sn-2 position of TAG, did not differ from OO with regard to their effects on lipid profiles.

http://www.anzctr.org.au: ACTRN12616000069459

**Keywords:** Palm olein, olive oil, cocoa butter, lipids, TC/HDL-C, sn-2 hypothesis

144/1508

THE RELATIONSHIP BETWEEN P53 TUMOR SUP- PRESSOR PROTEIN AND ANTI-APOPTOTIC BCL- 2 PROTEIN IN COLORECTAL ADENOCARCINO- MA ASSOCIATED WITH TYPE 2 DIABETES AND OBESITY

(1)Horatiu-Cristian, Popescu-Valceanu; (2)Stoicea, Mihai; (3)Enache, Valentin; (4)Dragut, Ramona Maria; (4)Rusu, Emilia; (5)Ionescu- Tirgovişte, Constantin; (6)Radulian, Gabriela.

(1)MD,PhD. Department of Diabetes Nutrition and Metabolic Diseases.; (2)MD. Department of Pathology. Synevo Central Laboratory Bucharest. Romania.; (3)MD. Department of Pathology. Bucharest Emergency Hospital. Romania.; (4)MD,PhD. Department of Diabetes Nutrition and Metabolic Diseases. "Carol Davila" University of Medicine and Pharmacy Bucharest. Romania.; (5)Department of Diabetes Nutrition and Metabolic Diseases.National Institute of Nutrition and Metabolic Diseases "Prof. Dr. N. Paulescu". "Carol Davila" University of Medicine and Pharmacy Romania.; (6)MD,PhD. Department of Diabetes Nutrition and Metabolic Diseases.National Institute of Nutrition and Metabolic Diseases "Prof. Dr. N. Paulescu". "Carol Davila" University of Medicine and Pharmacy Bucharest.Romania.

**Background and objectives:** The relationship between cancer and metabolic disorders (obesity, diabetes and metabolic syndrome) is well known from multiple studies. Obesity is associated with various types of cancer the most common being the liver, the breast in postmenopausal women, endometrial, esophageal and colorectal cancer before the pancreatic cancer. The aim of our study was to compare the frequency of obesity associated with cancer in type 2 diabetic patients vs obese and non-obese subjects, taking as markers the colorectal p53 protein (considered to be a guard of the genome) and anti-apoptotic Bcl-2 protein.

**Methods:** In a retrospective study we identified 1307 cases with diagnosis of colorectal cancer hospitalized between 2012-2015 in Bucharest Emergency Hospital, from which we random selected 95 cases for immunohistochemical analysis of p53 and Bcl-2 protein from colorectal adenocarcinoma samples using an automatic platform Bench Mark XT Ventana applying the dual protocol Bcl-2-p53 in the department of histopathology of laboratory center. From this 95 cases 52 were type 2 diabetic patients (33 males /19 females, mean age 70.2 years) and 43 non-diabetics (30 males /13 females mean age 69.5 years). There were 15vs2 obese subjects in diabetic/non-diabetic patients compared to 37vs41 with normal weight.

**Results:** Our data showed that the hiperexpression of p53 protein has been found more often in diabetic obese patients in the

80% (12/15 of cases) comparative with non-obese diabetic patients 40.5% (15/37 cases) or non-diabetics and non-obese controls 36.6% (15/41 cases p=0.024). No changes in Bcl-2 protein expression has been found.

**Conclusions:** It is known that the protein p53 is a powerful transcription factor acting as checkpoint controlling the differentiation of the various cells including adipocytes and also possible enterocytes (explaining the higher frequency of colorectal cancer which has been associated with the increased proliferation of adipocytes number and volume characterizing the obesity). Due to the protection conferred by a normal p53 protein its upregulation could be a new target for the treatment of obesity.

**Keywords:** obesity, type 2 diabetes, colorectal adenocarcinoma, immunochemistry, p53 and Bcl2

144/1512

ROLE OF MICRORNAS ON HEPATIC THYROID HORMONE ACTION IN DIFFERENT PROPENSITIES TO OBESITY IN MICE

(1)Cheng, Xiangrong; (2)Xia, Shufang; (3)Sun, Jing; (3)Tang, Xue; (3)Le, Guowei.

(1)Associate professor. School of Food Science and Technology. Jiangnan University. People's Republic of China; (2)Wuxi School of Medicine. Jiangnan University. People's Republic of China;

(3)School of Food Science and Technology. Jiangnan University. People's Republic of China.

**Background and objectives:** The mechanisms that individuals on the same genetic background showed different propensities to obesity were largely unknown. Considering the role of microRNAs (miRs) in the function of thyroid hormones (THs) and TH in energy homeostasis, this study was designed to investigate the possible mechanisms of hepatic microRNAs (miRs) in regulating local thyroid hormone (TH) action and ultimately different propensities to high-fat diet (HFD) induced obesity.

**Methods:** C57Bl/6 male mice were randomly divided into a control (Con) group and a HFD group. In the 7th week, HFD-fed mice were designated as obesity-prone (OP) and obesity-resistant (OR). Half of the mice were sacrificed and the remaining mice were kept on feeding until the 17th week. Small RNA sequencing was used to find the differentially expressed miRs between OP and OR mice in the early phase of HFD feeding, and bioinformatics algorithms was used to screen the miRs that target on hepatic Dio1 or TRb.

**Results:** In the 7th week, OR mice showed significantly lower body weight and higher hepatic thyroid hormone receptor b (TRb) expression and type 1 deiodinase (DIO1) activity than OP mice. Small RNA sequencing results showed that 13 miRs in liver were dysregulated between the two phenotypes, of which 8 miRs were predicted to target on Dio1 or TRb. In the 17th week, OR mice had mild hepatic steatosis and increased Dio1 and TRb expression than OP mice, with up-regulation of T3 target genes involved in fatty acid oxidation (Ppara, Cyp7a1, and Cpt1a) and down-regulation
of lipid synthesis related genes (Srebp1c, Acc1, and Fasn). A stem-loop qRT-PCR analysis confirmed that the tendency of miR-383 expression was contrary to Dio1 mRNA expression between the two phenotypes, while miR-34a and miR-146b expression was opposite to TRb expression at both periods.

**Conclusions:** Thus, Hepatic miR-383, miR-146b, and miR-34a might act on Dio1 and TRb, leading to dysregulation of TH responsive gene expression, and ultimately the different propensities to HFD-induced obesity.

**Keywords:** obesity-prone, obesity-resistant, microRNA, type 1 deiodinase, TRb

of dietary, behaviour, nutrient and/or bioactive based interventions on both short and long term health outcomes in the mother and child in different ethnicities and in better defined risk groups, with an aim to identify novel and tailored preventive strategies. Additionally, such studies should adopt a single set of criteria for GDM diagnosis to enable comparisons across studies to draw meaningful inferences.

**Keywords:** Gestational Diabetes mellitus, prevention, pre-conception

**Conflict of Interest Disclosure:** All authors are employees of Nestec Ltd

PREVENTION OF GESTATIONAL DIABETES MELITUS (GDM): WHERE WE STAND AND WHERE TO GO?

(1)Samuel, Tinu Mary; (2)Spieldenner, Jörg; (3)Silva Zolezzi, Irma.

(1)Phd. Maternal Nutrition Specialist. Department of Metabolic Health. Institute of Nutritional Sciences. Nestle Research Centre; Switzerland; (2)MD. Senior Manager. Micronutrient Plan. Nestle Research Centre; Switzerland; (3)PhD. Expert/GL Metabolic programming. Department of Metabolic Health. Institute of Nutritional Sciences. Nestle Research Centre; Switzerland.

**Background and objectives:** GDM develops in 1 in 25 pregnancies worldwide, affecting 1 in 7 births and is associated with pregnancy/ postpartum complications, short/long term morbidities and the transgenerational transmission of risk for type 2 diabetes, obesity and metabolic syndrome. This review provides a comprehensive assessment of intervention studies to inform GDM prevention strategies.

**Methods:** We reviewed studies on GDM prevention until 2017.

**Results:** Intervention studies have largely focused on the efficacy of dietary and/or lifestyle measures, and to a limited extent nutrients/bio actives, starting second trimester of pregnancy. Diet and/ or lifestyle based approaches, including complex large scale interventions in at risk women have shown limited success, inconsistent results, and have many limitations such as variations in intervention type, population characteristics, outcome definitions and low adherence to protocol. Recent evidence suggest a promising role for bio-actives (probiotics and myo-inositol) in reducing the incidence of GDM, however their efficacy needs to be investigated in large randomized intervention trials, involving a range of healthy women with and without known risk factors, such as overweight/obesity, family risk of diabetes and advanced age. The limited success of GDM prevention trials starting mid or late pregnancy together with the demonstrated associations between pre pregnancy and early pregnancy diet and lifestyle factors and increased GDM risk, indicates that metabolic alterations may occur prior to changes in the maternal phenotype, making the pre-conception period a critical time frame to intervene and interrupt the vicious cycle of GDM and childhood obesity and diabetes.

**Conclusions:** Considering the heterogeneity in GDM, large scale pre-conception prevention trials should investigate the impact

RELATIONSHIP OF VITAMIN D WITH HYPERTENSION AMONG CHILDREN FROM HIGH ALTITUDE REGIONS IN INDIA

(1)Singh, Gajendra; (2)Kapil, Umesh.

(1)PhD Scholar. Department of Gastroenterology and Human Nutrition. AllMS. New Delhi.; (2)Professor. Department of Gastroenterology and Human Nutrition. AllMS. New Delhi.

**Background and objectives:** Vitamin D deficiency (VDD) is pandemic and has recently been associated with extra skeletal health disorders. Both hypertension and VDD are highly prevalent worldwide, establishing an association between these two may potentially have major public health implications. Objective: To assess the relationship of Vitamin D with hypertension and risk factors associated with VDD amongst children.

**Methods:** A cross sectional study was conducted among rural school children aged 12-18y from two high altitude regions (>1000 meters) of Himachal Pradesh, India. A total of 513 children [242(47.17%) boys] were enrolled in the study. Blood pressure was measured using standard mercury sphygmomanometer and hypertension was defined as per WHO 2007 criteria. Validated questionnaire were utilized to elicit information on socioeconomic status (SES), physical activity, sunlight exposure and dietary pattern of children. Laboratory investigations were undertaken for serum 25-hydroxyvitamin D(25-OHD), parathyroid hormone (PTH), calcium, phosphorus, alkaline phosphatase (ALP) and Albumin levels using standard laboratory procedures. The relationship of 25-OHD and various parameters were assessed using statistical methods carried out on STATA (version 11) software.

**Results:** A total of 423(82.3%) subjects had VDD with levels less than 20ng/ml. The prevalence of pre-hypertension and hypertension was found to be 11.3% and 10.3% respectively. An increasing trend in blood pressure was observed with the increase in the severity of VDD. The correlation coefficient and p value [r(p)] between 25-OHD and SBP/DBP was noted as -0.08(0.058)/-0.13(0.002). Serum 25-OHD level was found significantly lower in subjects with pre-hypertension and hypertension compared to those having normal blood pressure. Regression model revealed that unadjusted β coefficient (95% CI) of SBP (mmHg) and DBP (mmHg) was -0.059(-0.117 to -0.001) (p=0.045) and -0.098(-0.171
to -0.026) (p<0.007), respectively. SBP and female sex had negative, whereas physical activity level, sunshine exposure and non vegetarian diet had positive impact on serum 25-OHD level as indicated in multivariable regression analysis.

**Conclusions:** The present study supports that Vitamin D plays an important role in the regulation of normal blood pressure homeostasis and VDD is a risk factor for the development of hypertension in children.

**Keywords:** Vitamin D, Hypertension, Children.

**Conclusions:** Mitochondrial function and antioxidant defense might be involved in propensities to obesity and the ability of OR rats to resist obesity was the maintenance of mitochondrial energy and redox balance.

**Keywords:** high-fat diet, obesity prone, obesity resistant, mitochondrial energy metabolism, antioxidant capacity.

144/1535

TIME-RELATED CHANGES IN HEPATIC ANTIOXIDANT CAPABILITY AND MITOCHONDRIAL ENERGY METABOLISM BETWEEN OBESITY-PRONE AND OBESITY-RESISTANT RATS

(1)Li, Yingrui; (2)Tang, Xue; (3)Sun, Yongjuan; (3)Xin, Xingan; (2)Shi, Yonghui; (2)Le, Guowei.

Affiliation: (1)BSc. The Laboratory of Food Nutrition and Functional Factors. Jiangnan University. China.; (2)PhD. The State Key Laboratory of Food Science and Technology, The Laboratory of Food Nutrition and Functional Factors. Jiangnan University. China.; (3)BSc. The Laboratory of Food Nutrition and Functional Factors, Jiangnan University. China.

**Background and objectives:** The role of oxidative stress in energy metabolism during obesity is still unclear. The aim of the present study is to reveal the regulation of energy metabolism by oxidative stress between obesity prone (OP) and obesity resistant (OR) rats after short-term and long-term high-fat diet (HFD) feeding.

**Methods:** Male Sprague-Dawley rats were randomly divided into two groups: the control group and the HFD group. Delineation of OP and OR was based on body weight gain (upper 30% for OP; lower 30% for OR) after 8 weeks on HFD. Rats were sacrificed at 8th and 20th week, and serum and liver were collected for ELISA assays and oxidative stress biomarkers determination by appropriate kits.

**Results:** Body weight gain and liver index, as well as triglycerides (TG) and total cholesterol (TC) levels increased significantly in OP group compared with control group and OR group during the experimental period. In the 8th week, compared with control group, OP group showed a significant decrease in oxygen consumption (VO2), energy expenditure (EE) and spontaneous physical activity, whereas OR group had a normal body weight gain and energy metabolism. In the 20th week, OR group had a significant increase in superoxide dismutase (SOD) activity, GSH/GSSG ratio and total antioxidant capacity (T-AOC) in liver as compared with OP group. A remarkable reduced production of reactive oxygen species (ROS) and malonaldehyde (MDA) content were also observed in OR group. Furthermore, OP group had higher accumulation of acetyl-CoA, with down-regulation of ATP production and NADH/NAD+ ratio and reduction of mitochondrial transmembrane potential involved in mitochondrial energy metabolism.

144/1574

ASSESSMENT OF HEPATIC NON- INVASIVE BIOMARKERS IN DIABETIC AND NON DIABETIC SUBJECTS: A CROSS SECTIONAL STUDY

(1)Bullón-Vela, Vanessa; (2)Abete, Itziar; (1)Cantero González, Irene;

(3)Zulet, Maria Angeles; (4)Martínez, J. Alfredo.

(1)MSc. Department of Nutrition, Food Sciences and Physiology Centre for Nutrition Research. University of Navarra. Spain;

(2)PhD. Department of Nutrition, Food Sciences and Physiology Centre for Nutrition Research. University of Navarra. Spain / CIBERobn. ISCIII. Spain; (3)PhD. Department of Nutrition, Food Sciences and Physiology Centre for Nutrition Research. University of Navarra. Spain / CIBERobn. ISCIII. Spain / Navarra Institute for Health Research (IdiSNA). Spain; (4)MD, PhD. Department of Nutrition, Food Sciences and Physiology Centre for Nutrition Research. University of Navarra. Spain / CIBERobn. ISCIII. Spain / Navarra Institute for Health Research (IdiSNA). Spain.

