A window of opportunity was opened to document HSG values in Ecuadorian elder subjects.

**Methods:** One-hundred-and-one elder subjects (Females: 74,3%; Average age: 70,5 ± 9,0 years) living in an urban destitute community in the city of Guayaquil (Ecuador). HSG was measured on both hemibodies with a mechanical dynamometer (Lafayette Inc., United States). HGS values were distributed according with age. Additional body composition (BC) measurements were performed with a professional bioimpedance machine (BodyStat Inc., United States).

**Results:** Average BMI was 27,5 ± 5,4 Kg.m-2. BC measurements were influenced by subject's sex. Males sustained higher HGS values, regardless of dominant arm. HGS values decreased with age.

**Conclusions:** HGS depends upon sex, dominant arm, and age.

**Keywords:** Muscle Mass; Hand Grip Strength; Dynamometer; Frailty; Sarcopenia; Geriatric Assessment; Aging.

**Further collaborators:** Sergio Santana Porben. Medical doctor, Profesor of Biochemestry. Ciudad de la Habana

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THE INFLUENCE OF MINERAL STATUS ON THE ACADEMIC PERFORMANCE

Assimi, Daniela.

MSc. Teacher. California Prep International School. Saraburi. Thailand.

**Background and objectives:** A balanced nutrition supplying the right amount of minerals is absolutely essential for the development of the brain, a normal cognitive function, and is a major influencing factor of behavior. This fact is even more important in the school-aged children but little has been studied on the actual extent in which mineral deficiencies actually affect the academic performance.

**Methods:** The study used a very simple non-invasive method observing mineral deficiencies in fingernails in 46 boys and 38 girls age 3-11 from Kindergarten and Elementary, and 33 boys and 21 girls age 12-18 from Middle and High School. Pictures were taken and their GPAs were collected for reference.

**Results:** In the age group 3-11, zinc deficiency was found in 26.09% boys and 23.68% girls, while iron deficiency was present in 13.04% boys and 7.89% girls. In the age group 12-18, 47.62% girls and 36.36% boys were zinc deficient, while 24.24% boys and 9.52% girls showed to be iron deficiency. Selenium and calcium deficiencies were found in isolated cases. Observations of the behavior were found to be concordant with the GPA and some previous ITBS scores addressing particularly the attention spans, concentration and comprehension.

**Conclusions:** Overall, this easy way of identifying eventual mineral deficiencies as early as possible by observing the fingernails proved to be a valuable method to trigger the students with problems and help improve academic performance while promoting the general health and improved behavior, through nutrition

**Keywords:** minerals, academic performance, fingernails

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NUTRITIONAL STATE AND BODY COMPOSITION OF ELDERLY CONSULTANTS IN OUTPATIENT MEDICINE IN CASABLANCA - MOROCCO

(1)El Arabi, Fatine; (2)NEJJAR, BASMA; (3)Bour, Abdellatif.

(1)Fatine El Arabi. MSc. Dietician. Department of Biology. Faculty of Sciences Kenitra. Morocco.; (2)MSc. Department of Biology. Faculty of Sciences Kenitra. Morocco. And. Department of Clinical chemistry. Faculty of medicine of Liège. Belgium.; (3)PhD. Professor. Department of Biology. Faculty of Sciences Kenitra. Morocco.

**Background and objectives:** Senescence represents a public health problem and its management is partly conditioned by assessed nutritional profile of the person. Thus, we have found it useful to conduct a study whose objective is to assess the nutritional state and body composition of the elderly Moroccan consulting in geriatric service in Casablanca region.

**Methods:** This is a cross-sectional survey of 62 elderly subjects: Aged over 60 years, selected from the database of the geriatric service of a Moroccan public hospital, from April to September 2015, in Casablanca. A questionnaire was used to identify socio-demographic characteristics and a grid to identify anthropometric (weight, height, body mass index (BMI), Calf circumference (CC) and brachial (CB)) and body composition indicators (lean mass (LM), fat mass (FM), Total cellular water (TCW), intracellular water (IW) and extracellular water (EW)) for each subject.

**Results:** The 62 subjects in the study represented a sex ratio of 0.5 and mean age, BMI, LM and FM were respectively 65.5 ± 6.8 years, 26.2 ± 4.8 Kg/m2, 64.3 ± 8.6 kg and 34.9 ± 8.7 Kg. 53.2% (n=33) of sample were in overweight (BMI> 18 Kg/m2) affecting women more (p<0.001). Significant differences between male and female subjects were recorded for LM and FM measurements (p <0.001) TCW (p<0.01), and EW (p<0.01). Negatively significant correlations were found between BMI and TCW (r = -0.3, p = 0.003) and EW (r = - 0.3, p = 0.003) and FM (r = -0.6, p<0.001) and positively significant between BMI and CB (r =0.6, p<0.001) and CC (F=0.7, p<0.001) and between TCW and EW (r = 0.7, p <0.001) and LM (r =0.5, p<0.001). The model of the multiple descending linear regression showed that FM is an associated factor with TCW (beta= -0.1, p= 0.05) in the elderly of our study.

**Conclusions:** At the end of this study, we concluded that the evaluation of the nutritional state of elderly was useful to prevent any risk of late complications and to allow early management.

**Keywords:** elderly, nutritional, body composition, Morocco
IRON ABSORPTION FROM BEANS WITH DIFFERENT IRON CONTENTS EVALUATED BY STABLE ISOTOPES

**Background and objectives:** Introduction: Brazil is a major beans producer and consumer and is part of the basic diet of the population. The introduction of biofortified crops such as beans with higher iron content is a useful tool in preventing iron deficiency diseases, as anemia. Thus, the measurement of the absorption of minerals is essential to evaluate the use of biofortified foods. Objective: This study evaluated the iron bioavailability of common beans cultivars BRS Estilo, with low iron content and BRS Pontal, that present intermediate iron content, in man through reliable techniques, not yet used in Brazil. The beans were produced by EMBRAPA.

**Methods:** Subjects and Methods: 29 young adult volunteers were divided into 2 groups: Group CB (13 subjects) received 100g of common beans (BRS Estilo) cooked labeled with iron 58 (58Fe) and Group BB (16 patients) received 100g target to biofortification beans (BRS Pontal), cooked and labeled with iron 58 (58Fe). The next day they receive the reference dose of ferrous sulfate enriched iron-57 (57Fe). After consumption was conducted isotopic evaluation of iron, for measurement of iron incorporation into erythrocyte.

**Results:** The difference between iron absorption from the meal containing common bean and that from the meal containing target to biofortification bean examined by means of a paired t test, were considered significant at P<0.05. The groups CB and BB did not differ in hemoglobin or serum ferritin concentrations. Serum ferritin ranged from 41 to 298 µmol/L. Mean isotopic ratio of iron absorption from the meal with common beans was 0.409% (±0.040%) and mean iron incorporation from the meal with biofortified beans was 0.407% (±0.038%).

**Conclusions:** The iron absorption from the common beans and target to bifortification beans was not significantly different. This study tested a single food; if its results are considered in making programmatic decisions, consideration must be given to the balance between iron absorption enhancers and inhibitors in the whole meal. The multiple meal study is necessary to evaluate the real iron absorption. The challenge for the global health commu-

nity remains how to tackle this efficacious intervention and implement it in a large scale.

**Keywords:** Biofortification, iron bioavailability, beans, iron deficiency.

**Further collaborators:**

Founds Collaborators: This work was supported by grants the National Council of Scientific and Technological Development (CNPq, Brazil) grant #482464/2012-7, FAEPA-HCFMRP-USP, Brazilian company of agricultural research (EMBRAPA) and HarvestPlus for the research financial support; the Coordination for the Improvement of Higher Education Personal (CAPES, Brazil)

PSYCHOSOCIAL AND FUNCTIONAL STATUS IN HOSPITALIZED GERIATRIC PATIENTS WITH MALNUTRITION

**Background and objectives:** Malnutrition has been associated with adverse outcomes such as functional disability, morbidity, mortality, and longer stays in the hospital. It is also a risk factor for frailty, particularly in older people. Physical function and psychological factors apparently contribute to dietary condition. Identification of those related status and treatment of malnutrition earlier can lead to improved clinical outcomes. This study was to investigate psychosocial and functional status of hospitalized geriatric patients with malnutrition screened by Mini Nutritional Assessment (MNA) tool at a regional hospital in Hsinchu, Taiwan.

**Methods:** We screened all hospitalized patients aged 65 years or older by using MNA from April to November of 2014 and excluded patients with confusion, terminal cancer and non-malnutrition caused by hypoalbuminuria. A total of 374 patients were screened and asked for attending the project if they were malnourished from screening. There were 160 patients included and their demographic characteristics, 3-day 24-hour diet recalls, anthropometric and biochemical data, Geriatric Depression Scale Short Form (GDS-SF) and Activities of Daily Living (ADL) scores were collected and analyzed. Statistical analysis for categorical variables was performed by the Chi-Square and t-tests, and Person's correlation test was used for two continuous variables.

**Results:** The mean age of 160 subjects (84 men and 76 women) was 77.0±6.8 years old. According to ADL and GDS-SF results, 43.5% of the patients were functionally dependent and 47.5% of them were with mild to severe depression. The results showed that protein intake was significantly related to body mass index (BMI),

<footnote>(1) Junqueira-Franco, Márcia Varella Morandi; (2) Nutti, Marilia R; (3) de Carvalho, José Luis V; (4) Pereira, Helton Santos; (5) Abrams, Steven A;</footnote>

<footnote>(6) Dutra de Oliveira, José Eduardo; (7) Marchini, Júlio Sérgio.</footnote>

<footnote>(1)PhD. Pharmacyst. Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo; (2) Msc. Food Engenner. Brazilian Company of Agricultural Research (EMBRAPA) Brazil; (3) Food Enginner. Brazilian Company of Agricultural Research (EMBRAPA) Brazil; (4) Agronomist Engineer. Brazilian Company of Agricultural Research (EMBRAPA) Brazil; (5) MD. Dell Medical School –University of Texas Austin, USA;</footnote>

<footnote>(6)PhD. MD Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo. Ribeirão Preto – SP. Brazil; (7)PhD MD Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo. Ribeirão Preto – SP. Brazil.</footnote>

<footnote>(1) Ouyang, Chung-Mei Ouyang; (2) Lin, Yu-Ru; (2) Fan, Ya-Wen; (3) Lai, Hsu-Yun.</footnote>

<footnote>(1)PhD. Dietitian. Department of Dietetics. National Taiwan University Hospital Hsin Chu Branch. Taiwan; (2) MS. Dietitian. Department of Dietetics. National Taiwan University Hospital Hsin Chu Branch. Taiwan; (3) Dr. Department of Family Medicine. National Taiwan University Hospital Hsin Chu Branch. Taiwan.</footnote>
mid-arm circumference (MAC), triceps skinfold (TSF), and grip strength. Patients' GDS-SF and ADL scores were correlated to their age and MNA.

**Conclusions:** About half of the hospitalized geriatric patients had functional and depressive problems and those were related to their nutritional status. Dietary intake especially protein intake was associated with many anthropometric measurements which were positively related to their daily activities.

**Keywords:** geriatric patients, activities of daily living, geriatric depression

**Further collaborators:**

Ai-Ting Lee

with only 1 value (0.5%) below -2 SD. NC was lower than in peers in other countries' reports. HC, NC, and WHtR values were lower in stunting children than non-stunting (p < 0.001). No obesity (BAZ >2 SD) was observed among the sample.

**Conclusions:** In the presence of linear growth retardation and underweight, head circumference is relatively preserved. At this age, obesity is virtually non-existent in preschoolers with widespread short stature, and neither waist nor neck circumferences appear to be increased.

**Keywords:** Stunting; cognitive development; head circumference; obesity; Guatemala

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## HEAD CIRCUMFERENCES AND BODY MASS INDEX ARE PRESERVED IN THE PRESENCE OF HIGH STUNTING PREVALENCE AMONG 4-7 YEARS OLD CHILDREN FROM WESTERN HIGHLANDS OF GUATEMALA

(1)Liem, Windy Mulia; (2)Shiu, Kimberly; (3)Garcia, Rosario; (4)Melse-Boonstra, Alida; (5)Solomons, Noel W.

(1)MSc.; (2)None; (3)MDS. Center for Studies of Sensory Impairment, Aging and Metabolism, Guatemala.; (4)PhD. Assistant Professor. Division of Human Nutrition. Wageningen University, Netherlands; (5)MD. Executive and Scientific Director. Center for Studies of Sensory Impairment, Aging and Metabolism, Guatemala.

**Background and objectives:** Stunting is suggested to be associated with suboptimal cognitive development, obesity, and chronic degenerative diseases. Researches on physical brain growth, as reflected in head circumference Z-scores, has been focusing on early childhood. Little is known about the brain growth nor how early is the onset of obesity during later childhood. The purpose of this study was to investigate circumferential measurements in preschool children with an extreme degree of linear growth retardation.

**Methods:** Body height, clothing-adjusted body weight, and circumferential measurements were obtained from 212 children, aged 4-7 years, 87 boys and 125 girls, from two rural areas with high prevalence of stunting in Western Guatemala. Conventional Z-scores for height, weight and head circumference, as well as body mass index (BMI), were derived; whereas waist circumference (WC) values were further divided by height to obtain waist-to-height ratio (WHtR) and neck circumferences values were compared with findings from other settings.

**Results:** The stunting prevalence was 63.2%, higher than the national under-five average of 46.5%, and similar to the Maya-indigenous rate of 61.2%, and higher among girls (65.6%) than boys (59.8%). Prevalence of underweight was 33%, with no instance of thinness, defined as < -2 SD in BMI-for-age (BAZ). Despite the highly prevalent stunting, median head circumference Z-scores (HCZ) was within the normal range (-0.65, 95% CI -0.72, -0.55),

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## MALNUTRITION AND ASSOCIATED FACTORS AMONG HOSPITALIZED GERIATRIC PATIENTS

(1)Ouyang, Chung-Mei Ouyang; (2)Lin, Yu-Ru; (2)Fan, Ya-Wen; (2)Yu, Szu-Chieh; (3)Lee, Ai-Ting; (4)Lai, Hsu-Yun.

(1)PhD. Dietitian. Department of Dietetics. National Taiwan University Hospital Hsin Chu Branch. Taiwan; (2)MS. Dietitian. Department of Dietetics. National Taiwan University Hospital Hsin Chu Branch. Taiwan; (3)Dietitian. Department of Dietetics. National Taiwan University Hospital Hsin Chu Branch. Taiwan; (4)Dr. Department of Family Medicine. National Taiwan University Hospital Hsin Chu Branch. Taiwan.

**Background and objectives:** Malnutrition negatively impacts on overall health status, morbidity and mortality. It is also a risk factor for frailty, particularly in older people. Nutritional status has been also shown to relate to many factors in the elderly. Identification and treatment of malnutrition earlier can lead to improved clinical outcomes. This study was to investigate nutritional status of hospitalized geriatric patients and its associated factors if they were malnourished or at risk of being malnourished.

**Methods:** We screened all hospitalized patients aged 65 years or older by Mini Nutritional Assessment (MNA) and Nutrition Risk Screening 2002 (NRS 2002) from April to November of 2014 and excluded patients with confusion, terminal cancer and non-malnutrition caused by hypoalbuminuria. A total of 374 patients were screened and asked for attending the project if they were malnourished from screening. There were 160 patients included and their demographic characteristics, 3-day 24-hour diet recalls, anthropometric and biochemical data and Activities of Daily Living (ADL) were collected and analyzed.

**Results:** The mean age of 374 subjects (193 men and 181 women) was 77.1±6.8 years. The NRS 2002 categorized 49.7% of patients as being malnutrition, and MNA categorized 19.5% and 52.4% of patients as being malnourished and at risk of being malnourished respectively. The average body mass index (BMI) of patients was 24.0±8.1 and only 9.2% was under 18.5. Weight status of the patients was significantly related to nutritional status. Age was associated with BMI, MNA, NRS 2002, hemoglobin, and total lymphocyte counts.
**Conclusions:** Results of this study identify multiple modifiable factors associated with the problem of malnutrition in hospitalized geriatric patients. Anthropometrical malnutrition as well as inadequate dietary intake at hospital were related to functional impairment and clinical outcomes.

**Keywords:** Malnutrition, geriatric patients, risk factors

**Further collaborators:**

Shu-Li Huang

144/1270

RELIABILITY AND VALIDITY OF THE MEDITER-RANEAN DIET ADHERENCE SCREENER AMONG THE IRANIAN ADULTS

(1)Mahdavi-Roshan, Marjan; (2)Soltanipour, Soheil Soltanipour;

(3)Salari, Arsalan.

(1)Assistant Professor in Nutrition Sciences, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.; (2)Associate Professor in Community Medicine, Department of Community Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran; (3)Associate Professor in cardiology, Guilan Interventional Cardiovascular Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

**Background and objectives:** Validated dietary assessment methods specific to population and food habits are needed for dietary assessment. Therefore, the aim of study was to assess the reliability and validity of the 14-point Mediterranean Diet Adherence Screener (MEDAS) among the Iranian adults.

**Methods:** Study was carried out on adults aged ≥ 43 who were admitted to a tertiary hospital in Rasht in the North of Iran, for elective angiography. Study was conducted in a country with a Shiite majority with religious restrictions, for this reason we eliminated some items and modified the MEDAS in the Farsi version by backward-forward method. We applied reliability analysis using model alpha, with SPSS to interpret the effects of each item of MEDAS in its internal consistency.

**Results:** After correcting the item scores, coefficients of Kuder-Richardson-20 was calculated 0.598. The mean ±SD of 13 items MEDAS was 5.82 ±1.90. None of Corrected Item-Total Correlation coefficients were negative. According to three categories of adherence to the Mediterranean diet, 42.5%, 50% and 7.5% participants had low, medium and high adherence to a Mediterranean diet respectively.

**Conclusions:** In spite of eliminating and making a few changes in questions due to religious reasons, the coefficients of Kuder-Richardson-20 did not decrease in reliability analysis. The MEDAS was translated and modified for the first time into Farsi. Administering this tool in future researches will help to understand how Iranian adhere to the mediterranean diet, aiming at improving cardiovascular health.

**Keywords:** Reliability, Validity, Mediterranean Diet Adherence Screener, Iranian adults

ANALYZING PROTEIN OXIDATION PERTURBATIONS AND ITS ROLE IN PROTEIN METABOLISM

(1)Vonk, Roel; (2)Reckman, Gerlof; (3)Koehorst, Martijn.

(1)PhD. Department of Medical Biomics. University of Groningen, University Medical Center Groningen. The Netherlands; (2)MSc, Department of Internal Medicine. University of Groningen, University Medical Center Groningen. The Netherlands;

(3)BASc, Department of Pediatrics University of Groningen, University Medical Center Groningen. The Netherlands.

**Background and objectives:** Protein intake has been suggested to play an important role in development of obesity; on one hand in newborn, where excess protein intake might stimulate development of obesity in later life. On the other hand, protein consumption is promoted for weight management. At present, no formal recommendations for the upper limit of protein intake have been presented. Information about rate-limiting steps in protein catabolism is scarce. We therefore studied the role of protein oxidation in this process.

**Methods:** To monitor protein oxidation we have developed a noninvasive 13C-protein breath test using naturally enriched 13C-milk protein (fractions). We used this technique to analyze the kinetics of protein oxidation and its interfering factors. Breath samples were collected and analyzed by Isotope Ratio Mass Spectrometry

**Results:** Whey was oxidized for 28.6% ± 6.8% (mean ± sd) during 240 min, compared to 22.9% ± 6.2% for glucose. Maximal milk protein oxidation was measured at a rate of 0.06 g/min, leading to a maximal oxidation capacity of 1.3 g/kg bw/day. Combining 30 g 13C-whey with 30 g glucose resulted in a 49% increase of whey oxidation. A three day low protein diet and/or exercise preceding the breath test resulted in a decrease in protein oxidation of ~20% and ~40% respectively.

**Conclusions:** Oxidation of whey protein is quantitatively of high importance and not down regulated by concomitant administration of glucose. Analyzing biological variations in acute protein oxidation in various target groups, in defining the upper limit of intake, might be relevant.

**Keywords:** protein oxidation, protein metabolism, breath test, naturally enriched 13C-milk proteins,

**Conflict of Interest Disclosure:** The naturally enriched 13C-milk protein has been made available as an in kind contribution by Hanze Nutrition B.V., which is owned by co-author prof. dr. R.J. Vonk. There are no other conflicts of interest.
# DIFFERENCES IN ANEMIA DIAGNOSIS OBTAINED USING VENOUS VERSUS CAPILLARY BLOOD: BIOLOGICAL BASIS AND POLICY IMPLICATIONS

(1)Neufeld, Lynnette M.; (2)Kurpad, Anura; (3)Mburu, Sheila; (4)Larson, Leila; (5)Martorell, Reynaldo; (6)Brown, Ken.

(1)PhD. Director Monitoring, Learning and Research. Global Alliance for Improved Nutrition. Switzerland.; (2)MD, PhD. Professor and Head of the Divison of Physiology and Nutrition. Department of Physiology. St John's Medical College. India; (3)MSc. Independent researcher. UK.; (4)MPH. PhD Candidate. Nutrition and Health Sciences Doctoral Program. Emory University. USA.; (5)PhD. Robert W. Woodruff Professor of International Nutrition. The Hubert Department of Global Health and the Nutrition and Health Sciences Program. Emory University. USA.; (6)PhD. Senior Program Officer and Initiative Lead, Nutrition, Global Development. Bill & Melinda Gates Foundation. USA.

**Background and objectives:** Anemia is recognized as a high priority health issue globally. The World Health Assembly (WHA) has set a target for 50% reduction in the prevalence of anemia in women of reproductive age by 2025, and relevant data will be needed to inform progress. However, factors affecting anemia diagnosis need to be considered to ensure accurate and comparable estimates of hemoglobin concentration and anemia prevalence (across countries and within countries over time). Possible sources of variability include: 1) differences between automated laboratory methods and portable devices, 2) differences between individual devices of a given type (e.g., different automated laboratory equipment or individual field instruments), 3) methodological errors due to sample collection technique, particularly for capillary samples and, 4) normal biological differences between venous and capillary blood, and as modified, for example, by age and sex.

