNICACH University population.

**Methods:** The main activities performed in the free time were classified, and a diagnosis was made regarding gender, age, occupation, and body mass index (BMI), applied through a sample of 20% (905 individuals), random sampling Stratified: CU-UNICACH teachers, administrators and students, men and women 18 years and older, with letter of informed consent. Application of questionnaire "Use of free time" (reliability of 0.84 Cronbach Alpha). Equipment: mechanical scale model 761, (150 kg), portable stadiometer (120 cm), brand SECA. BMI assessed with Quetelet cohort points, expressed as percentage and ANOVA.

144/2605

PROMOTION OF LOCAL AGROBIODIVERSITY IMPROVES DIETS OF WOMEN AND CHILDREN IN NORTH WEST VIETNAM: A CLUSTER RCT

(1)Raneri, Jessica E; (2)Hoang, Ky; (3)Berti, Peter; (4)Kennedy, Gina;

(5)Lachat, Carl.

(1)MSc. Healthy Diets from Sustainable Food Systems Initiative. Bioversity International. Italy. MSc. Department of Food Safety and Food Quality. Faculty of Bioscience Engineering. Gent University. Belgium.; (2)MPh. Health Nutrition and Food Security Program. HealthBridge Foundation Canada. Vietnam.; (3)PhD. HealthBridge Foundation. Canada.; (4)PhD. Healthy Diets from Sustainable Food Systems Initiative. Bioversity International. Italy.; (5)PhD. Department of Food Safety and Food Quality. Faculty of Bioscience Engineering. Gent University. Belgium.

**Background and objectives:** Local agrobiodiversity has the potential to improve diet quality. Ethnic minority groups in North West Vietnam have poor nutrition despite the region being an agrobiodiversity hotspot. A cluster randomized control trial was conducted in North West Vietnam.

**Methods:** Four communes were randomly selected and allocated to control and intervention groups. From each, 85 women with at least one child aged 12-24 months were randomly selected. The one-year intervention was community-based farmer field school-like model (clubs). These promoted increased diversity of target food groups (FGs) produced and consumed based on identified low consumption in the baseline: pulses and vitamin A-rich vegetables and fruits. From these, neglected crops (produced by <40% of households) were selected by communities as 'target crops'. Clubs delivered training on two components: 1) Nutrition education and cooking demonstrations and 2) Agricultural capacity building in home gardens. Dietary intake was assessed using an administered quantitative 24-hour recall.

**Results:** After controlling for pre-intervention values, child sex and age, mother age and education and household income, 37% more women and 18% more children met Minimum Dietary Diversity Score (MDDS) compared to the control group. MDDS
increased significantly in the intervention group by 0.4 (p<0.01) and 1.4 (p<0.08) in children and women respectively. The number of species consumed increased more in the intervention than control, by 1 species in women and 4 in children (P<0.001 for both). The mean quantity of target FGs consumed per day also increased more in the intervention group. For women, pulses increased by an average of 47g/day (p<0.05); vitamin A-rich vegetables by 47g (p<0.001) and for vitamin A-rich fruits by 11g (p<0.001). For children, consumption of pulses, vitamin A-rich vegetables and vitamin-A rich fruits increased by 40, 26 and 3 grams, respectively (p<0.05, p<0.001, and p<0.01 respectively). Mean micronutrient intakes also increased more in the intervention group, especially for Vitamin A (RE), Vitamin C, B2, Folate, Calcium, Iron and Zinc.

**Conclusions:** Diet diversity and quality increased significantly after the intervention. This is consistent with previous global research demonstrating links between agrobiodiversity and food and nutrition security. We recommend replication of the study in different farming and agroecological systems.

**Keywords:** Diet diversity, Home gardening, Vietnam, Agrobiodiversity, Nutrition Education.

**Further collaborators:** Nga Le Thi

144/2613

## FOOD SUPPLY AT CHILDREN SCHOOL CENTERS, AND PRESCHOOLARS' NUTRITIONAL STATE BEFORE AND AFTER FOOD NUTRITION ORIENTATION

(1)Bezares Sarmiento, Vidalma del Rosario; (2)Ballinas Aquino, José Manuel Ballinas Aquino; (3)León Gonzaléz, Juan Marcos; (4)Toalá Bezares, Karina Jeanette; (2)Cruz Serrano, Nely Isabel; (3)Coello Trujillo, Verónica Guadalupe.

(1)Phd. Facultad de Ciencias de la Nutrición y Alimentos. Universidad de Ciencias y Artes de Chiapas; (2)PhD. Doctor. Facultad de Ciencias de la Nutrición y Alimentos. Universidad de Ciencias y Artes de Chiapas. México; (3)Msc. Nutritionist. Facultad de Ciencias de la Nutrición y Alimentos. Universidad de Ciencias y Artes de Chiapas. México; (4)Msc.Communicator. Facultad de Ciencias de la Nutrición y Alimentos. Universidad de Ciencias y Artes de Chiapas. México.

**Background and objectives:** The 21% of the caloric intake in kids comes from sugary drinks. In Mexico, over-weight and obesity has increased by a 26%, mainly due to preschoolers' sedentary lifestyle. The objective of this research was to gather data regarding the food offer at children school centers in Tuxtla Gutiérrez, Chiapas, México, and to offer food orientation in order to see changes in preschoolers' nutritional state

**Methods:** Investigation at the convenience of the researcher, with the authorization of parents and managers of the institution through personalized service, applied in 62 preschoolers, aged between 3 to 6 years, applied to children's school. The study variables were: weight / age (P / E), weight / height (P / T), height /

age (T / E). The equipment used was: mechanical scale model 761, (150 kg), portable meter (120 cm), brand SECA. The observation of foods available in and out of school was done through a tracking log. In educational guidance, didactic games and images were used, aimed at mothers and children, with two times of anthropometric assessments for preschoolers

**Results:** Food availability was 59% high energy density, low in fiber, with higher consumption of fried preparations, sweetened waters and sweet. Size for age improved 7.7%, from Normal: 58.1% to 65.8%; On the other hand the low cut went from 25.8% to 20.9%. In the case of weight for height improved 3.2%, from the Normal status figure: 56.4% to 59.6%, as well as the Low weight step from 30.8% to 12.9%; Although in a negative way, the results show a weight increase of 2.9 to 27.5%, predominantly in children. With regard to weight for age improved 19.3%, from Normal: 42% to 61.3%; In the case of the deficit, malnutrition increased from 46.9 to 16.1%, but, with an increase in overweight or obesity of 11.4% (11.2 to 22.6%, higher in children

**Conclusions:** Obesogenic atmosphere at children school centers. The orientation towards mothers and children turned out beneficial to increase normality rates in nutritional state. A considerable number of mothers over-concerned about increasing their children's weight; by not improving the food offer availability this phenomena will grow

**Keywords:** Food, preschool, orientation.

144/2696

## PROCEDURAL ASSESSMENT IN FOOD AND NUTRITION EDUCATION GROUPS FOCUSING ON AUTONOMY FOR FOOD CHOICES

(1)Vieira, Viviane Laudelino; (2)Zillesg Borges dos Santos, Bruna;

(1)Caesar de Andrade, Samantha.

(1)PhD in Science. Food and Nutrition Reference Center (CRNutri). School Health Center Geraldo de Paula Souza. School of Public Health - University of São Paulo. Brazil.; (2)Undergraduate in Nutrition. Department of Nutrition. School of Public Health. University of São Paulo. Brazil.

**Background and objectives:** The assessment of food and nutrition education (FNE) actions can be considered a big challenge to the nutritionist, with the tendency to reduce it to quantitative indicators. Given that, this article describes the use of field diary as a procedural evaluation technique for FNE groups with focus on the autonomy for food choices.

**Methods:** Twelve reports from field diaries produced by two facilitators of the FNE groups (G1 and G2) and also, following the operating group benchmarks, were used. The groups presented 6 weekly meetings (1h30). In total, participated 10 people from G1 and 15 from G2, in addition to the facilitator and one observer. After each meeting, these steps were followed: (1) preliminary discussion immediately after the meeting, (2) field diary writing and (3) evaluation of the previous meeting and planning of the next one. There were successive diaries readings and plannings,
allowing the identification of evaluation vectors proposed by Pichon-Rivière: communication, belonging, learning, tele, coop-eration and relevance.

**Results:** Initially, it was delegated to the facilitator the leadership on knowledge proposition, however, it was provided a collective construction of different aspects related to health and nutrition, resulting in learning with greater significance among participants. The communication process has been developed during the weeks, both related to the facilitator, as well as among participants. In the G2, it was noted an initial difficulty in people's interaction, which was eventually overcome as participants began to feel as a part of the group (belonging). Cooperation was explicit in G1, noted by how participants felt responsible for each other. As the meetings were occuring, more intense affinities (G1) and rejections (G2) could also be observed (tele). The tasks proposed in the meetings were eventually questioned both by G1 as G2, in addition, in face of participants' demands, adjustments were made for greater relevance.

**Conclusions:** Field diary consisted in an accessible and distinguished technique not only to guide the assessment of the meeting but also the planning for the next one, enabling a better understanding of each participant profile, mainly of the group's movements as a whole, contributing to the improvement of the facilitator's performance.

**Keywords:** Food and Nutrition Education. Nutritionist. Health Education. Human Resources Training.

## MEXICAN FOOD BANKS: FROM ALLEVIATING FOOD INSECURITY TO PROMOTING HEALTHY EATING HABITS

(1)Cepeda Lopez, Ana Carla; (2)Quiroga Garza, Angélica; (3)Delgado González, Erika; (4)Vera Sayago, Ana Maria; (5)Plascencia Mendoza, Eduardo; (6)Leyva Ramos, Ana Cristina; (7)Banda Cambron, Sergio Antonio; (8)Ortiz-Tirado Aguilar, Almendra.

(1)PhD. MSc. MD. Ciencias de la Salud. Universidad de Monterrey. México.; (2)PhD. Psychologist. Departamento Académico de Psicología. Universidad de Monterrey. México.; (3)MSc student. MD. División de Ciencias de la Salud. Universidad de Monterrey. México.; (4)MD. División de Ciencias de la Salud. Universidad de Monterrey. México.; (5)Certified Chef. Centro de Investigación Innovación Gastronómica. México.; (6)Nutritionist. Banco de Alimentos de México. México.; (7)BS nutrition student. Banco de Alimentos de México. México.; (8)Sociologist. Banco de Alimentos de México. México.

**Background and objectives:** Mexico, as many other countries, is currently facing both sides of malnutrition. This problem goes beyond food availability and involves food quality. We are facing a diet transition that includes more processed food and inadequate vegetable intake. Food banks alleviate immediate food insecurity, and recently their ability to promote healthy nutrition has been recognised to play a central role.

In a descriptive study, previous to an educational program that aims to educate, train, and empower food bank recipients with the information and skills they need to improve eating patterns and preserve their health and the family's well-being: "Comer en Familia", a situational study was conducted.

**Methods:** 755 women/caregivers recipients of a food bank in San Cristobal de las Casas, Chiapas were surveyed about cooking knowledge, attitudes and behaviors.

**Results:** When asked about cooking tools and appliances 91% refer to own a blender, 61% a refrigerator, 34% a stove and 20% a microwave. Only 25% own a traditional "molcajete" (wrinding stone), 31% a Corn mill and 7% a metate (traditional flat stone used for grinding corn). Most of them own a pewter (62%) or aluminum (44%) pot, while 12% own a clay pot. Most participants (92%) cook at home and enjoy cooking for their family. 70% spend around 30 minutes to 1 hour cooking per day. Also, most of them eat at home (90%) together with their families (76%). However, 61% find it difficult to have access to fruits and vegetables at their communities, and 56% considered that eating healthy is expensive.

**Conclusions:** Food banks are potential sites for effective nutrition promotion programs by improving access to healthy and affordable food together with nutrition education such as cooking from scratch and getting the most from their food. Preliminary findings also suggest that women play an important role in the family's health. They are the caretakers of household food and nutrition security. Therefore, educating, training, and empowering women with the information and resources they need to improve eating patterns and preserve their health and the family's well-being is key to achieving food security in Mexico and deserves further study.

**Keywords:** Malnutrition, food security, nutrition education, cooking skills, food banks.

**Conflict of Interest Disclosure:** Ana Cristina Leyva, Sergio Antonio Banda Cambron, Almendra Ortiz-Tirado Aguilar are employees of the Mexican Food Bank (Banco de Alimentos de México). The other authors have not stated any conflicts of interest.

**Further collaborators.**

The authors are grateful to Fundación FEMSA for funding this project, to the food bank of San Cristobal de las Casas staff who assisted with data collection and facilitated the program, as well as the women/caregivers who participated.

## INFLUENCE OF MEAL CULTURES ON FOOD AND NUTRITION SECURITY: A CASE OF AFRICAN INDIGENOUS VEGETABLES IN KENYA

(1)Musotsi, Anne; (2)Abukutsa, Mary.

(1)Nutritionist. Department of Nutritional Sciences. Masinde Muliro University of Science and Technology. Kenya; (2)PhD. Horticulture. Department of Horticulture. Jomo Kenyatta University of Agriculture and Technology.Kenya.

**Background and objectives:** As Kenya focuses on achieving the sustainable development goals (SDGs), persistent food insecurity.
rity and high level of poverty in over 50% of the population are still prevalent in some parts of the country. Contrastingly, the prevalence of metabolic syndrome (MS) associated with excess intake of calories is 34.6%. Various micronutrient deficiencies are also prevalent. Intervention measures, therefore, have to address both excessive and inadequate intake of nutrients. The use of African Indigenous Vegetables (AIVs) to alleviate hunger and malnutrition in Africa is under study. African Indigenous Vegetables are nutritionally superior to their exotic counterparts in some respects, have several agronomic advantages and some are also reported to have medicinal value. This notwithstanding, consumption of AIVs has been decreasing in some parts of Kenya. This trend is accompanied by loss of diversity and indigenous knowledge on preparation and cooking of AIVs. The objective of this research was to establish the preparation and cooking methods and consumption of AIVs in Kenya. The research questions were: which factors determine AIV consumption and how do meal cultures affect consumption patterns of AIVs?

**Methods:** The research design was a qualitative approach involving focus group discussions, cooking-along interviews and participatory observation as well as expert interviews. Research areas were Nairobi (urban), Nakuru (peri-urban), Kakamega (rural). The sample size was 50 (expert interviews, FGD, cooking along interviews), which were conducted between March 2015 and October 2016. Findings showed that eight varieties of AIVs were commonly consumed in various parts of Kenya.