**Background and objectives:** The prevalence of Non-alcoholic fatty liver disease (NAFLD) is estimated at 30% on the western population being the most common cause of chronic liver disease worldwide. Moreover, this pathological condition accompanying by the presence of obesity and diabetes. In this sense, the aim of the study was to evaluate the presence of NAFLD by using non-invasive hepatic indexes as well as its association with anthropometric, biochemical and lifestyle variables in diabetic and non diabetic subjects.

**Methods:** We conducted a baseline cross-sectional study about 300 participants recruited in Navarra. Patients were categorized according to baseline diagnostic of diabetes based on American Diabetes Association criteria, non diabetic (n=197) and diabetic (n=116). Baseline anthropometric, biochemical and non-invasive hepatic indexes were compared. A validated food frequency questionnaire was carried out in order to measure current intake.

**Results:** Diabetic patients exhibited significant higher levels in serum triglyceride (p= 0.012), VLDL-c

(p= 0.013) and lower levels of HDL-c concentration (p= 0.003) compared with non diabetic patients. Non significant differences in AST, ALT and GGT levels were found. Moreover, multiple non-invasive hepatic indexes (LAP, BAAT score and TYG index) were higher in the diabetic group. Interestingly, associations between general biochemical and dietetic variables with non-invasive hepatic indexes were identified.

**Conclusions:** Our results show that diabetic patients are at higher risk for developing NAFLD. These non-invasive hepatic
indexes might be useful to assess the hepatic status in diabetic subjects.

**Keywords:** NAFLD, Diabetes, Obesity, Non-invasive hepatic index, TYG index.

**Further collaborators:** PREDIMED- PLUS investigators.

**Keywords:** Obesity, NAFLD, weight loss, energy-restricted diet, lifestyle intervention.

**Further collaborators:**

Monreal JI, Elorz M, Herrero JI, Benito-Boillos A, Fuertes-Ran MC, Quiroga J, Martinez-Echeverría A, Uriz-Otano JI, Huarte-Muniesa MP, San Juan-Rodriguez A, Tur JA.

144/1578

NON-ALCOHOLIC FATTY LIVER DISEASE IN
OVERWEIGHT AND OBESE PEOPLE UNDER NU-
TRITIONAL AND LIFESTYLE FOLLOW-UP: PRE-
LIMINARY RESULTS

**Background and objectives:** Non-alcoholic fatty liver disease (NAFLD) is a condition defined by an excessive accumulation of fat in hepatocytes, with prevalence rates of 57-98% in obesity. NAFLD treatment is based on lifestyle modifications. Nevertheless, there is no a well characterized dietary pattern and further studies are necessary. The objective of this study is to increase knowledge on nutritional/lifestyle interventions in obese patients with NAFLD.

**Methods:** A subsample of sixty-three overweight or obese patients with NAFLD (age: 49.33±9.33 years old; BMI; 33.9±3.95 kg/ m2) following a personalized energy-restricted diet (-30% individual needs) under healthy lifestyle advice (FLiO: Fatty Liver in Obesity study), was evaluated. Blood pressure, body composition (DXA), lipid and glycemic profile, as well as liver non-invasive biomarkers and scores were measured at baseline and when all the patients achieved 5% of weight loss according to American Association for the Study of Liver Diseases (AASLD). Furthermore, liver stiffness was assessed by transient elastography.

**Results:** In addition to weight loss, participants showed a significant reduction in waist circumference, total and android fat, blood pressure, glucose, ALT, total-cholesterol, LDL-c as well as in LDL-c/HDL-c, HOMA-IR, AST/ALT and FLI indexes. Interestingly, a significant improvement in liver stiffness was obtained (-5.11%; p<0.01).

**Conclusions:** These results support that well-designed dietary lifestyle interventions and weight loss are key factors in the management of obesity and NAFLD.

144/1590

ROLE OF DIETARY PROTEIN INTAKE LEVEL ON
EPITHELIAL REPAIR AFTER ACUTE INTESTINAL
INFLAMMATION IN A MURINE MODEL OF COLI-
TIS

**Background and objectives:** After an acute intestinal inflammatory episode, the specific protein requirement needed for the healing of injured areas remains largely unknown.

The objective of this study was to assess the effect of different protein intake levels on the mucosal healing (MH) process in a mouse model of dextran sodium sulfate (DSS, 3,5%, 5 days)-induced colitis.

**Methods:** After the inflammatory flare, mice were divided into three groups, each group receiving an isocaloric diet with different levels of whole-milk protein: 14% (P14), 30% (P30) and 55% (P55). The MH process was assessed macroscopically in colon in combination with functional approaches (permeability tests), biochemical measurements (protein and gene expressions of inflammatory and repairing factors) and histological analysis.

**Results:** While P14- and P30-fed mice started to regain weight after colitis induction at d7, the weight-gain was delayed in P55-fed mice. The colon inflammatory score was higher in this latter group during the resolution phase and was associated with an increased colon protein expression of IL-1β and IL-6 at d28 (vs P30). However, no difference in the histological score was noticed between groups at day 10 and 13. In contrast, DSS-induced colon permeability was reduced in P30-fed mice at d9 and d12 (vs P14), as well as the myeloperoxidase activity at d28 (vs P55). In addition, the colon gene expression of the anti-inflammatory cytokine Tgf-β1 (at d10) and of the tight junction-related protein

<footnote>(1)Marin-Alejandre, Araceli; (2)Abete, Itziar; (3)Cantero González, Irene;</footnote>

<footnote>(3)Bullón-Vela, Vanessa; (4)Martínez, J. Alfredo; (5)Zulet, Maria Angeles.</footnote>

<footnote>(1)MSc. Department of Nutrition, Food Sciences and Physiology.
Centre for Nutrition Research. University of Navarra. Spain;</footnote>

<footnote>(2)PhD. Department of Nutrition, Food Sciences and Physiology Centre for Nutrition Research. University of Navarra. Spain/ CIBERobn. ISCIII. Spain; (3)MSc. Department of Nutrition, Food Sciences and Physiology Centre for Nutrition Research. University of Navarra. Spain; (4)MD, PhD. Department of Nutrition, Food Sciences and Physiology Centre for Nutrition Research. University of Navarra. Spain/ CIBERobn. ISCIII. Spain/ Navarra Institute for Health Research (IdiSNA). Spain; (5)PhD. Department of Nutrition, Food Sciences and Physiology Centre for Nutrition Research. University of Navarra. Spain/ CIBERobn. ISCIII. Spain/ Navarra Institute for Health Research (IdiSNA). Spain.</footnote>

<footnote>(1)Vidal-Lletjos, Sandra; (2)Andriamihaja, Mireille; (3)Blais, Anne;</footnote>

<footnote>(4)Grausso-Culetto, Marta; (5)Benamouzig, Robert; (6)Tomé, Daniel;</footnote>

<footnote>(4)Blachier, François; (4)Lan, Annaïg.</footnote>

<footnote>(1)UMR 914 INRA/AgroParisTech/Université Paris Saclay Nutrition Physiology and Ingestive Behavior. Paris, France;;</footnote>

<footnote>(2)PhD. UMR 914 INRA/AgroParisTech/Université Paris Saclay Nutrition Physiology and Ingestive Behavior. Paris. France;;</footnote>

<footnote>(3)PhD. UMR 914 INRA/AgroParisTech/Université Paris Saclay Nutrition Physiology and Ingestive Behavior. Paris. France; (4)PhD. UMR 914 INRA/AgroParisTech/Université Paris Saclay Nutrition Physiology and Ingestive Behavior. Paris. France.; (5)MD, PhD. Department of Gastroenterology. Avicenne Hospital. Assistance Publique-Hôpitaux de Paris. F-93000 Bobigny, France; (6)Prof, PhD. UMR 914 INRA/AgroParisTech/Université Paris Saclay Nutrition Physiology and Ingestive Behavior. Paris. France.</footnote>
Cldn1 (at d13) was specifically increased in P30-fed mice. Moreover, high-protein intake (P30 and P55) seemed to improve restoration of goblet cells according to the observed increase in the goblet cell-associated gene expression Muc2 and Tff3 at d13 in these both groups compared to P14.

**Conclusions:** This study revealed that the level of protein intake might exert different effect after an acute colon inflammatory episode, P55 being rather deleterious, while P30 diet showed an apparent beneficial effect during the MH process when compared to the normoproteic diet P14. Ongoing analysis of colon epithelial restitution and adherent microbiota composition, as well as protein metabolism in different organs, will help to decipher the impact of dietary protein intake level on the MH process and the peripheral consequences.

**Keywords:** Dietary Protein. Colitis. Mucosal Healing

144/1621

ADVISING OVERWEIGHT PERSONS TO CONTROL WEIGHT BY LITHUANIAN HEALTH CARE PROFESSIONALS IN 2000-2014

Kriaucioniene, Vilma; Petkeviciene, Janina.

PhD. Researcher. Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences.

**Background and objectives:** Health care professionals are in a unique position to help patients prevent or manage chronic diseases.

The study objective is to assess changes in advising overweight persons to lose weight by health care professionals over fourteen years and to determine whether reported attempts to lose weight were associated with the advices.

**Methods:** The data were obtained from eight biennial cross-sectional postal surveys of Lithuanian health behaviours carried out between 2000 and 2014 using the same methodology. For every survey, a nationally representative random sample of 3000 individuals aged 20-64 was drawn from the National Population Register. In total, 8738 men and 11822 women participated in these surveys. Self-reported body weight and height were used to calculate BMI. Information on whether health professionals advised overweight or obese persons to increase physical activity or to change dietary habits was obtained. The odds of receiving advices were calculated using multiple logistic regression analyses.

**Results:** During fourteen years the proportion of overweight increased only in men from 50.6% to 58.6%, the prevalence of overweight in women showed decreasing trends. The prevalence of obesity in men increased from 11.3% to 19.5% and has not changed among women remaining 17.3% in 2014.

During study period proportion of overweight persons being advised by health care professionals to change their diet increased from 24.2% in 2000 to 38.4% in 2010, afterwards slightly decreasing trends were observed, reaching 29.4% in 2014. In 2014, 11.6% of overweight respondents reported that their health care professionals advised them to increase physical activity.

Older and better educated women, those having higher BMI, higher number of chronic conditions and more frequent visits to health care professional office were more likely to receive advices to lose weight.

Overweight men and women who reported receiving advices were more likely to report attempts to change diet and physical activity trying to lose weight than those who were not advised.

**Conclusions:** Providing advice on diet and physical activity are not yet a routine part of every Lithuanian physician. Still existing barriers to counselling need to be identified and strategies put in place to overcome them.

**Keywords:** overweight, weight control, health care professionals

144/1635

A CLUSTER RANDOMISED EVALUATION OF MOBILE APPLICATION TO SUPPORT THE TREATMENT OF ACUTELY MALNOURISHED CHILDREN IN WAJIR COUNTY, KENYA

**Background and objectives:** Community Management of Acute Malnutrition (CMAM) is a proven approach in the treatment of acute malnutrition, however its effectiveness is limited by Health Workers failing to adhere to standard CMAM treatment protocol, due in part to poor monitoring and support, relying on paper based systems. A mobile health application was developed by World Vision and Dimagi and piloted by Save the Children in Wajir, Kenya to help health workers follow national CMAM treatment protocols and to provide more timely and accurate data for decision making. A cluster randomized trial was conducted to evaluate the impact of the application on CMAM reporting and treatment outcomes.

**Methods:** Forty health facilities in Wajir were randomly allocated to an intervention and control group. Intervention facilities received a tablet with the mobile health application adapted to the Kenyan context and CMAM protocol, control sites continued to use the paper based system. Data gathered through the mobile application from intervention health facilities for a period of twelve months was compared to data gathered from paper based registers over the same period in control facilities. Data from paper based

<footnote>(1)Keane, Emily; (2)Mwendah, Cherotich; (3)Roschnik, Natalie;</footnote>

<footnote>(4)Ngombalu, Assumpta Ndumi Ngombalu; (5)Kemboi, Samuel;</footnote>

<footnote>(6)Osman, Ahmed; (7)Chui, Joanne; (8)Hall, Andrew.</footnote>

<footnote>(1)MSc. Nutrition Advisor. Programme Policy and Quality Quality. Save the Children UK. London. UK; (2)MSc. Research Fellow. Independent. Nairobi. Kenya; (3)MSc. Senior Nutrition Advisor. Save the Children UK. London. UK; (4)MSc. Nutrition Advisor Save the Children UK. Nairobi. Kenya; (5)MSc. Monitoring Evaluation Accountability & Learning Coordinator. Save the Children International. Nairobi. Kenya; (6)Research Assistant. Save the Children Internationl. Wajir. Kenya; (7)MSc. Research Assistant. Save the Children UK. London. UK; (8)PhD. Research Advisor. Independent.</footnote>
registers on treatment of acute malnutrition was also collected for
all forty facilities for twelve pre intervention to serve as a baseline
for comparison. Two observations of treatment were conducted in
a sub sample of facilities to assess adherence to treatment protocol.

**Results:** Data analysis is still underway and results will be
available by July 2017. These will compare data quality, complete-
ness and timeliness for decision making, adherence to treatment
protocol, and treatment outcomes between the two groups.

**Conclusions:** The CMAM mobile application has huge potential to improve CMAM services in Kenya and other countries. **Results:** **Keywords:** management of acute malnutrition, mobile health, data quality

condition. The basal and 24h concentration of ghrelin significantly
reduced during sleep restriction in normal weight group (p<0.05).

**Conclusions:** Acute sleep restriction, especially at the end of the night, increased RMR as well as leptin concentration in obese subjects, which suggests that sleep is involved in the acute regulation of daytime energy expenditure. These physiological findings might be relevant for better understanding the multiple metabolic pathways that link sleep restriction and obesity.

**Keywords:** sleep restriction, obesity, metabolism, leptin, ghrelin.

**Conflict of Interest Disclosure:** The present study was funded by the Associação Fundo de Incentivo à Pesquisa (AFIP), CEP-ID/SONO-FAPESP (#1998/14303-3), and FAPESP (#2009/05657-2, 2008/09565-2, 2008/53069-0, 2006/00684-3).

144/1637

ACUTE SLEEP RESTRICTION INCREASES ENERGY EXPENDITURE IN OBESE MEN

(1)Zimberg, Ioná; (2)Del Re, Mariana; (3)Tufik, Sergio; (4)de Mello, Marco Tulio.

(1)PhD. Departamento de Psicobiologia. Universidade Federal de São Paulo. Brazil.; (2)MS. Departamento de Psicobiologia. Universidade Federal de São Paulo. Brazil; (3)PhD. Departamento de Psicobiologia. Universidade Federal de São Paulo. Brazil;

(4)PhD. Escola de Educação Física, Fisioterapia e Terapia Ocupacional (EEFFTO). Universidade Federal de Minas Gerais. Brazil;.

**Background and objectives:** In recent years, experimental
studies have shown that sleep restriction is associated with a great-
er propensity for obesity and its comorbidities in normal weight
adults. However little is known about how repeated nights of insuf-
ficient sleep influence energy expenditure in obese subjects. The
present study aimed at analyzing the effect of sleep restriction on
energy expenditure of normal weight and obese volunteers sub-
jected to two protocols of sleep restriction.