**Methods:** In this presentation we will provide an in-depth literature review of the biological basis for differences in venous versus capillary blood and on the potential for systematic differences in hemoglobin concentration from diverse analytical platforms that cannot be attributed to sample collection technique. We will then use data from a recently completed survey in the state of Uttar Pradesh, India, (and other data sets if needed) to illustrate the implications that the choice of such method and the consistency of its use across multiple surveys may have on prevalence estimates and ultimately policy making.

**Results:** Ongoing

**Conclusions:** Forthcoming

**Keywords:** anemia, hemoglobin, diagnosis, capillary, venous

# CALCIUM SUPPLEMENTATION AMONG TARGETED PREGNANCIES: A LIFE SAVING STRATEGY TO REDUCE THE RISK OF ECLAMPSIA AND MATERNAL AND NEWBORN DEATHS

(1)Aminee, Ahmadwali; (2)Safi, Shir Agha; (3)Anwari, Ehsan.

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

**Background and objectives:** Maternal mortality ratio in Afghanistan is 372 deaths per 100,000 live births, which is the highest in the south Asian region. Hypertension during pregnancy increases the risk of eclampsia, newborn and maternal deaths. The World Health Organization (WHO) recommends calcium supplementation for pregnant women after the 20th week of gestation until the end of pregnancy, particularly among those at higher risk of hypertension. The objective of this study was to determine the effect of calcium supplementation to targeted pregnant women reduced the occurrence of eclampsia and related maternal mortality in one province of Afghanistan.

**Methods:** Quantitative methods were used to collect and analyses the data from health facilities including the provincial hospital in 15 districts of Kunar provinces during the life of the calcium supplementation pilot project, and comparison of reported eclampsia cases with the same period in the last year.

**Results:** The pilot project was implemented in Kunar province located in west part of Afghanistan. The project targeted pregnant women (N=785) in 15 districts of the province during a six-month period. They received 1.5-gram calcium tablet per day from the 20th week of gestation onwards through all health facilities. The project was funded by Common Humanitarian Fund and implemented by PU-AMI the main health care implementing Non-Governmental Organization (NGO) in the province. The analysis of data from Kunar provincial hospital register books (which is the only health facility for treatment and follow-up of pregnancy revealed complications including eclampsia in the province) revealed that during the life of the project (from Jun-Nov 2015) total of 50% reduction in the number of eclampsia cases admitted in the hospital compared to the same period in 2014.

**Conclusions:** Calcium supplementation among target pregnant women is associated with a reduction in eclampsia cases, in Kunar province, Afghanistan.

**Keywords:** Calcium supplementation, Pre-eclampsia & Eclampsia, Maternal morbidity
# DIETARY INTAKE AND METABOLIC PHENOTYPES IN A COMMUNITY-DWELLING COLOMBIAN COHORT

(¹)Corrales-Agudelo, Vanessa; (²)de la Cuesta-Zuluaga, Juan Jacobo;

(¹)Pulgarín-Zapata, Isabel Cristina; (³)Carmona-Valencia, Jenny Andrea; (⁴)Abad-Echeverry, José Miguel; (⁵)Escobar Restrepo, Juan Sebastián.

(¹)MSc. Nutritionist. Vidarium - Nutrition, Health and Wellness Research Center. Grupo Empresarial Nutresa. Colombia.; (²)MSc. Biologist. Vidarium - Nutrition, Health and Wellness Research Center. Grupo Empresarial Nutresa. Colombia.; (³)Research Coordinator. Dinámica IPS Especialista en Ayudas Diagnósticas. Colombia.; (⁴)MSc. MD. EPS-SURA. Colombia.; (⁵)PhD. Biologist. Vidarium - Nutrition, Health and Wellness Research Center. Grupo Empresarial Nutresa. Colombia.

**Background and objectives:** The analysis of dietary intake includes different components that individually analyzed are insufficient to explain health risks. The aim of this study was to integrate anthropometric and metabolic indicators to the nutritional analysis to identify the risk prevalence in nutrient intake according to metabolic phenotypes.

**Methods:** Participants were part of an adult community-dwelling cohort, enrolled across five cities of Colombia, South America. Anthropometric and clinical parameters in blood were assessed, as well as blood pressure. Clinical parameters and blood pressure served to classify participants by metabolic status. The metabolic status and the body mass index (BMI) were used to classify participants in six metabolic phenotypes (lean, overweight and obese, crossed by healthy or abnormal metabolic state); dietary intake was assessed in these groups of participants.

**Results:** Independent of BMI, the healthy metabolic phenotypes had greater contribution of proteins from the diet, while the lean abnormal and overweight abnormal phenotypes had excess intake of carbohydrates and sugars. Importantly, healthy lean participants had the lowest prevalence of nutrient deficiency, while abnormal lean, overweight and obese participants showed greater risk of micronutrient intake deficiency, especially calcium, magnesium and zinc. All metabolic phenotypes had low fiber intakes.

**Conclusions:** We report a comprehensive way to analyze dietetic intake that integrates nutritional status and health-related parameters. This analysis let us identify important nutrients in intervention or nutritional therapy that would improve metabolic health. Our analysis makes use of clinical parameters routinely assessed and could be applied to individuals or groups with normal weight or overweight; these results can be useful in the clinical practice to detect early risk factors of disease and to guide dietetic interventions.

**Keywords:** Metabolic phenotype, metabolic status, BMI, nutritional assessment, intake indicators.

# DAIRY AND CALCIUM INTAKE BY QUILOMBO-LAS FROM RIO GRANDE DO SUL- BRAZIL

(¹)Pacheco, Pauline Müller; (¹)Pauli, Silvia; (²)Neutzling, Marilda Borges; (³)Bairros, Fernanda Souza de; (⁴)Knauth, Daniela Riva;

(⁵)Drehmer, Michele.

(¹)MSc in Epidemiology. Department of Social Medicine. Universidade Federal do Rio Grande do Sul. Brazil.; (²)PhD in Nutrition, Department of Nutrition. Universidade Federal do Rio Grande do Sul. Brazil; (³)PhD in Epidemiology. Department of Social Medicine. Universidade Federal do Rio Grande do Sul. Brasil.; (⁴)PhD in Ethnology and social anthropology. Departament of Professional Assistance and Guidance. Universidade Federal do Rio Grande do Sul. Brazil.; (⁵)PhD in Epidemiology. Department of Nutrition. Universidade Federal do Rio Grande do Sul. Brazil.

**Background and objectives:** Milk and derivatives are the main source of calcium and recent studies have shown benefits in reducing risk for diabetes and metabolic syndrome. Quilombola communities are traditional communities of African origin organized from the slavery process and for which food consumption data are scarce. Thus, the objective of this work was to evaluate the consumption of calcium and its source food in quilombola communities of Rio Grande do Sul (RS)- Brazil.

**Methods:** Descriptive, cross-sectional population-based study of quilombola communities in RS developed in 2011. A total of 634 families, from 17 quilombola communities in the state, were selected by size-proportional sampling. Altogether, 589 household heads were interviewed. Calcium intake was assessed through a 24-hour food recall referring to the day before the interview. The data were processed in the ADS Nutri software - which uses the Brazilian Food Composition Table - and analyzed in the SPSS 18.0 software. The recommended calcium recommendation was the RDA for adults. The consumption of milk and dairy products (milk, cheese and yogurt) was evaluated as a dichotomous variable, considering the consumption report or not in the previous day. Ethical approval was received from the Research Ethics Committee of Universidade Federal do Rio Grande do Sul.

**Results:** About 30.0% of the sample reported having consumed milk or dairy products the previous day, being primarily cows'milk, whole and direct from the producer. The prevalence of dairy products consumption in the previous day varied among the 17 communities studied: in some of them, household consumption was not mentioned by anyone and in others by 63.6% of respondents. In relation to calcium, median consumption was 266.4mg (IQ 161.8-429.4). Considering the daily recommendations of 1000mg for adults, only 2.4% consumed the recommended amount.

**Conclusions:** The quilombolas of RS presented a low consumption of calcium and milk and dairy products, which can be explained by the impoverishment of the communities and consequent limitation for the acquisition of dairy products. These have a high price, besides the difficulty of access to purchase in more isolated rural communities.
**Background and objectives:** Background: Iron deficiency without anemia has detrimental effects on physical performance. However, the relationship between iron supplementation, daily aerobic training, and changes in fitness in untrained, non-anemic women remains unclear.

**Objective:** To determine whether iron supplementation increases fitness, measured as maximal oxygen consumption (VO2max), in trained and untrained women.

**Methods:** This randomized-control trial included 72 iron depleted, non-anemic women, defined as serum ferritin (sFer) < 25 µg/L and hemoglobin (Hb) >110 g/L. A double-blind study was conducted with a 2x2 design including iron supplements (42mg elemental iron/day) or placebo and daily aerobic training (five 25-minute sessions/week at 75-85% maximum heart rate) or no training. General linear models were used to evaluate the relationship between supplement type, training, and changes in fitness after 8 weeks.

**Results:** There were no baseline differences in any variable between groups. Additionally, there were no differences in compliance to training or supplementation. At endline, sFer significantly increased in the iron group (23.6 µg/L, p<0.01), but not the placebo group (6.0 µg/L, NS). Similarly, the trained group showed a significant improvement in VO2max (3.8 mL/min/kg, p<0.01), whereas there was no change in the untrained groups (-0.89 mL/min/kg, NS). There was a significant supplement by training-group interaction in models predicting VO2max (p<0.05). Specifically, the iron-untrained group had a greater change in VO2max than the placebo-untrained group (1.9 mL/min/kg, p=0.01), which remained significant when change in Hb was included in the model. No supplement effect was seen between the trained groups.

**Conclusions:** The data show that iron supplementation alone improves VO2max in untrained women. However, this improvement is masked by changes in fitness gained from regular aerobic exercise. The improvements in VO2max in the iron-untrained group were not affected by Hb concentration, suggesting that this change is independent of oxygen delivery to the muscles. Further analyses could help clarify whether other indicators of fitness such as energetic efficiency or the anaerobic threshold benefit from iron supplementation and whether an interaction exists between training and supplementation in these variables. These findings

indicate that fitness in relatively unfit women could improve from daily iron supplementation, even without regular aerobic training.

**Keywords:** iron deficiency, aerobic exercise, physical performance, VO2max

**Background and objectives:** Aloe vera contains multitudes of potentially active constituents of essential vitamins and minerals, enzymes, sugar, lignin, saponins and wealth of amino acids. The aim was to analyze quantitatively the Aloe barbadensis for proximate, anti-nutrient and phytochemical composition to find out if location affects their nutritional composition.

**Methods:** The aloe vera was collected from three different eastern regions. The proximate composition involves the moisture content, crude protein, crude fibre, crude fat, ash content and carbohydrate and it was determined using standard methods. The phytochemicals (saponins, alkaloids and flavonoids) and anti-nutrients (oxalate, tannin and phytate) were also obtained using standard methods. Mean, standard deviation and ANOVA was used to separate the means and p<0.05 was set to be a significant.

**Results:** Protein, fibre, fat and carbohydrates contents 1.57%, 0.15%, 0.04% and 1.72% respectively were highest in aloe vera sourced from Enugu State where protein was lowest in aloe vera sourced from Ebonyi State, and fibre did not differ significantly between aloe vera sourced from Anambra and Ebonyi States. Vitamin A (β-carotene RE), vitamin C (ascorbic acid), and vitamin B12 (Cyanocobalamin) content 51.64 µg RE//100g, 46.41mg/100g and 46.60µg/100g respectively were highest in aloe vera from Enugu State while vitamin A (β-carotene RE), vitamin C (ascorbic acid), and vitamin B12 (Cyanocobalamin) content 31.06 µg RE//100g, 36.46mg/100g, and 20.82µg/100g were lowest in aloe vera sourced from Ebonyi. However, iron content was highest (0.21mg/100g) in aloe vera sourced from Ebonyi State. Alkaloid and flavonoid were highest (1.60%, 2.40%) respectively in aloe vera sourced from Enugu State while alkaloid from aloe vera sourced from Anambra was lowest (0.50%) and flavonoid was lowest (0.97%) in aloe vera sourced from Ebonyi State. Saponin was highest (1.13%) in aloe vera in Anambra State but lowest (0.74%) in aloe vera sourced from Enugu State. Phytate, oxalate and tannin were highest in aloe vera sourced from Enugu, although Phytate of aloe vera sourced from Enugu and Anambra were statistically similar.
**Conclusions:** Nutrient contents of the Aloe vera varied in the different studied States which might be due to soil and seasonal differences of cultivation

**Keywords:** Aloe vera; nutrients; phytochemicals; Nigeria

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RELATIONSHIP BETWEEN BODY COMPOSITION AND PLAYING LEVEL IN RUGBY UNION PLAYERS

(1)Barale, Adrián; (2)Perovic, Nilda Raquel.

(1)BSc. Nutritionist. School of Nutrition. National University of Córdoba. Argentina.; (2)PhD. Nutritionist. School of Nutrition. National University of Córdoba. Argentina.

**Background and objectives:** Body composition (BC) is a factor that can influence sport performance. Therefore, its assessment, especially with simple methods such as anthropometric measurements, is essential to optimize performance.

The purpose of this study was to analyze the relationship between playing level (PL) with BC in rugby union players of the Province of Córdoba (Argentina).

**Methods:** A total of 94 players were grouped according to PL in: a) State Team (ST) (n=24), the highest level, b) 1st Division (D1) (n=52), c) 3rd Division (D3) (n=18), the lowest level of performance. Thirty-three anthropometric variables were measured following the protocol of the International Society for the Advancement of Kinanthropometry (ISAK). Body composition was assessed using the five-way fractionation method, partitioning the body into anatomically defined adipose, muscle, skeletal, residual, and skin tissue masses.

Descriptive (mean ± SD) and comparative statistics were calculated with Stata 14 software. A one-way analysis of variance (ANOVA) with Bonferroni post-hoc test for differences was used for the comparison between PL. The statistical significance was set at P < 0.05.

**Results:** The basic characteristics of the sample were: age 25.1 ± 4.2 years, weight 93.5 ± 12.6 kg and height 180.1 ± 7.3 cm. PL was associated with height (D3 players were shorter than the other 2 groups; p = 0.005) and age (D3 players were older than the other 2 groups; p = 0.001), but not with weight (p = 0.35).

BC in absolute terms (kg) was associated with PL; D3 players had significantly less muscle mass (p < 0.01), bone mass (p < 0.05) and residual mass (p < 0.05) than the other 2 groups. As well, BC relative to body mass (%) was associated with PL; D3 players had significantly more adipose mass (p < 0.05) than the other 2 groups, and less muscle mass (p = 0.015) and bone mass (p = 0.001) than D1 players. The residual mass (%) was significantly different (p < 0.01) among all 3 groups (D1 > ST > D3).

**Conclusions:** The PL was associated to height, age and BC in rugby union players.

**Keywords:** Body composition, Anthropometry, Rugby.

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ANTHROPOMETRIC PROFILE, SOMATOType AND BODY COMPOSITION OF RUGBY UNION PLAYERS ACCORDING TO PLAYING POSITION

(1)Barale, Adrián; (2)Perovic, Nilda Raquel.

(1)BSc. Nutritionist. School of Nutrition. National University of Córdoba. Argentina.; (2)PhD. Nutritionist. School of Nutrition. National University of Córdoba. Argentina.

**Background and objectives:** The morphology and body composition (BC) are factors that can influence sport performance. Therefore, their assessment, especially with simple methods, such as anthropometric measurements, is essential to optimize performance.

The purpose of this study was to analyze the relationship between playing position (PP) with somatotype and BC in rugby players of the Province of Córdoba (Argentina).

**Methods:** The sample were 94 players. Thirty-three anthropometric variables were measured following the protocol of the International Society for the Advancement of Kinanthropometry (ISAK). The somatotype was assessed with Heath-Carter's method. Body composition was assessed using the five-way fractionation method, partitioning the body into anatomically defined adipose, muscle, skeletal, residual, and skin tissue masses. The players were grouped by PP into forwards (F) and backs (B).

Descriptive (mean ± SD) and comparative statistics were calculated with Stata 14 software. A Student's t-test for independent samples was used for the comparison between F (n=55) and B (n=39), with statistical significance set at P < 0.05.

**Results:** The basic characteristics of the sample were: age 25.1 ± 4.2 years, weight 93.5 ± 12.6 kg and height 180.1 ± 7.3 cm. PP was associated with height (F: 181.4 ± 7.3 cm vs. B: 178.1 ± 7 cm; p = 0.03) and weight (F: 100.0 ± 11.6 kg vs. B: 84.5 ± 7.3 kg; p < 0.0001), but not with age (p = 0.30).

The mean somatotype of the overall players was 4.1-6.9-1.0. With respect to somatotype components, endomorphy was greater (p < 0.0001) in F (4.7 ± 1.8) than in B (3.1 ± 1.1); the same relationship was observed in mesomorphy (F: 7.2 ± 1.3 vs. B: 6.5 ± 0.8; p = 0.004); ectomorphy was greater (p = 0.001) in B (1.3 ± 0.6) than in F (0.8 ± 0.8).

Regarding BC in absolute terms (kg), F had greater values (p < 0.0001) for all fractions of tissue masses than B. Relative to body mass (%), F had greater adiposity (p = 0.0001), but B had greater muscle, bone and skin mass (p<0.01).

**Conclusions:** The PP was associated to physical characteristics, somatotype and BC in rugby union players.

**Keywords:** Body composition, Somatotyp, Anthropometry, Rugby.
# NUTRITIONAL STATUS OF SCHOOL-ADOLESCENTS IN OGUN WEST SENATORIAL DISTRICT, NIGERIA

Olunusi, Abosede.

PhD. Senior Lecturer at Department of Home Economics and Hotel Management. Tai Solarin University of Education. Nigeria.

**Background and objectives:** Adequate nutrition is the pivotal for nutritional development. Promoting good nutrition among school-adolescents will not only enhance excellent academic performances but foster optimal national development. Hence, the thrust of this research was to assess the nutritional status of school- adolescents in Ogun West Senatorial District, Nigeria

**Methods:** A cross-sectional study on nutritional status of 375 school-adolescents drawn from 3 out of 5 Local Governments (LGs) in the district using multistage random sampling was carried out. Twenty-five participants were chosen from 5 schools(1 private and 4 public schools) in each LGA. Validated questionnaire was used to collect socio-demographic, daily food intake and anthropometric (height and weight) data. Food intake data were obtained through a 24 hour dietary recall and analyzed using WHO total diet assessment software. Height z-score and body mass index (BMI) were used to evaluate subjects' nutritional status. Descriptive statistics were obtained using SPSS (version 17.0) software. Analysis of variance was used to explore differences in nutrient intake and anthropometric indices at 5% significant level. Male/Female participants were 49.9% /50.1% with 51.2% being younger adolescents (10-14 years) and 48.8% being older adolescents (15-19years).

**Results:** Anthropometric findings revealed 16.3% stunting, 17.4% underweight, 65.6% normal weight, 12.5% overweight and 4.5% obesity. Stunting was significantly (p<0.05) higher in girls and public school-adolescents while underweight was significantly higher (p<0.05) in boys and public school-adolescents. The dietary intake analysis reflected adequacy of energy (77%), protein (85%), though mostly of plant origin), vitamin A (81%), iron (91%) and thiamine (90%). The intake of vitamin C, riboflavin, niacin and calcium were inadequate. Differentials of intake between genders, age-cohorts and school categories were insignificant (p>0.05).

**Conclusions:** There was prevalence of double burden of malnutrition among the adolescents. Consequently, there is need to implement nutritional intervention program in the district.

**Keywords:** Nutritional status, Body mass indices, school-adolescents, Ogun West District.

# NUTRITIONAL STATUS, FOOD SELECTIVITY AND NUTRITIONAL ADEQUACY OF CHILDREN AND ADOLESCENTS BETWEEN 6 AND 16 YEARS OLD WITH AUTISTIC SPECTRUM CONDITION

**Background and objectives:** A healthy diet is essential for adequate growth and development. The autistic spectrum condition (ASC) presents some special characteristics, like hypersensitivity or altered sensory processing, that can hinder a feeding that meets all the nutritional requirements. The main objective was to analyze the nutritional status of 16 children between 6 and 16 years old with ASC.

**Methods:** This is an observational, descriptive and cross-sectional study, the nutritional status was assessed by anthropometry, nutritional adequacy through a seven-day prospective registration, and main gastrointestinal disorders and food selectivity by clinical interview.

**Results:** The results showed that 31% of participants had an adequate height and adequate BMI, 38% had an adequate height but their BMI indicated overweight, 6% had an adequate height but their BMI indicated obesity, 6% had an adequate height but his BMI indicated thinness, 13% had a low height and normal BMI and 6% had a low height and his BMI indicated overweight. About muscle mass, 31% of participants had an arm muscle area above average and 19% below average; according to abdominal perimeter only 1 participant presented metabolic risk. Also, age adjusted nutritional requirements indicated that the mean adequacy was: calories 112.5% (sd= 25.19%), protein 213.25% (sd=100%), calcium 38.25% (sd=22.46%), phosphorus 87.06% (sd = 45.12%), iron 86.81% (sd=28.21%), retinol 40.97% (sd=26.92%), thiamine 19.31% (sd=9.44%), riboflavin 34.68% (sd=15.14%), niacin 34.43% (sd=15.99%) and vitamin C 144.43%(sd=87.89%). The main gastrointestinal disorders were diarrhea in 13% of participants, constipation in 19% and flatulence in 13%, however, no food selectivity in number or type was found. It is highlighted that the percentage of adequacy of iron consumption with p = 0.068 was the one that most approached a significant correlation with the height-for-age index.

**Conclusions:** The analysis of the nutritional status of children and adolescents shows the existence of a double burden of malnutrition in 69% of participants, with high consumption of calories and proteins, that cause overweight, and at the same time an insufficient micronutrients consumption.