**Results:** Findings showed that eight varieties of AIVs were commonly consumed in various parts of Kenya. More varieties were consumed in rural than urban areas. Indigenous knowledge, time for preparation and cooking, gender relations, price and perception were among factors that influenced consumption of AIVs. Further, consumption largely depended on ethnicity and the cultural practices influencing choice of food in various ethnic groups.

**Conclusions:** The study concluded that for optimal utilization of AIVs for food and nutrition security, there is need for interventions to promote acceptability of foods across different ethnic groups in Kenya and to overcome obstacles to preparation, cooking and consumption of AIVs.

**Keywords:** African Indigenous Vegetables, meal cultures, food and nutrition security.

**Conflict of Interest Disclosure:** This is part of my PhD work registered at Jomo Kenyatta University of Agriculture and Technology, Kenya

**Further collaborators.**

Supported by the HORTINLEA Project

# Track 8: Agriculture, Food Science and Safety

144/391

## WHAT IS THE QUALITY OF SCHOOL MEALS IN BRAZIL?

(1)Camargo, Rafaella; (2)Domene, Semiramis.

(1)MSc. Dietitian. Federal University of São Paulo, Baixada Santista Campus. Institute of Health and Society, Graduate Program in Food, Nutrition and Health. Santos. São Paulo. Brazil.; (2)PhD. Dietitian. Federal University of São Paulo, Baixada Santista Campus. Institute of Health and Society. Department of Public Policies and Collective Health. Santos. São Paulo. Brazil.

**Background and objectives:** Brazilian is recognized internationally through the National School Meal Program (PNAE). PNAE, created in 1954, is reference for other countries in view of their universal coverage, perenniality, specific regulatory legislation, articulation with other policies and advances in relation to family agriculture.

Despite the importance of monitoring the policy for Food and Nutrition Security, there is still a lack of information about the quality of Brazilian school menus. Objective this study is to assess the quality of Brazilian school meals.

**Methods:** This cross-sectional study analyzed 2500 menus from 500 Brazilian municipalities. Menus were assessed by the Quality Index for School Meal Menus. This method proposes the evaluation of the weekly menu according to the following criteria: a) daily supply of cereals and tubers, legumes, vegetables, fruits, meat and eggs, dairy products, sweets as substitutes for meal, cured meats and sausages; B) weekly frequency of the sweets as dessert and ultra-processed foods; C) eventual offer of a second meal and meal timing adequacy. Data were analyzed by descriptive statistical analysis.

**Results:** A total of 29.4%, 50.6%, and 20% of the study menus presented high, intermediate, and low quality, respectively. Grains and tubers (86%) and meats and eggs (67%) groups presented the highest frequencies in the menus, followed by legumes (42.16%), vegetables (40%), fruits (35.56%), and dairy products (18.6%). Cured meats and sausages (8.68%) and sweets in place of meals (3.64%) were less frequent. Of the other components, 84.6% of the menus did not include sweets for dessert or included them only once a week. Ultra-processed foods appear in 65.6% of the menus at least once a week. Meal time was compatible with meal type in 22% of the sample.

**Conclusions:** Important foods for healthy and adequate diet, such as dairy products, vegetables, and fruits, are not provided regularly by Brazilian school meals. Despite the advances in policy management, the use of ultra-processed foods is still frequent in the menus.

**Keywords:** School feeding, menu planning, quality index.
## ASSESSMENT OF NUTRITIONAL QUALITY AND SAFETY OF WINGED TERMITES (MACROTERMES BELLICOSUS) ENRICHED LOCALLY FORMULATED COMPLEMENTARY FOODS FROM SOUTHWEST, NIGERIA

(1)Kayode, Ajayi; (2)Oladejo Thomas, Adepoju.

(1)BSc. MSc. Department of Human Nutrition and Dietetics. College of Medicine and Health Sciences. Afe Babalola University. Ado-Ekiti. Ekiti State. Nigeria; (2)BSc. MSc. PhD. Department of Human Nutrition. Faculty of Public Health. College of Medicine. University of Ibadan. Ibadan. Oyo State. Nigeria.

**Background and objectives:** Adequate nutrition during first 1000 days of life is crucial to child's healthy growth. Blending of local staple foods with edible insects which are nutrient dense can improve nutrient intake and prevent early childhood malnutrition. Nutritional quality and safety of Macrotermes bellicosus enriched locally formulated complementary foods (CFs) was assessed using rats

**Methods:** Macrotermes bellicosus (MB) were collected during their swarming, roasted for 10 minutes, and refrigerated at -40C. Ground MB was added to boiled rice (BR) and boiled yam (BY) in ratio 10.0%, 15.0% and 20.0% (w/w) levels to give BR1 and BY1; BR2 and BY2, and BR3 and BY3 respectively. Nutrient and anti-nutrient composition of MB, BY, BR and the MB-enriched CFs were determined using standard AOAC methods. Nutritional quality of two best MB-enriched CFs were assessed using Wistar strain rats (six per group) fed adlibitum for 28 days. Serum trace minerals in MB-enriched CFs, control and basal diets were assessed using standard methods, and histopathological effects of CFs on rats' kidney, liver and spleen were determined. Data were analysed using descriptive statistics and ANOVA at α 0.05.

**Results:** Roasted MB contained 31.8g protein, 16.4g fat, 3.8g ash, 227.5mg calcium, 2.1mg iron, 15.0mg zinc, 330.4µg retinol equivalent (RE), 6.7µg vitamin D, 0.1mg trypsin-inhibitor, and yielded 529.0kcal energy/100g sample; while 100g of BR and BY contained between 3.7-5.9g protein, 2.4-2.7g fat, 2.6-2.7g ash, 70.0-120mg calcium, 4.2-5.6mg iron, 1.2-1.5mg zinc and yielded 380-386kcal energy. Enriched CFs contained 7.9-15.3g protein, 2.9-4.1g fat, 4.1-4.5g ash, 242.2-264mg calcium, 2.4-4.4mg iron, 15.1-19.8mg zinc and yielded 357-372kcal energy/100g sample. Enriched CFs showed significant increase in nutrient content compared with BR and BY (p<0.05). Serum trace minerals in rats fed with two best MB-enriched diets ranged between 3.4-4.3mg zinc, 23.4-27.9mg calcium, 30.6-37.0mg iron and 52.5-56.9µg RE, which were significantly higher than control (3.2, 22.2, 34.1, 48.2) and basal (2.2, 21.1, 24.0 mg, 32.3 µg) diets respectively. No pathological lesions were observed in the internal organs of rats fed CFs diets.

**Conclusions:** Adding Macrotermes bellicosus to local complementary foods improved their nutrient and gross energy content, hence its use should be encouraged among mothers

**Keywords:** Macrotermes bellicosus, complementary foods, nutritional quality, trace elements, minerals.

## GREATER IMPROVEMENTS IN CHILD GROWTH AND DIET QUALITY AFTER A HOLISTIC COMMUNITY DEVELOPMENT INTERVENTION THAN AFTER NUTRITION TRAINING ALONE

(1)Miller, Laurie; (2) Joshi, Neena; (3)Lohani, Mahendra; (4) Rogers, Beatrice; (5)Mahato, Shubh; (6) Neupane, Sumanta; (7) Ghosh, Shibani; (8)Neupane, Shailes; (9) Webb, Patrick.

(1)M.D. Professor of Pediatrics. Tufts University School of Medicine. Boston MA. USA.; (2)Director of Programs. Heifer Nepal. Kathmandu Nepal.; (3)Senior Vice President. Heifer International. Little Rock AR. USA.; (4)Professor of Food Policy and Applied Nutrition. Friedman School of Nutrition Science and Policy. Tufts University. Boston MA. USA.; (5)Country Director. Heifer Nepal. Kathmandu Nepal.; (6)Analyst. Nutrition Innovation Lab. Kathmandu Nepal.; (7)Adjunct Assistant Professor. Friedman School of Nutrition Science and Policy. Tufts University. Boston MA. USA.; (8)Valley Research. Kathmandu Nepal.; (9)Alexander McFarlane Professor of Nutrition. Friedman School of Nutrition Science and Policy. Tufts University. Boston MA. USA.

**Background and objectives:** Linkages between nutrition-sensitive agriculture interventions and direct improvements in child nutritional status have been difficult to demonstrate. Likewise, household-level nutrition training has had variable results. Few organizations provide such training in the context of multi-sectoral community-based activities emphasizing livestock management practices and social capital development. The importance of this holistic approach to child outcomes has not been systematically studied. Therefore, we investigated the impact of a comprehensive community development intervention on child growth and diet, compared to training alone.

**Methods:** 3 matched communities (Banke, Nepal, 974 households) were randomly assigned to receive either Intervention ("full package" community development provided by Heifer Nepal, including social capital promotion, livestock/ nutrition training), Partial Intervention (livestock/ nutrition training alone), or Control (no interventions). Child growth monitoring plus comprehensive household surveys were completed at 5 household visits over 33 months.

**Results:** Wealth, hygiene practices, dietary diversity, and food security increased more in Intervention households (p<.0001, p<.001, p<.0001, p<.0001) than Partial or Control households. In addition, child diet diversity and WAZ, WHZ, HCZ, and MUACZ scores all improved significantly more in Intervention households than the other two groups (p<.0001, p=.006, p<.0001, p<.0001, p<.0001). In regression analysis, group assignment predicted child anthropometry (HAZ, WAZ, WHZ) and diet quality (diversity and animal source food consumption), after adjusting for child age/ gender as well as multiple household factors (caste, animals, wealth, women's empowerment and education).

**Conclusions:** In this longitudinal study, a comprehensive multi-sectoral intervention encompassing social and economic capital development and active nutrition messages more successfully improved key nutrition indicators and diet quality in young children. Livestock and nutrition training activities alone had little effect on
measures WE domains: time use, livestock/livestock-product-re-
lated decision-making, nutrition decision-making, and access to
and control over assets, opportunities, and own-income.

**Results:** Women's mean WELI was 0.4±0.2 and DDS was 4.1±1.5; children's mean DDA was 2.8±1.2; 47.4% of households were food insecure, of which 20.4% were severely food insecure. One percentage point higher WELI score was associated with higher diversity of women (2.02 ± 0.36, P<0.001) and children (2.23±0.74, P<0.003). WELI scores were inversely associated with milk intake in the prior 24 hours in women (-7.31±1.15mL, P <0.01) and children (-1.23±0.38mL, P< 0.01) and the number of days milk was consumed in the previous 7 days (women: -0.07±0.02 days, P <0.01; children: -0.04± 0.01 days, P<0.01). WELI was not associated with household food insecurity.

**Conclusions:** Int these pastoral communities, WE was associ-
ated with more varied diets but not with household food security.
With greater control over assets and products, more empowered
women might procure a wider range of quality foods for them-
selves and their children. Further research is needed to understand
the inverse association of WE on milk consumption and the lack
of association with household food security, although this has also
been found in other studies.

**Keywords:** Pastoralists, Tanzania, Women Empowerment, Diet, Milk.

144/1391

SENSORY ACCEPTABILITY OF IRON BIOFORTI-
FIED BEANS AND ORANGE FLESHED SWEET PO-
TATO IN MALAWI

(1)Hummel, Marijke; (2)Talsma, Elise Francina; (3)Van der Honing, Ati; (4)Zulu, Rodah Morezio; (5)Gama, Arthur Chibwana; (5)Van Vugt, Daniel; (6)Spillane, Charles.

(1)MSc. Plant and Agrobiosciences Research Centre (PABC).
National University of Ireland Galway (NUIG). Ireland.; (2)PhD.
Harvest Plus. International Center for Tropical Agriculture (CIAT).
Colombia.; (3)MSc. Division of Human Nutrition. Wageningen
University . Netherlands.; (4)PhD. International Center for Tropical
Agriculture (CIAT). Malawi.; (5)MSc. International Potato Centre
(CIP). Malawi; (6)PhD. Plant and AgriBiosciences Research Centre
(PABC). National University of Ireland Galway. Ireland.

**Background and objectives:** Over one-third of women and children under 5 in Malawi are suffering from micronutrient deficiencies. Research has shown the efficacy of biofortified crops, such as beta-carotene rich orange-fleshed sweet potato (OFSP) and iron rich beans, to improve nutritional status of target populations. The extent of consumption of biofortified crops will depend on the acceptability by consumers. Such acceptability has not been extensively investigated in Malawi. Therefore, we investigated the sensory acceptability of OFSP and iron beans in households in rural Malawi.

**Methods:** Sensory acceptability of OFSP (n=270 subjects) and iron beans (n=320) was investigated in adults using a discrimination test (blinded), preference test, and an acceptance test for 7 attributes. Also 57 children (beans) and 60 children (OFSP) aged

4-5 years took part in the preference test. Three OFSP varieties and one biofortified iron bean variety were tested against a local control variety. A 5-point facial Likert scale was used and participants were randomly assigned to taste either sweet potato or beans.

**Results:** Participants were able to discriminate between the taste of OFSP and local sweet potato variety, whereas they could not discriminate between non-biofortified beans and biofortified beans (p<0.05). Adults preferred the local sweet potato variety (76%) over OFSP. Although more children did prefer the orange variety (58%) this was not significant. Iron beans were more (p<0.05) liked than the non-biofortified beans by both adults (82%) and children (67%). In the acceptance test, the control sweet potato variety scored highest (4.4), whereas the three OFSP varieties scored significantly lower (range scores 3.4-4.0, p<0.05). Important factors for acceptance are starchiness and sweetness of the different sweetpotato varieties. The iron beans were significantly preferred over the non-biofortified variety (overall liking 4.3 vs. 3.8). For beans, the largest differences in liking were found for the attributes texture and hardness of the skin.

**Conclusions:** Overall, from a sensory perspective, biofortified OFSP and beans are well accepted in Malawi. However, although both were liked, there is still a preference for the local variety of OFSP and more research is needed to determine the reasons for this, to be able to develop varieties that are more preferred.

**Keywords:** Biofortification, sensory acceptability, beans, OFSP, Malawi.

144/1487

RURAL-URBAN DYNAMICS IN NUTRIENT CON-
SUMPTION: EVIDENCES FROM INDIA

(1)Ramadas, Sendhil; (2)Palanisamy, Ramasundaram; (3)Kharkwal, Sheela.

(1)PhD. Scientist. ICAR-Indian Institute of Wheat and Barley Research. Karnal-132001. Haryana. India.; (2)PhD. National Coordinator. National Agricultural Higher Education Project. ICAR. New Delhi-110012. India.; (3)MSc. Research Scholar. ICAR-National Dairy Research Institute. Karnal-132001. Haryana. India.