**Methods:** Fifteen healthy obese and normal weight young adults (22.43±1.72 and 24.13±2.90 y; BMI: 33.11±2.58 and 22.22±2.54, respectively) were submitted to three crossover randomized conditions of sleep for three consecutive nights: normal sleep (11.00pm-7.00am); restriction at the beginning of the night (RBN, 3.00am-7.00am); and restriction at the end of the night (REN, 11.00pm-3.00am). Participants consumed a weight-maintenance diet with fixed meal times in each condition. Body weight was measured daily at the same time in each condition. Concentration of leptin and ghrelin were monitored hourly for 24 hours after the second night. Resting metabolic rate (RMR) was measured after the third night using an indirect calorimetry.

**Results:** Body weight was stable in all sleep conditions and washout period. In comparison with normal sleep, RMR was 15% higher in the obese group after REN (1973±364kcal compared with 2332±357kcal, ≈300kcal, p=0.03). Sleep restriction significantly increased the morning and afternoon plasma concentrations of leptin in the obesity group (p<0.05), especially under SBN

144/1644

ANTI-INFLAMMATORY DIETARY COMPOUNDS,
INFLAMMATION BIOMARKERS AND CARDIO-
METABOLIC RISK FACTORS

(1)Perovic, Nilda Raquel; (2)Carrizo, Lidia Ana del Valle; (3)Popelka, Regina; (4)Diserio, Gustavo; (3)Pedernera, Cristian; (5)Defagó, Maria Daniela.

(1)PhD. Nutritionist. CENINH Centro de Investigación en Nutrición Humana. Escuela de Nutrición. Facultad de Ciencias Médicas. Universidad Nacional de Córdoba. Argentina; (2)MSc. Nutritionist. Dirección del Área de Alimentación y Nutrición. Hospital Nacional de Clínicas. Facultad de Ciencias Médicas. Universidad Nacional de Córdoba. Argentina.; (3)BSc. Nutritionist. CENINH Centro de Investigación en Nutrición Humana. Escuela de Nutrición. Facultad de Ciencias Médicas. Universidad Nacional de Córdoba. Argentina.; (4)Biochemical. Hospital Nacional de Clínicas. Facultad de Ciencias Médicas. Universidad Nacional de Córdoba. Argentina.; (5)PhD. Nutritionist. CENINH Centro de Investigación en Nutrición Humana. Escuela de Nutrición. Facultad de Ciencias Médicas. Universidad Nacional de Córdoba. Argentina. INICSA-CONICET. Argentina.

**Background and objectives:** Dietary phenolic compounds (PC) are involved in regulation of inflammatory processes such as in cardiometabolic diseases (CMD). The aim was to analyze the association between dietary PC, inflammatory biomarkers and risk factors of CMD.

**Methods:** Observational and correlational study. Participated 120 adults, both sex (60 women and 60 men), attended at the Non-Invasive Cardiology Division of the National Hospital of Clinics, Córdoba, Argentina, period 2014-2016. A clinical history, a validated food intake questionnaire, a physical activity questionnaire, smoking habits, systolic (SBP) and diastolic (DBP) blood pressure, nutritional status, waist circumference (WC), triglycerides (TG), serum lipid profile (total cholesterol, HDLc and LDLc) and ultrasensitive C-reactive protein (hs-CRP) were evaluated. Interfood v.1.3 software was employed to estimate fruits, vegetables and PC (isoflavones, flavones, flavonones, flavonols, flavanones,
anthocyanins) intake. Spearman correlation test was used for the correlation analysis.

**Results:** Average age was 61±1.43 years old, body mass-index (BMI) 28.76 ± 0.96 kg/m2 and WC 100.50 ± 2.35 cm. About risk factors, BMI was associated with SBP and DBP (r=0.22, p <0.01, r=0.26, p <0.05, respectively), and total cholesterol and BMI with TG concentration (r=0.31, p<0.05; r=0.33, p<0.05, respectively). Fruits and vegetables intake, source of PC, was 897.62 ± 89.45 gr/day. A correlation between genistein and LDLc and TG (r=-0.49, p <0.05, r=0.47, p<0.05, respectively), was observed. Other correlations were found among isoflavones and HDLc (r=0.36, p<0.05), and between flavonols and flavanones with fruits and vegetables (r=0.71, p<0.01; r=0.38, p<0.01, respectively).

**Conclusions:** These results showed preliminary evidence about PC intake and CMD risk factors.

**Keywords:** Phenolic compounds, risk factors, cardiometabolic diseases, biomarkers

144/1645

LEVELS AND VITAMIN D INTAKE IN CHILDREN AND ADOLESCENTS WITH PHENYLKETONURIA

**Background and objectives:** Vitamin D has a broad role on bone metabolism, cardiovascular, neurological and immunomodulation. Active vitamin D [1,25 (OH) 2 D3] can be provided from the diet or skin. It has been reported that children with phenylketonuria are at risk for vitamin D deficiency and the same applies in Chilean population. The objectives of the study was to study the levels of 25-OH Vit D and vitamin D intake in patients with phenylketonuria, mild hyperphenylalaninemia and control group.

**Methods:** The study was conducted in the laboratory of the Institute of Metabolic Diseases and Nutrition Food Technology (INTA), the variables collected for each patient included levels of 25-OH-VIT D and intake of vitamin D. The study included a total of 48 Chilean patients, aged 6-23 years, of both sexes; 16 patients were included for group. The Kruskal-Wallis statistical test was applied.

**Results:** Were statistically significant differences (p <0.05) levels of 25-OH-vitamin D between PKU and HFA group (PKU: 38.9 ng / ml; HFA: 28 ng / ml) (VN> 32 ng / ml). The PKU group consumed 440 IU of Vit D, the HFA: 150 IU / day and control group: 145 IU / day, with statistically significant differences between the PKU group and groups HFA and control.

**Conclusions:** This study showed that the vitamin D intake in the PKU group was bigger than the control and HFA group, because PKU consume special formulas from birth to 25 years. They contain 400-500 IU/100 g of product and are delivered by the Ministry of Health. HFA and control group consumed a low amount of Vitamin D, because dietary sources of vitamin D are scarce and the Chilean market has not fortified foods. Thus adequate intake of vitamin D protects of vitamin D deficiency in PKU patients. Is important to create a protocol of fortification for domestic consumption, as it has been documented a high prevalence of vitamin D deficiency in the Chilean population.

**Keywords:** Vitamin D, Phenylketonuria

144/1646

THE EFFECTS OF POLYUNSATURATED FATTY ACIDS AND RUMINANT TRANS FATTY ACIDS ON ALLERGIC DISEASES IN EARLY LIFE: A SYSTEMATIC REVIEW AND META-ANALYSIS

**Background and objectives:** The nutrition status in early life could influence the future development of allergic diseases. Although both polyunsaturated fatty acids (PUFAs) and ruminant trans fatty acids (R-TFAs) modulated immune functions in allergic subjects, their effects on allergic diseases in early life remained unclear. Thus, we conducted a systematic review and meta-analysis to determine whether PUFAs and R-TFAs could reduce the risk of allergic diseases in early life.

**Methods:** We searched PubMed, EMBASE, PsycINFO, Scopus, the Cochrane Library, and ClinicalTrials.gov from inception through January 2, 2017 for relevant full-text articles in English. Observational studies were selected if they examined the effects of PUFAs or R-TFAs on allergic diseases (eczema, asthma, wheeze and allergic rhinitis) or sensitization in early life. The period of early life is restricted to the first 1,000 days from conception to age 2 years. We excluded studies if they included participants with medical conditions. The quality of studies was examined by Newcastle-Ottawa Scale for assessing risk of bias, and a best evidence synthesis (BES) was applied. Random-effects models were used in the meta-analysis.

**Results:** Among the 3434 identified articles, we included 23 observational studies, and seven of them showed high quality. BES suggested that a moderate evidence for the protective effect of vaccenic acid on eczema in early life, while insufficient or no evidences were found in the relationship of other R-TFAs and PUFAs with allergic diseases. In the meta-analysis of 18 cohort studies, vaccenic acid was inversely associated with the risk of eczema (pooled odds ratio [OR] =0.43, 95% confidence intervals [95% CI]: 0.26-0.72). A-linolenic acid and linoleic acid also showed protective effects on allergic rhinitis and sensitization (pooled OR=0.77, 95% CI: 0.60-0.98; 0.86, 95% CI: 0.76-0.99). Meanwhile, higher n-6/n-3 PUFAs ratio and linoleic acid were associated with higher risk of eczema (pooled OR=1.08, 95% CI: 1.01-1.16; 1.08, 95% CI: 1.01-1.15).

<footnote>(1)Leiva Rodriguez, Carla Andrea; (2)Cornejo Espinoza, Verónica;</footnote>

<footnote>(3)Bravo Jimenez, Paulina; (4)Toledo Astudillo, Juan.</footnote>

<footnote>(1)Msc. Nutricionista. Carrera de Nutrición y Dietética. Facultad de Medicina. Pontificia Universidad Católica de Chile.; (2)MSc. Nutricionista. Instituto de nutrición y tecnología de los alimentos. Universidad de Chile. Chile.; (3)MSc. Médico Pediatra.</footnote>

<footnote>Universidad de los Andes. Chile.; (4)Medico General. Médico General de Zona. Servicio de Salud Metropolitano.</footnote>

<footnote>(1)Wu, Weijia; (1)Lin, Lizi; (2)Jing, Jin; (2)Cai, Li.</footnote>

<footnote>(1)MSc. School of Public Health. Sun Yat-sen University. China;</footnote>

<footnote>(2)PhD. School of Public Health. Sun Yat-sen University. China.</footnote>
**Conclusions:** Our systematic review and meta-analysis suggested that vaccenic acid showed benefit on decreasing the risk of eczema in early life, while PUFAs and other R-TFAs showed limited effects on allergic diseases because of insufficient evidences. More robust studies especially for R-TFAs are required in the future.

**Keywords:** polyunsaturated fatty acids, ruminant trans fatty acids, allergic disease, meta-analysis

**Background and objectives:** Reactive oxygen species (ROS) are important in regulating normal cellular processes, but deregulated ROS contributes to the development of diseases, including cancers. In addition to maintain body weight, a balanced diet rich in antioxidant nutrients can positively affect the effectiveness of antineoplastic treatment by reducing the physiological and oxidative damage caused by treatment. It is suggested that a diet rich in fats can stimulate lipid peroxidation, favoring the increase of ROS in cancer patients. The objective of this study was to verify the association between diet quality and antioxidant capacity of plasma in women with breast cancer before and after antineoplastic treatment.

**Methods:** Sociodemographic, clinical, anthropometric and therapeutic data of 70 women were collected. Food consumption was assessed by food frequency questionnaire. The diet quality was evaluated using the Brazilian Healthy Eating Index Revised (BHEI-R) and its components. The antioxidant capacity of plasma was evaluated biochemically from the determination of iron reducing antioxidant potential (FRAP). Food consumption assessment and antioxidant capacity of plasma were conducted before and after the treatment. Multiple linear regression was used to assess the relationship between diet quality and FRAP before and after treatment. Logistic regression model was used to verify the association between change in diet quality and change in FRAP during treatment.

**Results:** The median total score of the BHEI-R before and after treatment was similar (p=0.684) (median=76.2 e 76.5, respectively). No association was found between the FRAP before and after treatment (μ=629.5, DP=19.1 and μ=573.8, DP=22.7, respectively

p=0.051). Patients classified in the third tertile of diet quality (better quality) significantly increased the FRAP (β=106.78, p=0.019) before the treatment, however no association was found after the treatment. In prospective analyses, the association between change in diet quality and change in FRAP was not statistically significant (p= 0.260).

**Conclusions:** Women with breast cancer with better quality of diet had better concentrations of plasma antioxidants before treatment. However, the diet did not change the antioxidant capacity of plasma after treatment. Increase quality of diet is not enough to improve the antioxidant capacity of plasma in patients undergoing treatment for breast cancer in this sample of Brazilian women.

**Keywords:** oxidative stress; breast cancer; diet quality

**Background and objectives:** To analyze the ability of C-RP to predict death or cardiovascular events (myocardial infarction or stroke) or development of diabetes, after 3 years, in an overweight or obese population, with or without metabolic syndrome (MS) defined by ATPIII and IDF.

**Methods:** In the framework of a research project on the relationship between nutritional deficiencies and obesity, 175 overweight or obese adults (mean age: 52.3 + 13.8), both genders were studied. We evaluated C-RP and the presence of MS at time 0 (T0). These patients then entered a weight loss program characterized by healthy eating and exercise guidelines for 6 months. After 3 years, 109 of the patients were contacted again by telephone and major events they suffered during that period were recorded.

**Results:** Among the 13 patients who had events, 53.8% had MS, and 46.15% lacked this condition. The difference was not statistically significant (p=0.5524).

In T0 it was observed that, among patients with and without MS, there was no statistically significant difference in the C-RP value (p=0.2352 and p=0.1478 defined by ATPIII and IDF, respectively).

Among patients who developed events, a prevalence of elevated C-RP was observed. We performed the ROC curve between

<footnote>(1)Rockenbach, Gabriele; (2)Santos, Elaine da Silva; (1)Hinnig, Patrícia;</footnote>

<footnote>(1)Vieira, Francilene Gracieli Kunradi; (1)de Assis, Maria Alice; (2)de Liz, Sheyla; (3)da Silva, Edson Luiz; (1)Di Pietro, Patricia Faria.</footnote>

<footnote>(1)PhD. Assistant Professor, Department of Nutrition, Centre of Health Sciences, Federal University of Santa Catarina, Brazil;</footnote>

<footnote>(2)MSc. Nutritionist, Department of Nutrition, Centre of Health Sciences, Federal University of Santa Catarina, Brazil; (3)PhD. Assistant Professor, Department of Clinical Analyses, Centre of Health Sciences, Federal University of Santa Catarina, Brazil.</footnote>

<footnote>(1)Presner, Natalia; (2)Pandolfo, Marcela; (3)Dupraz, Hernán;</footnote>

<footnote>(3)Weisstaub, Adriana Ruth; (3)Felipoff, Ana Lídia; (4)González, Claudio D.; (5)Cúneo, Aldo; (5)Rivera, Santiago; (3)Zago, Liliana; (5)González Infantino, Carlos A.</footnote>

<footnote>(1)Nutritionist; (2)Biochemist. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Bioquímica Clínica. Argentina.; (3)PhD. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Cátedra de Nutrición. Argentina.; (4)MD. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Argentina.; (5)MD. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas "José de San Martín". División Nutrición. Argentina.</footnote>
C-RP and event development and observed an AUC of 0.734. Analyzing the cut-off points it was found that a C-RP > 5 predicted the occurrence of events in a statistically significant way (p=0.0095; RR: 4.388, CI: 95%: 1.444 to 13.277; Sensitivity: 69.2%; Specificity: 70.8%).

Among the 109 patients who were contacted after 3 years, 24.32 % of the ones who had C-RP > 5 developed events; and just 5.55 % of the ones who had C-RP <5 developed events.