**Keywords:** autism spectrum condition, nutritional status, food selectivity, nutritional adequacy.

<footnote>(1)Baquerizo Sedano, Luis; (2)Lazo Paúcar, Pabel; (3)Mamani Salinas, Juan; (2)Santillán Gonzáles, Pamela; (2)Simeón Zacarías, Amery;</footnote>

<footnote>(4)Aguilar Mendoza, Luis; (2)Baquerizo Sedano, Marilia.</footnote>

<footnote>(1)MSc. Nutritionist Laboratory of Neuroscience and Behavior. Cayetano Heredia Peruvian University. Peru; (2)BSc. Nutritionist. Laboratory of neuroscience and behavior. Cayetano Heredia Peruvian University. Peru; (3)BSc. Nutritionist. Department of nutrition. Ramiro Priale Priale National Hospital. Peru; (4)PhD. Biologist. Laboratory of neuroscience and behavior. Cayetano Heredia Peruvian University. Peru.</footnote>
ASSESSMENT OF THE VALIDITY AND RELIABILITY OF THE DIETARY INDEX FOR A CHILD'S EATING (DICE) IN CHILDREN AGED 2 TO 8 YEARS LIVING IN AUCKLAND, NZ

(1)von Hurst, Pamela; (2)Delshad, Maryam; (3)Conlon, Cathryn; (3)Beck, Kathryn; (4)Mugridge, Owen.

(1)PhD.Senior Lecturer in Nutirition. School of Food and Nutrition. Massey University. Auckland. New Zealand; (2)Graduate Student. School of Food and Nutrition. MasseyUniversity. Auckland. New Zealand; (3)PhD. Senior Lecturer. School of Food and Nutrition. Massey University.Auckland.New Zealand; (4)Research Project Manager. School of Food and Nutrition. Massey University. Auckland.New Zealand.

**Background and objectives:** Background: Completing a four-day estimated food record (4DFR) can be a high burden for parents, but New Zealand has no valid and reliable dietary index to assess the adherence of children to the New Zealand Food and Nutrition Guidelines for Healthy Children and Young People Aged 2 -18 years (NZFNG).

Aim: To examine the validity and reliability of the Dietary Index for a Child's Eating (DICE) in children aged 2 to 8 years living in Auckland, NZ.

**Methods:** Caregivers of healthy children (2-8 years) living in NZ were recruited by email and print advertising. Caregivers completed both 4DFR for their child, and the DICE online on 2 occasions, eight weeks apart, to assess reliability. The DICE consists of 17 questions that reflect current statements in the NZFNG, with greater adherence indicated by a higher score (maximum 100). Relative validity was assessed by comparing the DICE scores with 4DFR scores using Wilcoxon signed rank test, Spearman correlation coefficients, cross-classification, and weighted kappa (κ) statistic. For evaluating construct validity, the DICE scores were compared with energy and nutrient intake extracted from the 4DFR. Intra-class correlation coefficients (Cronbach's α) were used to assess the reliability of DICE.

**Results:** From a possible score of 100, the mean ± SD of DICE was 78.2±11.5 (range 47-100) and the 4DFR was 73.8±10.8. Pearson's correlation coefficient showed a high correlation between the total scores for DICE and 4DFR (r=0.72; P<0.001). Results from the weighted κ-statistic also showed that the DICE total score and 4DFR total score had very good agreement (κ=0.94). There were positive relationships between the DICE total score and vitamin C (r=0.53), folate (r=0.45), and calcium (r=0.44) (P<0.001). Those who were categorised in the highest tertile of DICE consumed higher fibre, vitamins A, C, D, folate (P<0.05), and calcium (P<0.001). Almost perfect agreement (0.87) was found through the Intra-class correlation coefficient for reliability test (P<0.001).

**Conclusions:** Discussion and Conclusion: Results from this study demonstrated that DICE is a valid and reliable tool for the assessment of children's adherence to a health-promoting diet, and could be used in certain circumstances instead of the more burdensome 4FDR.

**Keywords:** dietary assessment, diet index, validity, reliability

HIDDEN HUNGER IN INDONESIA: WHAT ARE STILL HIDDEN?

(1)Usfar, Avita; (2)Riyanti, Akhir.

(1)Dr. Avita A. Usfar. Nutritionist. Sakanti Consulting. Jakarta. Indonesia.; (2)Akhir Riyanti, MSM. Nutritionist. Sakanti Consulting. Jakarta. Indonesia.

**Background and objectives:** Indonesia has recognized the importance of addressing stunting (35% children 24-59 months) and obesity (12% age 0-59 months, 11% 13-15 years, 29% adult). However, little is known on the magnitude of the problem of hidden hunger in the country, nor integrating effort to combat them.

**Methods:** The authors conducted literature search of nationally represented data and interviews with key informants.

**Results:** The national prevalence of anemia is available for all age groups, while information on the prevalence of iodine deficiency is only available for children and women, and vitamin A and D for children. The prevalence of anemia in children 6 to 23 months is 57% (2011) and in pregnant women 37% (2013). The prevalence of vitamin D deficiency is 43% in children (2011). Fortification of salt with iodine was mandated in 1975 and wheat flour with iron, zinc, folic acid, vitamin B1 and B2 in 2001. Iron and Folic Acid distribution to pregnant women and vitamin A supplementation to children 6-59 months and to post-partum women are on-going programs. However, less progress is made on fortifying other products. A pilot of multiple micronutrient (MNP) to pregnant women was tried in 2000, but no follow-up thereafter. Trials of home fortification of MNP to children 6 to 59 months started in 2008, which resulted in a decree of mandatory content of the powder in 2013. However, its use is left to the local government and unevaluated. Voluntary fortification of vitamin A in cooking oil started in 2012, but experienced delay on its mandatory implementation. The result of rice fortification pilot in 2016 is yet to be announced. Based on six nationally represented food intake data, inadequacies of calcium, iron, vitamin A and C are found in children. Based on the interviews, the following deficiencies are suspected: calcium, vitamin B12, D, and E.

**Conclusions:** National data of the following micronutrients need to be updated or made available: vitamin A, B1, D, E, folic acid, iron, zinc, selenium, iodine, and calcium.

**Keywords:** hidden hunger, micronutrient, deficiencies, fortification, Indonesia
THE PILOT KOREAN KEY FOODS BASED ON DIET COMSUMPTION

(1)Chang, Moon Jeong; (2)Shim, Jee Seon; (3)Lee, Jung Sug; (4)Kim, Hye Young; (5)Lee, Hyun Sook; (6)Kim, Ki Nam.

(1)Professor. Department of Food and Nutrition. Kookmin University. South Korea.; (2)PhD. Medical college. Yonsei University. South Korea.; (3)PhD. Department of Food and Nutrition. Kookmin University, South Korea.; (4)PhD. Department of Food and Nutrition, Yongin University. South Korea; (5)PhD. Department of Food and Nutrition. Dongseo University. South Korea.; (6)PhD. Department of Food and Nutrition. Daejeon University. South Korea.

**Background and objectives:** This study was performed to develop the Key foods approach to select food for nutrient analyses of up-to-date National Food Nutrient Composition database by National Laboratory System (NLS) of the Ministry of Food and Drug Safety in Korea (KFDA), based on the United States Department of Agriculture (USDA) Key concept. The primary objective of NLS in Korea is to provide the best database to represent the nutrients consumed by the population of the nutrient profile for each offds identified as important in the food consumption. The key food approach assists NLS to prioritize foods that contribute significant amounts of nutrients of public health interest to the diet.

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

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

**Conclusions:** This Key Foods list will be used for updating and revising the KFDA Food nutrient composition database from 2017 and allow NLS to concentrate resources for food composition analysis. We expect the updating database will give representative data for researchers, consumers, and policy makers.

**Keywords:** Key nutrients, Food nutrient composition database, Korean Key Foods

THE RELATIONSHIP AMONG HOUSEHOLD FOOD INSECURITY, DIETARY DIVERSITY, AND MICRONUTRIENT INTAKE BETWEEN FARMING AND NON-FARMING HOUSEHOLDS IN SELECTED RURAL COMMUNITIES ACROSS GHANA

(1)Christian, Aaron; (2)Marquis, Grace; (3)Colecraft, Esi; (4)Lartey, Anna.

(1)Regional Institute for Population Studies, University of Ghana, Legon. Ghana; (2)PhD.Nutritionist.Canadian Research Chair in Social and Environmental Aspects of Nutrition.School of Dietetics and Human Nutrition.McGill University. Ste. Anne-de-Bellevue. Quebec. Canada; (3)DrPH.Nutritionist.Nutrition and Food Science Department.University of Ghana.Legon.Accra; (4)President, IUNS 2013-2017.

**Background and objectives:** Improving nutrition requires both access to food, higher dietary quality and diversity and the understanding of the relationship among these indicators in different livelihoods. This study examined the relationships among household food insecurity, dietary diversity, and the micronutrient density adequacy of diets of children 2-5 years of age of farming (n=461) and non-farming households (n=147) in Ghana.

**Methods:** Household food insecurity (HFI) was measured using an adapted version of the USDA Household Food Security Core Module. A household dietary diversity score (HDDS) was calculated based on the number of food groups (12 maximum) from which a household consumed. Children's diet quality were assessed using data from 2-d, 12-hr weighed food records, for a sub-sample of 120 households. The nutrient density adequacy of eight micronutrients -vitamin A, vitamin B6, vitamin B12, vitamin C, calcium, folate, zinc and iron- were calculated by dividing individual nutrient densities by recommended nutrient densities based on age-specific energy requirements. The mean micronutrient density adequacy (MMDA) of children's diets was then calculated as the mean of all eight individual micronutrient density adequacies, capped at 1. Spearman's correlation was used to assess the relationship among HFI, HDDS and MMDA. Predictors of MMDA were examined with linear regression analysis.

**Results:** Fewer non-farming households were moderately or severely food insecure compared to farming households (63.3% vs.75.7% P=0.003). HDDS of non-farming households was significantly higher than that of farming households (mean ± SD: 10.0 ± 1.8 vs. 9.3 ± 1.9; P=0.0001). MMDA was not significantly different between the non-farming farming and households. There were negative correlations between HFI and HDDS and MMDA (rs = -0.38, p<0.001 and rs = -0.25, p=0.005 respectively). After controlling for wealth, caregiver's education, and the number of children <5 y in the household, HFI was negatively associated with MMDA only in non-farming households.

**Conclusions:** Non-farming households consume more diverse foods and were less food insecure compared to farming households. This study suggests the utility of HFI to predict adequate intake of micronutrients in the diets of 2-5 yr. olds may be limited to non-farming households and not farming households.
**Keywords:** Household food insecurity, Dietary diversity, Micronutrients density

cronutrients density

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CONSUMPTION OF ULTRA-PROCESSED FOODS AMONG JAPANESE MIDDLE-AGED ADULTS AND THE ASSOCIATIONS WITH DIETARY INTAKES AND BMI

(1)koiwai, kaori; (2)Hayashi, Fumi; (1)Matsumoto, Saika; (3)Takemi, Yukari.

(1)RD. Graduate School of Nutrition Sciences Kagawa Nutrition University. Japan; (2)Ph.D. RD. Faculty of Nutrition. Kagawa Nutrition University. Japan; (3)Ph.D. RD. Graduate School of Nutrition Sciences Kagawa Nutrition University. Japan.

**Background and objectives:** Japan retained the top spot in terms of average life expectancy, and nutritionally balanced Japanese diet is thought as being an important factor. However, in Japan, consumption of processed foods has continued its upward trend in recent years due to the reason to easy to cook, and to be able to eat at anytime or anywhere. The present study aimed to estimate the consumption of ultra-processed foods(UPF), and determine its association with dietary intakes and body mass index (BMI) among Japanese adults.

**Methods:** Cross-sectional study data from the Saitama Prefecture Health and Nutrition Survey 2011 was used for analyses. Dietary intake was assessed using two non-continuous day dietary records. Foods were classified based on NOVA system. Sociodemographic factors, lifestyle, height and weight were obtained from self-administered questionnaire. BMI was calculated using self-measured weight and height. 376 (156 men, 220 women) subjects aged 30 to 59 years who completed non-continuous two-day dietary records and self-administered questionnaire were included for the analysis. We divided the subjects into three groups according to tertile of the contribution of UPF in the total energy intakes (% of total energy):Low group (<30.7%), Middle group(30.7≤and<48.9%), High group (48.9%≤). ANCOVA adjusted for sex and age, marital status, income, total energy was used for the association with dietary intakes. For the association with BMI, exercise habits, smoking status were additionally adjusted.

**Results:** The mean ± standard deviation contribution of UPF was 41.0±20.5. High group had a significantly greater intakes of total fat, saturated fat, smaller intakes of potassium, iron, vitamin K, dietary fiber than lower groups. Furthermore, High group had a significantly greater intakes of other cereals (except rice), confectioneries, smaller intakes of rice, vegetables than lower groups. In addition, BMI of High group tended to be higher BMI in women. **Conclusions:** UPF consumption were significantly related to dietary intakes. Out findings suggest that higher consumption of UPF among Japanese middle-aged adults was associated with intake of unhealthy diet and greater BMI. )

**Keywords:** Ultra-processed foods, dietary intake, Body Mass Index, Japanese

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APPLICATION FOR MEASURING FREQUENCY OF EATING HIGH-FAT FOODS – COMPARISON WITH OTHER METHODS

(1)Chmurzynska, Agata; (2)Młodzik, Monika; (3)Czarnocinska, Jolanta;

(4)Wiebe, Douglas.

(1)PhD. Nutritionist. Department of Human Nutrition and Hygiene. Poznan University of Life Sciences. Poland.
International Society of Nutrigenetics/Nutrigenomics (ISNN);

(2)MSc. Biotechnologist. Department of Human Nutrition and Hygiene. Poznan University of Life Sciences. Poland;

(3)PhD. Nutritionist. Department of Human Nutrition and Hygiene. Poznan University of Life Sciences. Poland; (4)PhD. Epidemiologist. Department of Biostatistics and Epidemiology.
Perelman School of Medicine. University of Pennsylvania. USA.

**Background and objectives:** Monitoring food intake is a challenge in nutritional studies. Ecological momentary assessment (EMA) may offer a solution, by enabling data collection on study participants' activities and states in real-time by means of a smartphone application (app). The aim of our study was to design and test the feasibility of an application for assessing the frequency of eating high-fat foods.

**Methods:** 30 subjects (15 men and women) were enrolled in Poznan, Poland for the so called Fat Taste Project. Usual frequency of eating high-fat foods were assessed with the Block Screening Questionnaire for Fat intake (Q1) and a version modified to include products typically consumed in Poland (Q2). We also developed an app that was loaded on a smartphone provided to each participant for use daily over 10 days. The app gave prompts four times per day to report on high-fat foods consumed since the last prompt. The app contained the same list of food items as Q2. Overall food intake was assessed with dietary records.

**Results:** The average total frequencies of eating high-fat foods per week were 17.1±1.5 (Q1), 32.7±2.2 (Q2), and 34.5±2.1 (the app). There were no significant correlations between % energy from fat and the frequencies of eating high-fat foods, irrespective of the method used. The results from Q1 and Q2 were correlated (r=0.78, p<0.001). There was also a correlation between the results from Q2 and the application (r=0.56, p<0.05) but in women only. The mean difference between Q1 and Q2 was 15.6, while between Q2 and the application 1.73.

**Conclusions:** Using the application for measuring frequency of eating high-fat foods does not significantly affect assessment of the overall mean frequency of eating those products. However, the detailed data analysis considering time intervals and types of products eaten is needed.

This work was supported by the Polish National Science Centre (grant no. 2014/15/B/NZ9/02134).

**Keywords:** ecological momentary assessment, high-fat foods, food intake
# THE LEVEL OF HEMOGLOBIN AND THE MEAN CORPUSCULAR VOLUME (MCV) AMONG PRE-CONCEPTION WOMEN IN BANGGAI REGENCY

(1)Monoarfa, Yustiyanty; (2)Widasari, Lucy; (3)Yekti, Rahayu; (4)Narsi, Ketut; (5)Otoluwa, Anang Samudera; (6)Daeng Mamala, Firman;

(7)Retnowati, Endang; (8)Gumilar, Erry; (9)Thaha, Abdul Razak;

(10)Wirjatmadi, Bambang.

(1)Doctoral Candidate at Department of Nutrition, School of Public Health, Airlangga University. Indonesia; (2)MSi.PhD. Doctoral Candidate at Department of Nutrition, School of Public Health, Hasanuddin University. Indonesia; (3)Dra. MBiomed. Doctoral Candidate School of Public Health, Hasanuddin University, Makassar. Indonesia; (4)SKM, MKes. Head of Department of Public Health. Banggai Health District Office. Indonesia; (5)MD.MPPM.Dr. Head of Banggai District Office. Indonesia; (6)SAg.MA. Head of Banggai Religious Affairs, Banggai District. Indonesia; (7)MD, MS. Lecturer. Department of Clinical Pathology, School of Medicine, Airlangga University, Dr. Soetomo Hospital. Indonesia; (8)MD, Dr. Lecturer. Department of Fetomaternal Health, School of Medicine, Airlangga University. Indonesia; (9)MD, MSc, Dr. Lecturer. Department of Nutrition, Faculty of Public Health, Airlangga University. Indonesia; (10)MD, MSc, PhD. Lecturer. Department of Nutrition, School of Public Health, Airlangga University. Indonesia.

**Background and objectives:** Because the most common cause of anemia in pregnancy is iron deficiency, it is important to study the level of hemoglobin and the mean corpuscular volume (MCV) in preconception women. The current study aimed to describe the level of hemoglobin and the MCV, which are iron status parameters in red blood cells, among preconception women in Banggai Regency.

**Methods:** The research was conducted in three sub-districts of Banggai district, namely, Luwuk, North Luwuk, and South Luwuk, from October 2016 to February 2017. The subjects were newlywed preconception women who were visiting the religious affairs office to register their marriages; who were 18-35 years of age; and who did not have serious diseases, such as tuberculosis, heart disease, or kidney failure. A total of 102 preconception women were recruited. Venous blood samples were extracted, and hemoglobin and the MCV were measured using the SLS-hemoglobin method. The normal values for hemoglobin and the MCV are 12 g/dL and 80-100 fL, respectively.

**Results:** The results showed that of 102 preconception women, 16 women (15.7%) had a hemoglobin level under 12 g/dL or reported anemia, and 21 women (20.6%) had an MCV below 80fL. Of the 16 women who had anemia, 12 women (57.14%) had an MCV under 80 fL, which indicated that their anemia was correlated with the iron parameters in red blood cells.

**Conclusions:** The results of study indicated that anemia is frequent in preconception women and that iron plays an important role in this anemia. This study indicates the importance of multi-micronutrient supplementation in preconception women

**Keywords:** Anemia, MCV, Preconception

**Further collaborators:** Inayah Hi. Zaini Dg. Taha, Researcher. Banggai District Health Office

# PHYSICAL CHARACTERISTICS, PROXIMATE COMPOSITION AND ANTI-NUTRIENT FACTORS OF LABLAB BEAN (LABLAB PURPUREUS) VARIETIES GROWN IN KENYA

(1)Kilonzi, Sheila; (2)Makokha, Anselimo; (3)Kenji, Glaston.

(1)Karatina University; (2)PhD. Professor. Department of Food Science. Jomo Kenyatta University of Agriculture and Technology. Kenya.; (3)PhD. Professor. Department of Food Science. Jomo Kenyatta University of Agriculture and Technology. Kenya.

**Background and objectives:** The lablab bean (lablab purpureus) is an important staple food in Kenya. It is well adapted to the local climatic conditions and plays an important role in food and nutrition security, particularly in the arid and semi-arid parts of the country. However, there is limited information on the nutritional value of the different varieties of the beans. The main objective of this study was to determine the physical characteristics, proximate composition and anti-nutritional factors of three lablab bean varieties.

**Methods:** The length, width and thickness of the seeds was determined using vernier calipers. Seed density was determined by water displacement. Hydration and swelling coefficients were determined by soaking the seeds in water and determining the water absorbed. Crude protein was determined by Semi-Kjedahl method while crude fat was determined by Soxhlet extraction. Phytic acid was determined using HPLC, while tannin content was determined by the Vanillin Hydrochloric method.

**Results:** The mean 100 seed weight was significantly different among the three varieties, and ranged from 26.1 g to 29.2 g. The length, thickness and width ranged from 9.7 to 10.7 mm, 5.2 to 5.6 mm and 6.8 to 7.4 mm, respectively. The hydration and swelling coefficients of the beans ranged from 130.7 to 147.2, and 125.1 to 153.3, respectively. The mean protein and energy content varied from 22.5 to 25.4%, and 347.4 to 353.7 Kcal/100g, respectively, and differed significantly among the varieties. There were significant differences in the phytic acid and tannin levels, which ranged from 533.4 to 723.6 mg/100 g, and 0.27 to 232.6% CE, respectively.

**Conclusions:** There is good potential to select for lablab varieties with good cooking and nutritional characteristics.

**Keywords:** lablab beans nutrition anti-nutritional Kenya
**Background and objectives:** Multifaceted indicators, scores and assessment tools exist to measure and depict food insecurity and malnutrition. However, most studies eventually only use one approach. Relatively little is known about how the results of different approaches relate, which is important to evaluate the reliability of the estimates and to better plan nutrition interventions. We contribute to the literature by comparing results from different assessment tools for the same households and individuals.

**Methods:** The study took place in two counties in Western Kenya in 2015 and included 809 households and 1,775 individuals. A 24-hour dietary recall and a 7-day food consumption recall were administered at individual and household level, respectively. At individual level, children between six and 59 month and male and female adults were targeted. Anthropometric measures were also taken. Pearson's correlation coefficient was used to evaluate the relationship between different measures.

**Results:** Household dietary diversity (HDD) depicts a usage of nine food groups per week. In contrast, the average individual dietary diversity score (IDDS) for adults and children depicts usage of six food groups. Average individual energy intake is 2237.43 kcal/day (± 961.59) and 1759.21 kcal/day (± 981.31) for adults and children, respectively. Significant correlation is found between energy intake (kcal) and different dietary scores for children and adults (e.g. adult energy intake and HDDS r=0.195***; adult energy intake and IDDS: r=0.258***; child energy intake and HDDS: r=0.244***). However, the magnitude of the correlation coefficients is mostly small. Looking into macro- and micronutrient levels, significant correlation is found only for selected nutrients and score combination and at adult level.