**Background and objectives:** Economic development is as-
sociated with nutrition improvement. National food security not-
withstanding, household nutritional security remains a problem,
this paper explores into.

**Methods:** National Sample Survey data on consumption, expenditure and nutrition intake were analysed for instability (CV, Cudy-Della Valle Index) and inequality (Gini, Lorenz Curve and Biplot).

**Results:** Monthly per capita expenditure on food declined from 72.90% in 1972-73 to 52.90% in 2011-12 in rural and from 64.50% to 42.60% in urban. The per capita monthly consumption of cereals declined from 15.26kg to 11.86kg in rural and from 11.24kg to 9.28kg in urban. The rural-urban differential has reduced despite a discernible shift in the consumption pattern noticed between them. The monthly per capita consumption of rice was 7kg in rural against 5kg in urban. Surplus production and availability of wheat increased its consumption from 25.43% (42.88%) to 39% (46.12%) in rural (urban). The rural coarse cereals consumption declined from
4.79 to 0.66kg due to its substitution by fine cereals, milk, fruits and vegetables with changing income, customs, habits and taste. High consumption of cereals in rural is due to the high energy required for physical work and payment of kind wages. The share of non-cereals increased in rural but declined in urban. However, the share of non-food items witnessed an increase across the country.

The per capita calorie intake declined by 1.46% in rural owing
to reduced cereals consumption but increased by 4.70% in urban.
Consumption of fat increased in both rural (92.08%) and urban
(61.11%). Inequality in consumption of calories, protein and fat
declined in rural, increased in urban but declined among expend-
iture classes. Instability in nutrient uptake was high and more
pronounced in rural. State-wise correlation between calorie intake
and per capita cereal production was positive and significant indi-
cating that local production determined cereal consumption. Low
prices enabled the poor consume enough calories in surplus states.

**Conclusions:** The rural per capita cereal consumption is a concern. Raising income increased the non-cereal and non-food consumption. Policy should focus on accelerating the supply of non-cereals and providing the poor access to right food-basket to reduce the gap and inequality in nutrition intake.

**Keywords:** Consumption pattern, Nutrient intake, Calorie consumption, GINI coefficient, NSSO

144/1582

CROP PRODUCTION AND LIVESTOCK PRODUC-
TION DIVERSITY ARE POSITIVELY ASSOCIATED
WITH DIETARY DIVERSITY IN RURAL UGANDAN
WOMEN AND CHILDREN AGED 6-59MONTHS

(1)Ghosh, Shibani; (2)Liang, Lichen; (3)Kabunga, Nassul; (4)Agaba, Edgar; (5)Griffiths, Jeffrey; (6)Duggan, Christopher; (7)Bashaasha, Bernard; (8)Webb, Patrick.

(1)PhD. Nutritionist. Feed the Future Innovation Lab for Nutrition. Friedman School of Nutrition Science and Policy. Tufts University;
(2)PhD. Statistician. Feed the Future Innovation Lab for Nutrition. Friedman School of Nutrition Science and Policy. Tufts University. Boston. USA; (3)PhD. Agricultural Economist. International Food Policy Research Institute. Kampala. Uganda.; (4)MS.MPH. Nutritionist. Feed the Future Innovation Lab for Nutrition. Friedman School of Nutrition Science and Policy. Tufts University. Kampala. Uganda; (5)MD. PhD. Infectious Disease Specialist. Feed the Future Innovation Lab for Nutrition. Friedman School of Nutrition Science and Policy and School of Medicine. Tufts University. Boston. USA.; (6)MD. MPH. Nutritionist. Pediatrician. Harvard T. H. Chan School of Public Health and Boston Children's Hospital. Boston. USA; (7)PhD. Agricultural Economist. College of Agricultural and Environmental Sciences. Makerere University. Kampala. Uganda; (8)PhD. Nutritionist. Agricultural Economist. Feed the Future Innovation Lab for Nutrition. Friedman School of Nutrition Science and Policy. Tufts University. Boston. USA.

**Background and objectives:** Household production diversity is a common strategy promoted to improve dietary diversity of vulnerable populations in developing countries. The objective

of this analysis is to examine the association between crop and
livestock production diversity in rural Ugandan households and
women's and child's dietary diversity.

**Methods:** Data used are from two survey rounds (2012, 2014) on the same households from 3 North and 3 South West Ugandan districts (random self weighting sample, n=6377 households, 6369 women, 2463 children 6 to 59 months). Pooled mixed effects repeated measures linear regressions tested the association between crop or livestock production diversity, women's dietary diversity score (WDDS) or child's dietary diversity score (CDDS). WDDS and CDDS are a count of all food groups consumed in the past 24 hours, crop production and livestock production diversity scores (CPDS and LPDS respectively) a count of all crops and livestock respectively. Co-variates include year of survey, geographical location, woman's age (WDDS model), household head gender, household wealth index, child's age and gender (CDDS models).

**Results:** Mean WDDS was 4.27± 1.48 and Mean CDDS was 2.48±1.57. Mean CPDS was 4.09±1.23 and mean LPDS was 1.12±1.11. WDDS was negatively associated with age (β=-0.010,p<0.001), while CDDS is positively associated with age (β=0.067,p<0.001). We find a significant positive association between WDDS and CPDS (β=0.22,p<0.001) and LPDS (β=0.23,p<0.001). Controlling for age, geographical location, year, household head, wealth index and correcting for sample dependency did not alter the association (CPDS β=0.23,p<0.001, LPDS, β=0.13,p<0.001). CDDS was significantly and positive associated with both crop production (β=0.15,p<0.001) and livestock production diversity (β=0.13,p<0.001). Controlling for child's age, gender, geographical location, survey year, household head gender, wealth index and correcting for sample dependency did not alter the association (CPDS β=0.14,p<0.001, LPDS β=0.07,p=0.016)

**Conclusions:** Dietary diversity in rural Ugandan women and children 6-59 months of age is significantly associated with crop and livestock production diversity. The strength of association is consistent for crop production on adjusting for co-variates decreasing for livestock production diversity. Further analysis to understand the role of market access is required.

**Keywords:** Production diversity, dietary diversity, women, children, rural Uganda.
# USE OF A SYSTEMS-BASED APPROACH TO IMPROVE DIETS AND SUSTAINABILITY OF FOOD PRODUCTION

(1)Kennedy, Gina; (2)Raneri, Jessica E; (3)Termote, Celine; (4)Nowak, Verena; (5)Remans, Roseline; (6)Groot, Jeroen; (7)Thilsted, Shakuntala.

(1)PhD. Senior Scientist. Bioversity International.; (2)MSc. Nutrition Research Specialist. Bioversity International. Rome. Italy; (3)PhD. Associate Scientist. Bioversity International. Nairobi. Kenya.; (4)PhD. Nutrition consultant. Bioversity International. Lusaka. Zambia.; (5)PhD. Consultant. Bioversity International. Rome. Italy.; (6)PhD. Associate Professo. Farming Systems Ecology Group. Wageningen University. Netherlands.; (7)PhD. Research Program Leader. Value chains and nutrition. WorldFish. Phnom Penh. Cambodia.

**Background and objectives:** Our current food system is damaging to both human health and nutrition and the environment. Poor diet quality is now the leading cause of morbidity and mortality worldwide while the way in which food is produced, distributed and consumed is causing extensive environmental damage. Using a systems-based approach we studied food production systems and dietary intakes in Kenya, Vietnam and Zambia to identify entry points for improving dietary diversity and improve sustainability of the food system through the inclusion of locally available nutrient-dense food by season.

**Methods:** Qualitative participatory methods were used to assess seasonal food availability and species diversity in Zambia. Quantitative household surveys of dietary intake and household level production were repeated across seasons in all sites. Kenya included two rounds of data collection and a total sample of 647 households, Vietnam included two rounds of data collection and a total sample of 416 households and Zambia included three rounds of data collection and a total sample of 1089 adults.

**Results:** Abundant food biodiversity was recorded for Kenya and Vietnam. In Kenya 67 edible plant species were recorded on-farm and households reported collection of 38 different wild edible plants. In Vietnam, 398 different species (292 species of plants and 106 animal/fish/insect species) were produced in the landscape. Dietary diversity scores for women in the lean season were 4.1(1.3), 4.8 (1.1) and 3.5 (1.0) and in the more abundant season for food availability 4.4 (1.3), 4.8 (1.1) and 2.9 (0.9) in Kenya, Vietnam and Zambia respectively. Food groups consumed by fewer than 50% of respondents in all sites and across all seasons include beans and peas, nuts and seeds, eggs and other fruits. Based on this assessment communities participated in different agriculture and nutrition interventions aimed to diversify both production as well as dietary intake.

**Conclusions:** This approach enabled communities to identify locally available foods to improve diet and production diversity. The identification of local solutions can also add environmental benefit such as adding diversity to the landscape that can improve soil fertility, pollinator density and also reduce distance food travels between producer and consumer.

**Keywords:** Diet diversity. food systems. biodiversity. sustainability. Seasonality.

# A HYBRID APPROACH: MERGING AGRICULTURE AND HEALTH-BASED FORMATIVE RESEARCH TOOLS TO INFORM NUTRITION BEHAVIOR CHANGE INTERVENTIONS AMONG MOTHERS AND YOUNG CHILDREN IN SIERRA LEONE

(1)Moses, Philip; (1)Moses, Philip; (2)Pinga, Victor; (2)Granger, Kristina;

(2)Koniz-Booher, Peggy; (2)Pietropaoli, Jenny; (2)Forrester, Heather;

(2)Cunningham, Andrew.

(1)MPH. SPRING Project. JSI Research and Training Institute, Inc. USA.; (2)Strengthening Partnerships.

**Background and objectives:** The 2014 Ebola outbreak in Sierra Leone left rural districts with reduced food production and deteriorating household nutrition practices. This adversely affected nutrition status of pregnant and lactating women (PLW) and children under two years old. The USAID-funded Strengthening Partnerships, Results, and Innovation Globally (SPRING) project developed a hybrid formative research approach combining traditional agriculture Extension Advisory Services (EAS) and nutrition-based social and behavior change (SBC) tools to inform a more comprehensive response to this nutrition crisis.

**Methods:** SPRING adjusted traditional formative research tools common to both agriculture and health. EAS often use an agricultural value chain assessment to identify constraints to increasing income and yields. SPRING adjusted the value chain assessment tool to also identify constraints and opportunities to improving supply and quality of vitamin A-rich and animal-source foods (deficient in the diet of the target population), and to adopting agriculture practices that reduce impacts on time, energy, and income control of PLW. Health programs commonly use formative research tools such as barrier analysis and trials of improved practices to identify barriers and enablers to the adoption of improved household-level nutrition practices. SPRING adapted these tools to include nutrition-sensitive agriculture and hygiene practices (such as such as clean play spaces and handwashing) to identify factors related to the accessibility of targeted foods and to reducing environmental enteropathy. SPRING used the revised tools to assess 506 agriculture actors and PLW in Tonkolili District, Sierra Leone from March-June 2016.

**Results:** The merged tools provided unique information on the intersection of both the agriculture system and household-level nutrition behaviors that would not have been found using the traditional agriculture and health tools separately.

**Conclusions:** These new tools allowed SPRING to develop a tailored set of SBC communication materials for Sierra Leone that complement each other to affect change at both the market/value chain level (to improve the supply of highly nutritious foods) as well as the household level to enhance demand and consumption of nutritious foods and improve hygiene. Merging tools and approaches across sectors can greatly facilitate the development of more effective SBCC tools.

**Keywords:** Nutrition. Agriculture. Social Behavior Change.

**Conflict of Interest Disclosure:** K. Granger. Manoff Group. P. Koniz-Booher and P. Moses John Snow, Inc. V Pinga Save the Children

**Further collaborators:** Sarah McClung
# COMPATIBILITY OF NANO-FIBRILLATED CELLULOSE TO THE PHYSIOLOGICAL HOMEOSTASIS IN THE GASTROINTESTINAL TRACT

(1)Tani, Fumito; (2)Nakayama, Yusuke; (2)Yamanoue, Miki; (3)Ogawa, Takenobu; (4)Morishima, Michiyo; (5)Abe, Kentaro; (3)Masuda, Tetsuya; (6)Tsukahara, Takamitsu; (7)Kondo, Eisaku; (8)Yano, Hiroyuki.

(1)PhD. Professor. Graduate School of Agriculture. Kyoto University. Japan; (2)BSc. Master Student. Graduate School of Agriculture. Kyoto University. Japan.; (3)PhD. Assistant Professor. Graduate School of Agriculture. Kyoto University. Japan.; (4)BSc. Technical Assistant. Graduate School of Agriculture. Kyoto University. Japan.; (5)PhD. Associate Professor. Research Institute for Sustainable Humanosphere. Kyoto University. Japan.; (6)PhD. President. Kyoto Institute of Nutrition and Pathology Inc. Japan.; (7)MD. Professor. Graduate School of Medicine. Niigata University. Japan.; (8)PhD. Professor. Research Institute for Sustainable Humanosphere. Kyoto University. Japan

**Background and objectives:** Cellulose is a major component comprising dietary fiber in many food products. Many studies indicated that dietary fiber exhibits various physiological functions not only for leading a decrease in the incidence of colon cancer but for promoting our health, exemplified by the control of mobility of the intestines and population of gut microflora. Recently nano-fibrillation techniques have been developed to apply cellulose as new and effective food materials acting as thickeners and/or stabilizer of emulsion, focusing on some attractive characteristics of cellulose nanofiber (CNF) including a high viscosity and water-holding activity. However, it remains largely unknown how CNF affects the physiological functions in the intestines, therefore, we aimed to reveal the compatibility of CNF to the physiological functions in the gastrointestinal tract in this study.

**Methods:** The nano-fibrillation for cellulose samples was treated using a grinder after wood tips were subjected to softening and delignification processes. Carboxymethylated cellulose nanofiber (CMC-NF) was produced by a surface modification of cellulose and nano-fibrillation. Mice were fed with the diet containing 3% cellulose, CNF or CMC-NF.