**Conclusions:** MS did not predict the occurrence of events in this population; on the other hand, C-RP > 5, did.

The definition of MS according to ATPIII and IDF is associated with insulin resistance and obesity, but is not necessarily related to C-RP levels. Therefore, seeing that events are significantly related to a C-RP > 5, we consider that a better definition of MS as a prognostic marker should incorporate it.

Supported by UBACyT 20720130100006BA

**Keywords:** Overweight, Obesity, C-Reactive Protein, Metabolic Syndrome

144/1700

CHRONIC USE OF PROTON-PUMP INHIBITORS IS ASSOCIATED WITH LOWER MAGNESIUM AND IRON STATUS AND MORTALITY IN RENAL TRANSPLANT RECIPIENTS

**Background and objectives:** Proton-pump inhibitors (PPI) are commonly prescribed in renal transplant recipients (RTR) to prevent gastro-intestinal complaints and complications from immune-suppressants. However, chronic PPI use may induce magnesium and iron deficiencies and increase the risk of mortality. We investigated the association of PPI use with magnesium- and iron- status and mortality in a large single-center cohort of RTR.

**Methods:** We included 706 RTR with a functioning graft ≥ 1 year. Medication use was verified from medical records. Magnesium intake was assessed using a FFQ. Serum ferritin, magnesium and 24-h urinary magnesium excretion were measured with standard methods. Associations of PPI use on magnesium and ferritin were analyzed by linear regression. Logistic regression was used to assess association with iron deficiency (serum ferritin <100 µg/l) and magnesium insufficiency (<0.75 mmol/l). Cox regression was used to analyze the association of PPI use with mortality.

**Results:** At a median[IQR] of 5.4 [1.9-12.0] years after transplantation, mean±SD age was 53±13 years, 56.8% were male and

53% used PPI. Mean magnesium intake was 330±85 mg/day and was similar between users and non-users of PPI (P=0.204). PPI use was inversely associated with magnesium excretion (St.β:-0.21, P<0.001), serum magnesium (St.β:-0.08, P=0.046) and serum ferritin (St.β:-0.16, P<0.001), independent of age, gender, BMI, CRP, renal function and calcineurin inhibitor use. Iron deficiency and magnesium insufficiency were present in 208 (29.7%) and 26 (3.7%) RTR, respectively. PPI use was associated with iron deficiency (OR 1.98; 95%CI 1.44-2.73, P<0.001) and magnesium insufficiency (OR 3.25; 95%CI 1.26-8.39, P=0.015). During median follow-up of 5.4 [4.8-6.1] years, 152 RTR died. PPI use was associated with higher risk of mortality (HR 2.0; 95%CI 1.43-2.8, P<0.001), independent of potential confounders (HR 1.94; 95%CI 1.32-2.88, P=0.001).

**Conclusions:** PPI use is associated with low urinary magnesium excretion and serum magnesium, reflecting magnesium status, despite similar intake between PPI-users and non-users. It also seems to adversely influence iron status, together indicating impaired gastro-intestinal absorption, potentially related to the reduced gastric acid secretion. Moreover PPI use appears independently associated with increased risk of mortality in RTR, suggesting PPI use is not without danger in RTR and treatment indication may need to be revisited.

**Keywords:** proton pump inhibitors, magnesium, iron, all-cause mortality, renal transplantation.

144/1713

EFFECTS OF LOW FAT DIET ON BODY COMPOSITION AND BLOOD PARAMETERS IN NON-ALCOHOLIC FATTY LIVER DISEASE: A PILOT STUDY

**Background and objectives:** Non-alcoholic fatty liver disease (NAFLD) is the most widespread reason of chronic liver diseases in Western countries. Enhanced diet and increased physical activity is crucial for the treatment of NAFLD. The purpose of this study is to determine the effects of nutrition on body composition and some biochemical parameters in non-alcoholic fatty liver disease.

**Methods:** A total of 9 sedentary adults aged between 19 to 64 years participated in this study. Subjects were evaluated at the beginning of the study and 4 weeks later. Data collected during each visit included height, weight, body fat mass, fat free mass, total body water and waist, hip and neck circumference. Anthropometric measurements were collected using bioelectrical impedance analysis (TANITA TBF-215). Serum blood samples were obtained from participants at the beginning and after 4 weeks to assess liver enzymes. During these measurements subjects were instructed to be fasted for at least 10 hours prior to testing. Diet which

<footnote>(1)Douwes, Rianne; (2)Gomes Neto, António; (2)Eisenga, Michele;</footnote>

<footnote>(3)Gans, Rijk O. B; (3)van den Berg, Else; (3)Navis, Gerjan; (4)Blokzijl,</footnote>

<footnote>Hans; (3)Bakker, Stephan J.L.</footnote>

<footnote>(1)MD. Department of Internal Medicine. University Medical Center Groningen. The Netherlands; (2)MD. Department of Internal Medicine. University Medical Center Groningen. The Netherlands.; (3)MD-PhD. Department of Internal Medicine.</footnote>

<footnote>University Medical Center Groningen. The Netherlands.;</footnote>

<footnote>(4)MD-PhD. Department of Gastroenterology and Hepatology.</footnote>

<footnote>University Medical Center Groningen. The Netherlands.</footnote>

<footnote>(1)Ilhan, Merve; (2)Goktas, Zeynep.</footnote>

<footnote>(1)BSc. Dietitian. Department of Nutrition and Dietetics.</footnote>

<footnote>Hacettepe University. Ankara. Turkey.; (2)PhD. Dietitian.</footnote>

<footnote>Department of Nutrition and Dietetics. Hacettepe University.</footnote>

<footnote>Ankara. Turkey.</footnote>
compatible with NAFLD was prescribed to each participant at the beginning. 2-day food records and physical activity records were collected from participants each week. Statistical significance was set at p<0.05.

**Results:** A total of 6 female and 3 male subjects participated in this pilot study. Energy intakes of participants were found 1357±337 kcal/day. 3 of 9 subjects were exceed the daily fat limit. A statistically significant reduction in body weight (-2,32±2,19 kg, p<0,05), body mass index (-0,91±0,85 kg/m2, p<0,05), fat mass (-1,87±1,91 kg, p<0,05), waist circumference (-3,33±2,92 cm, p<0,01), waist to hip ratio (-0,03, p<0,05) and neck circumference (-1,00 cm, p<0,05) was observed after 4 weeks of diet treatment. Also there is a decline in liver enzymes (Alanine aminotransferase (ALT): -21,20±13,41 U/L, p<0,05; Aspartate aminotransferase (AST): -8,40±4,39 U/L, p<0,05; Alkaline phosphatase (ALP): -11,60±20,74 U/L, p>0,05; Gamma-glutamyl transferase (GGT): -28,00±33,79 U/L, p>0,05), however difference in ALP and GGT levels were not statistically significant.

**Conclusions:** In conclusion, low fat diet can provide weight reduction, improvement in body composition and enhance in liver enzymes in NAFLD.

**Keywords:** NAFLD, body composition, low fat diet

144/1714

AN EXPERIMENTAL STUDY OF SUBSTITUTING SUGAR IN INDIAN TRADITIONAL SWEET WITH DRY FRUITS

(1)Modem, Sai leela; (2)N, Chaitra Moulika.

(1)Associate Professor.St.Joseph's college for Women(Autonomous).Visakhapatnam; (2)Assistant Professor. St.Joseph's college for Women(Autonomous).Visakhapatnam. India.530004.

**Background and objectives:** Ramaiah et al 1990 suggested that in an epidemiological study of diabetes in Asians of the Indian sub continent, steady migration of people from rural to urban areas coinciding with the economic boom, corresponding lifestyle changes are leading to steady rise in incidence of Type II Diabetes. Moreover an ethnic susceptibility to diabetes among Indians was quoted. Thomas (2015) reported an all time high prevalence of T2DM. In this context the food and dietary patterns have undergone changes leading to consumption of predominantly high glycemic foods, one of which is the sweets,made of cane sugar or sugar syrup.

**Objective of the study:** To experiment on developing a low glycemic sweet by incorporating fresh and dry fruits in the place of cane sugar.

**Methods:** A traditional sweet Gulab jamun was selected for the experiment. The standard recipe of the sweet suitable for four servings was chosen from recipe book. In the experiment, the cane sugar alone was substituted with banana fruit and dry grapes, to keep the sweetness as close as possible to original sweet. Both the recipes were administered to a panel of diabetic patients, diети-

tians and normal subjects people, to evaluate the acceptance of the sweet without cane sugar.

**Results:** The nutritive value of the original and experimental recipe of the sweet Gulab jamun was calculated. It was observed that the energy value of the experiment recipe reduced by 120 K. calories while the carbohydrate content reduced by 30%. The acceptance of the recipe was satisfactory with excellent scoring by 50% dietitians,70% diabetics and 80% normal subjects.

**Conclusions:** The experiment recipe of the sweet Gulab Jamun was well accepted and was observed to be an encouraging alternative for the diabetic subjects who crave for the consumption of sweets in parties,weddings, festive occasions etc. which are very common in the Indian society.

**Keywords:** Type 2 Diabetes Mellitus, recipe, glycemic index, Indian sweet, Gulab jamun,energy, carbohydrate, dietitians.

**Conflict of Interest Disclosure:** This is to disclose that the study is a dissertation work undertaken by the co-author during Graduate study under my supervision.

144/1716

LOW VEGETABLE INTAKE IS ASSOCIATED WITH HIGH RISK OF NEW-ONSET DIABETES AFTER RENAL TRANSPLANTATION

(1)Gomes Neto, António; (2)Osté, Maryse; (3)van den Berg, Else; (3)Gans, Rijk O. B; (4)Soedamah-Muthu, Sabita S; (3)Bakker, Stephan J.L.; (3)Navis, Gerjan.

(1)University Medical Center Groningen; (2)Bsc. Department of Internal Medicine. University Medical Center Groningen. The Netherlands.; (3)MD. PhD. Department of Internal Medicine. University Medical Center Groningen. The Netherlands.; (4)PhD. Division of Human Nutrition. Wageningen University & Research. Wageningen. The Netherlands.

**Background and objectives:** New-Onset Diabetes After Transplantation (NODAT) occurs in 4-25% of renal transplant recipients (RTR) and increases risk of cardiovascular disease, graft failure and mortality in this population. NODAT is generally attributed to adverse effects of immune-suppressants (i.e. steroids and tacrolimus). Little is known about whether the risk of NODAT is modifiable by dietary factors, such as fruit and vegetable intake. We investigated whether fruit and vegetable intake is associated with risk of NODAT in RTR.

**Methods:** In this prospective observational study we included adult RTR with a functioning graft for ≥ 1 year. Dietary intake was assessed using a validated Food Frequency Questionnaire consisting of 177 food items. RTR with a medical history of diabetes or diabetes at baseline or RTR missing dietary data were excluded, leaving 473 RTR eligible for analyses. RTR were considered to have NODAT when ≥ 1 of the following criteria was met: repeated fasting plasma glucose ≥ 7.0 mmol/l, HbA1c ≥ 6.5%, or anti-diabetic drug use

**Results:** Mean ± SD age was 51.3 ± 13.2 years, 57% were male. Median [IQR] vegetable and fruit intake was 108 [72-154] and 99
[44-192] g/d, respectively. Only 11% met the recommended intake for vegetables (200g/d), and only 22% met the recommended intake for fruit (200g/d). During median follow-up of 5.3 years, 52 RTR (7%) developed NODAT. Vegetable intake was inversely associated with NODAT (HR 0.77 [95%CI 0.63-0.94] per 2log g/d). When divided in tertiles, RTR in the lowest tertile of vegetable intake (median intake: 54 [34-72] g/d) had higher risk of NODAT compared to RTR in the highest tertile (median intake: 175 [153-216] g/d) independent of age, sex, time after transplantation, total energy intake and physical activity (HR 2.2 [95%CI 1.11-4.52]). Fruit intake was not associated with risk of NODAT (HR 0.91 [95%CI 0.80-1.04] per 2log g/d).

**Conclusions:** The majority of RTR do not meet the recommended intake of vegetable and fruit. Low vegetable intake is associated with higher risk of NODAT. Stimulating vegetable intake may reduce the risk for NODAT in RTR. This study shows that even in the context of allegedly iatrogenic diabetes, dietary factors are important.

**Keywords:** New Onset Diabetes After Transplantation. Renal Transplant Recipients. Vegetable Intake. Fruit Intake.

**Results:** 70,9% (CI 95% 64,1-77) were obese, 50,2% (CI 95% 43,2-57,3%) pubescent and 50,7% (CI 95% 43,7-57,8%) females. MS frequency was 15,3% (CI 95% 10,8-21,1%). Prevalence of MH phenotype was 31% (CI 95% 24,8-38) and its was associated significantly with age range 11-14 years: 39,8% (CI 95% 29,9-50,5) vs 8-10 years: 23,6% (CI 95% 16,3-32,9) (p =0,01), overweight: 67,8% (CI 95% 54,2-79) vs obesity: 16% (CI 95% 10,6-23,2) (p=0), HOMA-IR< 3: 41,7% (CI 95% 32,7-51,3) vs HOMA-IR ≥ 3: 17% (CI 95% 10,2-26,9) (p=0,0001) and absence FH of type 2 Diabetes: 38% (CI 95% 28,6-48,3) vs presence FH of type 2 Diabetes: 24,3% (CI 95% 16,6-33,9) (p=0,024). The non-associated parameters were sex (p=0,443), pubertal development (p=0,287), FH of obesity (p=0,089), FH of arterial hypertension (p=0,396), FH of dyslipidemia (p=0,435) and FH of early acute myocardial infarct (p=0,539).

**Conclusions:** The MH phenotype was present in 1 out of 3 patients with overweight/obesity. It was significantly associated with age range 11-14 years, overweight, HOMA-IR < 3, and absence FH of type 2 diabetes.

**Keywords:** children, adolescents, obesity, metabolically healthy phenotype.

## PREVALENCE OF THE METABOLICALLY HEALTHY PHENOTYPE IN PEDIATRIC OBESITY AND ITS ASSOCIATION WITH CLINICAL, METABOLIC AND FAMILY HISTORY PARAMETERS

(1)Patricia Lucía, Casavalle; (2)Laura Soledad, Romano.

(1)Pediatrician. Pediatrics Department. Hospital de Clínicas José de San Martín. Buenos Aires University. Argentina; (2)Nutritionist. Food Department. Hospital de Clínicas José de San Martín. Buenos Aires University. Argentina.

**Background and objectives:** Identifying the presence of the metabolically healthy (MH) phenotype and the factors to which it is associated in pediatric obesity, allows early detection of those who have a lower risk of future cardiometabolic complication and treatment adequation. Therefore, the objective of this study is to estimate the prevalence of MH phenotype in overweight/obesity children and adolescents and its association with clinical, metabolic and family history parameters.

**Methods:** 203 patients were studied, age range 8-14 years, both sexes, overweight (n=59) and obese (n=144), according to z score BMI (OMS), in the section of Pediatric Nutrition, February 2005-October 2016. Exclusion criteria: patients with endogenous obesity. The design was descriptive, observational, prospective, cross-sectional and comparison of independent samples. Evaluated variables: age, sex, z score BMI, pubertal development, HOMA-IR, family history (FH) of obesity, type 2 diabetes, arterial hypertension, dyslipidemia and early acute myocardial infarct. The MH phenotype was defined by the absence of any components of the metabolic syndrome (MS) according to the criteria of the Argentine Society of Pediatrics. Fisher's test was performed and p-value <0,05 was considered statistically significant.