**Conclusions:** We tentatively conclude that there is a positive and significant relationship between different scores of the same households and individuals. However, further analyses are needed to understand the relationship across households, individuals and nutrient level. Additional research steps will be to look into the relationship between dietary quality indicators/scores and anthropometric measures.

**Keywords:** Nutritional assessment, Dietary Diversity, Correlation, Household, Individual

**Conflict of Interest Disclosure:** We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.

We confirm that the abstract has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us.

**Background and objectives:** Dietary protein quality has been recognised as a critical issue by international authorities. It depends on amino acid (AA) composition and bioavailability. We aimed to investigate whether differences in the amount of bioavailable AA can be measured using a dual stable isotope ratio method. The principle is the use of two differently labelled proteins in a single meal; one test protein (e.g. 15N-labelled) given at a normal dietary quantity and one protein (e.g. 13C-labelled) given at trace quantity. The ratio between the two labelled AAs in serum (15N/13C) reflects the relative bioavailable amount of the differently labelled AA in the meal. Here, we have tested the difference in the amount of bioavailable AAs between two meals, hypothesizing that a two-fold difference in the amount of test protein in the meals would proportionally cause different ratio (15N/13C) in the serum.

**Methods:** In a cross-over study, ten subjects ingested a 500 kilocalorie pudding containing either 50 or 25 gram of intrinsically labelled 15N-milk protein (1.9 atom percent excess (APE)) and 400mg intrinsically labelled 13C-spirulina (97APE), along with 10E% fat and 50 or 70E% carbohydrates. On both days, pudding was divided in nine portions provided every 20 minutes. Isotopic enrichment of total serum free AAs at baseline and in the postprandial period was determined.

**Results:** The meal containing 50 gram dose of 15N-milk protein compared to 25 gram 15N-milk protein, also resulted in two-

<footnote><sup>(1)</sup>Fongar, Andrea; <sup>(2)</sup>Goedecke, Theda; <sup>(3)</sup>Qaim, Matin.</footnote>

<footnote><sup>(1)</sup>Research Associate. University of Goettingen. Department of Agricultural Economics and Rural Development; <sup>(2)</sup>Dr. University of Goettingen. Department für Agrarökonomie und Rurale Entwicklung; <sup>(3)</sup>Prof. Dr. University of Goettingen. Department für Agrarökonomie und Rurale Entwicklung.</footnote>

<footnote><sup>(1)</sup>van der Wielen, Nikkie; <sup>(2)</sup>Khodorova, Nadezda; <sup>(3)</sup>Gerrits, Walter;</footnote>

<footnote><sup>(4)</sup>Gaudichon, Claire; <sup>(5)</sup>Feskens, Edith; <sup>(6)</sup>Tomé, Daniel; <sup>(7)</sup>Mensink, Marco.</footnote>

<footnote><sup>(1)</sup>PhD. Nutritionist. Division of Human Nutrition. Wageningen University and Research. The Netherlands.; <sup>(2)</sup>PhD. Biologist. Research Unit for Nutritional Physiology and Feeding Behaviour. AgroParisTech. Institut national de la recherche agronomique. France.; <sup>(3)</sup>PhD. Animal scientist. Animal Nutrition group. Wageningen University and Research. The Netherlands.;</footnote>

<footnote><sup>(4)</sup>PhD. Nutritionist. Research Unit for Nutritional Physiology and Feeding Behaviour. AgroParisTech. Institut National de la recherche agronomique. France.; <sup>(5)</sup>PhD. Nutritionist. Division of Human Nutrition. Wageningen University and Research. The Netherlands.; <sup>(6)</sup>PhD. Nutritionist. Research Unit for Nutritional Physiology and Feeding Behaviour. AgroParisTech. Institut national de la recherche agronomique. France. Division of Human Nutrition. Wageningen University and Research. The Netherlands.; <sup>(7)</sup>PhD.MD. Physiologist. Division of Human Nutrition. Wageningen University and Research. The Netherlands.</footnote>
fold higher serum free AAs 15N-enrichment. Both meals con-
tained 400mg 13C-spirulina, resulting in similar serum free AAs
13C-enrichment. The high protein meal resulted in a 15N/13C
ratio of 11.04(±1.53 (mean±SEM)) at t=180 minutes and the low
protein meal resulted in a 15N/13C ratio of 6.26(±1.27).

**Conclusions:** A two-fold difference in the ingested amount of bioavailable 15N-milk protein in our test meal resulted in a 1.8 fold difference in serum free AA 15N/13C ratio. We showed that using this dual stable isotope ratio it was possible to detect differences in the amount of bioavailable protein. Thus, the dual stable isotope ratio might be a potential method for the estimation of protein bioavailability and hence protein quality in vivo in humans.

**Keywords:** Protein quality, stable isotopes, protein bioavaila-
bility, dietary protein, isotopic ratios.

**Conflict of Interest Disclosure:** This study was funded by the
Dutch Dairy Association (NZO).

ug/d. The lowest averages of 25 (OH)-D were for obese 31, RI
women 28 and obese with RI 28,2 ng/mL. The highest prevalence
(25 (OH) -D <30 ng/mL) was for the obese women (62.2%), those
with RI (72.4%) and for obese with IR (76.5%). HOMA-I and tri-
glycerides had a moderate negative relationship with serum 25
(OH) -D levels. The prevalence of deficiency + insufficiency had
a significant association between 25 (OH) -D with IR and hyper-
triglyceridemia.

**Conclusions:** The deficiency plus vitamin D insufficiency showed an association with two variables that identify cardiovascular risk, which could explain the possible relationship of this vitamin with cardiovascular diseases

**Keywords:** Vitamin D; Obesity; Insulin Resistance; Dyslipidemia; Diabetes mellitus 2

144/1605

VITAMIN D AND ITS RELATIONSHIP WITH OBE-
SITY, DYSLIPIDEMIA AND DIABETES MELLITUS
2 IN ADULT WOMEN, LIMA - PERU

(1)Bernui, Ivonne; (2)Pajuelo Ramírez, Jaime; (1)Bernui, Ivonne;

(3)Sánchez González, José; (3)Arbañil Huamán, Hugo; (3)Gamarra González, Dante; (4)Miranda Cuadros, Marianella; (3)Chucos Ortiz, Rafael; (5)Estrada Acero, Bill; (5)Salas Ramos, Humberto.

(1)MSc. Biologist. Centro de Investigación de Bioquímica y Nutrición. Universidad Nacional Mayor de San Marcos. Perú;

(2)MSc. Medical Doctor. Instituto de Investigaciones Clínicas. Universidad Nacional Mayor de San Marcos. Perú; (3)Medical Doctor. Servicio de Endocrinología. Hospital Nacional Dos de Mayo. Perú; (4)MSc. Nutritionist. Centro Nacional de Alimentación y Nutrición. Instituto Nacional de Salud. Perú; (5)Estudiante. Escuela de Nutrición. Universidad Nacional Mayor de San Marcos.

**Background and objectives:** Vitamin D deficiency is considered a public health problem. The objective was to determine the relationship between vitamin D and obesity, dyslipidemias and type 2 diabetes mellitus in a group of adult women.

**Methods:** One hundred and ten adult women between 20 to 55 years were weighted and their height measured in order to obtain the BMI to define the nutritional status. Insulin, glucose, lipid profile and vitamin D (25 (OH) -D) were determined. With the first two we calculated the Homeostatic Model of Assessment Index (HOMA-I) and to define insulin resistance (RI) a HOMA-I ≥ 2.7. Holick cutoff points were used to categorize 25-hydroxyvitamin D level: deficient <20 ng/mL, insufficient 21-29 ng/mL and sufficient ≥ 30 ng/mL. We identified dyslipidemia as recommended by the Third Report of the National Cholesterol Education Program. The frequency of consumption was used to measure vitamin D intake. We calculated prevalence, average, SD, 95% CI, correlation of quantitative variables, and association of categorical variables.

**Results:** Forty nine percent of the respondents were insuffi-
cient and 2,7% deficient of 25 (OH) -D. The intake was about 3

144/1612

BODY WEIGHT CONTROL, NUTRIENT INTAKE
AND RESTRAINED EATING BEHAVIOURS OF
HEALTHY ADULTS

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

(1)MSc. Nutrition and Dietetics Department, Hacettepe University, Turkey.; (2)PhD. Nutrition and Dietetics Department, Hacettepe University, Turkey.

**Background and objectives:** Dietary restraint is defined as the intention to restrict food intake in order to control body weight. The Restraint Scale (RS) is the most widely used measure for dieting to achieve or maintain a desired weight. Therefore the aim of this study was to evaluate the nutrient intake and BMI values of participants according to their restrained scale scores.

**Methods:** In order to determination a relation between nu-
trient intakes, anthropometric measurements and restrained scale
scores of participants a questionnaire that consists restrained scale
and some socio-demographic characteristics of healthy partici-
pants were administered by the face-to-face method. Participants'
24 hour food recall and anthropometric measurements were also
taken by specialized dietitians. The results were evaluated by the
statistical program SPSS.

**Results:** The mean energy value of the individuals was 2038.4 ± 678.34 kkal. According to the participants' 24-hour food recall, the average percentage of energy from carbohydrate, fat and protein intake were 47.9 ± 9.31%, 37.2 ± 8.66% and 14.9 ± 3.50%, respectively. According to RS, 37% of the participants had restricted eating behaviours. The mean energy value of the individuals with restricted eating behavior were 2209.2 ± 716.09 kkal, while the mean energy value of the individuals with restricted eating behavior were 1747.1 ± 503.74 kkal (p = 0.02). Similarly, individuals without restrained eating behaviors were found to have higher carbohydrate (g / day), protein (g / day) and fat (%) values compared to individuals with restricted eating behaviors and the difference was found to be statistically significant (p = 0.01 , 0.04 and 0.01, respectively). The mean BMI of women without restricted eating
behaviors was 23.1 kg/m2, while the BMI of women with restrict-
ed eating behaviors was 21.0 kg/m2 (p = 0.03). But there was no
significant difference between the mean BMI values of individuals
with and without restricted eating behaviors in men (p> 0.05).

**Conclusions:** The findings of this research suggest that re-
straint subscales are sensitive to nutrient intake of participants.

**Keywords:** Nutrient intake, body weight, restrained scale

144/1613

EFFECTS OF IODISED SALT AND IODINE SUP-
PLEMENTS ON PRENATAL AND POSTNATAL
GROWTH: A SYSTEMATIC REVIEW

(1)Farebrother, Jessica; (2)Naude, Celeste; (2)Nicol, Liesel; (3)Sang, Zhongna; (4)Yang, Zhenyu; (5)Andersson, Maria; (6)Zimmermann, Michael Bruce.

(1)MPharm MPH. Human Nutrition Laboratory. Institute of Food, Nutrition and Health. ETH Zurich. Switzerland.; (2)PhD. Centre for Evidence-Based Healthcare, Faculty of Medicine and Health Sciences. University of Stellenbosch. South Africa.; (3)PhD. Department of Nutrition and Food Hygiene, School of Public Health. Tianjin Medical University. China.; (4)PhD. Key Laboratory of Trace Element Nutrition of the Ministry of Health. Chinese Centre for Disease Control and Prevention. China.; (5)PhD. Human Nutrition Laboratory. Institute of Food, Nutrition and Health. ETH Zurich. Switzerland.; (6)MD. Human Nutrition Laboratory. Institute of Food, Nutrition and Health. ETH Zurich. Switzerland.

**Background and objectives:** Globally, 161 million children are stunted. Stunted children have an increased risk of mortality and morbidities. Iodine is a key component of thyroid hormone, which influences the growth of skeletal and peripheral tissues. Inadequate dietary iodine intake is associated with stunted growth. We systematically reviewed the evidence for the effectiveness of iodine supplementation or fortification on growth (prenatal to 18 years).

**Methods:** Following Cochrane methods, we searched ten databases including two Chinese databases (latest search February 2017) for eligible studies. RCTs and non-RCTs controlled before-after studies, interrupted time-series studies and interrupted time series studies with repeated measures conducted in pregnant women and children aged 0-18 years, comparing the effectiveness of iodine (in any form, dose or regimen) to a placebo, non-iodised salt, or no intervention, on pre-and post-natal growth markers were assessed. Analyses were stratified by iodine status. We calculated mean differences (MD) with 95% confidence intervals (95%CI), and performed random-effects meta-analyses. The quality of the evidence was assessed using GRADE.

**Results:** Nineteen trials with 5733 participants were includ-
ed in the review. Providing moderately-to-mildly iodine deficient
pregnant women with iodine supplements may make little or no
difference to offspring birth length (MD 0.01 cm (95% CI -0.39,
0.41cm); I2=0%; 3 RCTs, n=1106; low quality evidence). The im-
pact of iodine supplements to severely iodine deficient pregnant

women on offspring birth length is uncertain due to the very
low quality of evidence (MD 4.7 cm (95% CI -1.6, 11cm); 1 non-
RCT, n=456; very low quality evidence). Similarly, supplementing
schoolchildren with iodine may make little or no difference to
their height, irrespective of their baseline iodine status (MD -0.03
cm (95% CI -1.45, 1.39 cm); I2=28%; n=890; 4 RCTs; low quality
evidence).

**Conclusions:** Despite the importance of adequate dietary iodine intake for normal growth during infancy, childhood and adolescence, there are few rigorous, adequately powered trials investigating the effectiveness of iodine supplementation or fortification on prenatal and postnatal growth during these life stages. Based on the limited, low quality data available, the impact of iodine supplementation or fortification on prenatal or postnatal growth outcomes remains uncertain.

**Keywords:** Iodine, iodine deficiency disorders, growth, stunting

144/1618

NUTRITIONAL STATUS ASSESSMENT OF ELITE
MALE CRICKETERS FROM GUJARAT, INDIA

(1)Deota, Prachi; (2)Chandorkar, Suneeta.

(1)MSc. Doctoral Scholar. Department of Foods and Nutrition. The Maharaja Sayajirao University of Baroda. India.; (2)PhD. Assistant Professor. Department of Foods and Nutrition. The Maharaja Sayajirao University of Baroda. India.

**Background and objectives:** There is lack of data on nutri-
tional status of cricketers and therefore the study was planned to
assess the anthropometry, body composition and dietary intake of
the male cricketers 19-23 years of age (n=28). The subjects trained
for 4 hours a day for 6 days a week at the academy and had an av-
erage 9 years of experience.

**Methods:** Weight, height and Waist- hip circumference were measured using standard procedures. Body mass index (BMI) was classified using Asia Pacific cut offs. Body composition analysis was conducted using Bio-electrical impedance method (Bodystat Quadscan 4000 unit). Dietary intake was assessed using 24-hour dietary recall method (3 days) and food frequency questionnaire was used for Iron and Calcium intake. The data for macronutrient intake were compared with the Recommended Dietary Allowanc- es by National Institute of Nutrition (NIN) for Team event athletes while for micronutrients, RDA by NIN for non-athletic popula- tion were used as those for athletes are unavailable.

**Results:** The measured BMR of subjects was higher (1679±153 kcal/day) than the BMR for reference man (1587 kcal/day) calculated using formula by Indian Council of Medical Research. A typical short fat phenotype was observed even in the elite cricketers as indicated by the waist height ratio which identified 21% to be abdominally obese. Body composition revealed that only 46% subjects had normal body fat while 93% had normal lean mass. Thirty nine percent of cricketers were identified as overweight (28%) and obese (11%) by BMI. Percent energy contributed by Carbohydrate: Fat: Protein (50:35:15) compared well with the rec-
ommended values (54:31:15). None of the subjects met the (RDA) for Energy (-48%), Carbohydrates (-52%), Protein (-47%) and Fat (-59%). Daily Iron (19.31mg) and Calcium intake (1572mg) met the RDA of 17mg and 600mg respectively. Iron rich foods consumed daily were whole wheat flour (96.4%), Lentil (7.1%) and Puffed rice (7.1%) while the Calcium rich foods were Milk (100%), Dried dates (42.9%), Curd (39.3%).

**Conclusions:** Overweight and obesity was prevalent even in elite cricketers along with central obesity. The deficits in Energy and macronutrients if not corrected may lead to impaired performance.

**Keywords:** Nutritional status, Elite Male Cricketers, Central obesity, Body composition

144/1620

ALTERNATE DAY DOSING, AND SINGLE MORNING DOSES RATHER THAN B.I.D. DOSING, MAXIMIZE TOTAL AND FRACTIONAL IRON ABSORPTION FROM ORAL IRON SUPPLEMENTS: STABLE IRON ISOTOPE STUDIES IN IRON-DEPLETED WOMEN

(1)Stoffel, Nicole Ursula; (2)Cercamondi, Colin Ivano; (3)Zeder, Christophe; (4)Brittenham, Gary; (5)GeurtsMoespot, Anneke J.; (6)Swinkels, Dorine W.; (2)Moretti, Diego; (7)Zimmermann, Michael Bruce.

(1)Msc. Department of Health Science and Technology. Laboratory of Human Nutrition. ETH Zürich. Switzerland.; (2)PhD. Department of Health Science and Technology. Laboratory of Human Nutrition. ETH Zürich. Switzerland; (3)Msc. Department of Health Science and Technology. Laboratory of Human Nutrition. ETH Zürich. Switzerland; (4)MD. Department of Pediatrics. Columbia University. College of Physicians and Surgeons. USA; (5)Bsc. Department of Laboratory Medicine. Translational Metabolic Laboratory. Hepcidinanalysis.com. Radboud University Medical Centre. The Nederlands; (6)PhD. Department of Laboratory Medicine. Translational Metabolic Laboratory. Hepcidinanalysis.com. Radboud University Medical Centre. The Nederlands; (7)MD. Department of Health Science and Technology. Laboratory of Human Nutrition. ETH Zürich. Switzerland.

**Background and objectives:** Oral iron supplementation (OIS) is a primary approach to treat iron deficiency, but there is no clear consensus on the optimal regimen, and compliance is often poor. Oral iron supplements acutely increase serum hepcidin (SHep); the duration and magnitude of this increase and its dose dependence could be used to optimize OIS to maximize absorption. In short-term studies (1-3) we defined the duration of the SHep increase, compared single day versus two consecutive daily doses and single versus twice a day (b.i.d.) dosing. In long-term studies (4), we compared iron absorption (60mg) from consecutive day dosing for 14 days versus alternate day dosing for 28 days

(equal total dose) and (5) from 120mg given in daily doses versus split b.i.d. 60mg over 3 days.

**Methods:** In studies (1-3: n=54; 4: n=40; 5: n=20) labeled Fe [54Fe]-, [57Fe]- or [58Fe]-FeSO4 was given to fasting iron-depleted women (plasma ferritin <25µg/L). Iron absorption was measured as erythrocyte incorporation of iron stable isotopes 14 days later.

**Results:** Studies 1-3 showed an increase in SHep at 24h after doses of >60mg (P<.05), but not at 48h. Fractional iron absorption (FIA) decreased by 36% when 60mg was administered on the second day compared with the first day (P<.001). Total iron absorption (TIA) did not improve if 3 doses were administered within 24h (b.i.d.) compared to when only the 2 morning doses were given (P=.79). In study 4, TIA from alternate day dosing was increased compared to consecutive day dosing: geometric mean (-SD, +SD) 175.3 (110.3,278.5) versus 131.0 (71.4,240.5)mg (P=.001). SHep increased over time in both groups, with a time x group interaction (P<.001). In study 5, there was no difference in TIA over 3 days between single dosing and b.i.d: geometric mean (-SD, +SD) 40.7 (40.9,40.6) versus 44.7 (44.8,44.5)mg, respectively; b.i.d. dosing increased SHep over the 3 days compared with single day dosing (P<.05)

**Conclusions:** In both short- and long-term studies in iron-depleted women: 1) FIA and TIA are higher from 60 mg doses given on alternate days versus consecutive days; and 2) an iron dose (120 mg) split b.i.d. does not increase TIA compared with a single morning dose.

**Keywords:** oral iron supplementation, iron absorption, hepcidin

**Conflict of Interest Disclosure:** DWS and AJGM are employees of Radboud University and Medical Centre that offers high quality hepcidin measurements to the scientific, medical and pharmaceutical community, at a fee for service basis. The other authors do not have conflict of interest to disclose.
# HARMONIZATION OF DIETARY INTAKE ASSESSMENT IN BALKAN REGION USING DIET ASSESS & PLAN (DAP) PLATFORM

(1)Gurinovic, Mirjana; (1)Gurinovic, Mirjana; (2) Milešević, Jelena;

(3)Kadvan, Agnes; (4) Nikolić, Marina; (5) Zeković, Milica; (6) Djekić-

Ivanković, Marija; (7) Dupouy, Eleonora; (8)Finglas, Paul; (9) Glibetic, Maria.

(1)MD PhD. Senior Researcher. Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Serbia. Capacity Development Network in Nutrition in Central and Eastern Europe, Capnutra, Serbia;

(2)MSc Nutrition. PhD candidate. Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Serbia. Capacity Development Network in Nutrition in Central and Eastern Europe, Capnutra, Serbia;

(3)Programmer. Capacity Development Network in Nutrition in Central and Eastern Europe, Capnutra, Serbia.; (4)MSc Mathematics. PhD candidate. Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Serbia. Capacity Development Network in Nutrition in Central and Eastern Europe, Capnutra, Serbia;

(5)MPharm Spec. PhD candidate. Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Serbia. Capacity Development Network in Nutrition in Central and Eastern Europe, Capnutra, Serbia;

(6)PhD. Capacity Development Network in Nutrition in Central and Eastern Europe, Capnutra, Serbia.; (7)Food safety and consumer protection Officer. FAO Regional Office for Europe and Central Asia (REU), Budapest, Hungary.; (8)President and Managing Director. EuroFIR AISBL, Brussels, Belgium.; (9)PhD. Head of Department. Senior Researcher. Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Serbia. Capacity Development Network in Nutrition in Central and Eastern Europe, Capnutra, Serb.