**Results:** There were no significant differences in body weight and dietary intake among the three groups of mice fed with cellulose during 8 weeks. After 8 weeks feeding, the plasma level of TNF-α and the concentration of lipocalin in feces were evaluated as inflammatory parameters. Myeloperoxidase (MPO) activity was measured as an indicator of neutrophils' infiltration into colon tissue. However, any significant difference was not observed in plasma TNF-α level, lipocalin concentration, and MPO activity among the three groups. Histological observation showed no reduction in the length of the large intestine and no incidence of colitis as seen in mice that had been administered dextran sodium sulfate. No symptom of inflammation was also supported by the data showing no significant difference in liver weight and some blood parameters. Moreover, analysis of T cell population in mesenteric lymph node using flow cytometer showed no significant fluctuation in the frequency of regulatory T cells and Th17 cells.

**Conclusions:** It thus follows that CNF can be used as a new promising food material so that nutritional, physiological, and immunological homeostasis are maintained.

**Keywords:** Compatibility. gastrointestinal tract. nano-fibrillated cellulose. physiological homeostasis. Safety.

**Conflict of Interest Disclosure:** This study was partially funded by grants from the Project of the NARO Bio-oriented Technology Research Advancement Institution (Integration research for agriculture and interdisciplinary fields) and from Nippon Paper Group.

**Further collaborators.**

Yusuke Nakayama. Miki Yamanoue. Takenobu Ogawa. Michiyo Morishima. Kentaro Abe. Tetsuya Masuda. Takamitsu Tsukahara. Eisaku Kondo. Hiroyuki Yano.

# LIVESTOCK REARING AND DEPRESSION IN ADOLESCENTS ARE ASSOCIATED WITH THEIR MENTAL DEVELOPMENT IN THE KASSENA-NANKANA DISTRICT OF GHANA

(1)Mohammed, Husein; (2)Aboud, Frances; (3)Otoo, Gloria; (4)Marquis, Grace.

(1)PhD. Nutrition. IMMANA postdoctoral fellow. Friedman School of Nutrition Science and Policy, Tufts University, Boston, USA.; (2)PhD. Psychology. Department of psychology. McGill University. Montreal. Canada.; (3)PhD. Nutrition. Nutrition and food Sciences department. University of Ghana. Legon. Ghana.; (4)PhD. Nutrition. School of dietetics and human nutrition. McGill University. Montreal. Canada.

**Background and objectives:** Animal source food and mental well-being have long been thought to be essential for child mental development. This results are part of a larger study to adapt and use a mental development tool in Ghana and evaluate the long-term effect of the Enhancing Child Nutrition through Animal Source Foods (ENAM) project in Ghana.

**Methods:** This study evaluated the effect of the ENAM project on the 2-5 y old children who were enrolled in the study in 2005. The vocabulary and similarity subtests of Wechsler Abbreviated Scale of Intelligence II were translated and back translated and then the vocabulary subtest was adapted to the local context to be used in rural and peri-urban communities in Ghana. The block design, matrix reasoning and similarity subtests did not need much translation. The adapted tool was then tested and re-tested in a selected school within the Kassena-Nankana district of Ghana. Information on adolescent's academic performance, nutritional status, assets, livestock rearing, and depression symptoms using a self-reporting questionnaire was taken. Data were analyzed using SAS 9.4 version.

**Results:** A total of 30 children (56.7% girls) with an average age of 11 y (range= 8 - 14 y) participated in the first part of this pretest. They had high assets (8 out of 10), raised livestock (67.9% had >1) and had a depression symptom score of 6 out of 20. The
average school attendance of 62 out of 70 d and academic score of 69.7%. Livestock rearing was negatively associated with depression (r=-0.5; p=0.02), while child academic score was associated with similarity subtest (r=0.43; p=0.03). In boys, the block design was associated with livestock rearing (r=-0.7, 0.04) and similarity was associated with school attendance (r=0.7, p=0.04) and depression (r=-0.7, p=0.03). However, in girls vocabulary, matrix reasoning and school attendance were associated academic score (r=0.5, p=0.04), (r=0.5, 0.04) and (r=-0.6, p=0.03) respectively.

**Conclusions:** The modified WASI appears to be valid in relation to academic performance, and in boys is positively related to livestock rearing and negatively to depression.

**Keywords:** Livestock, child development, depression, academic.

**Further collaborators.**

Sponsored by IMMANA fellowship, Tufts University.

144/2122

ADVANTAGES OF SUGAR REDUCTION WITH
BLENDS VERSUS INDIVIDUAL STEVIOL GLYCO-
SIDES

(1)Petit, Marcia Petit; (2)Samuel, Priscilla.

(1)M.S. Innovation. PureCircle Ltd. Oak Brook. IL. USA; (2)PhD.
Global Stevia Institute. Oak Brook. IL. USA.

**Background and objectives:** Healthier lifestyles, clean label and natural-origin are of rising interest among consumers around the world which gives stevia leaf extract, a zero-calorie sweetener a unique opportunity. Stevia leaves contain over 40 steviol glycosides (SGs) that provide different sweetness and organoleptic properties. Rebaudioside A (Reb A) is one of the most abundant and the primary focus of stevia usage to date, but not without some taste challenges. This has led to an exploration of the characteristics of other SGs, both, individually and in combinations.

**Methods:** We hypothesized that blends of SGs may provide improved taste profiles versus Reb A. To test this hypothesis, two separate studies were conducted. Trained sensory panelists assessed the performance of Reb A versus a custom blend, versus an 8% sugar control, in acidified water at 3.2pH sugar reduction in study-1 and, in a 20% orange juice-drink with a 50% sugar reduction in study-2. Study-1 assessed the temporal profiling of the three products while study-2 was a descriptive analysis.

**Results:** The results study-1 showed that the duration of sweet aftertaste lasted longer for Reb A versus the custom blend and full sugar control (55.55 vs. 44.03 vs. 40.43 secs, P≤0.20). Other study parameters were not significantly different. Study 2 showed that the bitterness of the custom blend was significantly lower than the full sugar control (0.89 vs 1.34, P≤0.10) and, the Reb A and sugar control were not significantly different. In addition, metallic flavor (0.11 vs 0.55, P≤0.20) and licorice-root notes (0.15 vs. 0.67, P≤0.20) were lower with the custom blend versus Reb A, respectively. Reb A had a significantly higher “artificial-taste” character versus the control sugar and the custom blend (1.05 vs 0.28 vs. 0.25, P≤0.10), respectively.

**Conclusions:** These data suggest that the taste profile of the custom SG blends in these studies were closer to that of sugar, the preferred taste profile and, an improvement over Reb A. Future success will lie in the science of combining the right SGs for acceptable better tasting products that can positively impact reduced-sugar intake and health.

**Keywords:** Stevia, sugar reduction, sensory, taste, Reb A.

**Conflict of Interest Disclosure:** Marcia Petit works at PureCircle and the research was funded by PureCircle Ltd.

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

144/2256

EXPOSURE BIOMARKERS OF ACRYLAMIDE AND
GLYCIDAMIDE HEMOGLOBIN ADDUCTS AND
ALL-CAUSE AND CARDIOVASCULAR MORTALI-
TY IN NHANES 2003-2006

(1)Zhang, Yu; (2)Wang, Jun; (3)Jiao, Jingjing; (2)Huang, Mengmeng.

(1)Yu Zhang, PhD. Nutritionist. Department of Food Science and Nutrition, College of Biosystems Engineering and Food Science. Zhejiang University. China.; (2)BSc. Department of Food Science and Nutrition. College of Biosystems Engineering and Food Science. Zhejiang University. China.; (3)PhD. Nutritionist. Department of Nutrition. School of Public Health. Zhejiang University School of Medicine. China.

**Background and objectives:** Acrylamide has been acknowledged for its neurotoxicity, genotoxicity and reproductive toxicity, and classified as a Group 2A carcinogen. However, the relationship between the internal exposure to acrylamide and its metabolite glycidamide and mortality remains unclear. The aim of this study is to examine the association of hemoglobin adducts of acrylamide (AA-Hb) and glycidamide (GA-Hb) with all-cause and cardiovascular mortality in NHANES 2003-2006.

**Methods:** We followed 5504 participants who were ≥ 25 years of age. The exposure biomarkers and related variables were measured, including AA-Hb, GA-Hb, their sum (GA-Hb + AA-Hb) and their ratio (GA-Hb/AA-Hb). Hazard ratios (HRs) and 95% confidence intervals (CIs) were determined for all-cause mortality and cardiovascular mortality through the end of 2011. HRs and 95% CIs were estimated using Cox proportional hazards regression models using age as the underlying time metric and adjusted for sex, race/ethnicity, education level, physical activity, alcohol intake and other suspected risk factors.

**Results:** A total of 314 deaths were documented during 9 years of follow-up. After adjustment for known and suspected risk factors, GA-Hb/AA-Hb was inversely associated with all-cause mortality (hazard ratio [HR] comparing extreme quarters 0.606; 95% CI, 0.372-0.987; P < 0.05 for trend) and cardiovascular mortality (hazard ratio [HR] comparing extreme quarters 0.368; 95% CI, 0.169-0.802; P < 0.01 for trend). We did not observe any evidence to support the hypothesis that levels of biomarkers of acrylamide and glycidamide exposure measured as hemoglobin adducts (AA-
Hb and GA-Hb) were associated with the risk of all-cause and cardiovascular mortality. However, we found strongly suggestive evidence that GA-Hb/AA-Hb is inversely associated with all-cause and cardiovascular mortality in US adults. The ratio of hemoglobin adducts of glycidamide to acrylamide means the extent of acrylamide metabolism and can be used as an indicator of formation of the genotoxic metabolite glycidamide in the body and its detoxification. Moreover, the ratio GA-Hb/AA-Hb can be used as a useful marker of the mortality.

**Conclusions:** The ratio of GA-Hb to AA-Hb was inversely associated with all-cause and cardiovascular mortality. Efforts on further up-regulate GA-Hb/AA-Hb in the population can contribute to a substantial decrease in cardiovascular disease burden.

**Keywords:** Acrylamide; Glycidamide; Cardiovascular disease; Mortality; NHANES.

the FBDGs. Therefore the promotion of food-based recommendations through nutrition education or behavior change communications activities alone is not enough to lead to improvements in diets. Additional strategies are required such as agricultural- and market-based strategies in combination with nutrition specific interventions including food fortification, and home fortification options. These may offer opportunities to further facilitate adoption of recommendations and provide additional support to improve diets of vulnerable populations. The relation between household food availability and children's diet need to be further investigated for better understanding and identifying opportunities for strategies to improve children's diet.

**Keywords:** Food-based dietary guidelines; food coverage; nutrient coverage; crop diversity; dietary diversity

144/2359

## DOES LOCAL FOOD AVAILABILITY SUPPORT IMPLEMENTATION OF FOOD-BASED DIETARY RECOMMENDATIONS IN NORTHERN GHANA?

(1)de Jager, Ilse; (2)Giller, Ken; (3)Brouwer, Ingeborg.

(1)Msc. Nutritionist. Division fo Human Nutrition. Wageningen University. The Netherlands; (2)PhD. Agronomist. Production Systems Group. Wageningen University. The Netherlands;

(3)PhD. Nutritionist. Division of Human Nutrition. Wageningen University. The Netherlands.

**Background and objectives:** Local feasible food-based dietary guidelines (FBDGs) help provide guidance to policy makers and consumers to redesign food systems and to improve diets of vulnerable populations. As FBDGs are based on the actual dietary patterns and their costs, it is assumed that they are available, affordable and acceptable for the population under study. However, often extremes of the distribution of foods consumed are used and therefore it remains unclear whether FBDGs are supported by the local availability of food.

**Methods:** Using quantitative dietary intake data of young children in rural Northern Ghana, we developed local FBDGs and studied whether these are supported by the diversity and quantity of household's foods production and the associations between household's production diversity, household's food and nutrient coverage and the child's diet.

**Results:** We found very low coverage of household's food needs (according to the developed FBDGs) and nutrient needs by their food production. None of the households cover their vegetables needs and more than 50% of household do not cover their calcium, vitamin A, vitamin B12 and vitamin C needs. Household's food production diversity is positively related with household's food and nutrient coverage. Household's production diversity, food and nutrient coverage are not related with the child's diet.

**Conclusions:** This study shows that although local FBDGs are based on actual dietary patterns and costs, the availability of food can be a limiting factor in the ability of populations to implement

144/2486

## EFFECT OF POLISHING ON CONTENT AND BIOACCESSIBILITY OF SELECTED MINERALS FROM FIVE RICE VARIETIES

(1)Prakash, Jamuna; (2)Kamaraddi, Vijayalaxmi.

(1)Professor (Retd.), Department of Food Science and Nutrition, University of Mysore, India.; (2)Assistant Professor.

**Background and objectives:** Rice is a staple food for more than half of worlds' population. There are many varieties of rice grown with inherent compositional differences. Rice also undergoes excessive polishing to remove the bran layer and the consumer acceptability of white rice is much higher on account of better organoleptic characteristics. However, polishing also reduces the nutritional content of rice as most of the protective nutrients are concentrated in the brown aleurone layer.

**Objective:** The objective of the study was to estimate the mineral content and analyze bioaccessibility of calcium, iron and zinc in selected rice varieties with different degrees of polishing.

**Methods:** Rice samples selected were IEI-13901, KHP-2, KHP-5, KHO-10 and Rajamudi. These were subjected to different levels of polishing (0, 15, 30, 45, and 60 seconds) and analyzed for calcium, iron, zinc and phosphorus content following standard techniques. The bioaccessibility of calcium, iron and zinc was studied with dialysis technique.

**Results:** Results indicated that the calcium content of rice varieties ranged from 14.52 to 24.53 mg/100g in rice with no polish and reduced to 5.19-11.43 mg/100g in highly polished rice. Among the varieties, KHP-10 had a higher calcium content. Similar variations were also found in bioaccessible calcium which was in the range of 12.58-30.54%. Rice is fair source of iron with contents ranging from 0.83-3.03 mg/100g and highest bioaccessibility was seen in rice with first degree of polish (3.68-4.20%). Excessive polishing reduced iron availability considerably in all samples. Polishing also reduced zinc content, though the effect was lesser in both in content and availability which ranged from 11.27-17.51% in four varieties with one being much higher at 201-23.3% (Rajamudi). Phosphorus content also showed a decline with polishing.
**Conclusions:** In conclusion polishing of rice reduced the mineral content of all varieties, though the bioaccessibility were influenced to varying extent. Varietal differences were also observed in mineral content and bioaccessibility.

**Keywords:** Rice polish, brown rice, calcium, iron, zinc.

Bogard, Jessica.

BSc. PhD candidate. School of Public Health. The University of Queensland. Brisbane. Australia.