## HIGHER ADHERENCE TO THE MEDITERREAN DIET IS ASSOCIATED WITH LOWER RISK OF GRAFT FAILURE IN RENAL TRANSPLANT RECIPIENTS

(1)Gomes Neto, António; (2)Osté, Maryse; (2)Sotomayor, Camilo G.;

(3)van den Berg, Else; (4)Gans, Rijk O. B; (5)Soedamah-Muthu, Sabita S;

(6)Bakker, Stephan J.L.; (6)Navis, Gerjan.

(1)University Medical Center Groningen; (2)Bsc. Department of Internal Medicine. University Medical Center Groningen. The Netherlands.; (3)MD. PhD. Department of Internal Medicine. University Medical Center Groningen. The Netherlands.; (4)MD PhD. Department of Internal Medicine. University Medical Center Groningen. The Netherlands.; (5)PhD. Division of Human Nutrition. Wageningen University & Research. The Netherlands; (6)MD. PhD. Department of Internal Medicine. University Medical Center Groningen. The Netherlands.

**Background and objectives:** Renal transplantation is considered the preferred treatment in end-stage renal disease. Despite improved short-term graft survival over recent years, long-term graft survival after renal transplantation has not improved. Research in this field is traditionally dominated by immunological evaluation and treatment, however non-immunological causes including diet and lifestyle are often overlooked. In the general population the Mediterranean Diet is associated with better cardiovascular and renal outcomes. We investigated whether adherence to the Mediterranean Diet is associated with graft failure in a large cohort of renal transplant recipients (RTR).

**Methods:** In this prospective observational cohort study we included all adult RTR with a functioning graft for ≥ 1 year who
visited the outpatient clinic. Dietary intake was assessed using a validated Food Frequency Questionnaire of 177 food items. RTR missing dietary data were excluded, leaving 632 RTR eligible for analyses. Adherence to the Mediterranean Diet was calculated using the nine-point Mediterranean Diet Score (MDS) by Trichopoulou based on intake of legumes, nuts, soy products, cereals, fruit, vegetables, meat, dairy, fish, alcohol and fat. Cox regression was used to analyze the association of MDS on death-censored graft failure.

**Results:** Mean ± SD age was 53 ± 13 years, 57% were male. Mean MDS was 4.7 ± 1.7. During median [IQR] follow-up of 5.3 [4.5-6.0] years, 76 RTR developed graft failure. MDS was inversely associated with graft failure (HR 0.88 [95%CI 0.77-0.99] per MDS-point increase). Adjustment for potential confounders including age, sex, time after transplantation, primary renal disease, eGFR, urinary protein excretion, smoking status and physical activity did not materially alter this association (HR 0.84 [95%CI 0.73-0.98] per MDS-point increase). When divided in tertiles, risk of graft failure was twice as high in RTR in the lowest tertile of MDS compared to RTR in the highest tertile of MDS (HR 2.0 [95%CI 1.05-3.84]), independent of potential confounders.

**Conclusions:** Higher adherence to the Mediterranean Diet is associated with lower risk of graft failure, independent of potential confounders. These findings suggest increasing Mediterranean Diet adherence may be a novel measure to improve long-term graft survival in RTR.

**Keywords:** Renal Transplantation. Graft Failure. Mediterranean Diet.

that responds to both iron status and inflammation in the regulation of iron absorption and sequestration. Our objective was to determine if enteric inflammatory activity is associated with an increase in systemic inflammation and hepcidin concentrations.

**Methods:** Serum and fecal samples were collected from 435 children aged 22-34 months. Hepcidin, C-reactive protein (CRP), and alpha-1-acid glycoprotein (AGP) concentrations were quantified in serum, while the EED biomarkers neopterin (NEO), alpha-1-antitrypsin (AAT), and myeloperoxidase (MPO) were analyzed in stool. We also measured serum ferritin, soluble transferrin receptor, hemoglobin and the presence of a hemoglobinopathy (β-thalassemia or Hemoglobin E) and considered these factors in multivariable adjusted models.

**Results:** In this sample, 8.0% had inflammation (CRP≥5mg/L or AGP≥1), 11.0% had anemia (Hb< 110g/L), and 27.2% were iron deficient (serum ferritin < 12 µg/L, corrected for inflammation). The median concentrations of NEO, AAT, and MPO were 581 nmol/L, 0.3 mg/g, and 2584 ng/mL, respectively, and the median hepcidin concentration was 13.4 ng/mL. Using a generalized linear mixed model, and adjusting for serum ferritin, age, and sex, we found no associations between hepcidin and any of the fecal inflammatory biomarkers. Though hepcidin was positively correlated with systemic inflammatory biomarkers CRP and AGP, none of the fecal inflammatory biomarkers was associated with CRP or AGP.

**Conclusions:** These data suggest that these markers of EED were not associated with a strong enough systemic inflammatory response to stimulate a response in hepcidin. Further research is needed to better understand whether EED may influence iron absorption through other pathways

**Keywords:** Environmental Enteric Dysfunction, iron, hepcidin

(1)Byrd, Kendra; (2)Lin, Audrie; (3)Rahman, Md. Ziaur; (3)Ali, Md. Shahjahan; (4)Arnold, Charles D.; (5)Jannat, Kaniz; (6)Luby, Stephen P; (5)Rahman, Md. Mahbubur; (7)Dewey, Kathryn; (7)Stewart, Christine.

(1)PhD. University of California, Davis. USA; (2)PhD. Division of Epidemiology. School of Public Health. University of California, Berkeley. USA.; (3)MS. International Center for Diarrheal Disease Research. Dhaka. Bangladesh.; (4)MS. Program in International and Community Nutrition. University of California, Davis. USA.; (5)MBBS. International Center for Diarrheal Disease Research. Dhaka. Bangladesh.; (6)Infectious Disease and Geographic Medicine. Stanford University. USA.; (7)Program in International and Community Nutrition. University of California, Davis. USA.

**Background and objectives:** Environmental Enteric Dysfunction, or EED, is an inflammatory condition of the gut that afflicts many infants and children in low- and middle-income countries. EED is characterized by increased inflammatory cell activity in the small intestine, a reduced absorptive capacity, and reduced barrier function. Hepcidin is an iron-regulatory hormone

(1)Jarosz, Miroslaw; (2)Rychlik, Ewa; (3)Sekula, Wlodzimierz.

(1)MD, PhD. Physician. Department of Nutrition and Dietetic with Clinic of Metabolic Diseases and Gastroenterology. National Food and Nutrition Institute in Warsaw. Poland; (2)PhD. Nutritionist. Department of Nutrition and Dietetic with Clinic of Metabolic Diseases and Gastroenterology. National Food and Nutrition Institute in Warsaw. Poland; (3)PhD. Economist. Department of Nutrition and Dietetic with Clinic of Metabolic Diseases and Gastroenterology. National Food and Nutrition Institute in Warsaw. Poland.

**Background and objectives:** Red meat is a source of some compounds which could promote carcinogenesis. It is characterized by high haem content that increases levels of N-nitroso compounds in the body. Processed meat contains nitrite that can react with the degradation products of amino acids to form N-nitroso compounds. During cooking at high temperate heterocyclic amines or polycyclic aromatic hydrocarbons can be formed. Red
meat is also rich in animal fat and high consumption of such products can lead to obesity.

The aim of the study was to examine the relationship between
trends in red meat consumption after the economic transforma-
tion and some cancers (colorectal, pancreatic and oesophageal)
morbidity in Poland.

**Methods:** The study was based on colorectal, pancreatic and oesophageal cancer incidence rates derived from the National Cancer Registry in 1990-2014. Data on red meat consumption (in kg/person/year) were derived from the national food balance sheets. Analysis includes the consumption of pork, beef, lamb and goat from domesticated animals. Spearman correlation coefficients were used to estimate the relationship between the examined variables.

**Results:** In 1990-2014 red meat consumption in Poland decreased from 56.1 to 41.3 kg/person/year. In the analyzed period the incidence of pancreatic and oesophageal cancer increased initially, however since the mid-90s of the twentieth century a marked decline began to be observed.

The colorectal cancer morbidity continues to grow, but to a
lesser degree than in previous years.

Positive correlations were found between red meat consump-
tion and pancreatic (0.74 for males and 0.48 for females) and
oesophageal cancer (0.64 for males, correlation coefficient not
statistically significant for females) incidence rates. There was no
positive correlation between red meat consumption and colorectal
cancer morbidity during analyzed period.

**Conclusions:** The decrease in red meat consumption in Poland could favourably affect some gastrointestinal cancers such as pancreatic and oesophageal cancer morbidity in Poland and probably was one of the reasons of the observed decline in these cancer incidence in recent years.

Furthermore smaller proportion of red meat in the diet could
influence on the reduction in the rate of increase of colorectal can-
cer incidence.

**Keywords:** red meat, gastrointestinal cancers, morbidity

ods, and assessment of nutritional status and mutual relations of
cardiovascular risk in this population.

**Methods:** This study is transversal and included 171 patients with HCV 60 HCV infected patients without MS and 111 patients with HCV and MetS. The nutritional status was assessed using body mass index (BMI) score MNA (Mini Nutritional Assessment), nutritional assessment score instantly - (instant nutritional assessment - INA) and nutritional risk index (NRI). We also calculated a combined score thus malnutrition: MNA results have merged, NRI, INA and BMI in a single combined score. We considered patients with malnutrition rezutatul based on the combined score, so it is considered malnourished individual score indicates if any is present. The diagnosis of MS was established using a modified IDF definition. Cardiovascular risk was assessed for each patient using software UKPDS-CHD.

**Results:** The age of patients with malnutrition and MetS was higher than that of the MetS without malnutrition (57.75±6.16 years vs. 51.85±9.65 years, p=0.125). Using the combined score of the total number of patients, malnutrition was present in 18 patients (10.5%). Of these, 12 patients (66.7%) belong to the group of those with MetS. The combination of malnutrition - moderate cardiovascular risk level, was observed in a small number of patients, most of the malnutrition associating with a low cardiovascular risk (n=2). Cardiovascular risk among those with only 6 patients had moderate malnutrition, and among those at high risk, only 4 associated malnutrition. The presence of Obesity was present in 122 patients (71.3%) - 58 women and 64 men. Of these, 8 patients (4.7%) had malnutrition based on the combined score.

**Conclusions:** Assessment of nutritional status in patients with HCV and MetS brings significant benefits by identifying malnutrition risk and to which they are exposed. Assessing the relationship of cardiovascular risk - malnutrition, has placed patients with malnutrition among those with low cardiovascular risk (n=2) or moderate (n=6), only a small number of people with malnutrition (n=4) with a high cardiovascular risk.

**Keywords:** nutritional status, cardiovascular risk, metabolc syndrome, chronic hepatitis C

144/1751

RELATIONSHIP BETWEEN NUTRITIONAL STATUS AND CARDIOVASCULAR RISK IN PATIENTS WITH CHRONIC HEPATITIS C AND METABOLIC SYNDROME

**Background and objectives:** The objective of this study was to evaluate the nutritional status of patients with chronic hepatitis C virus (HCV) and metabolic syndrome (MetS) by various meth-

<footnote>(1) *Dragut, Ramona Maria; (1) Rusu, Emilia; (1) Enache, Georgiana*</footnote>

<footnote>(1) *Cursaru, Raluca; (2) Rusu, Florin; (3) Gheorghita, Andra; (3) Radulian, Gabriela.*</footnote>

<footnote>(1) University of Medicine and Farmacy Carol Davila; Romania</footnote>

<footnote>(2) Emergency Military Hospital Carol Davila; Romania (3) National Institute of Diabetes Nutrition and Metabolic Diseases "N Paulescu". Romania</footnote>
# COFFEE CONSUMPTION AND SELECTED GASTROINTESTINAL CANCERS MORBIDITY IN POLAND

(1)Jarosz, Miroslaw; (2)Rychlik, Ewa; (3)Sekula, Wlodzimierz.

(1)MD, PhD. Physician. Department of Nutrition and Dietetic with Clinic of Metabolic Diseases and Gastroenterology. National Food and Nutrition Institute in Warsaw. Poland; (2)PhD. Nutritionist. Department of Nutrition and Dietetic with Clinic of Metabolic Diseases and Gastroenterology. National Food and Nutrition Institute in Warsaw. Poland; (3)PhD. Economist. Department of Nutrition and Dietetic with Clinic of Metabolic Diseases and Gastroenterology. National Food and Nutrition Institute in Warsaw. Poland.

**Background and objectives:** Coffee has been shown to induce the endogenous defense system, DNA repair capacity and to reduce the expression of genes involved in inflammation.

According to recent reports higher consumption of coffee probably protects against liver cancer. Some data from the literature suggest that it may reduce also the risk of gallbladder and colorectal cancer.

The aim of the study was to examine the relationship between trends in coffee consumption and liver, gallbladder and colorectal cancer morbidity in the past decades in Poland.

**Methods:** The study was based on liver (in 1980-2014), gallbladder (in 1970-2014) and colorectal (in 1960-2014) cancer incidence rates derived from the National Cancer Registry. Coffee consumption was determined on the basis of data on imports of coffee derived from the national statistics and converted into kg / person/year quantities.

Spearman correlation coefficients were used to estimate the relationship between the examined variables.

**Results:** In 1960-2014 imports of coffee to Poland increased from 0.13 to 3.02 kg/person/year.

Liver cancer incidence rates were rather stable in the decade of the 80's of the 20th century, whilst since the beginning of the 90's downward trends were observed. Gallbladder cancer incidence rates were stable between 1970 and the half of the 90's of the 20th century and then the decrease was noted. The colorectal cancer morbidity has increased over the whole period, but since the mid-90s of the 20th century to a lesser degree than in previous years.

Adverse correlations were found between coffee consumption and liver (-0.68 for males and -0.80 for females), and gallbladder cancer (-0.71 for males and -0.74 for females). There was no adverse correlation between coffee consumption and colorectal cancer morbidity during analyzed period.

**Conclusions:** The increase in coffee consumption in Poland could favourably affect some gastrointestinal cancers such as liver and gallbladder cancer morbidity rates in Poland and probably was one of the reasons of the observed decline in these cancers incidence in recent years.

Furthermore positive (growing) trends in coffee consumption could influence the reduction in colorectal cancer incidence rate.

**Keywords:** coffee, gastrointestinal cancers, morbidity

# RELATION OF THE PERCEPTION AND SATISFACTION OF BODY IMAGE OF CHILDREN AND ADOLESCENTS WITH DOWN SYNDROME

(1)Manochio Pina, Marina Garcia; (2)Pansani Maniglia, Fabiola;

(3)Haddad Caleiro Pereira, Cláudia; (4)Bagatini Saud Ferro, Élen Lúcia;

(5)Boiani, Mariana Barbosa.