**Background and objectives:** Initiatives in the Capacity Development in Nutrition Research in Balkan region in past decade have been toward creation of contemporary, harmonized Research Infrastructure (RI) compliant to European standards. One of the elements of this RI is an innovative tool, DIET ASSESS & PLAN (DAP), a platform for standardized food consumption collection, comprehensive dietary intake assessment and nutrition planning.

**Methods:** DAP, advanced dietary assessment application, compliant to EuroFIR(TM) standards, comprises computerized food consumption questionnaires (24-h dietary recalls (24HDR), Food Frequency Questionnaire (FFQ), Food Records (FR), Food Propensity Questionnaire (FPQ)), general and pre-screening information about subjects, anthropometric and biochemical parameters, blood pressure measurements, supplements intake and physical activity, and complementary Food photo atlas. It extracts nutrient data from compatible food composition database (FCDB) (30 national FCDBs from EuroFIR(TM) Food platform), and evaluates results based on sets of international nutrient recommendations.

Its structure is based on MySQL database (for FCDB) and Microsoft VisualFoxPro database engine.

**Results:** DAP enables dietary intake assessment on individual and/or population levels, dietary planning (for public institution procurements and personal dietary advice), foods design/refinement, food labelling, and assessment of the Minimum Dietary Diversity-Women (MDD-W) as one of the priority indicators for Post-2015 Sustainable Development Goal (SDG) framework. It operates in bilingual options: English (default) and other language. DAP platform has EuroFIR(TM) thesaurus, LanguaL(TM) and EFSA FoodEX2 coding systems integrated in its structure, where food matching is possible on level of foods, recipes and dietary questionnaires. The software has been evaluated within EFSA project: "Dietary monitoring tools for risk assessment", 2014, and presents major platform for two new EFSA projects in Balkan region: National Dietary Surveys in Compliance with the EU Menu methodology (sixth support): "The adults' survey", including subjects from 10 to 74 years old, 2017-2021 (Serbia, Bosnia and Herzegovina and Montenegro) and "The children's survey", including subjects from three months up to 9 years old, 2017-2021 (Serbia and FYROM).

**Conclusions:** DAP platform with its standardized and harmonized tools for dietary assessment is RI that synchronizes nutrition surveillance in the Balkan region, and with its features could be employed on larger scale nutrition epidemiology studies.

**Keywords:** Dietary assessment tool, Research Infrastructure, Food consumption, Dietary survey, Balkan region

# EFFECT OF DIFFERENT AMOUNTS OF ALCOHOL INTAKE ON GUT MICROBIOTA COMPOSITION OF HEALTHY ADULTS

(1)Nova, Esther; (2)Redondo, Noemí; (3)Villavisencio, Brenda; (1)Díaz-Prieto, Ligia E.; (1)Marcos, Ascensión.

(1)PhD. Nutritionist. Institute of Food Science, Technology and Nutrition (ICTAN) - CSIC. Madrid. Spain; (2)MSc. Nutritionist. Institute of Food Science, Technology and Nutrition (ICTAN) - CSIC. Madrid. Spain; (3)BSc. Nutritionist. Institute of Food Science, Technology and Nutrition (ICTAN) - CSIC. Madrid. Spain.

**Background and objectives:** Knowledge on the effects of alcohol consumption on the gut microbiota composition is scarce and mainly derived from animal studies or from studies on alcoholic subjects with alcohol-liver disease or cirrhosis. However, the effects are bound to be different depending on the amount of alcohol intake, as evidenced with other alcohol effects on health. The objective of the present work was to assess the effect of the amount of alcohol intake in the gut microbiota composition of healthy adults

**Methods:** A non-representative population sample of 261 healthy adults (25-45 y) of Madrid was studied (51% males, 49% females). Anthropometry was measured and socioeconomic, lifestyle and medical history data were obtained through a battery of
validated questionnaires. Gut microbiota composition was analyzed in fecal samples through 16S rRNA gene amplicon sequencing (V3+V4 gene regions. MiSeq 2x250 Illumina) and taxonomic analysis. Three groups of alcohol consumption were considered. 1) None-Low (N=124), average consumption <5g alcohol/day; 2) Moderate: ≥ 5 g/d and ≤20g/d (men) or ≤12 g/d (women) (N=99); 3) High: > 20 g/d (men) or > 12 g/d (women) (N=38). After post-processing OTUs data cleaning, general linear model including alcohol group and sex as independent factors and non-parametric Kruskal-Wallis and Mann-Whitney tests were used for the statistical analysis of normal and non-normal distribution phyla encountered, respectively

**Results:** Differences between groups of subjects with different amount of alcohol intake were observed specially in the less abundant phyla while the predominant phyla were similar irrespective of alcohol consumption. A higher proportion of Spirochaetes was observed when alcohol consumption is high (Kruskal-Wallis test, P=0.001), and remains significant in a separate sex analysis. Other differences are observed in some minor phyla depending on amount of alcohol consumption but the findings are different in men and women.

**Conclusions:** Alcohol consumption above the recommended daily intake was associated with an increased proportion of Spirochaetes in gut microbiota of healthy adults compared to moderate, low or no-alcohol intake.

**Keywords:** Gut microbiota. Alcohol intake. 16S metagenomics. Healthy adults.

Brazilians (15-65 y.o) participating in EBANS (Brazilian Health and Nutrition Study). Two 24-hour recall were used to identify the intake of AS and the major food items accounting for AS, using the weighed-proportions formula developed by Block (1985) in which the relative contribution (RC) of a given food item/food group is defined as: RC=[(Total AS grams from a food item x 100)/Total AS grams from all food items]. Median intake and sources of AS were performed by age group, gender, socioeconomic level (SES) and nutritional status.

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

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

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

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

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

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

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

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

**Background and objectives:** Added sugar (AS) intake is highly associated with the epidemic of overweight and obesity. This study aimed to identify the dietary intake and sources of AS among Brazilian population.

**Methods:** Latin American Health and Nutrition Study (ELANS) is a multicenter study developed in urban areas of 8 Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. Data were obtained from 2,000
## MONITORING AND EVALUATION OF DIET-RELATED NCD RISK FACTORS UNDER NUTRITION TRANSITION: A SECONDARY ANALYSES OF THE DATA OF NATIONAL FOOD CONSUMPTION SURVEY, LAO PDR

(1)Miyoshi, Miki; (2)Kounnavong, Sengchanh; (2)Douangvichit, Daovieng; (3)Yoshiike, Nobuo.

(1)RD. MPhil. PhD. Head, Section of Section of International Nutrition Research and Development, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition; (2)National Institute of Public Health, Lao PDR; (3)Dean, Graduate School of Health Sciences, Aomori University of Health and Welfare, Japan.

**Background and objectives:** Recently, the countries where undernutrition and infectious diseases have been the significant public health problems are increasingly facing with the increased disease burden of non-communicable diseases (NCDs) like diabetes and cardiovascular diseases under nutrition transition, hence "double burden of malnutrition". Sustainable development goals (SDGs) were formulated in September 2015 as post-MDGs, thereby promoting global trend to focus on nutrition and NCDs. It is therefore important to develop a framework of policy planning to tackle "double burden of malnutrition" as well as evaluate the diet-related NCD risk factors in the countries undergoing nutrition transition. In our previous study, we developed the database on nutrition/NCDs monitoring systems and the relevant indicators (e.g. definition, criteria). The present study aims to develop a standardized tool (FFQ) for dietary assessment to evaluate the impact of intervention for "double burden of malnutrition" using the dataset of nationwide food consumption survey in Lao PDR.

**Methods:** National Food Consumption Survey is the first comprehensive nationwide survey on dietary intake in Lao PDR, which has been conducted by the National Institute of Public Health, Lao PDR (NIOPH) since 2014. This survey was undertaken by one day 24-hour recall method using food photo book developed by a pilot study, and INMUCAL-N was applied for calculation of nutrient intake. In addition, a questionnaire on the socio-demographic characteristics and the anthropometric data were collected. For the purpose of this study, the approval for secondary analyses is being sought to the NIOPH and the supporting bodies (e.g. FAO).

**Results:** Results of data analyses will be presented at the congress.

**Conclusions:** We expect to apply the newly-developed FFQ for monitoring and evaluation of diet-related NCD risk factors in the country, followed by the dietary surveys in Cambodia and Myanmar for standardization to monitor and evaluate diet-related NCD risk factors in each country.

**Keywords:** nutrition transition, food consumption data, dietary survey, 24-hour recall, FFQ

## EXPLORATORY STUDY ON FATTY ACID PROFILE FROM SEVERAL EDIBLE FISH SPECIES IN CHILE

(1)Rincón-Cervera, Miguel Ángel; (2)González-Barriga, Valeria;

(3)Romero Ormazábal, Jaime; (4)Valenzuela-Báez, Rodrigo;

(3)Valenzuela-Bonomo, Alfonso.

(1)PhD. Chemist. Institute of Nutrition and Food Technology (INTA). University of Chile. Chile; (2)Nutritionist. Institute of Nutrition and Food Technology (INTA). University of Chile. Chile.;

(3)PhD. Biochemist. Institute of Nutrition and Food Technology (INTA). University of Chile. Chile.; (4)PhD. Nutritionist. Department of Nutrition, Faculty of Medicine. University of Chile. Chile.

**Background and objectives:** Marine fish is one of the most important current dietary sources of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), two of the most recognized omega-3 long-chain polyunsaturated fatty acids (ω-3 LCPUFA) because of their beneficial effects and physiological roles in human health. In Chile there is a lack of information concerning EPA and DHA content in fish consumed by the population. In this work, we determined the fatty acid amount of seven fishes consumed in Chile with a focus on EPA and DHA, thus providing relevant information for consumers.

**Methods:** Specimens from seven fish species were collected for this study from local fishermen in Coquimbo (IV Region, Chile): Chilean hake (Merluccius gayi gayi), Peruvian morwong (Cheilodactylus gayi), Southern rays bream (Brama australis), Pacific sandperch (Prolatilus jugularis), Chilean jack mackerel (Trachurus murphyi), chub mackerel (Scomber japonicus) and Chilean flounder (Paralichthys adspersus). Fillets from 3 fishes of each species were put together and minced, and then the lipid fraction was extracted by the Folch method. Fatty acid profiles were obtained by gas chromatography coupled with flame ionization detection (GC-FID) using methyl tricosanoate as internal standard.

**Results:** Most analyzed fish fillets contained an EPA+DHA amount higher than 250 mg per serving size (100 g fillet), which is the minimum recommended daily intake of both ω-3 LCPUFA. The highest EPA+DHA amount was found in Peruvian morwong (440 mg/100 g fillet) whereas the lowest amount was found in Chilean flounder (202 mg/100 g fillet). It was observed that DHA amount was higher than EPA in all studied species: the highest and lowest DHA levels were found in Chilean jack mackerel (280 mg/100 g fillet) and Chilean hake (149 mg/100 g fillet) respectively, whereas the highest and lowest EPA levels were found in Peruvian morwong (144 mg/100 g fillet) and Southern rays bream (24 mg/100 g fillet) respectively.

**Conclusions:** This exploratory study provides valuable data to the very scarce literature regarding fatty acid composition of Chilean fishes. It did not include longitudinal data, but it can be used as starting point to design a larger study considering geographical, climate and seasonal conditions.

**Keywords:** Fish fillet, eicosapentaenoic acid, docosahexaenoic acid, fatty acid profile.
# PROTEIN INTAKE, PROTEIN QUALITY, PROTEIN STATUS AND EARLY CHILDHOOD LINEAR GROWTH IN RURAL ETHIOPIA

(1)Tessema Anegago, Masresha; (2)D. Brouwer, Inge; (3)S. Gunaratna, Nilupa; (4)Belachew, Tefera; (5)Belayneh, Demissie; (6)Donato, Katherine; (7)De Groote, Hugo.

(1)PhD Fellow in Wageningen University's, Associate Researcher, Food Science and Nutrition Research Directorate Ethiopian Public Health Institute (EPHI); (2)PhD.Division of Human Nutrition, Wageningen University. Wageningen. The Netherlands.; (3)PhD. Harvard T.H. Chan School of Public Health. Boston.MA, USA; (4)PhD.Human Nutrition Unit, Jimma University. Jimma. Ethiopia; (5)MSC.International Maize and Wheat Improvement Center (CIMMYT). Addis Ababa. Ethiopia; (6)MSC.Harvard University, Cambridge. MA. USA; (7)PhD. International Maize and Wheat Improvement Center (CIMMYT). Nairobi Kenya.

**Background and objectives:** Linear growth failure is a major public health concern in developing countries. Poor linear growth of children, manifested as stunting, is associated with higher child mortality and morbidity, poorer motor and cognitive development, and lower educational attainment and economic productivity in adulthood. Protein and essential amino acids play biological roles in bone elongation and necessary for linear growth. The quality of protein in foods consumed by low-income groups in developing countries is often limited, which reduces the availability of protein for use by the human body. However, so far limited evidence is available on the relationship between early childhood linear growth and protein intake, particularly in settings with a high prevalence of inflammation. We therefore examine the associations among protein intake, protein quality, protein status, and linear growth among young children in rural Ethiopia.

**Methods:** We used a cross sectional data set (n=846) collected from July-September 2015 during baseline of an ongoing randomized controlled intervention trial of children aged 6-35 months in a rural area of Ethiopia. Protein intake was assessed using 24 h dietary recall, and protein quality was measured using the PDCAAS method. Determination of protein status (prealbumin), alpha-1-glycoprotein (AGP), and C-reactive protein (CRP) was conducted using immunoturbidimetry. Multivariable linear regression was used to evaluate the associations among protein intake, protein quality, protein status, and early linear growth.

**Results:** Prevalence of inflammation (elevated AGP > 1 g/L or CRP > 5 g/L) was about 37%. After adjustment for sex and socio-economic status, we found protein status measured using prealbumin was correlated with height and weight of children. We found that among stunted children in the first one year, median protein intake was below the estimated average requirement (EAR) (P<0.05). After adjusting for potential confounders, we found total protein intake(β=0.32), and protein quality((β=0.45), and intake of the most limiting amino acids(β=0.53) were positively associated with early childhood linear growth(P<0.005)

**Conclusions:** High linear growth failure in Ethiopian children likely affected by low protein intake. Nutrition programs that emphasize higher dietary protein intake as well as improving the quality of that protein might improve early child linear growth

**Keywords:** protein intake; protein status; linear growth; Ethiopia

**Further collaborators:**

Jessica L. Cohen and Margaret McConnell from Harvard T.H. Chan School of Public Health, Boston, MA, USA

# VALIDATION OF A MOBILE APPLICATION AS A TOOL TO ESTIMATE FOOD INTAKE IN ADULTS

(1)Bittencourt Mescoloto, Samantha; (2)Caivano, Simone; (2)Domene, Semiramis.

(1)Dietitian. Graduate student at Health Sciences Interdisciplinary Program. Federal University of São Paulo. Brazil; (2)PhD. Department of Public Policies and Collective Health. Federal University of São Paulo. Brazil.

**Background and objectives:** Knowing the dietary patterns of the population includes nutritional assistance actions and can contribute to health care. However, traditional methods of dietary intake analysis have weaknesses that lead to measurement errors. The development of new tools can assist in information quality in dietary surveys while the use of digital technology with mobile devices facilitates recording and analysis of data, as already demonstrated. The objective of this investigation is to verify the validity of Nutrabem application -NApp, as a tool for recording food intake in adults. This study was conducted to determine the optimal sample size by considering dietetic variability.

**Methods:** A cross-sectional pretest study conducted with NApp users; food intake was also estimated by the application of a 24-hour recall; nutritional composition analysis was performed using Nutrabem Pro software. Student' t-test, Pearson's Correlation Coefficient and Bland Altman's chart will be applied to verify the agreement between methods.

**Results:** The sample of 40 subjects was composed of 33 women (82,5%); the average age of the respondents was 29.7 years (SD=8.96).

**Conclusions:** This study indicated that a sample of 280 individuals will able to produce results accurate enough to identify the significant differences in the variables of interest in this study with the power of 0.8.

**Keywords:** validation studies, dietary surveys, digital technology.

**Further collaborators:** Support: grant #2016/13978-7, São Paulo Research Foundation (FAPESP).
# MARKET ASSESSMENT OF OIL BRANDS TO ASSESS THEIR AVAILABILITY AND COMPLIANCE WITH VITAMIN A FORTIFICATION STANDARDS IN PAKISTAN

**Background and objectives:** The mandatory fortification of oil with vitamin A has been identified as a key strategy to address prevalent deficiency in the Pakistan population. However, the potential efficacy of fortification can be compromised by sub optimal compliance to standards. Given the need to ascertain compliance, we sought to assess (1) availability of oil brands across provinces and (2) compliance of oil brands and producers with oil standards.

**Methods:** In Aug 2016, different retail outlets were visited in the 2-4 main urban market hubs (based on high population density) to record available brands in each of the 4 main provinces.

12 oil samples were collected from each oil brand available in Pakistan. Composite samples were prepared by brand and the average vitamin A content was quantified using HPLC. Unweighted averages by producer were calculated across brands.

**Results:** We were able to identify the number of brands available in Pakistan and the variety of available brands in the main provinces. Punjab province has the highest variety of available oil/ ghee brands (70 brands), Sindh (45), KPK (44) and Baluchistan province the lowest (19).

The annual market volumes of the 50 producers included in the compliance assessment represents about 70% of the market volume. 70% of this volume is fortified (by 28 producers), but only 40% according to the national standard (by 11 producers).

The fortified oil is available in all the main 4 provinces.

**Conclusions:** The majority of the oil in Pakistan is fortified and fortified oil is available in all the main 4 provinces. Two-thirds of the oil is not fortified or does not meet the standard. Therefore, strengthening of the regulatory monitoring by key stakeholders (Regulatory bodies including Pakistan Standards and Quality Control Authority (PSQCA) /Food Authorities etc.) may be required to ensure inspections are carried out at the production sites of producers that do not fortify or do not meet the standard requirements, to understand the bottlenecks in collaboration with industry and to make sure that fortification of oil is initiated and quality assurance and control measures improved.

Market monitoring can identify non-compliant producers and prioritize follow-up for corrective action.

**Keywords:** market assessment, compliance, availability, food fortification, Pakistan

The market assessment was made possible through the support of the Pakistan Vanaspati Manufacturers Association (PVMA), stakeholders from the National and Provincial Governments, PSQCA, Pakistan Council for Scientific Research (PCSIR), Qarshi research Centre, Institute of Home and Food Science of the Government College of the Faisalabad University and GAIN, as well as the financial support from the USAID/GAIN Pakistan Regional Food Fortification Project.

# COMPREHENSIVE FOOD AND NUTRIENT DATABASE OF THE DIETSYS SYSTEM FOR DIET SURVEYS IN BRAZIL, ARGENTINA, AND THE UNITED STATES

**Background and objectives:** The need for information on food composition that is up to date, accurate and reliable is critical to assess components of the diet aiming to promote health. The DietSys diet-data processing system allows using customized databases to calculate food components. We aimed to build a comprehensive food and nutrient database to be used in the DietSys system to assess dietary intake in epidemiological research in Brazil, Argentina, and the United States.

**Methods:** Three nutrient composition tables were unified: the Brazilian food composition table (TACO), the Argentinean food composition table (Argenfoods), and the U.S. Department of Agriculture, Agricultural Research Service (USDA) release 27. We created 21 food groups and used NOVA to classify food items into four food processing categories (FPC): unprocessed or minimally processed foods (UMP), processed culinary ingredients (PCI), processed foods (PF), and ultra-processed foods (UPF). For each FPC and food group, we calculated the number and proportion (%) of food items and the average density of energy (kcal/100 grams) and macronutrients (grams/100 grams).

<footnote>(1) Jungjohann, Svenja; (2) Rasool, Faiz; (3) Anjum, Faqir Muhammad;</footnote>

<footnote>(4) Arshad, Muhammad Umair; (5) Ahmad, Nazir; (6) Afzaal, Muhammad.</footnote>

<footnote>(1) Global Alliance for Improved Nutrition (GAIN); (2) Public Health (MSc). Global Alliance for Improved Nutrition (GAIN). Islamabad, Pakistan; (3) Food Science (PhD). University of The Gambia. Islamic Republic of The Gambia; (4) Food Science (PhD). Institute of Home and Food Sciences. Government College University Faisalabad, Pakistan; (5) Food Science (MSc). Institute of Home and Food Sciences. Government College University Faisalabad, Pakistan.</footnote>

<footnote>(1) Rossato, Sinara L.; (2) Rodrigues, Marcela Perdomo; (3) Sampson, Laura; (4) Beato, Gariel c; (5) Defagó, Maria Daniela; (6) Fung, Teresa T;</footnote>

<footnote>(7) Willett, Walter C.</footnote>

<footnote>(1) MSc. PhD. Research Fellow. Department of Nutrition. Harvard T.H. Chan School of Public Health. Boston. United States.;</footnote>

<footnote>(2) MSc. PhD fellow. Post-graduation program in cardiology and cardiovascular disease. Federal University of Rio Grande do Sul. Brazil.; (3) RD. Nutritionist. Channing Division of Network Medicine, Department of Medicine Brigham and Women's Hospital. Harvard Medical School. Boston. United States.;</footnote>

<footnote>(4) Nutricionist. Instituto de Bioscience, Universidade Estadual Paulista "Julio Mesquita Filho". Botucatu. Brazil.; (5) PhD. Professor. School of Nutrition. Universidad Nacional de Cordoba. Cordoba. Argentina.; (6) PhD. Professor. Harvard T.H. Chan School of Public Health. Boston. United States.; (7) MD. PhDr. Professor. Department of Nutrition. Harvard T.H. Chan School of Public Health. Boston. United States.</footnote>
**Results:** The DietSys database comprised 9386 food items: 6.1% from TACO, 4.7% from Argenfoods, and 89.2% from the USDA. Of food items classified as UMP, 53% were from Argenfoods and 23% from USDA. The USDA contained 78% of the UMP (N=1987), 83% of the PCI (N=318), 89% of the PF (N=2404), and 96% of the UPF (N=4203). Average density of energy, proteins, lipids, and carbohydrates from PCI was 23%, 4%, 26% and 42% lower in TACO and Argenfoods food items than the three tables' average. Some food groups included more than one FPC (e.g. in TACO, 16.0% of meats and derivatives were UMP, 34.6% were PF, and 3.7% were UPF; whereas in the USDA 39.9% of meats and derivatives were UMP, 50.4% were PF, and 1.1% were UPF).