**Background and objectives:** Food production systems are traditionally designed to maximising yields or income for producers. Shifting the goal of food systems away from 'feeding people to nourishing people' requires valuing and measuring the nutritional quality of production systems. The objective of this study was to identify indicators which capture the ability of a production system to nourish the most people, which could potentially be useful for prioritising and decision-making in agricultural production systems.

**Methods:** Two comprehensive agriculture and nutrition indicator guides were reviewed to identify indicators that capture an aspect of food or nutrient availability, access, consumption or utilisation. Relevant indicators were then mapped to the applicable stage of the food and nutrition system (production, distribution, consumption, nutrition). Those pertaining to agricultural production were applied to selected aquaculture production systems to yield insights into the strengths and limitations of different indicators that capture an element of nutritional quality of production output.

**Results:** The majority of existing indicators are relevant at the consumption or nutrition stages (n=33) of the food and nutrition system, rather than production (n=7). Application to aquaculture production systems demonstrates that different indicators capture different aspects of nutritional quality. Indicators that reflect nutrient composition of foods produced, diversity in nutrients produced, and the abundance or quantity of those nutrients, which are simple to calculate and interpret by decision makers are of most relevance here.

**Conclusions:** In capturing the ability of a production system to nourish the most people, the indicators 'nutritional yield, 'potential nutrient adequacy' and 'Rao's quadratic entropy' are likely to be of significant value.

**Keywords:** Food system, nutritional quality, production, aquaculture, diversity.

**Background and objectives:** Pinus pinea L. produces highly valued commercial pine tree nuts. It is endemic to the Mediterranean Basin, where pine nuts are part of the Mediterranean diet. The aim of the study was to compare the chemical composition of pine nuts harvested from six countries. In this comparative study, geographic zones and agro-climatic conditions that may affect the chemical composition of pine nut seeds were considered.

**Methods:** The chemical composition of pine nuts harvested from 15 growing areas, distributed in Chile (3), Argentina (2), Italy (3), Spain (1), Turkey (3), and Israel (3) was determined. All proximate analyses were performed using AOAC methodologies (2012). The relative contribution of climatic variables to chemical components was estimated using CART algorithms. As confirmatory analysis, the groups suggested by the identified climatic variables thresholds were compared by ANOVA. A principal component analysis was applied, generating a biplot for chemical composition of pine nuts and climate variables of different countries. Analyses were achieved using the software Infostat® and its interface with the software R®.

**Results:** The main component was fat (3.47 to 4.53 g kg-1), followed by protein (3.21 to 3.66 g kg-1). Dietary fiber averaged 1.23 g kg-1, while ashes averaged 0.44 g kg-1. Pine nuts from Chile and Argentina were similar, both countries exhibiting the highest thermal oscillation and rainfall. Italian nuts had the highest fiber content, while Spanish nuts had the highest fat content. Israel exhibited the highest number of dry months, and pine nuts contained more protein and minerals, while nuts from Turkey showed an intermediate position. The climatic variables affecting the chemical composition were: minimum and maximum average temperatures, amount of dry months, and thermal oscillation.

**Conclusions:** The differences observed in the chemical composition of pine nuts grown in different regions may be explained, at least in part, by the environment and soil type variability between regions. However, all pine nuts exhibited high nutritional quality, independently of the zone where they were grown.

**Keywords:** Pinus pinea L.; pine nuts; chemical composition; growing zone; agro-climatic conditions.

**Further collaborators:** Supported by CONICYT, Project FONDEF D11I1134, Universidad de Buenos Aires, Argentina, and Universidad de Valparaiso, Chile

<footnote>(1)Lutz, Mariane; (2)Loewe, Veronica; (3)Zuleta, Ángela.</footnote>

<footnote>(1)PharmD. MSc. CIDAF. Faculty of Pharmacy. Universidad de Valparaiso. Chile; (2)PhD. INFOR. Ministry of Agriculture. Chile;</footnote>

<footnote>(3)MSc. Faculty of Pharmacy and Biochemistry. Universidad de Buenos Aires. Argentina.</footnote>
**Background and objectives:** The 2013 Lancet nutrition series argues that in order to achieve global targets for reducing undernutrition, there needs to be a multi-sectoral approach including scaled-up, proven nutrition-specific interventions and nutrition-sensitive agriculture and other sector interventions. While a multi-sectoral approach is arguably the most effective way to improve nutrition, little evidence exists about how to implement it. To understand the role multi-sectoral collaboration may play in improving nutrition, the SPRING Project asked: how can we make multi-sectoral collaboration operationally feasible?

**Methods:** To answer this, SPRING conducted a literature review and analysis of attempts to coordinate nutrition across USAID portfolios in Bangladesh, Guatemala, and Rwanda. SPRING collected data through over 50 key informant interviews in those countries, and extensive review of project documents and existing literature. The Garrett conceptual model for working multi-sectorally was used to formulate interview questionnaires and analyze responses. 3

**Results:** The countries used different approaches and were at various stages in the cross-sector collaboration process, but shared similar obstacles in implementing structures, processes, and practices that affected their ability to initiate and sustain their efforts, including difficulties developing strategies that defined shared roles and responsibilities and systems for communications, monitoring and feedback. Lack of shared mandates and metrics created disincentives to investing time and resources toward collaboration. From findings, SPRING developed a set of key considerations along the program cycle that may contribute to making multi-sectoral collaboration more feasible and effective.

**Conclusions:** While collaboration strategies, goals, and models vary, they often follow a similar life cycle that can be systematically designed, implemented, and monitored. Understanding the context and opportunities in each phase can help standardize certain key approaches and inform future strategies. Incorporating the recommendations highlighted by this assessment may lead to more successful and sustained collaboration for nutrition.

**Keywords:** Nutrition-sensitive agriculture. Multi-sectoral collaboration. Program cycle.

**Further collaborators:** United States Agency for International Development.

**Background and objectives:** Home is one of the primary locations of foodborne illnesses risks. Chances of food handling errors can pose high risk to susceptible people at home, especially under-five children (U5C). About 40% of global foodborne disease burden is contributed by this susceptible group, more so in countries like India where 15% of foodborne diseases are reported at household (HH) level. Food safety risks could be different among households with/without this vulnerable population. Given this background, we aimed to assess household food safety using a validated food safety index and identify critical issues in HHs with/without U5C.

**Methods:** A cross-sectional study was conducted among primary food preparers at home (N=400) with and without U5C (@200 in each category) drawn from rural and urban areas of Telangana State in south India. An 11-item validated food safety index (Maximum score-17) was administered. Data on incidence of food/waterborne illnesses in the fortnight preceding the survey was also collected. In addition, leftover cooked-foods (100g), drinking water (250ml) at point-of-use (PoU) and hand-rinses were collected for microbiological analysis (USFDA-BAM).

**Results:** About 23% of the respondents reported at least one foodborne illness in the previous 15 days of the survey. Of those who suffered, as many as 53% were children. About 50% of HHs were at food safety risk (Index cut-off score ≤9) and among these, a higher number had U5C. Such HHs have also shown significantly higher levels of food contamination than their counterparts with no U5C. Improper food storage, lack of pure water at PoU and fewer enabling assets (like separate kitchen; piped-water facility) were found to be critical issues affecting food safety among HHs with/without U5C. Along with these, practices like not reheating the leftovers and presence of pest/pet near the kitchen area

<footnote>(1)Danton, Heather; (2)Clark, Samantha; (2)Klein, Alyssa; (3)Du, Lidan; (4)Titus, Sarah.</footnote>

<footnote>(1)MSc. Food Security and Nutrition Director. Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) Project. JSI Research and Training Institute, Inc.;</footnote>

<footnote>(2)MSc. Food Security and Nutrition Specialist, Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) Project. JSI Research & Training Institute, Inc.; (3)PhD. Research Advisor. Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) Project. Helen Keller International; (4)MSc. Food Security and Nutrition Manager. Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) Project. Save the Children, Inc.</footnote>

<footnote>(1)Reddi, S G D Nagalakshmi; (2)Gavaravarapu, M SubbaRao;</footnote>

<footnote>(3)Mendu, Vishnu vardhana rao; (4)R, Naveen kumar; (5)Vemula, Sudershan Rao.</footnote>

<footnote>(1)PhD Scholar. National Institute of Nutrition (ICMR Institute). Osmania University. Hyderabad. India; (2)MSc. PhD. Scientist E. Extension and training division. National Institute of Nutrition (ICMR Institute). Hyderabad. India; (3)MTech. PhD. Scientist F. Bio statistic division. National Institute of Nutrition (ICMR Institute). Hyderabad. India; (4)MSc. Technical officer. Food and drug toxicology research centre. National Institute of Nutrition (ICMR Institute). Hyderabad. India; (5)MSc. PhD. Scientist E. Food and drug toxicology research centre. National Institute of Nutrition (ICMR Institute). Hyderabad. India.</footnote>
were also affected food safety in HHs with U5C. However, poor hand-hygiene was critical among HHs without U5C. Rural HHs with U5C reported significantly (p<0.05) higher food safety risk than urban HHs.

**Conclusions:** This study highlighted critical issues affecting food safety among HHs with/without U5C. These would be useful to design targeted food safety education programmes and thus improve child health.

**Keywords:** Household, Food safety, Index, Under-five children.

**Conclusions:** Local stakeholders involvement and participation is key to promotion of production and consumption of biofortified crops. Lead farmers approach and passing on information to other farmers in the villages is a feasible delivery model for introduction and scale up biofortification. Integrating biofortification to public programs is key to sustainability.

**Keywords:** Biofortification, Orange Flesh Sweet Potato, Zinc Rice, Zinc Wheat.

**Further collaborators.**

World Vision Works with HarevstPlus on Biofortification

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PROMOTION OF BIOFORTIFED CROPS TO IMPROVE MICRONUTRIENT INTAKE AMONG CHILDREN UNDER FIVE AND WOMEN IN CHILD BEARIGN AGE IN TANZANIA, PAKISTAN AND BANGLADESH

(1)Tolossa, Asrat; (2)Thomas, Abena.

(1)MD, MPH Chief of Party- ENRICH MNCH Program; (2)Grant Manager/DME advisor ENRICH program.

**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:** ENRICH program trained and supported Lead Farmers, para-professional farmers and agricultural extension agents to become Trainers of Trainers (ToTs) within their communities and train select growers to become bio-fortified crops producers and seed multipliers in all 3 countries. ENRICH staff oversaw and directed the training of farmers on the production, harvest and post-harvest handling of bio-fortified crops. The program sensitized communities on bio-fortification to build consumer demand. Beneficiary farmers were encouraged to pass on the information to other farmers and scale up crop production.

**Results:** In Pakistan a total of 600 farmers were trained and 600 bags (each package weighing 25 kg) of Zincol-2016 seed was distributed among 600 farming households (438 male, and 162 female) for cultivation of half an acre of land. In Bangladesh, 17 trainers were trained on zinc rice production technology. The program selected 1560 rice farmers and 4.68 tons of zinc rice variety, BRRI dhan74, seeds were purchased and distributed. In Tanzania a total of 72 lead farmers were trained and received training manuals and vines for OFSP production. Twenty seven (27) OFSP production demonstration farm sites were also established. In all countries, the program negotiated an agreement with local stakeholders for the delivery of biofortified planting materials.

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PERFORMANCE AND CARCASS CHARACTERISTICS OF BROILER CHICKENS FED DRIED CASHEW APPLE PULP IN REPLACEMENT FOR MAIZE

(1)Yisa, Iyabode Kehinde; (2)Longe, Oyebiodun Grace; (3)Awojulugbe, Oluseyi; (4)Oshibanjo, Olusegun.

(1)M.Sc. Animal Nutritionist. Department of Animal Science. University of Ibadan. Nigeria.; (2)PhD. Professor. Animal Biochemistry and Nutrition. Department of Animal Science. University of Ibadan. Nigeria; (3)B.Sc. Animal Scienist. Department of Animal Science. University of Ibadan. Nigeria; (4)PhD. Animal products and Meat Scienist. Department of Animal Science. University of Ibadan. Nigeria.

**Background and objectives:** Alternative ingredients have become a major focus of the broiler industry given the dire competition between man, industry and livestock for conventional ingredients such as maize. Dried cashew apple pulp (DCAP) has been used to replace maize broiler diets in Brazil and Asian countries. This study was to evaluate the effect of replacing maize with dried cashew apple pulp (DCAP) in broilers chicken diets on performance and carcass characteristics in Nigeria.

**Methods:** A total of 250 four weeks old Arbor Acre plus commercial broiler chickens were randomly selected and assigned to 5 dietary groups of 0%, 5%, 10%, 15% and 20% DCAP replacement for maize in a twenty-eight day trial. Each group comprised 5 replicates of 10 birds each. Growth performance characteristics was recorded, birds were slaughtered at the end of the experiment and carcass characteristics were measured.

**Results:** It was observed that 10% replacement level had the highest final weight, weight gain and least feed conversion ratio (FCR) while 20% replacement level had the least final weight, weight gain, feed intake and highest FCR. There were no significant differences (P>0.05) in head, neck, drumstick, breast, back, wings, gizzard, empty gizzard, heart, liver and gastrointestinal tract weight except thigh weight, abdominal fat and spleen which are higher at 10% replacement level.

**Conclusions:** Dried cashew apple pulp compared favourably with maize at the given level, it therefore can be used successfully in its replacement without deleterious effect to growth and carcass characteristics.

**Keywords:** Alternative ingredient, dried cashew apple pulp, maize, broiler chicken.
RESIDUAL B-CAROTENE AND CYANIDE LEV-
ELS IN GARI PRODUCED FROM UNFERMENT-
ED YELLOW CASSSAVA (MANIHOT ESCULENTA
CRANTZ) USING LOCAL PROCESSING METHOD

(1)Onimawo, Ignatius; (1)Onimawo, Victor; (1)Alamu, Osas.

(1)University; (1)Nigeria University

**Background and objectives:** In order to find ways of improv-
ing the consumption of vitamin A rich foods in Nigeria, yellow
fleshed cassava was introduced to farmers. This study was carried
out to determine the level of the retained β-carotene in processing
yellow cassava (variety IITA TMS 01/1371 or UMUCASS 38) into
gari using local processing method, and also to determine the re-
sidual cyanide after processing (fermented and unfermented) of
the yellow-fleshed cassava.

**Methods:** Harvested samples of the yellow fleshed cassava were fermented in the traditional way (natural fermentation for 48hr) while some samples were unfermented. The fermented cassava were processed into cassava grit- gari which is a staple food commonly consumed in Nigeria. High performance liquid Chromatography (HPLC) was used to determine the level of β-carotene in gari produced from fermented and unfermented yellow cassava while the cyanide level was determined by an automated enzymic method.