(1)Doutora.Nutricionista.Universidade de Franca.Brasil; (2)Mestre. Nutricionista.Pontifícia Universidade Católica de Campinas. Universidade de Franca.Brasil; (3)Mestre.Nutricionista. Universidade do Sagrado Coração.Universidade de Franca. Brasil; (4)Mestre.Nutricionista.Universidade de Franca.Brasil; (5)Nutricionista.Universidade de Franca.Brasil.

**Background and objectives:** Due to the greater predisposition to weight gain and excess body fat in children and adolescents with Down Syndrome (DS), care regarding feeding and weight gain should be doubled. When this process does not happen naturally, it can contribute to young people assessing yourselfel in an inaccurate way, these changes contribute to the body image also being reformulated. The objective of this study to identify the perception and satisfaction of body image of children and adolescents with DS and to associate it with anthropometric characteristics of this population.

**Methods:** It deals with a cross-sectional and observational study with 27 children and adolescents aged 7 to 18 years old with DS, in an interior town in São Paulo state. It was applied the Figure Rating Scale and it was realized the nutritional assessment using anthropometry, electrical impedance analysis.

**Results:** It was possible to observe that the classification of body weight by age showed the following result: 11.11% underweight, 48.14% of adequacy and 40.74% above the recommended weight. The ratio of height for age showed that 55.5 % of youth had adequate linear growth. The average waist circumference was 86.33cm. The examination of electrical impedance analysis showed good hydration, muscle mass below the minimum limit and body fat above the recommended maximum. Regarding the perception of body image, there was no statistically significant difference (p>0.05), while the satisfaction of body image, indicated statistical difference (p<0.05) between the actual BMI and the desired BMI. By correlating the waist circumference was statistically different (p<0.0001).

**Conclusions:** Children and adolescents with DS are not satisfied with their body image because they wish to have a slimmer body and how bigger the waist circumference is much bigger they will notice them self's. It is necessary to have further studies in order to add new values and knowledge of the perception and satisfaction with body image of individuals with DS.

**Keywords:** Down Syndrome, Nutrition Assessment, Body Image, Nutricional Status

**Further collaborators:**

UNIFRAN (University of Franca) and APAE (Association of Parents and Friends of the Exceptional - Franca).
# A META-ANALYSIS OF THE ROLE OF A PRIORI DIETARY INDICES IN DEPRESSION AMONG 7 COHORTS; THE MOODFOOD PROJECT

(1)Nicolaou, Mary; (2)Vermeulen, Esther; (3)Elstgeest, Liset; (4)Knüppel, Anika; (5)Colpo, Marco; (6)Schoenaker, Danielle; (7)Gibson-Smith, Deborah; (8)Pot, Gerda; (9)Brouwer, Ingeborg; (10)Visser, Marjolein.

(1)PhD. Nutritionist. Academic Medical Centre - University of Amsterdam. Department of Public Health. Amsterdam Public Health research institute. Amsterdam. the Netherlands.;
(2)MSc. Nutritionist. Academic Medical Centre - University of Amsterdam. Department of Public Health. Amsterdam Public Health research institute. Amsterdam. the Netherlands.; (3)MSc. VU University. Department of Health Sciences. Amsterdam Public Health research institute. Amsterdam. the Netherlands.;
(4)MSc. Research Department of Epidemiology and Public Health. University College London. London. United Kingdom; (5)MSc. Department of Statistics, Informatics and Application. University of Florence. Laboratory of Clinical Epidemiology. InCHIANTI Study Group. Azienda USL Centro. Florence. Italy.; (6)MSc. School of Public Health.University of Queensland.Brisbane.QLD 4006. Australia.; (7)MSc. Department of Psychiatry/ EMGO+ Institute for Health and Care Research. Amsterdam Public Health research institute. VU University Medical Center. GGZ inGeest Amsterdam. The Netherlands.; (8)PhD. Diabetes and Nutritional Sciences Division. King's College London. United Kingdom; VU University Amsterdam. Section Health and Life. Faculty of Earth and Life Sciences. Amsterdam. the Netherlands.; (9)PhD. Professor. Department of Health Sciences. Faculty of Earth and Life Sciences and EMGO+ Institute for Health and Care Research. VU University. Amsterdam Public Health research institute. Amsterdam. The Netherlands.; (10)PhD. Professor. Dept of Health Sciences. Faculty of Earth and Life Sciences and EMGO+ Institute for Health and Care Research. VU University. Dept of Nutrition and Dietetics. Internal Medicine. VU University Medical Centre. Amsterdam Public Health.

**Background and objectives:** Depression will be the second leading cause of disability globally by 2020. There is increasing evidence that dietary patterns play a role in depression but recent reviews have failed to find consistent associations and have speculated that this might be due to differences in study designs and assessment methods.

We aimed to examine the association between dietary patterns and depression across a number of cohorts using a standardised protocol, and to meta-analyse the findings of these studies.

**Methods:** We developed a standardised protocol to assess the association between four a priori dietary patterns: AHEI-2010 (Chuive et al); Mediterranean diet score (Panagiotakos 2007); DASH diet (Fung 2008); The MooDFOOD diet.

Included were data of more than 20,000 participants from seven cohorts that have measured both diet and depression at different time points: InCHIANTI (Italy), LASA, NESDA, HELIUS (all three Netherlands), ALSWH (Australia), Whitehall and NSHD

(both UK). Four cohorts had repeated measures allowing prospective analysis (Whitehall, InCHIANTI, ALSWH, NSHD).

Predictor and outcome variables were standardised to enable comparison between studies. The association between dietary pattern and continuous depressive symptom scores was investigated using linear regression analysis and the association with a dichotomous 'depression' outcome using logistic regression. Analyses were conducted by researchers from the individual cohorts and meta-analyses were conducted centrally.

**Results:** Analyses will be completed by the end of May 2017. Preliminary findings of cross-sectional data show a statistically significant protective effect of the Mediterranean diet score on continuous depressive symptoms in most cohorts. Random effects meta-analysis also yielded a statistically significant protective effect, standardized B -0.08 (95%CI -0.12; -0.04, p-value<0.01).

**Conclusions:** There are indications that healthy dietary patterns are associated with fewer depressive symptoms. The full findings of this study will provide important insights that can help answer the question "Can diet contribute to the prevention of depression?"

**Keywords:** Dietary patterns. Depression. Meta-analysis.

**Further collaborators:**

Giovanna Sini. MSc. Laboratory of Clinical Epidemiology. InCHIANTI Study Group. Azienda USL Centro. Florence. Italy

A.H. Zwinderman. PhD. Professor. Department of Epidemiology, Biostatistics & Bioinformatics. Amsterdam Public Health research institute. Academic Medical Center. Meibergdreef 9. 1105 AZ Amsterdam. The Netherlands.

Brenda Penninx. PhD. Professor. Department of Psychiatry, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands.

Eric Brunner. PhD. Professor. Research Department of Epidemiology and Public Health, University College London, London, United Kingdom.

Stefania Bandinelli. PhD. MD. Professor. InCHIANTI Study Group. Azienda USL Centro. Florence. Italy.

Richard Marcus. PhD. CPsychol. Professor. MRC Unit for Lifelong Health and Aging. University College London

Gita Mishra. PhD. School of Public Health. University of Queensland. Brisbane. Australia
# HYPERTENSION, NUTRITION STATUS, DIETARY INTAKE AND PHYSICAL ACTIVITIES OF KENYATTA UNIVERSITY EMPLOYEES: THE ROLE OF NUTRITION AND PHYSICAL ACTIVITY IN CATCHING UP THE SILENT KILLER

(1)Samburu, Betty; (2)Waudo, Judith; (3)Kimiywe, Judith; (4)Kuria, Elizabeth.

(1)Msc. Programme Manager Maternal Infant and Young Child Nutrition. Ministry of Health Nutrition and Dietetics Unit. Kenya.; (2)PhD.Prof. Nutrition. Department of Foods Nutrition and Dietetics. Kenyatta University. Kenya; (3)PhD. Assistant Prof. Nutrition. Department of Foods Nutrition and Dietetics. Kenyatta University. Kenya; (4)PhD. Kenyatta University. Department of Foods Nutrition and Dietetics. Kenyatta University. Kenya.

**Background and objectives:** Background: Non communicable diseases contribute to 59% deaths worldwide annually of which 16.7% are as a result of cardiovascular diseases. It was estimated that, in 2000, up to 80 million African were hypertensive and this figure is expected to double by the year 2025. In Kenya 23.8% adults are hypertensive and out of these 91.8% are not on medication. Hypertension is referred to as a "Silent Killer" as it often goes unrecognized and undiagnosed. It may drain the country to economic and social stagnation due to related mortality, costs of treatment and absenteeism from work.

**Objectives:** To determine the prevalence of hypertension, nutrition status and dietary intake and its relationship to socio demographic characteristics among Kenyatta University (KU) Employees.

**Methods:** The target respondents were employees aged 25 to 75 years. A total of 236 subjects were selected using multistage sampling. A self administered questionnaire was used to collect data. Blood pressure (BP) and weight were measured in the respondent's offices.

**Results:** of the 236 employees, 39.4% had hypertension (BP≥140/90mmHg/taking antihypertensive medicine). However, 36.7% of respondents with hypertension were unaware. 35.6% were overweight, 16.9% were obese 1 and 3.4% were obese 2. Diets of most employees (70%) needed improvement, whereas 10% had a good diet while 20% had poor dietary intake. Only 14.6% met the daily recommended allowances for 6 key micronutrients. Majority of subjects rarely participated in sporting activities and 95% were never involved in leisure time activities. Mean diastolic BP of moderately active normal weight men (118mm/Hg) as well as the moderately active overweight men (119mm/Hg) were lower than the BP of inactive normal weight (130mm/Hg) and overweight men (137mm/Hg). There was a strong positive relationship between obesity and hypertension p value 0.000 at 95% confidence interval

**Conclusions:** Conclusion: Employee's dietary intake is wanting and therefore institutions should take action to protect health of their populations. The low intake of micronutrients and physical activity is a health risk and preventive measures need to be

put in place. Despite being overweight, physical activity is key in controlling BP.

**Keywords:** Key words: hypertension, diastolic, systolic

# THE EFFECT OF HIGH AND LOW DAIRY CONSUMPTION ON CARDIO-METABOLIC RISK FACTORS IN OVERWEIGHT ADULTS

(1)Eelderink, Coby; (2)Rietsema, Susan; (3)Van Vliet, Iris M. Y.; (4)Boer, Theo; (5)Singh-Povel, Cecile M.; (5)Geurts, Jan; (6)Corpeleijn, Eva; (7)Bakker, Stephan J.L.

(1)MSc. Department of Internal Medicine - Nephrology. University Medical Center Groningen. The Netherlands.; (2)BSc. Department of Internal Medicine - Nephrology. University Medical Center Groningen. The Netherlands.; (3)MSc. Department of Dietetics. University Medical Center Groningen. The Netherlands.; (4)BSc. Department of Laboratory Medicine. University Medical Center Groningen. The Netherlands.; (5)PhD. Department of Nutritional Sciences. FrieslandCampina. Amersfoort. The Netherlands; (6)PhD. Department of Epidemiology. University Medical Center Groningen. The Netherlands.; (7)PhD. Department of Internal Medicine - Nephrology. University Medical Center Groningen. The Netherlands.

**Background and objectives:** Dairy products contain many nutritious components that benefit health. An inverse dose-response relationship between dairy consumption and the risk of metabolic syndrome was recently reported based on a meta-analysis. There are indications that dairy intake decreases the risk for type 2 diabetes and improves glucose metabolism and insulin sensitivity which is generally disturbed in overweight and obese individuals. This study aimed to investigate the effects of high and low dairy intake on cardio-metabolic health parameters.

**Methods:** 47 overweight males and postmenopausal females [age 58.7±4.5 y, BMI 27.9±1.9 kg/m2 (mean±SD)] completed this randomized, cross-over, intervention study. Each person consumed an isocaloric high and low dairy diet (HDD (5-6 portions) and LDD (≤1 portion), respectively; 200 g semi-skimmed yoghurt, 30g low-fat (30+) cheese, 250 mL semi-skimmed milk and buttermilk) for 6 weeks in a cross-over design, with a wash-out period of 4 weeks. After each 6-week intervention period blood pressure was measured, and blood samples were collected, both fasted and during challenge tests. The tests were a 75 g OGTT (13C-labeled and combined with 2H-labeled glucose infusion to study glucose kinetics) and a subsequent fasting challenge.

**Results:** After HDD compared to LDD there were significant decreases in blood pressure [127/79 mmHg vs 132/82 mmHg, respectively (p<0.01)] and uric acid [0.29±0.06 vs 0.31±0.07 mM, respectively (p<0.001)]. Fasting glucose concentrations were similar, whereas fasting insulin concentrations were lower after the LDD [10±4 mU/L after HDD vs 9±4 mU/L after LDD (p<0.05)]. In addition, there was a small difference in HDL concentrations [1.40±0.34 mM after HDD, 1.44±0.38 mM after LDD, (p<0.05)],
but the cholesterol/HDL-ratio was not different after the interven-
tion periods [4.0 vs 3.9 (p=0.14)]. Postprandial glucose and insulin
responses as well as glucose kinetics were similar after both diets.

**Conclusions:** High dairy intake had a positive effect on blood pressure, which may be related to the decreased plasma uric acid concentration. Results: **Keywords:** Dairy consumption, metabolic syndrome, cardio-vascular health, blood pressure, overweight

**Conflict of Interest Disclosure:** Cecile M. Singh-Povel and Jan Geurts are employed at FrieslandCampina.

144/1789

DIETARY SUPPLEMENTATION OF OMEGA-3 POL-
YUNSATURATED FATTY ACIDS MANIPULATE LI-
PID HOMEOSTASIS VIA BROWNING OF WHITE
ADIPOSE IN ALREADY INDUCED OBESE MICE

(1)Zhuang, Pan; (2)Jiao, Jingjing; (3)Wang, Wenqiao; (1)Wang, Jun.

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

(3)MD. Department of Nutrition. School of Public Health. Zhejiang University School of Medicine. China.

**Background and objectives:** Obesity and related metabo-
ic disorders has reached pandemic levels. Previous studies have
showed the ameliorative effect of omega-3 fatty acids on the devel-
opment of obesity. But it is still unclear how omega-3 fatty acids
improve lipid homeostatic imbalance in already existing obesity.
Here we assessed the biological effects of eicosapentaenoic acid
(EPA; 20:5n3) and docosahexaenoic acid (DHA; 22:6n3) from
long-term dietary intake on lipid and energy homeostasis in high-
fat-diet (HFD) induced obese (DIO) mice.

**Methods:** Four-week-old C57Bl/6 mice were fed with HFD (45% fat) for 10 weeks to introduce obesity. The HFD fed mice were then trisected and fed with DHA or EPA enriched HFD (HF-D+DHA or HFD+EPA; 1% wt/wt) or HFD for 15 weeks. Systemic adiposity, hypothalamic feeding regulators, browning process of adipocytes and risk factors of hepatosteatosis were investigated. In vitro, 3T3-L1 adipocytes at different stages of differentiation were treated with EPA or DHA, and expressions of browning programme markers and mitochondrial biogenesis were investigated.