**Conclusions:** This food and nutrient database will allow the DietSys user to calculate the intake of foods, food groups, FPCs, and nutrient content for Brazilian, Argentinean, and North-American populations, and to prioritize regional food items or to select alternative items. This dynamic database allows the addition of other foods and nutrients in the future.

**Keywords:** DietSys, DietSys database, food and nutrient database, international nutrient database, international food database.

**Further collaborators:**

Scientific initiation group.

João Pedro Floriano, Iris Maciel Cavalcante, Vanessa de Castro Mello Macedo, Pietra Antônia Filiol Belin, Rayanne Carneiro dos Santos, Vanessa Mota, Gabriela Nadai.

144/1742

SOMATOTIPO AND NUTRITIONAL STATUS OF SCHOOLCHILDREN OF ETNIA MAPUCHE OF THE COMMUNE OF PADRE LAS CASAS-CHILE

Rosas Muñoz, Marcelo Elías.

MSc. Nutritionist. School of Nutrition and Dietetics. Santo Tomás University. Temuco. Chile.

**Background and objectives:** The Mapuche ethnic group, originally from southern Chile, is suffering from a migration from rural to urban, adapting to changes in current society, developing behaviors and lifestyles typical of urban and industrialized areas where it predominates excess of malnutrition. The objective of this research is to establish the impact of these social changes on the somatotype and nutritional status of Mapuche youth.

**Methods:** A descriptive, cross-sectional and quantitative study of 127 Mapuches schoolchildren of both sexes with their parents' consent was carried out in three rural schools in the community of Padre Las Casas, Chile. 74 men (58.3%) and 53 women (41, 7%), between 10 and 14 years of age. Measurements were taken of: weight, height, skin folds and bones diameters; following the ISAK protocol. BMI and nutritional status were determined according to the Chilean standard and somatotype (endomorphy, mesomorphy and ectomorphy) using the anthropometric method described by Heath & Carter. Student's t test and Mann Whitney U test were used to analyze the results (p <0.05).

**Results:** Men presented a mesoendomorphic somatotype (4.1 - 4.7 - 1.6). Women are endomesomorphic (5.0 - 4.2 - 1.3). Nutritional status showed that 37.8% of the men were obese and 16.2% were overweight. In the ladies, 34.6% were obese and 22.1% were overweight. When comparing by gender, significant differences were found in Endomorphism in favor of women (p = 0.01), but not in Mesomorphy and Ectomorphism, with no differences.

**Conclusions:** It is evident that in schoolchildren of the Mapuche ethnic group of both sexes a nutritional state of excess predominates. In relation to the somatotype, the women showed a higher relative adiposity than the men. The Obesigenic environment, which highlights the modification of lifestyle, food, and the effect of sedentarism is affecting the Mapuche population as well as the rest of the school population.

**Keywords:** Somatotype, Nutritional Status, Mapuches Schoolchildren.

**Further collaborators:**

Address of rural schools in the commune of Padre las Casas - Chile.

144/1765

EFFECT OF DIETS RICH IN SATURATED FATTY ACIDS ON THYMUS OF GROWING RATS

(1)Perris, Paula; (1)Fernandez, Inés; (2)Godoy, Maria Fernanda;

(3)Mambrin, Maria Cecilia; (4)Slobodianik, Nora H.; (1)Feliu, Maria Susana.

(1)PhD. University de Buenos Aires. Faculty of Pharmacy and Biochemistry. Nutrition and Food Science.; (2)Biochemical. University de Buenos Aires. Faculty of Pharmacy and Biochemistry. Nutrition and Food Science.; (3)Technical assistant. University de Buenos Aires. Faculty of Pharmacy and Biochemistry. Nutrition and Food Science.; (4)PhD. University of Buenos Aires, School of Pharmacy & Biochemistry. Dept. Nutrition & Food Science. Argentina.

**Background and objectives:** The importance of diet in maintaining health is widely accepted and recognized. Dietary lipids play an important role in the regulation of the immune system. Thymus shows important functional changes in response to nutritional disorders.

The aim of this work is to analyze the effect of diets rich in saturated fatty acids in normal and high concentration on thymus' fatty acid profiles of growing rats.

**Methods:** Weanling Wistar rats were fed during 10 (10D) and 40 (40D) days with 15% and 42% (F%=Kcal lipids/100total Kcal) of dietary fat provided by butter (F15 y F42 groups). Control group received normocaloric diet (soy oil, F%=15) according to AIN '93. Thymus was removed. Thymus fatty acid profiles were determined by gas chromatography (GC). The statistical analysis used analysis of variance (ANOVA) and Dunnett's post test (*p<0.01).

**Results:** Thymus fatty acid profile were (% area):

PALMITIC: F15-10D=27,05±5.01; F42-10D=25.75±3.63;
CONTROL 10D=25.96±3.23;
OLEIC: F15-40D=29,73±2,34; F42-40D=24,60±2,99; CONTROL 40D=27,79±3,73

F15-10D=19.00±5.35; F42-10D=22.01±5.37; CONTROL 10D=18.22±3.23; F15-40D=19,57±4,50; F42-40D=16,09±6,34; CONTROL 40D=16,84±5,20;

F15-10D=3.69±0.48*; F42-10D=4.82±0.40*; CONTROL 10D=10.26±1.37; F15-40D=2,29±0,72*; F42-40D=3,73±0,65*; CONTROL 40D=10,22±3,10

F15-10D=0,35±0.04*; F42-10D=0.34±0.04*; CONTROL 10D=0.59±0.09; F15-40D=0,37±0,16*; F42-40D=0,40±0,08*; CONTROL 40D=0,75±0,11;

ARAQUIDONIC: F15-10D=9.84±3.31; F42-10D=7.33±1.94; CONTROL 10D=10.46±2.60; F15-40D=9,26±2,02; F42-40D=11,66±3,33; CONTROL 40D=9,98±4,75

F15-10D=0.71±0.12; F42-10D=0.64±0.24; CONTROL 10D=0.50±0.12; F15-40D=0,62±0,26; F42-40D=0,24±0,11; CONTROL 40D=0,15±0,07

F15-10D=0.61±0.14; F42-10D=0.60±0.17; CONTROL 10D=0.52±0.16; F15-40D=0,57±0,21; F42-40D=0,73±0,19; CONTROL 40D=0,51±0,15.

**Conclusions:** All experimental groups showed decrease of linoleic and alfa linolenic acid.

The results observed on thymus lipid profile, demonstrate a decrease on the levels of essential fatty acids when a diet rich in saturated fatty acids is administered, independent of F%.

Thymus, characterized by a high rate of cellular turnover, is severely affected by nutritional imbalances and particularly by distortion in the proportion and type of fat.

Supported by UBACYT 20020150100011BA

**Keywords:** Thymus- essential fatty acids- diet- rat

a complex disorder that encompasses cardiovascular risk factors associated with abdominal obesity and insulin resistance. The metabolic syndrome has become the most frequently diagnosed, proving to be a trend for the next few years. According to the who, about 25% of adult Americans fit the profile that characterizes the syndrome. It is estimated that between 20-25% of the world population report SM.

The main objective of this study was to evaluate the risk factors that predispose to metabolic syndrome of São Camilo University Center workers, participants of the "HEALTH FOR ALL" project.

**Methods:** This study was carried out with 107 workers of both genders, aged between 18 to 60 years, with a predominance of younger adults that voluntarily were involved at the research. Were measured height and weight for the calculation of body mass index (BMI), waist circumference (CC), hip circumference and neck circumference as well as percentage of body fat and blood pressure. Others tests carried out: glycated hemoglobin, triglycerides, total cholesterol and his fractions. This work is part of the project presented by the ethics and Research Committee under paragraph 61/2014.

**Results:** It was found that 64.4% presented excessive weight, being 45.8% overweight, 21.5% with different degrees of obesity and only 31.8% had weight adequate. Of individuals diagnosed with metabolic syndrome (17.8% of the population), they all showed levels of diabetes diagnosed, glycated hemoglobin, abdominal obesity appears in both sexes, prevalent in these individuals with metabolic syndrome, and strongly associated with increase cardiovascular morbidity and mortality. In this same group, found himself high percentage of body fat, total and HDL quite diminished. 19.6% of the studied population showed hypertension. 53.2% of the population were sedentary.

**Conclusions:** This is a population with numerous risk factors for cardiovascular diseases. The results presented in the study, suggest the need for specific actions that intervene in factors that determine the triggering of the metabolic syndrome and that can contribute to the promotion of health.

**Keywords:** Nutritional Assessment; Cardiovascular Diseases; Metabolic Syndrome

144/1791

EVALUATION OF RISK FACTORS THAT PREDISPOSE TO METABOLIC SYNDROME THE WORKERS OF THE SÃO CAMILO UNIVERSITY CENTER PARTICIPANTS OF THE PROJECT "HEALTH FOR ALL" - SÃO PAULO - BRAZIL

**Background and objectives:** Inserted in the context of obesity and related co-morbidities, the metabolic syndrome (SM) is

144/1795

AN ASSESSMENT OF THE QUALITY OF DHS ANTHROPOMETRIC DATA, 2005-2014

**Background and objectives:** Providing reliable estimates of anthropometric indicators among children is important for monitoring global progress toward the World Health Assembly targets, and also for short and long-term nutrition and health interventions. The collection of anthropometric data has been a key component of the Demographic and Health Surveys (DHS) since 1986.

<footnote>(1)Korukian Freiberg, Clara; (2)Basso, Renata; (3)Bom, Juliana;</footnote>

<footnote>(3)Corcovado, Fabiana; (3)Silva, Bruna Carina; (3)Parise, Nicole;</footnote>

<footnote>(3)Camargo, Lais.</footnote>

<footnote>(1)MSc. Nutricionist. Nutrition Department. São Camilo University Center. São Paulo. Brazil.; (2)MSc. Farmaceutic. Nutrition Department. São Camilo University Center. São Paulo. Brazil.;</footnote>

<footnote>(3)Nutritionist. Nutrition Department. São Camilo University Center. São Paulo. Brazil.</footnote>

<footnote>(1)Kothari, Monica; (2)Kothari, Monica; (3)Pullum, Tom.</footnote>

<footnote>(1)PATH; (2)MS, MPH. Deputy MQSUN+/M&E Lead. Washington DC. PATH. USA; (3)PhD. Director of Research. Demographic Health Surveys. Rockville. Maryland. USA.</footnote>
To date, DHS has collected height and weight data for more than three million children and adults in 238 surveys in 77 countries. It is important to assess the quality of the nationally representative data for future improvements.

**Methods:** This analysis examines the quality of anthropometric data from 52 DHSs conducted between 2005 and 2014. The analysis includes height, weight, and age measurements of children under five years of age as well as three nutritional status indices—height-for-age (HAZ), weight-for-age (WAZ), and weight-for-height (WHZ)—that follow WHO guidelines. The data quality indicators used to investigate the measurements include: standard deviation of z-scores; heaping of measures of height, weight, and age; and the percentage of extreme cases flagged during data processing. In addition, linear regressions of the z-scores were conducted to examine the amount of heterogeneity in z-scores that can be explained by covariates, including cluster-level variation. The analyses identified surveys that have outperformed others in terms of anthropometric data quality along with surveys that have been deficient in data quality.

**Results:** The countries vary substantially in the data quality indicators examined. Some countries perform poorly on several of the data quality indicators, Albania and Benin, while other countries such as Colombia, Honduras, and Peru were identified as having high quality data. Of particular concern is the higher variability in the SD for children at younger ages, which may be due to the difficulty of measuring very young children lying down in contrast to measuring older children standing up.

**Conclusions:** Based on the results, the quality of anthropometric data can be improved in nationally representative surveys by including rigorous training on measurement of younger children. It is important to identifying new types of equipments to accurately measure the height/length of children, including digital and lightweight measuring boards.

**Keywords:** Anthropometry, stunting, nutritional status, z-score, DHS, data quality.

**Further collaborators:**

Shireen Assaf, PhD, Statistician, Demographic and Health Surveys, Rockville, Maryland, USA

(1)Reig García-Galbis, Manuel; (2)Albert Pérez, Enrique; (3)Mateu Olivares, Victoria; (4)Martínez-Espinosa, Rosa María; (5)Molina Vila, Mariola D.

(1)PhD. Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Atacama.; (2)Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Atacama (Chile); (3)Department of Nursing, Faculty of Health Sciences, University of Alicante (España).; (4)PhD. Division of Biochemistry and Molecular Biology, Department of Agrochemistry and Biochemistry, Faculty of Sciences. University of Alicante (España).; (5)PhD. Department of Mathematics, Faculty of Sciences, University of Alicante (España).

**Background and objectives:** Background: Metabolic syndrome (MS) currently affects to more than 20% of the adult population.

Objective: evaluate the variation of the expressions of loss in the ME in ≥ 18 years, through dietary intervention and / or physical exercise.

**Methods:** Method: four databases, Pubmed, CINAHL, ProQuest and Web of Science were used. Selection criteria: ≥ 18 years; diagnosed with MS; weight loss intervention programs, which use diet and exercise as tools; Interest in loss should be manifested through parameters and units; clinical trials published between 2005 and 2015, in English and Spanish, in peer-reviewed scientific journals. The protocol of the PRISMA method was used to analyse the information.

**Results:** only 2% of clinical trials were selected (1805). The most frequent characteristics are: ATPIII and FID, as diagnostic criteria; number of patients ≤100; male sex; located in Europe, the United States and Oceania; duration of ≤6 months; waist circumference (cm), BMI (kg/m2), weight (kg and%) and multidisciplinary interventions showed the highest losses.

**Conclusions:** Discussion: the heterogeneity in the design of clinical trials makes difficult to identify the interventions with the highest losses in the parameter analysed and which techniques are the most advisable to achieve this goal.

Conclusion: there is a great diversity in the diagnoses of MS and disparity in the design of these clinical trials. Therefore, a series of recommendations are presented for the design of future clinical trials and, in addition, the most adequate techniques for loss with the Extrapolation of two clinical guidelines for overweight and obesity (ACE / AACE and European Guidelines).

**Keywords:** metabolic syndrome, weight loss, fat loss, diet, exercise and lifestyle.

**Further collaborators:** Pérez Albert Enrique: collaborated in the selection of included clinical trials; elaboration of the tables and the flow diagram.

Poveda González Marina: collaborated in the selection of included clinical trials; elaboration of the tables and the flow diagram.

Martínez-Espinosa Rosa María: selection of the information of interest in the tables; information analysis using the PRISMA methodology; writing, translation and revision of the manuscript.

Molina Vila Mariola D: selection of information of interest in the tables; Information analysis using the PRISMA methodology; Writing, translation and revision of the manuscript.
Reig García-Galbis Manuel: collaborated in the selection of the included clinical trials; elaboration and design of the tables; information analysis using the PRISMA methodology; Writing of the manuscript draft.

VARIATION OF THE EXPRESSIONS OF LOSS IN
THE METABOLIC SYNDROME, IN CHILDREN
AND ADOLESCENTS: DIETARY INTERVENTION
AND PHYSICAL EXERCISE

(1)Reig García-Galbis, Manuel; (2)Pérez Albert, Enrique; (3)Mateu
Olivares, Victoria; (4)Martínez-Espinosa, Rosa María.

(1)PhD. Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Atacama.; (2)Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Atacama (Chile).; (3)Department of Nursing, Faculty of Health Sciences, University of Alicante (Spain).; (4)PhD. Division of Biochemistry and Molecular Biology, Department of Agrochemistry and Biochemistry, Faculty of Sciences. University of Alicante.

**Background and objectives:** Background: Metabolic syndrome (MS) affects ≥ 10% of the adolescent population worldwide. Objective: evaluate the variation of the expressions of loss in the MS in ≤18 years, through dietary intervention and / or physical exercise.

**Methods:** Method: search date, between 2005 and 2015, in English and Spanish, in peer reviewed journals and following the PRISMA method. The selection criteria were: diagnostic for MS, overweight, obesity, type II diabetes, insulin resistance, hyperinsulinemia, hyperinsulinism, hyperglycemia, dyslipidemia, glucose intolerance and / or prediabetes; Randomized clinical trials, ≤18 years of age; Intervention programs that use diet and / or exercise as a tool, with or without metformin (interventions showing an interest in weight loss).

**Results:** only 1.3% of the clinical trials were selected (924) and the use of the diagnosis of MS was not observed. The most frequent characteristics of the clinical trial selected were: they were carried out in North America; the number of patients ranges from 25 to 120; female sex; duration of 6 months; weight loss (kg), BMI (kg/m2, percentile) and multidisciplinary intervention reported the highest losses.

**Conclusions:** the design of the clinical trials is heterogeneous and no trials diagnosed as MS have been found. A series of recommendations are presented for the design of future clinical trials; the most adequate techniques for loss with the extrapolation of two clinical guidelines for overweight and obesity (AND and ISCI) are indicated and it is recommended to investigate why the diagnosis of MS is not used.

**Keywords:** metabolic syndrome, children, teens, diet and exercise.

**Further collaborators:**

Pérez Albert Enrique: collaborated in the selection of included clinical trials; elaboration of the tables and the flow diagram.

Mateu Olivares Victoria: collaborated in the selection of included clinical trials; elaboration of the tables and the flow diagram.

Martínez-Espinosa Rosa María: selection of the information of interest in the tables; information analysis using the PRISMA methodology; writing, translation and revision of the manuscript.

Reig García-Galbis Manuel: collaborated in the selection of the included clinical trials; elaboration and design of the tables; information analysis using the PRISMA methodology; Writing of the manuscript draft.

BETTER MICRONUTRIENT INTAKE COULD BE
RELATED TO PHYSICAL FITNESS IN OLDER
ADULTS?

(1)Aparicio Ugarriza, Raquel; (1)López Torres, Olga; (2)Maroto Sánchez, Beatriz; (3)Bibiloni, María del Mar; (4)Julibert, Alicia; (2)Palacios, Gonzalo; (3)Tur, Josep Antoni; (2)Gonzalez Gross, Maria Marcela.

(1)MSc. ImFINE Research Group. Department of Health and Human Performance. Universidad Politécnica de Madrid. Spain;

(2)PhD. ImFINE Research Group. Department of Health and Human Performance. Universidad Politécnica de Madrid. Spain;

(3)PhD. NUCOX Research Group. Fundamental Biology and Health Science. University of the Balearic Islands. Spain.; (4)MSc. NUCOX Research Group. Fundamental Biology and Health Science. University of the Balearic Islands. Spain.

**Background and objectives:** Diet and physical fitness (PF) have been described as major modifiable behaviours related to poor health. Indeed, diet and PF seem to be strong promoters of healthy ageing. Hence, the main aim of this study was to assess the association between micronutrient intake and PF in Spanish older adults.

**Methods:** 428 participants (43% males) aged over 55 years were recruited for the study. Dietary intake was assessed using two non-consecutive 24h dietary recalls. Energy intake (EI) and micronutrient intake were calculated through ALIMENTA software. Estimated average requirements (EAR) cut-off point method was applied to estimate the prevalence of nutrient intake adequacy/inadequacy. When EAR was not defined for a specific micronutrient, adequate intake (AI) was chosen. Energy expenditure (EE) was calculated using a validated physical activity questionnaire. Likewise, participants completed a battery of validated PF tests. The total score for each test ranged from 0 (worst) to 3 (best) points. The maximum score was 12 points. Scores of PF tests were added together and participants were divided into 3 groups (low, medium and high) using cluster statistical analyses. Data was analysed using generalized linear model.

**Results:** Inadequate intake for 11 and 8 micronutrients was observed in 9.8% and 11.4% of the subjects, respectively. More than 50% presented inadequate intakes for potassium, vitamin D, vitamin E, calcium, magnesium, vitamin B6, pantothenic acid and
**Conclusions:** The IFCT2017 shows that fish is the richest source for dietary B6. The dietary intake results suggest that, intake of vitamin B6 significantly varies among all age and sex groups. The dietary intake of vitamin B6 in the rural Indian population appears to be not adequate to meet the RDA across all age groups.

**Keywords:** Vitamin B6; Dietary intake; Indian rural population; RDA; 24 hours dietary survey.

144/1850

## ROLE OF A-TOCOPHEROL TRANSFER PROTEIN ON THE CELLULAR UPTAKE AND INTRACELLULAR LOCALIZATION OF A-TOCOPHEROL AND A-TOCOTRIENOL IN CULTURED LIVER CELLS

(1)Irías Mata, Andrea Paola; (2)Sus, Nadine; (3)Frank, Jan.

(1)MSc. Chemist. Division of Biofunctionality and Safety of Food. Institute of Biological Chemistry and Nutrition. University of Hohenheim. Germany.; (2)BTA. Chemist. Division of Biofunctionality and Safety of Food. Institute of Biological Chemistry and Nutrition. University of Hohenheim. Germany.; (3)PhD. Nutritionist. Division of Biofunctionality and Safety of Food. Institute of Biological Chemistry and Nutrition. University of Hohenheim. Germany.

**Background and objectives:** Since its discovery, vitamin E and its functions have been deeply studied. However, the mechanism underlying the intracellular localization and preferential retention of α-tocopherol (αT) in the body are still incompletely understood. The liver protein α-tocopherol transfer protein (α-TTP), located in the lysosomes is suggested to be involved in the preferential transport of αT in the liver. Despite the preferred affinity for αT, previous research shows a possible interaction of α-TTP with vitamin E metabolism that protects from metabolization other forms of vitamin E. The α-TTP role in the absorption and intracellular distribution of αT, but also the others forms need to be clarified. This research focuses on αT and its unsaturated isomer α-tocotrienol (αT3).