**Results:** Results showed that the gari produced from ferment-
ed yellow cassava had a higher level of β-carotene depending on
the number of days of fermentation compared with the gari from
unfermented yellow cassava. The gari produced from unferment-
ed cassava had the least content of β-carotene (8.076±0.311ug/g)
during the first week of storage compared with those produced
from fermented cassava (10.600±0.470- 20.610±0.098ug/g). There
was a reduction in the β-carotene contents in all groups during the
5week storage period. The rate of loss of β-carotene over a five week
period showed that the gari from unfermented cassava had the
least rate of loss (0.885ug/week) compared with the gari from fer-
mented cassava over the same period (0.955-2.447ug/week). How-
ever the level of Hydrogen cyanide (HCN) retained was more in
the gari from unfermented yellow cassava (3.160±0.006mg/100g)
compared with the gari from fermented cassava (0.470±0.046-
1.423±0.006 mg/100g).

**Conclusions:** On the basis of the result, it is suggested that yellow cassava should be fermented before being roasted into gari and adequate method of storage be adopted to reduce loss of the β-carotene while in storage.

**Keywords:** β-Carotene, Cyanide, Unfermented, Gari, Yellow Cassava
Track 1: Advances in Nutrition Research

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INFLAMMATORY AND IRON STATUSES AND
THEIR RELATIONSHIP WITH BODY FAT MASS IN
LEAN AND OBESE INDIGENOUS GUATEMALAN
WOMEN

(1)Orozco, Monica; (2)Arriaga, Claudia Lorena; (3)Zamora, Alejandra;

(4)Solomons, Noel W.; (5)Schümann, Klaus.

(1)PhD. Senior Program Leader for Iron Safety Studies. Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM). Guatemala; (2)BSc. Research Chemist. Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM). Guatemala; (3)BSc. Research Nutritionist. Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM). Guatemala; (4)Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM). Guatemala City. Guatemala.; (5)MD. Ph.D. Director. Hildegard Grunow Foundation. Munich. Germany.

**Background and objectives:** Obesity is usually accompanied by chronic, low-grade, systemic inflammation and up-regulated hepcidin gene expression, often reflected by higher circulating C-reactive protein (CRP) and 25-hepcidin levels. These events lead to lower intestinal uptake and increased tissue sequestration of iron. The high prevalence of overweight/obesity and poor living conditions observed amongst indigenous Mayan populations may both predispose to inflammation and disturbances in iron metabolism. Here, we sought to explore the differences in biomarkers of iron and inflammation status, and their relationship with body fat mass, in lean and obese indigenous Guatemalan women.

**Methods:** Twenty-two non-pregnant, non-anemic, pre-menopausal women, aged 30-45 years, from Sololá, Guatemala were recruited, evaluated and classified into two groups of lean (n=11) and obese (n=11) women, using combined body mass index (BMI) and % body weight as fat mass (%FM) criteria. Serum 25-hepcidin and ferritin concentrations for both groups were assessed and compared using one-tailed Student T-tests, whereas CRP values were analyzed with a Wilcoxon test (one-tailed).

**Results:** The mean age for lean (34.8±5.0 years) and obese (36.2±3.3 years) did not differ (p=0.23). Mean BMI and %FM for the lean and obese groups were: 21.2±1.5 kg/m2, 27.1±4.5% and 32.0±2.6 kg/m2, 45.4±4.0%, respectively. The average concentrations of serum 25-hepcidin were: (means) 3.1±1.2 and 3.9±2.3 ng/ml (p=0.12); ferritin: 41.3±24.1 and 72.9±47.6 ng/ml (p=0.03); and

(median) CRP: 1.3 (95% CI -0.2,6.0) mg/L and 3.9 (95% CI 2.2,8.0) mg/L (p<0.005) for the lean and obese women groups, respectively.

**Conclusions:** The biomarkers of inflammation observed in this group of women perform as expected, confirming the paradigm of the effect of obesity on inflammation and iron status, when women were carefully selected and polarized using the dual criteria for both relative body mass (BMI) and adiposity (%FM).

**Keywords:** inflammation, 25-hepcidin, body fat mass, obesity, women

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ASSOCIATIONS OF PLASMA AMINO ACID AND ACYLCARNITINE PROFILES WITH THE INCIDENCE OF HYPERURICEMIA IN A CHINESE POPULATION

(1)Lin, Xu; (2)Wang, Feijie; (3)Sun, Liang; (4)Deng, Yueyi; (5)Zeng, Rong.

(1)Dr. Key Laboratory of Nutrition and Metabolism. Institute for Nutritional Sciences. Shanghai Institutes for Biological Sciences. Chinese Academy of Sciences and University of Chinese Academy of Sciences. Shanghai. China.; (2)Msc. Key Laboratory of Nutrition and Metabolism. Institute for Nutritional Sciences. Shanghai Institutes for Biological Sciences. Chinese Academy of Sciences. University of Chinese Academy of Sciences. Shanghai. China.; (3)PhD. Key Laboratory of Nutrition and Metabolism. Institute for Nutritional Sciences. Shanghai Institutes for Biological Sciences. Chinese Academy of Sciences; University of Chinese Academy of Sciences. Shanghai. China.; (4)MD. Department of Nephrology. Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine. Shanghai. China.; (5)PhD. CAS Key Laboratory of Systems Biology. CAS Center for Excellence in Molecular Cell Science. Institute of Biochemistry and Cell Biology. Shanghai Institutes for Biological Sciences. Chinese Academy of Sciences. Shanghai. China.

**Background and objectives:** Hyperuricemia is casually linked with pathogenesis of gout and cardio-metabolic diseases with prevalence of 8-22% worldwide. Profiling metabolites by metabolomic approach will facilitate discovering metabolic pathway(s) and novel markers involving pathophysiology of hyperuricemia. Previously, certain amino acids and acylcarnitines were reported to be cross-sectionally associated with serum uric acid, but longitudinal associations remain to be established. Therefore, we aimed to investigate the associations between amino acid and acylcarnitine profiles with incident hyperuricemia in a prospective Chinese cohort.

**Methods:** A total of 1,616 Chinese aged 50-70 years participating in a 6-year cohort with a baseline free of hyperuricemia
were included. Baseline plasma amino acids and aclycarnitines were profiled by targeted gas or liquid chromatography coupled to mass spectrometry metabolomics. Hyperuricemia was defined as serum uric acid ≥416.0 µmol/L (7.0 mg/dL) in men and ≥357.0 µmol/L (6.0 mg/dL) in women. Multivariable log-Poisson models were used to examine the associations between metabolites and incident hyperuricemia. Statistical significance was defined as P <0.0009 (0.05/56) with Bonferroni correction.

**Results:** The 6-year incidence of hyperuricemia was 24.6%. Among all quantified metabolites (22 amino acids and 34 acylcarnitines), only cysteine and long-chain acylcarnitines C20:4 were positively associated with incident hyperuricemia. The relative risks (95% confidence intervals [CI]) per standard deviation increment) were 1.24 (1.14-1.36; P = 8.4E-07) for cysteine and 1.16 (1.07-1.25; P = 0.0004) for C20:4, respectively, after multivariable adjustment including lifestyle, body mass index, fasting glucose, lipids, creatinine and uric acid. The underlying mechanism(s), which although remains unclear, might involve oxidative stress or mitochondrial dysfunction accompanied by elevated cysteine and long-chain acylcarnitines.

**Conclusions:** This study is the first one showing the longitudinal associations of cysteine and long-chain acylcarnitines C20:4 with future incident hyperuricemia, independent of established risk factors. More studies are needed to confirm our findings in different ethnical populations and also potential utilization for early prediction and prevention.

**Keywords:** Amino acid, uric acid, hyperuricemia, prospective study, metabolomics

144/420

IRON CONTAMINATION IN PARENTERAL NUTRITION MIXTURES

(1)Menéndez, Ana María; (2)Farias, Silvia; (2)Servant, Roberto; (3)Cortez, Iris; (4)Montemerlo, Hugo José; (5)Weisstaub, Adriana Ruth; (6)Russi, Fernando; (5)Pita Martín de Portela, Maria Luz.

(1)PhD. Pharmacyst. Universidad de Belgrano. Buenos Aires. Argentina.; (2)Analytical Chemistry. Atomic Energy National Agency. San Martín. Buenos Aires. Argentina; (3)Analytical Chemistry Laboratory. Benito Roggio Ambiental. Belgrano University; (4)Universidad del Salvador. Buenos Aires. Argentina; (5)School of Pharmacy and Biochemistry. Buenos Aires University. Buenos Aires. Argentina; (6)Centro de mezclas intravenosas SA. Hospital Militar Cosme Argerich. Buenos Aires. Argentina.

**Background and objectives:** Iron is an essential trace element, but it is not recommended to add excessive amount of it to total parenteral nutrition (TPN) because it affects the mixtures stability. Nevertheless, the variable iron contamination has been documented in the components used to prepare TPN. This contamination must be taken into account by the compatibility limitations regarding lipids destabilization.

Objectives: 1) to determine iron contamination levels in commercial individual components available in Argentina to prepare TPN mixtures. 2) to calculate the iron contamination amount

present in a neonate, an infant and an adult. typical TPN prepared with individual components.3) To calculate the contamination amount regarding the iron requirements.

**Methods:** Iron was determined in 40 individual solutions, from different labs and lots, belonging to 11 commercial products available in Argentina. Three replicates of each sample were analyzed by Argon Inductively Coupled-Plasma- Optical Emission Spectrometry (ICP/ OES). Perkin Elmer 5100 DV. Samples containing organic substances were digested in a laboratory microwave oven, using concentrated nitric acid. Analysis were carried out according to the guidelines provided by ISO/ IEC 17025: 05.

**Results:** Iron levels for each individual solution were (µg/mL): mean value±SD: Dextrose 50%: 1.12±0.03; Dextrose 70%: 1.32±0.52; Amino acids 10%: 0.25±0.11; Lipids 20%: 4.58±0.80; Potassium chloride: 0.11±0.03; Sodium chloride 20%: 0.11±0.03; Magnesium sulfate: 0.11±0.00; Sodium glicerophosphate: 2.76±0.48; Sodium phosphate: 4.51±0.13; Calcium gluconate: 2,01±0,27; Zinc sulfate: 0.12±0.04; Sterile water: non detectable.

According to the obtained values, the calculated iron total amount (mg) provided by the individual components contamination would be for a typical TPN mixture: adult 2.352; neonatology: 0.073; pediatric: 0.524.

**Conclusions:** iron found as contaminant in the studied components was not declared in the label. The Fe contamination levels in both pediatric mixtures were around 0.5 mg/L, but levels in adult TPN were 1.2 mg/L, which would affect the TPN stability. Regarding the iron daily requirements, Fe contamination in TPN mixtures for adults would be very high, but near 70% in infant and very low in neonate TPN. Therefore, It would be advisable that manufacturers declare the Fe contaminant content in the label products to avoid iron excess which would compromise the evolution of critical patients.

**Keywords:** Parenteral nutrition, Iron contamination, adults, pediatric

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MEASURING BRAZILIAN BREAKFAST QUALITY: THE DEVELOPMENT OF AN INDEX TO BE USED IN DIFFERENT POPULATIONS

(1)Santos, Roberta; (2)Gorgulho, Bartira; (2)Marchioni, Dirce; (3)Baltar, Valéria T.

(1)PhD student. Nutritionist. Department of Nutrition. School of Public Health. University of São Paulo. Brazil.; (2)PhD. Nutritionist. Department of Nutrition. School of Public Health. University of São Paulo. Brazil.; (3)PhD. Statistic. Department of Epidemiology and Biostatistics. Institute of Collective Health. Fluminense Federal University. Brazil.

**Background and objectives:** Breakfast is considered an important eating event. A single index to assess and compare the quality of this meal across different populations is needed. We are proposing an index to evaluate the nutritional quality of the breakfast, that can be applied across populations with different cultural backgrounds.
**Methods:** We used a representative sample of the Brazilian population aged 19 years or older with data of individual food consumption from the National Dietary Survey conducted in 2008-2009. We considered as breakfast the episode of consumption with the highest energy intake contribution in the time range 6AM to 10AM. The final study sample included 31.735 adolescents and adults of both genders. The Breakfast Meal Index (BMQI) was based on Main Meal Quality Index and nutritional guidelines and recommendations as World Health Organization and the World Cancer Research Fund nutritional recommendations and was composed by nine components: fruits, calcium, fiber, carbohydrate, total fat, saturated fat, processed meat, added sugar and energy density. Each component can score between zero and 10 points and the final score range is 0-100 points.

**Results:** The BMQI was positively (p<0.001) associated with intake of carbohydrate, protein, fiber, vitamins E, C and B6, thiamine, niacin, riboflavin, folate, iron, phosphorus, magnesium, zinc, selenium, calcium and potassium. Total fat, saturated fat, cholesterol, sodium and added sugar were negatively associated with indicator. The Cronbach's coefficient alpha for reliability was 0.66, and the BMQI score was positively associated with age (p<0.001) and income (p=0.045), and negatively associated with male (p<0.001) and residents of urban area.

**Conclusions:** The proposed BMQI seems to be an useful instrument for evaluating, monitoring and comparing the breakfast quality in populations studies.

**Keywords:** Meal quality. Breakfast. Meal index. Dietary quality. Nutritional guidelines.

**Methods:** Human adipose-derived stem cells (hADSC) were differentiated into adipocytes for 14 days. TNMD gene expression and protein levels were analyzed at different times from day 0 to day 14 (d0, d7, d10 and d14) by qRT-PCR and Western blotting. Subsequently, the mature adipocytes at d14 were incubated with an adenovirus-5 (Ad-5) vectors containing a shRNA-TNMD or shRNA-scrambled as a control for 48 hours. Different genes related to glucose and lipid metabolism and adipogenesis were analyzed by qRT-PCR such as CCAAT/enhancer-binding protein alpha (C/EBP-α), peroxisome proliferator-activated receptor-gamma (PPAR-γ), glucose transporter 4 (GLUT4), adiponectin (ADIPOQ), hormone-sensitive lipase (HSL), adipose triglyceride lipase (ATGL) and perilipin (PLIN).