**Results:** After long-term supplementation with EPA or DHA in DIO mice, the body weight of mice did not decline (HFD+DHA or HFD+EPA vs. HFD) whereas DHA-fed female mice gained more weight if compared with the mice in HFD group. Interestingly, DHA or EPA administration improved hypercholesterolemia but aggravated hypertriglyceridemia. Nonetheless, DHA significantly reduced subcutaneous fat of male mice and both DHA and EPA improved fatty liver in female mice via down-regulating expressions of triglyceride synthesis genes and promoting β-oxidation relative genes expression. Moreover, EPA inhibited the appetite of female mice by controlling hypothalamic inflammation. Importantly, DHA or EPA significantly lowered the respiratory exchange

ratio of DIO mice, suggesting enhanced lipid mobilization. These
effects may result from promoted thermogenesis of brown adipose
tissue in all mice except DHA-fed female mice. In vitro, preadi-
pocytes treated with DHA induced a phenotypic white-to-brown
shift whereas EPA elevated uncoupling protein 1 expression and
mitochondrial biogenesis in 3T3-L1 adipocytes at differentiation
and also in mature adipocytes.

**Conclusions:** Our findings reveal the effect of DHA and EPA on lipid and energy homeostasis in already existing obesity and further clinical investigations are warranted to formulate recommendations of DHA and EPA intakes for obese subjects.

**Keywords:** Obesity, Lipid metabolism, EPA, DHA, Browning of white adipose

144/1810

CONSUMPTION OF MACRONUTRIENTS BY CE-
LIAC CHILDREN AND COMPOSITION OF MIXES
GLUTEN FREE FLOURS

(1) Wright, Ricardo A.; (2) Dyner, Luis; (3) Ferretti, Martina; (4) Olivera
Carrión, Margarita.

(1)PhD Student, Nutritionist. Center for Nutrition and Child Development Studies. Commission for Scientific Research, Argentina.; (2)PhD, Buenos Aires University, Faculty of Pharmacy and Biochemistry, Food Science Department. Argentina;

(3)Biochemist, Buenos Aires University, Faculty of Pharmacy and Biochemistry, Food Science Department, Argentina; (4)PhD, Buenos Aires University, Faculty of Pharmacy and Biochemistry, Food Science Department; Argentina.

**Background and objectives:** The gluten-free diet is the only treatment indicated for people with celiac disease. International studies indicate high intake of carbohydrates with protein and dietary fiber deficiencies. Since in Argentina there are no topic information, it was considered of interest to highlight the intake of macronutrients in celiac children and the composition of mixes gluten free flours (GFF).

**Methods:** We studied 40 children (group A: 22 children 6-8 years, group B: 18 children 9-11 years), who attended in a public hospital. Food consumption was recorded for two days and macronutrient intake was calculated using national composition tables. Simultaneously it was analyzed the composition of 4 commercial mixes GFF most commonly used by families to make bread, pasta, cookies, cakes, etc. Protein, total fat, dietary fiber, carbohydrate by difference and energy were determined.

**Results:** Intake for groups of children A and B were respectively: 1670 and 2348 Kcal; 236 and 311 g carbohydrates; 59 and 91g protein; 55 and 76g fat and 9 and 13g dietary fiber. When comparing these values with the recommendations of the Institute of Medicine, National Academies of Sciences (2005), high consumption of carbohydrates and proteins, adequate amount of fats and low of fiber was evidenced.

The analytical results of mixes GFF showed low protein content (3.1-8.5%), fat (0.2-5.4%), fiber (2.1-5.0%) and high carbohydrate
content (72,1 - 82.4%) and energy (348-359Kcal%). The ingredi-
ents used in the mixes formulation were similar with prevalence
of starchy compounds (maize starch, rice flour and potato starch
/ cassava).

**Conclusions:** The diversification of the formulation of mixes GFF with high fiber ingredients, would favor the intake of a more balanced diet in celiac children with a decrease in high carbohydrate intake and increase in dietary fiber.

**Keywords:** Celiac Disease, Children, Macronutrients, Gluten Free Flours, Chemical Composition

**Conclusions:** There are several malnourished patients to con-
sider in the first 6 months since diagnosis. BMI is the nutrition-
al indicator most commonly used by physicians. MST detected a
number of people at risk similar to the diagnoses of nutritional
assessment not BMI. So, BMI could underdiagnose malnourished
people by delaying an opportune nutritional care in persons suf-
fering HIV infection.

This work was supported by a grant from Universidad de Bue-
nos Aires, UBACyT 2014-2017 (20020130200054BA)

**Keywords:** HIV, nutritional assessment, MST, BMI, malnutrition.

NUTRITIONAL STATUS IN RECENTLY DIAG-
NOSED HIV-INFECTED PEOPLE

(1)Peralta, Leticia; (2)Slobodianik, Nora H.; (3)Feliu, Maria Susana;

(3)Stambullian, Marcela.

(1)PhD student; (2)PhD. University of Buenos Aires, School of Pharmacy & Biochemistry. Dept. Nutrition & Food Science. Argentina.; (3)PhD.

**Background and objectives:** Despite the benefits from highly active antiretroviral therapy (HAART), malnutrition remains as a problem among HIV-infected individuals specially in newly diagnosed, in whom HAART does not start o just started few weeks ago. Objective: To assess nutritional risk and/or nutritional status from different indicators, in a group of HIV patients.

**Methods:** Cross-sectional, descriptive study. Patients diagnosed with HIV infection no more than 6 months ago were included. Malnutrition screening tool (MST) was performed. Anthropometry: weight, height and mid-upper arm circumference. BMI, % of involuntary weight loss (UWL) and significantly UWL, were calculated. It was considered BMI at risk between 18,5-20 kg/m2 (Wanke MD, et al. 2004). Total cholesterol (TC) and albumin levels were collected from medical records. Transferrin and ultra-sensitive C-reactive protein were determined by quantitative radial immunodifussion on plates and immunoturbidimetry, respectively. Nutritional assessment (NA) was performed by 2 registered dietitian specialized in HIV infection. Values were considered statistically significant at p<0.05. Software STATA 11,1.

**Results:** 53 patients were included. Regarded MST, 28% presented moderate and 16% had high nutritional risk. In relation to BMI, 6% were between 18,5-20kg/m2 and 4% were <18,5kg/m2. Nutritional assessment diagnosed 30% at nutritional risk and 14% with undernutrition. 36% showed a significant UWL. There is statistical significantly association between NA and MST (p≤0.0001) and BMI (p≤0.001) but not all undernourished people were identified by BMI. 73.4% of patients with BMI in normal range were diagnosed with undernutrition by NA. Biochemical analysis showed, a media of TC of 142mg/dL (IQR 102,7;192.2) and transferrin of 205,8mg/dL (RIQ 167,2;240,4), but albumin level in normal range: 3,9g/dL (RIQ 3,5;4,4). The average value of CRP was 27,4g/L. (RIQ 14,4;47,0)

WALNUT SUPPLEMENTATION FOR 2 YEARS IN
OLDER INDIVIDUALS REDUCES LDL-CHOLES-
TEROL WITHOUT ADVERSE EFFECTS ON ADI-
POSITY. A SUB-STUDY OF THE WALNUTS AND
HEALTHY AGING (WAHA) STUDY

(1)Freitas-Simoes, Tania M.; (2)Cofán, Montserrat; (3)Serra-Mir, Mercè;

(3)Roth, Irene; (4)Calvo, Carlos; (5)Valls-Pedret, Cinta; (6)Doménech, Mónica; (2)Sala-Vila, Aleix; (6)Ros, Emilio.

(1)MSc. Nutritionist. Endocrinology and Nutrition Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain.; (2)DPharm, PhD. Endocrinology and Nutrition Service, Hospital Clínic, IDIBAPS), Spain / CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain.; (3)RD. Endocrinology and Nutrition Service, Hospital Clínic, IDIBAPS), Spain / CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain.; (4)BSc. Endocrinology and Nutrition Service, Hospital Clínic, IDIBAPS), Spain / CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain.; (5)MSc. Endocrinology and Nutrition Service, Hospital Clínic, IDIBAPS), Spain / CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain.; (6)MD, PhD. Endocrinology and Nutrition Service, Hospital Clínic, IDIBAPS), Spain / CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain.

**Background and objectives:** Nuts are long known to have a cholesterol-lowering effect. Because nuts are fat-rich, energy-dense foods, there is a widespread concern that their regular consumption may lead to unwanted weigh gain, but there are no long-term (>24 weeks) data on lipids and adiposity changes after nut-supplemented diets. We hypothesized that incorporating daily doses of walnuts to the habitual diet of older free-living individuals for 2 years would lower blood cholesterol without adverse effects on adiposity.

**Methods:** WAHA is a dual-center randomized controlled trial aimed at assessing the effects of walnuts on age-related diseases in individuals aged 63 to 79 years. In the Barcelona node, 352 participants (108 men/244 women) were assigned to either usual
diet without nuts (control group, CG) or usual diet with walnuts at
≈15% of energy (30-60 g/day depending on energy requirements)
(walnut group, WG). Fasting serum lipids, body weight, waist cir-
cumference and body fat distribution by DEXA were assessed at
baseline and at the end of the trial. We used changes in the red
blood cell proportion of alpha-linolenic acid (ALA) as a biomark-
er of adherence to the intervention. Differences in outcomes were
assessed by ANCOVA adjusting for sex, age, and baseline values;
lipid changes were additionally adjusted for in-trial changes in sta-
tin treatment.

**Results:** 2-year data were available for 329 subjects (165 WG, 164 CG). RBC ALA increased in the WG by 0.236 % (95% confidence interval [0.219 to 0.263]; P<0.001 vs. CG). LDL-cholesterol changes in the WG and CG were -8.36 [-11.90 to -4.82] vs. -2.90 [-6.55 to 0.75] mg/dl, respectively (P=0.036). No between-group differences were observed for other lipids, body weight, body mass index, waist circumference, or body fat distribution.

**Conclusions:** 2-y supplementation with walnuts decreased LDL-cholesterol. This concurs with prior evidence observed in smaller trials conducted in younger individuals treated for up to 24 weeks. The results help dispel the notion that nuts are obesogenic foods, a still common constraint to recommend their consumption as a cost-effective strategy to prevent cardiovascular disease.

**Keywords:** adiposity, cholesterol, walnuts.

**Conflict of Interest Disclosure:** ER has received research funding from the California Walnut Commission and is a nonpaid member of its Scientific Advisory Committee.

144/1832

NUTRITIONAL STATUS REGARDING IRON AND ZINC IN CELÍAC CHILDREN AND MINERAL CONTRIBUTION OF MIXES FLOURS

(1) Wright, Ricardo A.; (2) Dyner, Luis; (3) Rosa, Diana; (4) Cagnasso, Carolina; (5) Olivera Carrión, Margarita.

(1)PhD Student, Nutritionist. Center for Nutrition and Child Development Studies. Commission for Scientific Research.;

(2)PhD, Buenos Aires University, Faculty of Pharmacy and Biochemistry, Food Science Department. Argentina; (3)PhD. National University of La Plata. Faculty of Veterinary Medicine.

Mineral Nutrition Laboratory. Argentina; (4)PhD, Buenos Aires
University, Faculty of Pharmacy and Biochemistry, Food Science
Department.

**Background and objectives:** In order to mitigate iron (Fe) deficiency in Argentina, 3 mg / 100g of Fe is added to wheat flour (WF). Nevertheless, Gluten Free Flours (GFF) are not added to Fe. Deficiencies of Fe and zinc (Zn) have been reported in celiac people even though they may consume red meat.

In this paper we studied Fe and Zn reserves in celiac children attending a public hospital and mineral content of the mixes GFF most commonly used at home.

**Methods:** As reserve indicators, serum Ferritin and Zn were determined in 40 children (age 8.8 ± 2.0 years, 67.5% female,

32.5% male). In 4 most used commercial mixes GFF, Fe and Zn were analyzed by atomic absorption spectrometry.

**Results:** The serum ferritin concentration was 23.0 ± 15.0 µg/L, where 37.5% (n=15) presented levels below the limit (≤15 µg/L), while 62.5% (n=25) presented normal iron deposits (> 15 µg/L).

For Zn, serum levels were 121.7 ± 36.0 µg/dL, where 12.5% (n = 5) presented deficiency (<0.82 µg/dL) while 87.5% (n=35) had adequate reserves (>0.82 µg/dL).

In commercial mixes GFF, Fe concentration was very low: not detectable in two samples and low in the remaining (0.10 ± 0.06 mg%, 0.60 ± 0.04 mg%). These values were very low compared to enriched WF (3mg / 100g)

Regarding Zn, the range found in mixes GFF (0.30 ± 0.01 - 0.70 ± 0.01 mg%), exceeded the results found in WF (not detectable - 0.36 ± 0.04 mg%).

**Conclusions:** In the studied population, the third part presented deficiency respect to the Fe, and the tenth part respect to the Zn. Compared to WF, the mixes GFF were very poor Fe contributors and adequate in Zn. This would indicate the importance of Fe addition to GFF flours.

**Keywords:** Celiac Disease, Children, Ferritin, Serum Zinc, Gluten Free Flours

144/1833

NUTRITIONAL STATUS OF FEMALE PATIENTS WITH BREAST CANCER ATTENDING THE RADIOTHERAPY DEPARTMENT OF THE UNIVERSITY COLLEGE HOSPITAL, IBADAN, NIGERIA

(1)Fadupin, Grace T.; (2)Lawal, Hadiyah I.; (3)Ogunkunle, Morenike.

(1)PhD. Nutritionist. University of Ibadan, Ibadan, Oyo State, Nigeria; (2)M.Sc. Nutritionist. University of Ibadan, Ibadan, Oyo State, Nigeria.

**Background and objectives:** Nutritional status of cancer patients can be compromised in direct response to tumor induced alterations in metabolism. There is dearth of information on the nutritional status of female Nigerian patients with breast cancer. This study was carried out to access the nutritional status of female patients with breast cancer attending the Radiotherapy Department of the University College Hospital, Ibadan, Nigeria.

**Methods:** Thirty-five female patients with breast cancer were assessed. A semi-structured interviewer administered questionnaire and food frequency questionnaire were used to obtain information on the socio-demographic characteristics, medical history and frequency of food consumed by the patients. The body mass index (BMI in kg/m2) of the patients was determined. Data were analyzed using descriptive statistics and chi-square at p<0.05.

**Results:** The mean age of the patients was 47.3± 9.58 years. Most (70.2%) of the patients were Yoruba, 60.0% had secondary or tertiary education, 91.4% were married and 82.9% had ≥ 3 children. Majority (80.0%) were diagnosed with breast cancer less than 2 years. Their main sources of staple were cereals, grains,
roots and tubers and their protein sources were meat fish and legumes. Fruits were only consumed occasionally as snacks and vegetables were only consumed as accompaniment to staples. The mean height (m), weight (kg) and BMI (kg/m2) of the patients were $1.57 \pm 0.040\text{m}, 69.57 \pm 11.56\text{kg/m2}$ and $29.15 \pm 4.79\text{kg/m2}$. None of the patients was underweight, 20.0% had normal weight while others were overweight (45.75%), obese (31.4%) or grossly obese (2.9%). A significant association was observed between the patient BMI and occurrence of breast cancer.