**Methods:** Time dependent absorption of αT and αT3 in HepG2, with and without αTTP expression, was investigated. Concentrations were measured inside and outside the cells by HPLC-FD over a time period of 72 hours. Maximum absorption times were selected for the intracellular distribution. This was ascertained using a density gradient centrifugation. Therefore HepG2 cells were separated into their cell compartments, identified by Western Blot, and αT and αT3 amounts were analyzed after 24 and 6 hours incubation with 50 µM of each compound.

**Results:** A continuous uptake of αT and αT3 in cells was determined, with no significant differences after 24 h. We observed a higher cellular uptake of αT3. αTTP did not reveal a significant enhance in the concentrations of each compound in cells. Intracellular distribution of αT and αT3 showed an accumulation in lysosomes, mitochondria and plasma membrane; being stronger in lysosomes at 6 h. No significant differences were detected for intracellular distribution between cells with and without αTTP expression.

**Conclusions:** Results suggest that αTTP is not essential for the uptake of the compounds in hepatocytes; its site of action is at a later step in the intracellular processing. The intracellular distribution might be because these organelles presumed to have higher levels of oxidative stress; or because is associated with the sites where αTTP is in the hepatocytes. However, with our results, an involvement of αTTP in specific transport inside cell compartments is still unclear.

**Keywords:** α-tocopherol. α-tocotrienol. α-tocopherol transfer protein. Intracellular distribution. Cultured liver cells.

**Further collaborators:**

MSc Daniela Stock.

Collaborates as MSc student. Division of Biofunctionality and Safety of Food. Institute of Biological Chemistry and Nutrition. University of Hohenheim. Germany.

144/1871

## MICRONUTRIENTS INTAKE, BODY COMPOSITION, AND LIPOPROTEIN-LIPID CONCENTRATIONS IN OBESE WOMEN

(1)Reis, Bruna; (1)Silva Duarte, Graziela Biude; (2)Vargas-Mendez, Ernesto; (3)Ferreira Pereira, Natália Barros; (4)Cercato, Cintia;

(5)Macedo Rogero, Marcelo; (6)Franciscato Cozzolino, Silvia.

(1)MSc. Nutritionist. Laboratory of Nutrition and Minerals. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Science, University of São Paulo.; (2)MSc. Biologist. Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Science, University of São Paulo.; (3)Student. Laboratory of Nutrition and Minerals. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Science, University of São Paulo.; (4)PhD. Physician. Department of Endocrinology, Faculty of Medicine, University of São Paulo.; (5)PhD. Nutritionist. Department of Nutrition, School of Public Health, University of São Paulo.; (6)PhD. Nutritionist. Laboratory of Nutrition and Minerals. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Science, University of São Paulo.

**Background and objectives:** Obesity is associated with important metabolic disorders and enhances the comorbidity of related disorders such as type 2 diabetes, hypertension, and cardiovascular disease. Many micronutrients are involved in reducing the risk of such metabolic disorders. Thus, the aim of this study was to evaluate the intake of selected micronutrients and their relation to body composition and lipoprotein-lipid concentrations among obese women.

**Methods:** We enrolled 71 obese women recruited in the outpatient clinic of endocrinology from Clinics Hospital of São Paulo, Brazil. To evaluate the habitual consumption of micronutrients, diet assessment was accomplished by using a 3-day nonconsecutive dietary food record and entered into the NutriQuanti Online Computerized System (http://www.nutriquanti.com.br). The nutrients analyzed were calcium, iron, magnesium, zinc, copper,
manganese, potassium, and selenium. Fasting blood samples were collected for analysis of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c) and triacylglycerol levels (TG). Pearson's correlations were calculated between micronutrients intake and body composition variables [body mass index (BMI) and waist circumference(WC)] and plasma lipoprotein-lipid variables (including the atherogenic indexes TG/HDL-c, TC/HDL-c and LDL-c/HDL-c ratios, which are powerful predictors of cardiovascular disease).

**Results:** The women aged 40.5±9.0 years and had a BMI of 35.56±5.88 kg/m² and WC of 100.20±9.27 cm. Some minerals were inversely correlated with body composition and atherogenic indexes. Magnesium intake was inversely correlated with BMI (r = -0.35, P = 0.003), WC (r = -0.44, P < 0.001), TC/HDL-c ratio (r = -0.26, P = 0.026), and LDL-c/HDL-c ratio (r = -0.29, P = 0.013). On the other hand, this intake was positively correlated with HDL-c (r = 0.27, P = 0.023). Copper (r = -0.25, P = 0.041) and manganese intake (r = -0.30, P = 0.013) were inversely correlated with WC. Sodium intake was positively correlated with TG levels (r = 0.26, P = 0.030) and TG/HDL-c ratio (r = 0.25, P = 0.037).

**Conclusions:** These results highlight the importance of healthy eating in body composition and risk of cardiovascular diseases among obese women.

**Keywords:** Obesity; Nutritional Assessment; Micronutrients; Cardiovascular disease; Atherogenic indexes.

**Further collaborators:** Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

**Methods:** Six specialists working in the area of clinical/outpatient nutrition and researchers/teachers in the nutrition area participated in the meeting. The guests were previously given a script, containing objectives, justifications and methodology addressing information on the conduction of the "experts' panel" and harmonization of food database. The classification of food in groups proposed by the researcher, based on household food availability data between 2008-2009 Brazilian Household Budget Survey, was sent to the experts for prior appraisal. During the meeting, the questions of harmonization were raised, followed by discussion.

**Results:** The panel contributed to the reorganization of food groups. The 1121 foods previously distributed in 15 groups and 33 subgroups, now consist in 14 groups and 42 subgroups. Culinary preparations and foods with a higher degree of industrialization, such as tapioca, fruit juice/soft drink, mate tea, couscous and sweetener, were some of the items that presented the greatest difficulty in being classified into groups.

**Conclusions:** The panel of experts proved to be an adequate tool to find consistent answers taking into account the experience of other professionals/researchers in the field of nutrition. The specialists' participation allowed the articulation of different visions and reduction of possible tendencies coming from the exclusive look of the researcher.

**Keywords:** Expert's panel. Nutrition. Food classification.

144/1882

ASSESSMENT OF CONSUMPTION AND CHALLENGE OF FOOD CLASSIFICATION IN GROUPS: EXPERTS' PANEL REPORT

(1)de Andrade Gomes, Adriana; (2)Santos, Débora Martins; (3)Barbosa Brito, Flávia.

(1)Nutritionist. PhD Student in Food, Nutrition and Health Program. Rio de Janeiro State University. Brazil;

(2)PhD. Nutritionist. Adjunct Professor of the Social Nutrition Department. Rio de Janeiro State University. Brazil.; (3)PhD. Statistician. Adjunct Professor of the Social Nutrition Department. Rio de Janeiro State University. Brazil.

**Background and objectives:** The panel of experts is a research technique employed in social sciences that is also used in investigations that include multi-method conceptions. The proposal is to bring together experts to produce suggestions for solving the doubts and gaps existing in a certain subject. One of the great challenges of assessing food consumption has been the structuring of harmonized food databases. How and where to allocate food in groups requires the structuring of defined parameters, especially when comparing the results within and between studies. The present study reports the use of this technique as a strategy to aid the decision regarding the allocation of food in groups, aiming the structuring of a harmonized food database.

144/1890

BRAZILIAN FOOD DATABASE HARMONIZATION: WHY FOOD GROUPING IS SO IMPORTANT?

(1)de Andrade Gomes, Adriana; (2)Santos, Débora Martins; (3)Barbosa Brito, Flávia.

(1)Nutritionist. PhD Student in Food, Nutrition and Health Program. Rio de Janeiro State University. Brazil;

(2)PhD. Nutritionist. Adjunct Professor of the Social Nutrition Department. Rio de Janeiro State University. Brazil.; (3)PhD.

Statistician. Adjunct Professor of the Social Nutrition Department. Rio de Janeiro State University. Brazil.

**Background and objectives:** Recent Brazilian population based studies analyzing food intake reports different food grouping, as shown by bibliographic research. This issue may affect the characterization of nutritional profile and restrict comparison between studies, even when they report results from the same dataset. Furthermore, the food identification through its group is almost mandatory when the goal is to develop food based approaches. As discussed by European Food Safety Authority (EFSA), "food classification and description system allow to improve the ability to capture all the useful details of food groups in exposure assessments", a crucial requirement for the risk assessment process for public health nutrition intervention. Additionally, in Brazil, we need to consider our food diversity, which may introduce misunderstandings in the food identification and group allocation, especially when the intention is to compare studies within and between countries.
**Methods:** This study proposes a standardized and harmonized food classification system using data from the 2008-2009 Brazilian Household Budget Survey. The discussion was based on the Data Food Networking (DAFNE) procedures.

**Results:** Harmonization procedures were based on food characteristics (nutritional/botanical), criteria used in previous studies, international and national food classification system (Codex Alimentarius and Anvisa food) and expert panel consultation. Therefore, were built 14 main food groups and 42 subgroups.

**Conclusions:** The proposed harmonization system allowed food grouping in accordance to pre defined criteria. Our results suggests that the use of this system may improve between and within studies (at national and international levels) comparison.

**Keywords:** Food classification. Nutrition. Food composition date.

between the differences in BMI z-score and in height z-score. Confirming this result, it was observed that children with the highest BMI in 2016 were those that presented the greatest difference in height between the two evaluations (Pearson r = 0.24, 95%CI: 0.14 to 0.34, p<0.001).

**Conclusions:** The results observed show that there is a correlation between the greater growth in height between 2 and 5 incomplete years of age and the risk of developing overweight.

**Keywords:** Growth, Body Height, Obesity, Overweight, Preschool.

**Further collaborators:**

Janaína Paula Costa da Silva. PhD. Nutritionist. Federal University of Rio Grande do Norte. Brazil.

Viviane Gabriela Nascimento. PhD. Nutritionist. Department of Maternal and Child Health. School of Public Health. University of São Paulo. Brazil.

GREATER HEIGHT GROWTH AND OVERWEIGHT IN PRESCHOOL CHILDREN

**Background and objectives:** Not unlike the world population, which experiences an important process of nutritional transition, an important increase in the diagnosis of overweight and obesity in childhood has been observed since the 1990s. Monitoring the nutritional status of children may help identifying patterns that may lead to the development of excess weight, since investigations have considered that differences in growth and body composition during childhood are determinants of nutritional status, in childhood and/or later. The purpose of the study was to verify if there is a relation between the greater growth in height and the excess of weight in children in preschool age.

**Methods:** An analytical cohort study of a representative sample of preschool children in a city in the countryside of São Paulo - Brazil. Weight and height of the children were collected in two moments: 2014 and 2016. Based on the anthropometric data and the age, the children were evaluated according to the anthropometric indices calculated in z-score with Anthro software v.3.2.215: height for age, and Body Mass Index (BMI) for age. The data analysis was performed using the Stata statistical package, version 9.2. The study was approved by the IRB of the School of Public Health/University of São Paulo.

**Results:** The final sample consisted of 359 children, 52.9% female, who had a mean age of 2.4 years on the first evaluation, and 4.8 years on the second evaluation. There was a positive and significant correlation (Pearson r = 0.28, 95%CI: 0.18 to 0.37, p<0.001)

THE POTENTIAL OF FOODBOOK24 TO COLLECT NATIONALLY REPRESENTATIVE NUTRIENT INTAKE DATA

**Background and objectives:** National food consumption surveys are necessary to estimate dietary intakes of populations from specified regions for the purposes of: (i) evaluating compliance with dietary guidelines (ii) identification of deficiency or excess intakes of particular foods or nutrients and (iii) to investigate food safety risks such as contaminant exposures. However, there are many constraints to conducting large surveys including significant cost, time and participant burden. The aim of this study is to investigate the comparability of data collected from the Foodbook24 (a web based dietary assessment tool developed for the Irish adult population) Proof of Principle (PoP) study to the dietary intake data from most recent Irish national food consumption survey.

**Methods:** The Foodbook24 PoP study involved the web based, self-administered 24 hour recall tool being made freely available to the Irish adult population. The data collected as part of the PoP study was weighted to represent the population of participants that completed the National Adult and Nutrition Survey (NANS) (2008-2010). The comparison of weighted mean daily nutrient intake data collected from the Foodbook24 PoP study (n= 330 plausible reporters) and the mean daily nutrient intake data collected

<footnote>(1)Forster Lopes, Amanda; (2)Mara Braga Rocha, Elida; (3)Bertoli, Ciro;</footnote>

<footnote>(3)Leone, Claudio.</footnote>

<footnote>(1)MSc. Nutritionist. Department of Maternal and Child Health. 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. Pediatrician. Department of Maternal and Child Health. School of Public Health. University of São Paulo. Brazil.</footnote>

<footnote>(1)Timon, Claire; (2)Blain, Richard; (3)Pigat, Sadrine; (4)Bompola, Foteini; (5)Walton, Janette; (6)Flynn, Albert; (7)Gibney, Eileen.</footnote>

<footnote>(1)Post doctoral researcher. Institute of Food and Health. UCD. Dublin. Ireland.; (2)Research assistant. Institute of Food and Health. UCD. Dublin. Ireland; (3)Head of Food and Nutrition. Creme Global. Dublin. Ireland; (4)Food Safety Scientist. Creme Global. Dublin. Ireland; (5)Research Fellow. School of Food and Nutritional Sciences. UCC. Cork. Ireland; (6)Professor. School of Food and Nutritional Sciences. UCC. Cork. Ireland; (7)Lecturer. Institute of Food and Health. UCD. Dublin. Ireland.</footnote>
from NANS (n=1051 plausible reporters) was conducted using the Wilcoxon-Mann-Whitney U-test in Creme Nutrition® software.

**Results:** Preliminary results highlight similar mean daily intakes for the majority of nutrients investigated. Percentage difference between mean daily intakes ranged from as little as 0.5% (potassium mg/day) to 35% (vitamin C mg/day). Despite weighting the PoP survey data, there were significant differences for some nutrient intakes however, for others e.g. energy (kcal/day), carbohydrate (g/day), iron (mg/day) and sodium (mg/day), there was no significant difference.

**Conclusions:** Foodbook24 (and similar validated web based dietary assessment methods) may offer a solution to the current constraints associated with the collection of data from large populations. Although further analysis is required, Foodbook24 has potential to assist in the collection of data in national nutrition surveys and also to facilitate the collection of rolling data intermittently between surveys.

**Keywords:** Foodbook24, web based, dietary assessment, consumption survey, comparison.

144/1904

NUTRITION STATUS AND RISK FACTORS ASSOCIATED IN OF HOSPITALIZED CHILDREN AND ADOLESCENTS IN THE PEDIATRIC SERVICE AT HOSPITAL SÃO JOÃO PORTO

**Background and objectives:** Identifying malnourished children/adolescents at hospital admission is important for their clinical evolution and growth. It is fundamental to research the risk associated.

The aim is to assess the nutritional status of an inpatient paediatric population at the Paediatric Service/Hospital São João (PSHSJ) and identify the risk factors responsible for their nutrition status impairment.

**Methods:** We included 813 patients, between the ages of 0-18 years old, who were admitted to the PSHSJ, from 2/19/2016 to 3/30/2017. The Anthropometrics Measure (AM) include weight and length/stature and it was calculated the weight/length index (W/L) for children ≤2 years old, body mass index (BMI) for >2 years old according World Health Organization (WHO), and the

respective z-score. Based on Fenton intrauterine growth curves, the newborn was classified as intrauterine growth restriction (IUGR), adequate for gestational age (AGA) or large for gestational age (LGA). The results are present in the total sample and per age groups: [0-2] years; [2-5] years; [5-10] years and >10 years. Statistic analyses were performed with SPSS® and the protocol was approved by Ethic Committee of Hospital São João.

**Results:** Of the 813 patients, 54,5% were males and 44,6% females on average 5,7±5,5 years. It was found 17,5% of undernutrition and 23,6% of overweight/obese on the admission. The higher frequency of undernutrition was verified in the first two years of life (25%) but in the other hand 34,8% of overweight/obese was found in school age ([5-10] years) with significant statistically difference between the groups (p=<0,001).

The multivariate analysis for children risk factors associated with child malnutrition we observed that a lower risk of undernutrition in the children/ adolescents was associated with age ([2-5] years: OR =0,320 (p=0,016); [5-10] years: OR=0,140 (p=0,002); >10 years: OR=0,005 (p=0,194)), in comparison with a younger group ([0-2] years) and birth weight (AGA: OR=0,285 (p=0,011)), in comparison with IUGR.

**Conclusions:** The results seem to indicate a very high prevalence of undernutrition, particularity in the first two years old and overweight/obese among the oldest.

This reinforces the importance of adequate nutritional assessment of the inpatient children/adolescents to prevent this deterioration during the hospitalization stay.

**Keywords:** children/adolescents, nutrition status assessment, malnutrition, risk factors

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COMPARING THE EFFECTIVENESS AND COST-EFFECTIVENESS OF FACILITY- VERSUS COMMUNITY-BASED DISTRIBUTION OF MICRO-NUTRIENT POWDERS IN RURAL UGANDA

**Background and objectives:** Micronutrient powders (MNP) are one of the few available nutrition interventions shown to reduce anemia and iron deficiency. While efficacy is well established, regular and sustained use of MNP in program settings has faced challenges. To better understand MNP delivery channels, we compared the effectiveness and cost-effectiveness of facility versus community-based distribution.

<footnote>(1)Silva, Diana; (2)Silva, Sara; (3)Rola, Marta; (4)Camila, Cláudia;</footnote>

<footnote>(5)Guerra, António.</footnote>

<footnote>(1)PhD. Nutritionist. Faculty of Nutrition and Food Sciences of the University of Porto. Nutrition and dietary unit and Integrated pediatric hospital of São João Hospital Center. Portugal; (2)Dr. Nutritionist. Integrated pediatric hospital of São João Hospital Center. Portugal; (3)MSc. Nutritionist. Nutrition and dietary unit and Integrated pediatric hospital of São João Hospital Center. Portugal; (4)PhD. Stastit. Biostatistics and Medical Informatics Service of Faculty of Medicine of Porto University. Porto; (5)PhD. Pediatrician. Nutrition unit of Integrated pediatric hospital of São João Hospital Center. Faculty of Medicine of Porto University. Porto.</footnote>

<footnote>(1)Namaste, Sorrel; (2)Richardson, Belinda; (3)Ssebiryo, Francis;</footnote>

<footnote>(4)Katuntu, David.; (5)Vosti, Stephen; (6)D'Agostino, Alexis.</footnote>

<footnote>(1)MHS. DrPH. Nutritionist. SPRING Project. Helen Keller International. USA.; (2)MSc. Economist. SPRING Project. John Snow Inc. USA;; (3)MSc. Monitoring and Evaluation. SPRING Project. John Snow Inc. Uganda; (4)MPH. MBA. Nutritonist. SPRING Project. John Snow Inc. Uganda; (5)PhD. Economist. Department of Agricultural and Resource Economics. University of California Davis. USA.; (6)MPP. Monitoring and Evaluation. SPRING. John Snow Inc. USA.</footnote>
**Methods:** We conducted the randomized intervention study in Namutumba, Uganda. The six sub-counties in Namutumba were randomly allocated to either a health facility (HF) or voluntary health team members [(VHT) (i.e. community health worker)] distribution arm. Individual packets containing 30 MNP sachets, a two-month supply, were available to caregivers from February to November 2016. Cost data were continuously collected, and included total direct and indirect costs to NGO implementers, delivery channel providers, and beneficiaries. A cross-sectional survey was conducted at the end of the intervention to obtain data on the following program outcomes: coverage (consumed MNP in the previous 24 hours), intake adherence (received more than 2 packets of MNP), and appropriate use (no more than one sachet per day, MNP consumed with food, and minimum of 3 sachets consumed in the previous week). Unweighted and unadjusted data were analyzed based on intention to treat using chi-square tests.

**Results:** Data for analysis were available on 1060 children 8-23 months. Nearly all caregivers had heard of MNP (100% VHT versus 98% HF, p<0.006) and most caregivers had received MNP at least once (98% VHT versus 84% HF, p<0.001). Coverage (54% vs 33%, p<0.001), intake adherence (59% vs 15%, p<0.002), and appropriate use (39% vs 19%, p<0.001) were higher in the VHT compared to the HF arm. Preliminary data on the incremental cost-effectiveness ratio (taking into account costs, program outcomes, and delivery channel) indicate the VHT arm was more cost-effective.

**Conclusions:** A community-based MNP delivery channel was more effective and more cost-effective at producing desired program outcomes compared to facility-based distribution. However, the difficulty in maintaining high levels of the desired program outcomes in both the facility and community-based delivery channels, as is often the case with other behavioral change interventions, may compromise sustainability.

**Keywords:** micronutrient powder. nutritional supplementation. infant and young child feeding. cost-effectiveness. delivery.

To evaluate the prevalence of anemia in preschool children in two provinces of eastern region of Cuba and the relation to food intake.

**Methods:** Children of 6 to 59 months living in provinces of Santiago de Cuba (Mella, La Maya and Santiago de Cuba municipalities) and Holguín (Frank País, Sagua de Tánamo, Antilla and Holguín municipalities). Hemoglobin (Hb) was measured by hematological cell counter ABX Micros 60 and anemia was defined as hemoglobin <110g/L in children. Food frequency questionnaire one month previous was used. The foods were classified as meat (red meat, poultry, fish and viscera), vegetables (lettuce, tomato, spinach, chard, carrot, okra, parsley and watercress), fruits (orange, tangerine, grape fruit, guava, papaya, mango, tamarind, banana, watermelon) and legumes (beans, pea, lentils, chickpea. Frequency intake was considered: "Frequently" (over 3 times a week or more), "Few Frequently" (intake below 3 times a week) and Never in this period.