**Results:** TNMD expression and protein levels were significantly up-regulated during the adipogenic differentiation (P<0.05). TNMD inhibition, both mRNA as protein levels, was approximately 90 % in the Ad-5-shRNA-TNMD-treated adipocytes compared with the Ad-5-shRNA-control. C/EBP-α, PPAR-γ, GLUT4, ADIPOQ, HSL, ATGL and PLIN gene expressions were significantly down-regulated in the Ad-5-shRNA-TNMD-treated cells (P<0.05).

**Conclusions:** TNMD is highly expressed in human differentiated adipocytes from hADSC. TNMD inhibition provokes a generalized alteration on glucose and lipid metabolism and adipogenesis in human adipocytes.

**Keywords:** Obesity, adipogenesis, metabolism.

TENOMODULIN GENE IS POTENTIALLY INVOLVED ON METABOLISM AND ADIPOGENESIS IN HUMAN DIFFERENTIATED ADIPOCYTES

(1)Ruiz Ojeda, Francisco Javier; (2)Gomez-Llorente, Carolina; (2)Rupérez-Cano, Azahara Iris; (2)Gil, Ángel; (2)Aguilera, Concepción María.

(1)PhD. Nutritionist. Department of Biochemistry and Molecular Biology II. School of Pharmacy. Institute of Nutrition and Food Technology; (2)PhD. Department of Biochemistry and Molecular Biology II. School of Pharmacy. Institute of Nutrition and Food Technology "José Mataix". Biomedical Research Centre. University of Granada. Granada. Spain.

**Background and objectives:** Tenomodulin (TNMD) is a transmembrane protein inhibiting angiogenesis and it is highly expressed during the adipogenic differentiation. In this sense, it has been reported an up-regulation of mRNA levels in adipose tissue from adults with obesity; and a down-regulation during diet-induced weight loss. Our group has observed that TNMD gene was up-regulated in omental adipose tissue from obese pre-pubertal children compared with their normal-weight peers by genome analysis and qRT-PCR. The aim of the present work was to study the putative metabolic function of TNMD and its association with adipogenesis and metabolism in human adipocytes.
# THE EFFECT OF INGESTION OF THE AMAZON DIET ON ELDERLY NEUROPSYCHIATRIC PATIENTS

**Background and objectives:** Changes in the nutritional condition of the elderly may be related to the aging process and/or pathological processes. With regard to the psychological aspect of this elderly person, the manifestation of neuropsychiatric disorders may also impair good nutrition. The fact that some also present underlying diseases reinforces the need for supply and nutrient balance, which can be found in foods of native cooking. Objective: to investigate the action of the Amazon diet during the period of home care for the elderly using psychotropic drugs.

**Methods:** It is an observational study in loco, to determine the effect of the food intake of the Amazonian diet on the improvement of signs and symptoms of adverse reactions to the use of psychotropics, by the elderly, with moderate and high risk for fragility.

**Results:** Some of the foods in the Amazon diet have natural compounds that may have activity in the fight against cardiometabolic diseases, chronic non-transmissible diseases, due to its antioxidant, anti-inflammatory, cholesterol-lowering, polyphenol-rich properties. The elderly, accompanied by the Pilot Health at Home Project and who presented neuropsychiatric disorders, were cared for by a multiprofessional team and oriented to the Amazonian diet, according to the categorization of Ribeiro and Cruz (2012) in fruits, flours and fish, and Its effects on health, quality of life, optimal amount of nutrient intake. It was verified that the elderly who started to insert in their daily food the native cuisine, have reported improvement of the symptoms related to the adverse effects of the administered psychotropics. The nutritional evaluation by the health professionals of the team also showed improvement of

nutritional standards, lipid profile, glucose, blood pressure, and self-esteem improvement.

**Conclusions:** Nutrition for the elderly population needs to be carefully discussed by the health team, especially when these elderly people use psychotropic drugs that are almost always associated with other medications. In view of the diversity and peculiarity of food in the Amazon region, the study also reveals the importance of the health team in the region to be bringing this information to the population and carrying out actions aimed at native nutritional education.

**Keywords:** Amazon diet; psychotropic drugs; elderly

# THE ASSOCIATION BETWEEN STUNTING, WASTING AND BREASTFEEDING, AND FAT-FREE MASS AND FAT MASS IN KENYAN CHILDREN AGED 6 AND 15 MONTHS

**Background and objectives:** It is important to understand the linkage between nutritional status, growth, breastfeeding and body composition in order to design interventions to prevent growth faltering, but few data from low- and middle-income countries are available.

The objective was to assess the role of nutritional status and other correlates of body composition in Kenyan children aged 6 and 15 months.

**Methods:** Four hundred and forty nine (449) infants were enrolled in an observational study embedded in a nutrition intervention trial conducted in rural Kenya. Infants were enrolled at 6 months of age. Anthropometric measurements were conducted, and fat-free mass (FFM) and fat mass (FM) were measured with the deuterium dilution technique when the children were 6 and 15 months of age, respectively. Linear regression was used to assess the association of sex, breastfeeding, stunting and wasting as correlates of fat-free mass index (FFMI), fat mass index (FMI) and body mass index (BMI).

<footnote>(¹)de Souza Praia, Raquel; (²)Ribeiro, Euler Esteves; (³)Ribeiro, Ednéa Aguiar Maia; (⁴)Cruz, Ivana Beatrice Mânica da; (⁵)Neta, Inez Siqueira Santiago;</footnote>

<footnote>(⁶)Oneti, Ciro Félix; (⁷)Mortágua, Andréa Rebouças; (⁸)Costa, Michelle Silva;</footnote>

<footnote>(⁹)Mesquita, Priscila Lyra; (¹⁰)Bondim, Helena Figueiredo Felisbino Barbosa.</footnote>

<footnote>(¹)Doutoranda em Saúde Pública. Universidade de Ciências Empresariales y Sociales (UCES). Enfermeira. Universidade Aberta da Terceira Idade (UNATI/UEA/AM). Brasil.; (²)Médico. Doutorado em Medicina e Ciências da Saúde. Diretor da Universidade Aberta da Terceira Idade (UNATI/UEA). Manaus/AM. Brasil.;</footnote>

<footnote>(³)Médica. Doutorado em Ciências da Atividade Física e Desporte. Universidade Aberta da Terceira Idade (UNATI/UEA/AM). Brasil.;</footnote>

<footnote>(⁴)Mestre e doutora em Genética e Biologia Molecular. Pós-doutorado na University of California, Davis-USA. Coordenadora do Programa em Gerontologia. Universidade Federal de Santa Maria. Brasil.; (⁵)Acadêmica de Enfermagem. Universidade Federal do Amazonas. Universidade Aberta da Terceira Idade (UNATI/UEA/AM). Brasil.; (⁶)Enfermeiro. Universidade Aberta da Terceira Idade (UNATI/UEA/AM). Brasil.; (⁷)Fisioterapeuta. Universidade Aberta da Terceira Idade (UNATI/UEA/AM). Brasil.; (⁸)Assistente Social. Especialista em Política Pública de Atenção a Família. Universidade Aberta da Terceira Idade (UNATI/UEA/AM). Brasil.;</footnote>

<footnote>(⁹)Educadora Física. Secretaria de Educação do Estado de São Paulo. Brasil.; (¹⁰)Enfermeira. Unidade de Reabilitação do Hospital Escola São Francisco de Assis- UFRJ. Brasil.</footnote>

<footnote>(¹)Konyole, Silvenus; (²)Ayoma, Selina; (³)Kinyuru, John; (⁴)Owuor, Bethwell; (⁵)Estambale, Benson; (⁶)Wells, Jonathan; (⁷)Michaelson, Kim F.; (⁸)Friis, Henrik; (⁹)Roos, Nanna; (¹⁰)Owino, Victor.</footnote>

<footnote>(¹)PhD. Nutritionist. Department of Nutritional Sciences. Masinde Muliro University of Science and Technology; (²)PhD. Nutritionist. Institute of Tropical and Infectious Diseases. University of Nairobi. Nairobi. Kenya.; (³)PhD. Nutritionist. Department of Food Science and Postharvest Technology. Jomo Kenyatta University. Juja. Kenya.; (⁴)PhD. Biologist. Department of Biology. Catholic University of East Africa. Nairobi. Kenya.; (⁵)PhD. Parasitologist. Research Division. Jaramogi Oginga Odinga University. Bondo. Kenya.; (⁶)PhD. Nutritionist. Childhood Nutrition Research Centre. Institute of Child Health. London. UK.; (⁷)Department of Nutrition, Exercise and Sports. Faculty of Science. University of Copenhagen. Denmark.; (⁸)PhD. Nutritionist. Department of Nutrition Exercise and Sports. University of Copenhagen. Copenhagen. Denmark; (⁹)PhD. Nutritionist. Nutrition Section. International Atomic Energy Agency. Vienna. Austria.</footnote>
**Results:** At the age of 6 months, boys had a 0.45 (95% CI 0.10-0.80) kg/m2 higher FFMI compared to girls. There was no difference in FMI. A similar pattern was seen when the children reached the age of 15 months. Those who stopped breastfeeding before the age of 15 months (11%) had a 0.10 (95% CI -0.60; 0.40) kg/m2 lower FMI when they reached 15 months. At 6 months, stunted infants had a 0.28(95%CI -0.85; 0.29) kg/m2 lower BMI than infants with LAZ above 0, due to 0.66(95% CI -1.08;-0.23) kg/m2 lower FMI, but not FFMI. Stunting was not associated with body composition at 15 months of age. Wasted children had both lower FFMI and FMI at 6 and 15 months of age.

**Conclusions:** Further research is needed to establish the relation between these early changes in body composition and later body functions and the risk of infectious and chronic diseases.

**Keywords:** lean mass, fat mass, rural Kenya, breastfeeding, stunting
**Further collaborators:**

Jutta KH Skau: MRC Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa

Suzanne M Filteau: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom

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BODY COMPOSITION AND GRIP STRENGTH BETWEEN OLDER ADULTS, INSTITUTIONALIZED AND TAI CHI CHUAN PRACTITIONERS IN CUBA. A SARCOPENIA STUDY

(1)Díaz Sánchez, María Elena; (2)Ruiz Álvarez, Vladimir; (3)Hernández-Triana, Manuel; (4)Llera-Abreu, Elisa; (5)Díaz Fuentes, Yoandry Alfonso; (6)Roque Treville, Celia María; (7)Lanyau Domínguez, Yeneisy; (8)Campos Domínguez, Derbis; (9)Díaz Domínguez, Maybe; (9)Rodríguez Domínguez, Lourdes.

(1)PhD. Anthropologist. Nutrition Center. National Institute of Hygiene Epidemiology and Microbiology. Havana. Cuba.; (2)MSc. Medical Doctor. Biochemist. Nutrition Center. National Institute of Hygiene Epidemiology and Microbiology. Havana. Cuba;
(3)PhD. Medical Doctor. Biochemist. International Institute for Healthcare Professionals. Miami. Florida. US.; (4)BSc. Nutritionist. Nutrition Center. National Institute of Hygiene Epidemiology and Microbiology. Havana. Cuba; (5)MSc. Nurse. Nutrition Center. National Institute of Hygiene Epidemiology and Microbiology. Havana. Cuba; (6)BSc. Biologist. Nutrition Center. National Institute of Hygiene Epidemiology and Microbiology. Havana. Cuba;
(7)MSc. Biochemist. Nutrition Center. National Institute of Hygiene Epidemiology and Microbiology. Havana. Cuba; (8)BSc. Biochemist. Nutrition Center. National Institute of Hygiene Epidemiology and Microbiology. Havana. Cuba; (9)MSc. Medical Doctor. Internist. Polyclinic Van troi. Medical School Calixto García. Havana. Cuba.

**Background and objectives:** Background: Aging is associated with profound changes in body composition that occur in late life. With age, adiposity increases and skeletal muscle mass is reduced.

This loss with age leads to sarcopenia, which is a multifactorial process that includes physical inactivity in its development. Sarcopenia establishes its symptoms in inactive individuals, but is also observed in some who remain active throughout their lives. Training with physical exercise is favorable to delay sarcopenia, like adequate food and nutrition, among other factors that improve the quality of life in old age.

**Objectives:** To analyze body composition and hand grip strength in elderly, institutionalized and active TAI CHI practitioners.

**Methods:** An anthropometric study was performed in old people attending day care for the elderly institutions and assiduous practitioners Tai Chi Chuan in the National School of Wushu. Fat mass (FM), fat free mass (FFM) and total body water (TBW) were calculated by electrical bioimpedance with an Impedimed DF50 analyzer. From the resistance, skeletal muscle mass (SMM) was obtained by equations. Muscle strength was obtained with a JAMAR dynamometer. Statistical analysis used the general linear model, principal component analysis, and polynomial logistic regression.

**Results:** The women had higher FM, lower FFM, TBW, SMM and muscular strength than men, verified with a General Linear Model. There is a significant effect of age on weight increase, decrease in height, SMM and muscular strength. The FFM and the subcomponents TWB and SMM corresponded to strength force and were more diminished in the institutionalized elderly. Logistic regression showed that decreased muscle strength was more representative in the institutionalized elderly. In them, sarcopenic obesity is also more frequent. Tai Chi Chuan practitioners have significantly more lean body mass development and physical performance than older adults who stay in day care institutions, that have a more sedentary behavior, corresponding to the sarcopenia.

**Conclusions:** The physical activity of TAI CHI CHIAN offers better predictions for body composition to reduce sarcopenia in the elderly.

**Keywords:** Body Composition, Sarcopenia, Obesity, Grip Strength

**Further collaborators:** MSc Héctor Hernández Hernández. Medical Doctor. Biochemist. Nutrition Center. National Institute of Hygiene Epidemiology and Microbiology. Havana. Cuba.

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GESTATIONAL PROTEIN RESTRICTION PLUS RICH-SUCROSE DIET IN ADULTHOOD PROMOTES AFFECTATIONS IN LIVER OF RATS

(1)Rodríguez-Antolín, Jorge; (2)Cervantes-Rodríguez, Margarita; (3)Cuevas, Estela; (3)Nicolás-Toledo, Leticia.

(1)Centro Tlaxcala de Biología de la Conducta. Universidad Autónoma de Tlaxcala. Mexico; (2)PhD. Licenciatura en Nutrición. Facultad de Ciencias de la Salud. Universidad Autónoma de Tlaxcala. Mexico.; (3)PhD. Centro Tlaxcala de Biología de la Conducta. Universidad Autónoma de Tlaxcala. Mexico.