**Results:** 450 children were included in the study. Anemia was found in 22.7% of the children. The percentage of children who consume meat, eggs, vegetables and legumes Frequently were low (53,5%, 47,5%, 40,3% and 30,3% respectively). Fruits were consumed Frequently in the 68.8% of the children. Poultry and Tomato were the most food intake in the respective group (36.7% and 38,1%). Anemia was significantly associated with Low Frequently intake of fruit (OR=2.26 95%CI=1.41-3.62), vegetables (OR=2.24 95%CI=1.35-3.71), legumes (OR=1.85 95%CI=1.09-3.13) and eggs (OR=1.68 95%CI=1.05-2.68).

**Conclusions:** Anemia is a moderate health problem in eastern provinces of Cuba. Low intake of meat, vegetables, eggs and legumes were found. The Low Frequently intake of food enhancer of iron absorption is the principal factor associated to anemia in children studied.

**Keywords:** Anemia, preschool children, food intake, Cuba

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## ANEMIA, LOW CONSUMPTION OF IRON-CONTAINING FOODS AND ENHANCER OF IRON ABSORPTION IN PRESCHOOL CHILDREN OF THE EASTERN PROVINCES OF CUBA, 2016

(1)Basabe Tuero, Beatriz; (2)Pita-Rodríguez, Gisela María; (3)Puentes Márquez, Ileana; (4)Arocha Oriol, Caridad; (5)Herrera-Javier, Dania.

(1)Phd. Department of Biochemistry and physiology. National Institute of hygiene, epidemiology and Microbiology.; (2)Msc. Doctor in medicine; (3)Msc; (4)Th.

**Background and objectives:** Anemia is the main nutritional health problem in preschool children in Cuba in spite of the multiples fortified food and supplemental intervention. Iron deficiency is the principal cause of anemia; other causes are invoked such as deficiency of other micronutrients, infection and inflammation. Eastern provinces remain as the most vulnerable region of the country.

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## DIETARY IRON BIOAVAILABILITY: AGREEMENT BETWEEN ESTIMATION METHODS AND ITS ASSOCIATION WITH SERUM FERRITIN CONCENTRATIONS OF WOMEN AT CHILDBEARING AGE

(1)De Carli, Eduardo; (2)Dias, Gisele Cristina; (3)Morimoto, Juliana Massami; (4)Colli, Celia.

(1)PhD. Nutritionist. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil.; (2)BSc. Nutritionist. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil.; (3)PhD. Nutritionist. Center for Biological and Health Sciences. Mackenzie Presbyterian University. Brazil.; (4)PhD. Pharmacist. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil.

**Background and objectives:** Over the past 40 years, many iron bioavailability models have been developed aiming to re-
late diet and iron status. However, their precision and accuracy
are questionable and studies that validate their practical use are
scarce. Here, we estimated dietary iron bioavailability of women
at childbearing age using a probabilistic approach and meal-based
or complete diet-based algorithms. Also, we tested associations of
these estimates to each other and to body iron stores, according to
serum ferritin concentrations.

**Methods:** Diet was assessed by three non-consecutive computerized food records from 127 university students (18-42 years old) at apparently steady-state body iron. In a probabilistic model, simulated distributions of iron absorption values from individual diets (1-40%) were contrasted with distributions of iron physiological requirements among users and non-users of hormonal contraceptives, separately. An average iron bioavailability was assumed as that absorption of dietary iron matching with the prevalence of women whose iron requirements were not attended at the moment of evaluation (ferritin < 15 µg/L). Moreover, estimates of five different algorithms (two of them based on complete diets) were determined. The association between measurements and serum ferritin was tested by linear regression.

**Results:** Iron intake and inadequacy were 10,9 mg/d and 12,6%, respectively. Although correlated (P < 0.001), all algorithm estimates differed from unity. In particular, bioavailabilities from meal-based (11.6-12.8%) or complete diet-based algorithms (8.5-8.9%) differed (P < 0.001). Meanwhile, all these estimates diverged from that calculated by probabilistic approach (17.2%). No significant association was found between serum ferritin and bioavailability measured with Monsen et al. (1978), Reddy et al. (2000) or Armah et al. (2013) algorithms. Nevertheless, after adjusting for non-dietary variables, differences from 30 to 37% in means of serum ferritin were found between women classified according to the median or the extremes tertiles of bioavailable iron measured with Hallberg & Hulthén (2000) and Collings et al. (2013) algorithms.

**Conclusions:** Measures of dietary iron bioavailability disagree when estimated with algorithms or probabilistic model. The association between serum ferritin and estimates of two algorithms suggests good performance in ranking diets and/or meals according to bioavailable iron contents.

**Keywords:** Iron status; algorithm; probabilistic approach

**Further collaborators:**

Pryscila Dryelle Souza Teixeira. MSc. Nutritionist. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil.

**Background and objectives:** Factor analysis methods using individual dietary data are frequently employed to describe dietary patterns. However, there is a scarcity of data on individual diets while household consumption expenditure surveys (HCES) are available in many countries. So far, factor analysis methods have not been applied to household dietary data. We aim to use this data source to assess changes in diets over time.

**Methods:** We analyzed data from seven rounds of the Bangladesh Household [Income and] Expenditure Surveys (H[I]ES) from 1985 to 2010, and derived dietary patterns from 52,380 households using principal component analysis. We used logistic regression to assess associations between dietary patterns, survey years, and socioeconomic characteristics of households.

**Results:** Six dietary patterns were identified which explained 26% of the variance in dietary intake: Modern (6%); traditional fish (5%); traditional vegetables/fruits (4%); milk, snacks, and sweets (4%); and two starchy monotonous diets – one with potatoes and one with taro (3% each). All diets were present in all survey years, though a quarter of households were not associated with any identified dietary pattern. The proportion of households following the “traditional fish” and “milk, snacks, and sweets” dietary patterns declined between 1985 and 2010, while other patterns increased. All dietary patterns, except the starchy monotonous diet with taro, were associated with higher household per capita expenditure. Four diets were associated with rural locality: traditional vegetables/fruits (OR 1.4, p<0.01); milk, snacks, and sweets (OR 1.8, p<0.01); and the two starchy monotonous diets (OR 2.6, p<0.01; OR 4.0, p<0.01). Households with children had greater odds of consuming modern (OR 1.5, p<0.01); traditional vegetables/fruits (OR 1.1, p<0.01); and milk, snacks, and sweets (OR 1.8, p<0.01) diets. Two diets were associated with Hindu households: milk, snacks, and sweets (OR 1.5, p<0.01) and the starchy monotonous diet with taro (OR 1.3, p<0.01).

**Conclusions:** Dietary patterns can be identified from household consumption data and are similar to those obtained from individual data in number and amount of variance explained. In Bangladesh, dietary patterns have changed gradually over time, but change has been limited among the poorest.

**Keywords:** HCES; Dietary change; Expenditure; Bangladesh

<footnote>(1)Waid, Jillian; (2)Gabrysch, Sabine; (3)Sinharoy, Sheela.</footnote>

<footnote>(1)M.S.W., Director - Research, Learning, and Evaluation, Helen Keller International, Bangladesh Country Office, Bangladesh;</footnote>

<footnote>(2)PD Dr. med., MSc, PhD, Head, Unit of Epidemiology and Biostatistics, Institute of Public Health University of Heidelberg, Germany; (3)MPH, PhD Candidate, Laney Graduate School, Nutrition and Health Sciences Program, Emory University, USA.</footnote>
# CHARACTERIZATION OF THE NUTRITIONAL STATUS, SUGAR AND TOTAL FAT CONSUMPTION AMONG PRESCHOOL AGE PANAMANIAN CHILDREN

(1)Montero, Ivania; (2)Farro, Katherine; (3)Rios, Israel; (4)De Caballero, Eira.

(1)Nutritionist.Nutrition and Dietetic Department.Medicine School.University of Panama.Panama City. Panama;

(2)Nutritionist.Nutrition and Dietetic Department.Medicine School.University of Panama.Panama City.Panama; (3)MSc. Nutritionist. Nutrition and Dietetic Department. Medicine School. University of Panama. Panama City. Panama; (4)MPH.

Nutritionist.Nutrition and Dietetic Department. Medicine School. University of Panama. Panama City.Panama.

**Background and objectives:** The increased prevalence of infant obesity is a current public health concern in Panama. The present study aimed to determine the nutritional status, sugar and total fat consumption among preschool-age children in institutional kinder gardens in Panama.

**Methods:** A cross-sectional study with 100 preschool-age children in three institutional kinder gardens at Panama District (Pedregal, San Francisco and Parque Lefevre). Data was collected from January-March 2016. A semi-quantitative food frequency questioner was used to estimate sugar and total fat consumption and was sought from the Institute of Nutrition for Central America and Panama Food Composition Table. Anthropometric (weight and height) were using to calculate HAZ and BAZ according with WHO2008 growth standards.

**Results:** Mean age and standard deviation (SD) was 49.6±14.0 months (45%) female. The forty percent was classified as overweight, 62.5% reported a high and very high consumption of sugar. Sugar consumption geometrical mean and ±1SD was found higher in overweight 531 (293.2-961.2) g/week than in non-overweight 237 (132.1-426.2) g (ttest, p<0.05).

**Conclusions:** High prevalence of overweight was observed. The sugar and total fat consumption was very high taking into consideration the WHO recommendations. Nutrition policy should be put in place in order to regulate the consumption of ultra-processed and sugar drinks among preschool age children. Nutrition education could be used to promote healthy eating habit among overall school community (parents, teachers, principal and community).

**Keywords:** Infant Obesity, Nutrition, Dietary intake, Malnutrition.

# KNOWLEDGE AND PRACTICES OF PROTEIN SUPPLEMENTS CONSUMPTION AMONG PEOPLE WHO ATTEND GYMS IN PANAMA

(1)De La Cruz, Danaé; (1)Cargill, Ariel; (2)Rios-Castillo, Israel.

(1)Nutritionists, Nutrition and Dietetic Department, Medicine School, University of Panama, Panama City, Panama; (2)MSc, Nutritionist, Nutrition and Dietetic Department, Medicine School, University of Panama, Panama City, Panama.

**Background and objectives:** The aim of this study was to describe the knowledge and practices of consumption of protein supplements in people who exercise in gyms in Panama City and the relationship between the protein supplementation and the knowledge that individuals have about it.

**Methods:** It was a cross-sectional descriptive study. A total of 163 subjects who exercise in five gyms of Panama City were part of this study. A survey of 24 questions was applied divided in three categories: demographic information, knowledge of protein and information on the protein consumption. The univariable statistical analysis was performed by means of the Chi2 test.

**Results:** Forty nine percent of the participants were using protein supplements. Of those who consumed protein 41.3% had adequate knowledge and 58.8% had inadequate knowledge. The main reason for the consumption of protein supplements was to increase muscle mass (36%). The most commonly used protein supplement was whey protein and the person who encouraged the consumption of these supplements was the trainer. No significant relationship was found in relating the knowledge of the participants regarding the previous knowledge of side effects at the p = 0.078. In assessing whether participants continue to use protein supplements despite knowing the risks associated with excessive intake, 60% said no, while 40% would continue use. The intake of protein supplements has become a common practice among people attending the gym.

**Conclusions:** The results show that the use and consumption pattern of protein supplements among those who attend gyms in Panama City, were found to be similar to those who exercise at gym around the world. It is needed more scientific evidence to know if they are actually working and not attributing the achievement to a placebo effect or some other external factor. As future research discovers additional problems with excessive supplementation, it will be important to educate people about the known risks and how they can obtain the right amount of protein through food and avoid consuming supplements.

**Keywords:** protein supplements, gym, knowledge, consumption of supplements, physical activity.
URINARY SODIUM AND POTASSIUM EXCRETION IN ADULT POPULATION FROM QUITO

(1)López, Pablo; (2)Muñoz, Fabián.

(1)MD. MSc. Professor. Human Nutrition Undergraduate Program. Pontifical Catholic University of Ecuador (PUCE).; (2)Estadístico. VISOR Statistical Analysis. Quito.Ecuador.

**Background and objectives:** High sodium intake and potassium reduction in the diet are associated with the increase of blood pressure. Identifying sodium and potassium intake is important in order to estimate the risk of high blood pressure

**Methods:** Through a sectional study of 117 cases, 43.6% males (n = 51) and 56.4% (n = 66) females, aged between 25-64 years, we analyzed 24-hour urine samples using the automated Ion-selective electrodes (ISE) to measure urinary sodium and potassium levels. The participants, Quito residents, did not report diagnosis of hypertensive disease, heart disease, nephropathy or change in their eating habits three months before the study.

**Results:** The average consumption of sodium estimated by 24-hour urinary excretion is 169.2 mEq/L, being higher in males (187.8 mEq/L) than in females (154.7 mEq/L). Moreover, the indicated values far exceed the safety recommendations for normotensive populations (90 to 130 mEq/L). The average of salt intake reached was 9.7 g / day, higher in men than in women (10.8 g/d and 8.9 g/d, respectively). Moreover, 94.1% of the men exceed the safe levels of their consumption (<6 g/d), in the case of women reached 72.7%. On the other hand, potassium consumption reached 44.4 mEq/L, below the recommended minimum of the ion (50 mEq/L). Overall, we noticed a significant imbalance of the sodium: potassium relation that is 3.8: 1, well above of the tolerable optimal ratio (1.4: 1).

**Conclusions:** The adults from the study show high sodium intake and low potassium that would result in adverse effects to maintain blood pressure levels and increased risk of cardiovascular disease.

**Keywords:** sodium, potassium, intake dietary

**Conflict of Interest Disclosure:** The authors declare no conflict of interest. This study was funded by PUCE.

**Further collaborators:**

Francisco Coronel. Nutricionist. Human Nutrition Undergraduate Program. Pontifical Catholic University of Ecuador (PUCE).

ENERGY AND MACRONUTRIENTS DIETARY INTAKE IN FEMALE SEMI-PROFESSIONAL CLASSICAL BALLET DANCERS

(1)Barbosa, Giovanna; (1)Ferreira, Rannapaula; (1)Avelino, Erikarla;

(2)Leal, Leilane; (3)Nunes, Adriana; (4)Vale, Sancha; (5)Leal Lima Maciel, Bruna.

(1)Nutrition Student. Nutrition Department. Federal University of Rio Grande do Norte. Brazil; (2)MSc Student. Postgraduate Nutrition Program, Nutrition Department. Federal University of Rio Grande do Norte. Brazil; (3)PhD. Clinical Medicine Department. University Onofre Lopes Hospital. Federal University of Rio Grande do Norte. Brazil.; (4)PhD. Nutrition Department. Federal University of Rio Grande do Norte. Brazil;

(5)PhD. Postgraduate Nutrition Program. Federal University of Rio Grande do Norte. Brazil.

**Background and objectives:** Classical female ballet dancers are dependent in aesthetic and weight for performance, which may increase the risk for energy intake imbalance. Nevertheless, little is known about eating behaviors of trained classical ballet dancers. This study aimed to investigate energy and macronutrient intake of semi-professional female classical ballet dancers.

**Methods:** Twelve female classical ballet dancers were evaluated for energy and macronutrients intake, comparing the results with sedentary women, matched by age (total mean age 26.05 ± 9.94 years). Three 24 h recall were done for each participant. Energy intake and requirements were estimated using the Institute of Medicine recommendations. Differences between dietary intakes and daily requirements were performed for data analysis. Shapiro-Wilk normality test was performed and results are shown as median – interquartile range. Wilcoxon test was used to compare differences in energy and macronutrients intake vs requirements in the same group. Mann-Whitney test was used to compare the two studied groups.

**Results:** Classical ballet dancers showed a high energetic imbalance when compared to sedentary controls (-857.71 – 1027.57 Kcal vs -126.61 – 891.56 Kcal, p = 0.034). Carbohydrate energy contribution in dietary intake was lower in classical ballet dancers when compared to sedentary controls (52.13 – 7.18% vs 56.03 – 8.12%, p = 0.047). Lipid and protein energy contribution in dietary intake were not different between groups, with medians of 29.01 – 9.55% and 17.40 – 6.41%, respectively. Nevertheless, classical ballet dancers consumed significantly more protein per body weight when compared to sedentary controls (1.64 – 1.24 g.Kg-1 vs 1.31 – 0.51 1.24 g.Kg-1, p = 0.025). Fiber intake was lower than recommended in both groups, and classical ballet dancers intake was -8.39 – 7.36 g less than recommended (p = 0.005).

**Conclusions:** We conclude that the evaluated semi-professional ballet dancers energy intake is significantly less than recommended and that macronutrient balance can be improved. Thus, energy and macronutrients intake are important aspects for further investigation and analysis in this group.

**Keywords:** food intake, fiber, carbohydrate, protein, lipids.
# DEVELOPMENT AND EVALUATION OF A REDUCED PROTOCOL FOR THE DEUTERIUM OXIDE DOSE-TO-MOTHER TECHNIQUE TO ASSESS EXCLUSIVE BREASTFEEDING PRACTICES

(1)Houghton, Lisa; (2)Liu, Zheng; (3)Preston, Thomas; (4)Slater, Christine; (5)Diana, Aly; (6)Gibson, Rosalind; (7)Duffull, Stephen.

(1)Department of Human Nutrition. University of Otago. New Zealand; (2)PhD. Pharmacometric modeller. School of Pharmacy. University of Otago. New Zealand.; (3)PhD. Professor. Scottish Universities Environmental Research Centre. University of Glasgow. United Kingdom.; (4)PhD. Nutritionist. Independent. United Kingdom.; (5)MD, MSc, PhD candidate. Department of Human Nutrition. University of Otago. New Zealand; (6)PhD. Emeritus Professor. Department of Human Nutrition. University of Otago. New Zealand.; (7)PhD. Professor. Department of Human Nutrition. University of Otago. New Zealand.

**Background and objectives:** Exclusive breastfeeding (EBF) practices can be assessed by quantifying infant water intake from sources other than human milk using a stable isotope deuterium oxide dose-to-the-mother (DTM) technique. While the DTM technique is non-invasive and relatively simple to perform, seven days of post-dose saliva sample collections from mother and infant over a 14-day study period makes it unsuitable for routine use in a public health setting. The purpose of this study was to determine if the DTM protocol could be reduced to a more practical design, which correctly classifies EBF practices with acceptable accuracy.

**Methods:** An existing DTM dataset collected using a stand-
ardised protocol from 9 countries was available and consisted of
790 mother-infant pairs. For the purpose of development and
evaluation of a reduced protocol, the data were randomly split into
i) model building (565 pairs) and ii) evaluation (225 pairs). The
model building dataset was considered the gold standard to assess
the reduced protocol. For each potential reduced design, a previ-
ously established model was fitted to the data, using a fully Bayes-
ian framework, and mother-infant pairs were assigned to EBF or
non-EBF categories based a non-milk water intake cut-off. The op-
erating characteristics of the reduced protocol were assessed using
sensitivity and specificity.

**Results:** One-day post-dose sample designs from days 3-9 were considered, however model fitting was unsuccessful in all cases. All combinations of two-day post-dose designs resulted in successful assignment of infants to a breastfeeding category and could be evaluated. The best EBF practice allocation characteristics were demonstrated (i.e., >95% sensitivity and specificity) for a single sample at any time between each of days 7-9 and days 13-14. Evaluation of this design provided acceptable agreement. In addition, a number of two-day post-dose designs over a shorter period (days 5-9) were also considered satisfactory with >90% sensitivity and specificity.

**Conclusions:** A less time and resource intensive DTM two-
day post-dose sampling design was found to be capable of separat-
ing EBF from non-EBF practices in infants and was comparable to

the full sampling protocol. The design included sampling window
periods to allow flexibility for field use.

**Keywords:** infants, exclusive breastfeeding, deuterium oxide dose-to-mother technique, human milk

**Further collaborators:**

Theodosia Adom, Thushari Bandara, David Bansa, Christian Edward Brown-Appiah, Anna Coutsoudis, Katherine Curi, Ur-mila Deshmukh, Suzanne Filteau, Manjula Hettiarachchi, Mon-ica Mazariegos, Helen Mulol, Shadrack Oiye, Victor Owino, Tippawan Pongcharoen, Manuel Ramirez-Zea, Tinku Thomas, Pattanee Winnachagoon, Gerado Weisstaub, William Wong

# ASSESSMENT OF NUTRIENT QUALITY OF SELECTED ASIAN DISHES USING THE HEALTHY RECIPE FRAMEWORK CRITERIA

(1)Sacdalan-Africa, Leila Sacdalan-Africa; (2)Ramos-Buenviaje, Rhoda Joy; (3)Principe, Meyrick.

(1)Associate Professor. Institute of Human Nutrition and Food.
College of Human Ecology. University of the Philippines Los Baños; (2)Nutrition and Health Manager. Unilever. Philippines;
(3)Nutrition Executive. Unilever. Philippines.

**Background and objectives:** The Healthy Recipe Frame-
work (HRF) contains nutrition criteria to assess the nutrition
quality of a dish, meal or food item as encouraging, good-for-you;
or healthy-for-you. The criteria are based on international gener-
ally accepted dietary recommendations as recommended by the
Joint FAO/WHO/UNU Expert Consultation on Diet, Nutrition
and Prevention of Chronic Disease. This study was conducted to
assess the nutrient quality of selected 75 popular dishes from Chi-
na, India, Indonesia, Philippines, Malaysia, Singapore, Thailand,
and Vietnam using the HRF criteria.

**Methods:** The nutrient content analysis of each recipe was done using the recipe calculator specially developed by Unilever in Microsoft Excel for the HRF analysis. The recipe calculator compute the energy, nutrients and the following: percentage of the amount of recommended ingredient; total amount of vegetable per serving; percentage of energy content from protein, carbohydrates, sugar, fats, saturated, and trans fatty acid; amount of fibre per 100 kcal energy content; amount of sodium per 100g of recipe; and amount of sodium per energy content. Most importantly it indicates if the recipe satisfies the encouraging; good-for-you; and healthy-for-you criteria and identify the component(s) why the recipe did not pass. The nutrient database was mostly from the United States Department of Agriculture Food Composition Table.

**Results:** Results showed that more than half(67%) of the rec-
ipes are encouraging; but only 12 recipes(16%) and one(1%) dish
were considered as good-for-you and healthy-for-you recipes, re-
spectively. The common reason why 33% of the recipes did not
pass any criteria was the use of meat with fat (48%) and refined