**Background and objectives:** Background. Gestational protein restriction increases metabolic diseases. The consumption of a high-sucrose diet has been associated with non-alcoholic fatty liver
disease in both infant and adult populations. The combination of gestational protein restriction and the intake of a carbohydrate-rich diet during adulthood on the development of non-alcoholic fatty liver disease is yet unknown. Objective. To analyze that sugared water consumption promotes cell damage and liver fat accumulation in adult offspring exposed to gestational protein restriction.

**Methods:** Four groups of rats Wistar (22 weeks age): 1) The offspring from mothers feed with a control diet, 2) the offspring from mothers feed with protein-restricted diet 3) the offspring from mothers feed with a control diet but with access to water with sucrose 5 % plus in adulthood, and 4) the offspring from restricted mother and with access to water with sucrose 5 % plus in adulthood. Growth and consumption of food and water were monitored throughout the study. We evaluated with histological analysis of the liver and anti 3-Nitrotyrosine with inmunohistochemistry technique.

**Results:** No differences were found in body weight throughout of 22 weeks. Food and water consumption were affected for sucrose diet. In female and male offspring from restricted mothers, the sweetened water consumption in adulthood promoted an increase in the liver weight and fat accumulation. In male offspring, only the sweetened water consumption induced fat accumulation and an intense cytoplasmic staining of anti 3-Nitrotyrosine in the liver.

**Conclusions:** Thus, female offspring from malnutrition mothers are more susceptible than male one to be affected by a sucrose-diet in adulthood.

**Keywords:** Malnutrition, sucrose diet, fatty liver disease, 3-Nitrotyrosine.

**Further collaborators:** Laura García.

and VLCD groups were similar, namely the mice in VLCD group gained more weight than the other for 21w. There were no significant differences in the weights of liver and WAT between HFD and VLCD groups. The concentration of insulin of VLCD-fed mice was significantly decreased compared with HFD-fed mice throughout the whole period. On the contrary, serum FGF21 concentration was significantly increased in the VLCD-fed mice. After feeding for 24w, the VLCD-fed mice showed heavier liver TG contents than HFD-fed mice. In the liver, the mRNA expressions of CD36 and FGF21 were increased in VLCD-fed mice.

**Conclusions:** VLCD-fed mice increased their body weights and the liver TG contents after feeding for 24w, in spite of the decrease in serum insulin concentration. Since hepatic expression of CD36 was increased, the increase in hepatic lipid might be caused by the activation of peroxisome proliferator-activated receptor γ. VLCD seems to be beneficial for the loss of weight for a short time.

**Keywords:** very-low carbohydrate diet, weight loss, hepatic lipids

**Background and objectives:** Obesity is caused by excessive fat or carbohydrate intake. The improvement of obesity is an important issue, especially in Western societies. Low-carbohydrate diet is used to achieve weight loss in humans. To clarify the effect on weight loss, we investigated the serum chemicals and the gene expression in liver of a very-low carbohydrate diet (VLCD)-fed diet-induced obese (DIO) mice.

**Methods:** DIO male ddY mice were divided into high-fat diet (HFD) and VLCD groups. The body, liver and white adipose tissue (WAT) were weighed and the serum chemicals and hepatic lipids and the mRNA expression were analyzed after feeding for 3, 12 and 24 weeks.

**Results:** The mice fed VLCD decreased their body weights for the first three weeks. After 24w, the body weights of HFD
# DO DIETARY PATTERNS DETERMINE LEVELS OF VITAMIN B6, FOLATE, AND VITAMIN B12 INTAKES AND CORRESPONDING BIOMARKERS IN EUROPEAN ADOLESCENTS? THE HELENA STUDY

(¹)1 GENUD (Growth' Exercise' NUtrition and Development) Research group. Universidad de Zaragoza. Instituto Agroalimentario de Aragón (IA2). Instituto de Investigación Sanitaria Aragón (IIS Aragón). Zaragoza. Red de Salud Materno-infantil. Spain; (²)PhD. Nutritionist. Department of Public Health. Ghent University. Ghent. Belgium. International Agency for Research on Cancer (IARC). 150 Cours Albert Thomas. 69372. Lyon. Cedex 08. France.; (³)PhD. Nutritionist. GENUD (Growth' Exercise' NUtrition and Development) Research group. Universidad de Zaragoza. Spain; (⁴)PhD. Statistician. Department of Preventive Medicine and Public Health. Universidad de Zaragoza. Zaragoza. Spain.; (⁵)PhD. Nutritionist. Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III. Madrid. Spain. GENUD (Growth' Exercise' NUtrition and Development) Research group. Universidad de Zaragoza. Spain.; (⁶)PhD. Nutritionist. GENUD (Growth' Exercise' NUtrition and Development) Research group. Universidad de Zaragoza. Spain. Instituto Agroalimentario de Aragón (IA2). Instituto de Investigación Sanitaria Aragón (IIS Aragón). Zaragoza. Spain.; (⁷)PhD. MD. Université Lille. CHU Lille. LIRIC UMR 995 Inserm. Clinical Investigation Centre. CIC-1403-Inserm-CHU. F-59000 Lille. France.; (⁸)PhD. MD. Research Institute of Child Nutrition. Pediatric University Clinic. Ruhr-University Bochum. Germany.; (⁹)PhD. Pharmacologist. ImFINE Research Group. Department of Health and Human Performance. Universidad Politécnica de Madrid. Madrid. Spain.; (¹⁰)PhD. MD. GENUD (Growth' Exercise' NUtrition and Development) Research group. Universidad de Zaragoza. Spain. Instituto Agroalimentario de Aragón (IA2). Instituto de Investigación Sanitaria Aragón (IIS Aragón). Zaragoza. Spain.

**Background and objectives:** Adolescence is a period in which micronutrients status might be compromised due to frequent consumption of food with low nutritional value and due to increased requirements for growth and development. Among those, B-vitamins, as key-role micronutrients, might be affected. For this reason, the aim of this study is to determine the dietary patterns (DPs) explaining the highest variance of vitamin B6, folate, and B12 intake and related concentrations among European adolescents.

**Methods:** 2,173 adolescents participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study met the eligibility criteria for B-vitamins intake analysis (46 % males) and 586 did it for biomarkers analysis (47 % males). Two non-consecutive 24-h dietary recalls were used to assess mean

intakes. Concentrations were measured by chromatography and immunoassay. Reduced rank regression was applied to elucidate the combined effect of food intakes in B-vitamins intakes and concentrations.

**Results:** Identified dietary patterns (one per each B-vitamin intake and biomarker and by sex) explained a variability between 34.2 % and 23.7% of the B-vitamin intakes and between 17.2 % and 7% of the biomarkers. Fish, eggs, cheese, and white and buttermilk intakes, loaded positively for B-vitamins intake in both sexes; in contrast, soft drinks and chocolate, loaded negatively. For biomarkers, there was a higher heterogeneity in terms of foods loads in the identified patterns, like in the case of cheese, that loaded negatively for the identified pattern in males and females for plasma vitamin B12, and positively in the pattern of males and females for RBC-folate, and also positively for PLP in females. Besides, some food items loaded differently between intakes and biomarkers, like fish products which, in females, loaded positively for intakes, but negatively for plasma folate.

**Conclusions:** The identified dietary patterns explained more variance of the B-vitamins intake than for their related biomarkers both in males and females. The dietary patterns were different for the same B-vitamin between males and females, and between intake and status of the same B-vitamin. Further studies are needed to elucidate the factors determining such differences.

**Keywords:** Dietary patterns, Reduced Rank Regression, B-vitamins, Europe, adolescents

**Further collaborators:**

Yannis Manios, Alejandro De la Puerta, Anthony Kafatos, Ascensión Marcos, Stefania Sette, Maria Plada, Peter Stehle, Dénes Molnár, Kurt Widhalm, Stefaan De Henauw.

# RELATIONSHIP BETWEEN NON NUTRITIVE SWEETENERS INTAKE AND NUTRITIONAL STATUS

García, María Isabel; Tello, Sofía; Poch, Clarisa; Rellecati, Candela; Muguerza, María de los Ángeles; Capaldi, Luciana; Ruiz, Laura Matilde.

LDN. Nutritionist. Department of food and nutrition. Centro Gallego de Buenos Aires. Argentina.

**Background and objectives:** Obesity and associated metabolic diseases are going through a constant worldwide increase. At the need to prevent and/or maintain a good health condition an interest for non-nutritive sweeteners (NNS) rise. Although their impact on intake and body weight is unclear, its consumption is high for being widely distributed in foods. Epidemiologic studies associate NNS consumption with excessive food intake and body weight gain.

The objectives are to estimate NNS consumption's prevalence in diet products on an adult population, evaluate association between nutritional status and NNS consumption and estimate NNS intake and compare it with the Acceptable Daily Intake (ADI).

<footnote>(¹)Iglesia, Iris; (²)Huybrechts, Inge; (³)Mouratidou, Theodora;</footnote>

<footnote>(⁴)Santabárbara, Javier; (⁵)Fernández-Alvira, Juan Miguel;</footnote>

<footnote>(⁶)Santaliestra-Pasías, Alba M.; (⁷)Gottrand, Frédéric; (⁸)Kersting, Mathilde; (⁹)González-Gross, Marcela; (¹⁰)Moreno, Luis A.</footnote>
termed by real-time PCR. Also, duodenum and jejunum was
ligated and water-soluble heme or hemin iron was administered
to measure the uptake of iron into mucosal cells and portal vein
blood.

**Results:** Levels of expression of HO-1 and Fpn1 mRNA were high in the duodenum, and these were upregulated in iron-deficient rats. In the duodenum, iron uptake was about 30% after loading with water-soluble heme iron, but hemin was not absorbed. Levels of expression of Hcp1 and Flvcr1 mRNAs were high in the jejunum, and iron uptake was also high after loading with hemin in this section. Hcp1 and Flvcr1 mRNAs were not upregulated by iron deficiency.

**Conclusions:** In the duodenum and jejunum of the small intestine, different iron absorption mechanisms for water-soluble heme iron and hemin are considered to exist.

**Keywords:** heme iron absorption, HCP1, Flvcr1, iron deficiency, hemin

and fasting insulin (70.2 vs 42.4 pmol·L; p<0.05). There were not
significant differences in plasma total FFAs concentration between
groups. However, children with AO had higher palmitoleic acid
(0.94 vs 0.70 wt%; p<0.05) and dihomo-gamma linoleic acid (2.76
vs 2.07 wt%; p<0.05). Palmitoleic and dihomo-gamma linoleic ac-
ids correlated (p<0.05) with BMI (r=0,397; r=0,296, respectively)
and waist circumference (r=0,380; r=0,276, respectively). Myristic
and palmitoleic acids correlated (p<0.05) with high-density lipo-
protein cholesterol (r=-0.408; r=-0.572, respectively).

**Conclusions:** These findings suggest that abdominal obese children have different plasma FFAs concentrations than non-obese peers, and the associations of FFAs with cardiometabolic risk factors are present in childhood.

**Keywords:** Students, body mass index, cardiometabolic risk factors, palmitoleic acid, dihomo-gamma linoleic acid.

(1)Aristizabal, Juan; (1)González-Zapata, Laura Inés; (2)Estrada-Restrepo, Alejandro; (3)Monsalve, Julia; (4)Restrepo-Mesa, Sandra; (5)Gaitan-Charry, Diego.

(1)PhD. Nutritionist. School of Nutrition and Dietetics, University of Antioquia, Medellín. Colombia; (2)MSc. Epidemiology. Grupo de Investigación en Demografía y Salud. Universidad de Antioquia. Colombia; (3)MSc. Nutritionist. Escuela de Nutrición y Dietética. Universidad de Antioquia. Colombia; (4)Professor. Colombia; (5)PhD. Doctor. Grupo de Investigación Alimentación y Nutrición Humana. Universidad de Antioquia. Colombia.

**Background and objectives:** In adults with abdominal obesity (AO), increased concentration of free fatty acids (FFAs) is associated with cardiometabolic risk factors. However, this association remains controversial in children. This study aimed to compare plasma FFAs concentration in children with and without AO, and to examine FFAs associations with cardiometabolic risk factors.

**Methods:** Twenty-nine children with AO were matched, one by one, according to sex and age, with 29 non-obese peers. Abdominal obesity was classified using the ninety percentile from the IDEFICS-Study (Identification and prevention of Dietary- and lifestyle-induced health EFects In Children and infantS). Fasting plasma glucose, insulin, and lipids were determined by colorimetric and enzymatic methods. Plasma FFAs were analyzed by gas chromatography.

**Results:** Seventeen boys and twelve girls with similar average age (7.1 ± 2.6 vs 7.2 ± 2.7 y; p>0.05) were included in each group. Children with AO showed higher body mass index (BMI) (19.7 vs 15.4 kg/m2; p<0.001), waist circumference (64.9 vs 53.7 cm; p<0.001), systolic blood pressure (98.6 vs 93.5 mmHg; p<0.01)

(1)Cho, Younok; (2)An, Jeehyun.

(1)PhD. Professor. Department of Food and Nutrition. Duksung women's university. Republic of Korea; (2)Department of Food and Nutrition. Duksung Women's University. Republic of Korea.

**Background and objectives:** Replenishment of body's fuel store after exercise is a key process for the next bout of exercise. This study was conducted to examine the effect of exercise-to-rest period ratio and physical training on the recuperation of stored fuel.

**Methods:** Forty rats weighing 95-105 g were randomly assigned to either non-exercise training (NT) or regular exercise training (T) groups for 5 weeks and were subdivided into two groups: non-exercise(NE), exercise and recuperation group(ER). NE group were sacrificed without exercise and ER group were sacrificed after 1 hour rest from exercising for 0.5(ER2:1), 1(ER1:1), 2(ER1:2) hours.

**Results:** Liver glycogen level was increased in ER group and was reached to the highest level at ER1:1 ratio while it was not different between NE group and ER group in NT animal. Muscle glycogen level was increased at ER2:1 ratio and returned to the level of NE in NT animal while it was reached to the highest level at ER2:1 ratio and decreased but still higher than those of the level of NE in T animal. Free fatty acid level was reached highest level at ER2:1 ratio and decreased and was lower than those of NE at ER1:1 and ER1:2 ratio in NT animal while it was reached to the highest level at ER2:1 ratio and decreased but was not lower than those of NE at ER1:2 ratio in T animal. Muscle triglyceride level of ER group was lower than that of NE group regardless of the different exercise-to-rest period ratio in NT animal while it was decreased and lower than that of NE group at ER2:1 and ER1:1 ratio but returned to that of NE in T animal. Muscle protein level was decreased at ER2:1 and started to be increased but was not reached to the level of NE group in NT animal while it was decreased.