**Conclusions:** Overweight and obesity were prevalent among the patients. The patients need proper nutritional counseling on adequate consumption of fruits and vegetables as well as maintenance of normal body weight for better health.

**Keywords:** Nutritional status, Female patients with breast cancer, Ibadan, Nigeria

144/1870

CD36 GENOTYPE DOES NOT AFFECT FAT SENSITIVITY IN NONOBESE SUBJECTS

(¹)Chmurzynska, Agata; (²)Galinski, Grzegorz; (³)Młodzik, Monika.

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

(²)PhD. Nutritionist. Department of Human Nutrition and Hygiene. Poznan University of Life Sciences. Poland; (³)MSc. Biotechnologist. Department of Human Nutrition and Hygiene. Poznan University of Life Sciences. Poland.

**Background and objectives:** A single nucleotide polymorphism of the CD36 gene (rs1761667; A/G) has been proposed to be one of the main determinants of fatty acid sensitivity. The relationships between fat intake, sensitivity to fat, and body weight and composition are still debatable. The aim of this study was to analyze whether the CD36 genotype affects oral fatty acid sensitivity and whether fat intake or body composition may modify this relation.

**Methods:** 131 people (88 women and 43 men) aged 20–40 were enrolled in the so-called Fat Taste Project. Body weight was measured using the electronic scale and body composition was analyzed using a BodPod (Cosmed, Italy). Food intake was assessed with dietary records and the intake of nutrients was calculated using the Dieta 5.0 program (National Food and Nutrition Institute). The ability to discriminate samples containing different amounts of fatty acids was investigated using salad dressings with different concentrations of canola oil. An ascending forced-choice triangle procedure was applied. The subjects were divided into three subgroups: with low, medium, and high sensitivity. The CD36 genotype (rs1761667) was analyzed using hybridizing probes.

**Results:** In women, the mean body mass was $62.1 \pm 1.1$ kg, the mean BMI was $22.4 \pm 0.3$ kg/m2, and the mean percentage body fat was $26.7\% \pm 1.0\%$; in men, these parameters were respectively $81.2 \pm 2.3$ kg, $25.1 \pm 0.7$ kg/m2, and $25.4\% \pm 1.4\%$. The average

daily fat intake was $78.6 \pm 3.0$ g in women and $77.8 \pm 3.0$ g in men. The average percent energy from fat was $32.3\% \pm 0.6\%$ in women and $32.2\% \pm 1.1\%$ in men. The CD36 gene frequencies were 0.5 for both alleles. The CD36 genotype did not affect the ability to discriminate fat content in the test samples, irrespective of body composition. People with the AA genotype, who are genetically less sensitive to fat, were able to detect lower concentrations of fat when their diets contained more fat, this tendency was however not statistically significant.

**Conclusions:** The CD36 genotype does not affect oral fatty acid sensitivity in nonobese adults.

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

**Keywords:** fat taste, CD36, body composition, fat intake

144/1886

QUALITY NUTRITIONAL COMPARISON OF PRE-HISPANIC DIET, DASH DIET, FAST METABOLISM DIET, GLUTEN FREE DIET & ALCALINE DIET AS A CONTRIBUTORY TREATMENT OPTION FOR CANCER

(¹)Cárdenas García, Maura; (²)Hernández Caballero, Marta Elena;

(³)Guerrero Africani, Marcela Lucía; (⁴)Jiménez Hernández, Diana;

(⁴)Zambrano Zacaula, Zurisadai.

(¹)D.C. Maura Cárdenas García. Facultad de Medicina. Benemérita Universidad Autónoma de Puebla. México; (²)D.C. Facultad de Medicina. Benemérita Universidad Autónoma de Puebla. México.; (³)M.C. Facultad de Medicina. Benemérita Universidad Autónoma de Puebla. México; (⁴)L.N.C.P. Laboratorio de Fisiología Celular y Molecular. Facultad de Medicina. Benemérita Universidad Autónoma de Puebla. México.

**Background and objectives:** During the development of this task quality nutrition was made of different diets which have been recommended as nutrition treatment contributories in patients who suffer from cancer, and also from energy protein nutritional deterioration on account of losing weight, emaciation, stress and malnutrition. Therefore, nutritional treatment is an essential pillar due to the nutritional requirements that are more specified and must be complemented.

**Methods:** Five different diets were selected taking into consideration five dietary events for a week with an estimated energy waste 30-35 kilocalories gram per day for 20-40 year-old adult woman with cancer. From the elaborated menus a calculi was made for each nutriment according to food composition table for Mexicans, taking into account the main nutrient compounds for cancer. The 7 weekdays results were achieved and was compared with the suggested diary ingested established for the healthy Mexican population according to age and gender.

**Results:** Cancer patient diet must include important nutrients as dietetic fiber, 25 – 35 grams per day, monounsaturated fatty acids, polyunsaturated, antioxidants, vitamins as ascorbic acid 75 mg/per day, retinol 800 µg - 1.000 µg, gamma tocopherol 15
mg/ día, phytoestrogens like isoflavons, oligometals like selenium, calcium and polyphenols. Diet with majority of these nutriments is prehispanic diet, which meets diary ingested requirements in comparison to alcaline, despite being richer in antioxidants but it does not meet the suggested requirements especially in macro nutriments. Obtained aminoacids quantities suggest epigenetic action as genomic modificators, acting as anti-cancerigen for supresor actions of tumoral genes.

**Conclusions:** It was observed that not all suggested menus meet the nutritional requirements for the oncologic aspects as a possible treatment. It is important to do more nutritional research to meet treatments and patient benefits. Nowadays, there are many diets with different characteristics, however, a diet it cannot be generalized for a nutritional treatment, it must be individualized according to patient to provide a more completed and specific nutritional support.

**Keywords:** nutrition, clinical, nutrition quality, diets, cancer

144/1896

HIGH 24-H URINARY SULFATE EXCRETION IS ASSOCIATED WITH LOW RISK OF GRAFT FAILURE IN RENAL TRANSPLANT RECIPIENTS

**Background and objectives:** Hydrogen sulfide (H2S) is a cytoprotective compound, which is an intermediate in the metabolic pathway between dietary sulfur-containing amino acids and the end-metabolite of this pathway, sulfate. High 24-h urinary excretion of sulfate (UExS) may therefore reflect high H2S bioavailability and thereby be associated with protection against organ damage. We therefore aimed to investigate the association of UExS is associated with graft failure in renal transplant recipients.

**Methods:** We included 687 stable RTR that were recruited at least 1 year after transplantation. UExS was measured from 24-h urine samples at baseline. Cox regression analyses have been performed to study association of UExS with outcome.

**Results:** In our cohort, median age was 55 years, 57% were males, mean eGFR was 45 ml/min, and median time between transplantation and baseline was 5.5 (interquartile range 4.5 –

6.0) years. Median 24-h UExS was 17.1 mmol/24-h. Over a median follow-up of 5.3 (interquartile range: 4.5 – 6.0) years 81 RTR experienced graft failure. UExS was significantly associated with decreased graft failure (HR: 0.44 per log2 increment, 95% CI: 0.33-0.59, P<0.001). The association remained significant (HR: 0.50 per log2 increment, 95% CI: 0.27-0.95, P=0.03) after adjustment for age, sex, eGFR, proteinuria, BMI, physical activity, protein intake, alcohol intake, smoking behavior, transplantation-related factors (e.g. cold ischemia time, early rejection), immunosuppressive drug usage, antidiabetic drug usage, antihypertensive drug usage, and blood urea level. Additional adjustment for 24-h urinary creatinine excretion (reflecting muscle mass) did not materially change the association, although it became slightly less significant (HR: 0.52 per log2 increment, 95% CI: 0.27-1.00, P=0.05).

**Conclusions:** The results of this study demonstrate a significant inverse association of UExS with graft failure in RTR and suggests a protective effect of increased sulfur intake. An underlying mechanism of this association may be increased H2S pathway activity. Additionally, the association may be explained by beneficial effects of increased muscle mass related to higher sulfuric amino acid intake and in general higher dietary protein intake. For future research, it is interesting to study what the effects are of specific dietary sources of sulfate on graft failure.

**Keywords:** sulfate; graft survival; renal transplantation, amino acids

144/1919

RELATIONSHIP BETWEEN FAT MASS AND WAIST CIRCUMFERENCE WITH THE TRANS FATTY ACIDS INTAKE ON WOMEN OF CHILDBEARING AGE. PRELIMINARY STUDY

**Background and objectives:** The childbearing years are an important life stage for women, where the obesity can have health consequences in the medium and long term. Intake of trans fatty acids (TFA) from diet has been associated with the development of abdominal obesity and consequently with cardiovascular disease and diabetes, these are currently considered risk factors. The aim of the work was to explore the relationship between the consumption of TFA and fat mass (FM), visceral fat (VF) and waist circumference (WC) on a population of childbearing women from

<footnote>(¹)Said, Yusof; (²)Post, Adrian; (³)Minovic, Isidor; (⁴)van Goor, Harry;</footnote>

<footnote>(⁵)Postmus, Douwe; (⁶)van den Berg, Else; (⁷)Navis, Gerjan; (⁸)Bakker, Stephan J.L.</footnote>

<footnote>(¹)MD. PhD candidate. Department of Nephrology. University Medical Center Groningen. The Netherlands.; (²)BSc. Department of Nephrology. University Medical Center Groningen. The Netherlands.; (³)PharmD. Department of Nephrology. University Medical Center Groningen. The Netherlands.; (⁴)PhD. Department of Pathology and Medical Biology. University Medical Center Groningen. The Netherlands.; (⁵)PhD. Department of Epidemiology. University of Groningen. The Netherlands.;</footnote>

<footnote>(⁶)MD. PhD. Department of Nephrology. University Medical Center Groningen. The Netherlands.; (⁷)MD. PhD. Department of Nephrology. Groningen Kidney Center. University Medical Center Groningen. The Netherlands.</footnote>

<footnote>(¹)Morínigo Martínez, Macarena; (²)Mereles Ceuppens, Laura Graciela; (³)Coronel Mendez, Eva Eugenia; (²)Wiszovaty, Lourdes;</footnote>

<footnote>(²)Caballero, Silvia; (³)Piris, Patricia; (²)Michajluk, Javier Boris; (³)Araujo Pino, Silvia Stella; (³)Aguilar Rabito, Ana Carolina; (³)Gonzalez Cespedes, Laura Elizabeth.</footnote>

<footnote>(¹)Nutritionist. Department of Nutrition Research. Faculty of Chemical Sciences. National University of Asuncion. Paraguay;</footnote>

<footnote>(²)Departamento de Bioquímica de Alimentos. Dirección de investigaciones. Facultad de Ciencias Químicas. Universidad Nacional de Asunción. Paraguay. (³)Departamento de Nutrición. Dirección de investigaciones. Facultad de Ciencias Químicas. Universidad Nacional de Asunción. Paraguay.</footnote>
Facultad de Ciencias Químicas (FCQ) of the Universidad Nacional de Asunción.

**Methods:** Three outcome measures have been examined in women students (n=56): The percentage of FM and VF, by the Omrom BF500 Body Composition Monitor with Bioimpedance (NIH/WHO guidelines for BMI- Gallagher et al). The WC, following the WHO Physical Measurement Guide. (3) Consumption of TFA per day (g/TFA/day) by a Food Consumption Frequency (FCA) survey. For statistical analysis; the Spearman correlation was applied and the Kolmogorov-Smirnov and Kruskal-Wallis Z tests were used for the comparison of means.

**Results:** The mean age was 21.8±2.4 years. The median of caloric intake by TFA was 3.3% of total energy (IC95%: 3.11-4.5%) and 7.3g/TFA/day (IC95%: 6.9-9.8 g/TFA/day). The mean of the anthropometric measurements was 31.5% (IC95%: 30.8-33.9%) for FM, 3.7 (IC95%: 3.4-4.0) for VF and 72.8cm (IC95% 70.8-74.8cm) for WC. The mean TFA consumption was increasing according to the FM classification, 8.4gTFA/d (Normal), 7.1gAGT/d (High) and 8.8gAGT/d (Very high), although the differences was not significant (p=0.278). The mean consumption of TFA was 6.8gTFA/day in women with WC not increased, whereas 9.5 gTFA/day with WC increased (p=0.092). All evaluated women had adequate VF. TFA consumption showed a proportional trend with FM (r=0.001) and WC (r=0.104), although not significant (p≤0.05).

**Conclusions:** A trend between FM, WC and the TFA intake was observed.

**Keywords:** Childbearing women, fat mass, waist circumference, trans fatty acids, intake.

**Methods:** The experiments were conducted on 60 male Wistar rats divided into 8 groups. Rats were fed with diets: group 1- C – a control diet; group 2 - CC– a control diet with Cornelian cherry powder (300 mg/100 g); group 3 - HLC– a control diet with honeyberry Lonicera caerulea powder (300 mg/100 g); group 4 – CC+HLC - a control diet with HLC powder (300 mg/100 g) and CC powder (300 mg/100 g); group; 5 – HF- a high fat diet containing 15% of animal fat (lard); group 6 – HF+CC– a HF diet with CC powder (300 mg/100 g); group 7 – HF+HLC– a control diet with HLC powder (300 mg/100 g); group 8 – HF+CC+HLC - a control diet HLC (300 mg/100 g) and CC powder (300 mg/100 g).

**Results:** CC and HLC did not significantly affect on morphological parameters in blood in experimental rats. It significantly affected on liver enzyme activity ALAT, which decreased significantly in CC+HLC animals regardless of fat content in diet (41.3 vs 33.8 U / l). Comparing the effect of CC vs HLC a higher reduction in addition of honeyberry were observed. Similar results in blood TG levels were observed. The addition of one of dried fruits caused TG reduction - 11% for CC, 19% for HLC and 38% for both of them. Polyphenols have a protective effect on the liver, which is related to its ability to block both inflammatory processes in the liver and activation of stellate cells. Addition of CC and HLC caused lowering Phosphorus, Calcium and Sodium level. The effect of the supplement is independent of the fat content in the diet.

**Conclusions:** Cornelian cherry and honeyberry Lonicera caerulea can be addet as an element of functional food to protect liver and reduce TG level.

**Keywords:** Cornelian cherry honeysuckle Lonicera caerulea, biochemical parameters, rats

**Further collaborators:** DORIAN NOWACKI

144/1941

THE EFFECT OF CORNELIAN CHERRY AND HONEYSUCKLE ADDED TO DIET ON SELECTED BIOCHEMICAL PARAMETERS IN WISTAR RATS

**Background and objectives:** Fruits of cornelian cherry (Cornus mas L.) and berries of honeysuckle (Lonicera caerulea L. var. kamtschatica) are a valuable source of phenolic compounds (1). These compounds show many properties beneficial for human organism (2). The fruits can also contain other biologically active compounds, like iridoids, which exhibit antibiotic, anti-inflammatory or hypertensive activities (3).

144/1947

EXPERIMENTAL, PROSPECTIVE, RANDOMIZED AND DOUBLE BLIND STUDY ABOUT SAFETY AND EFFICACY OF MAZINDOL AS A TREATMENT AGAINST OBESITY

**Background and objectives:** Background: since 1980, obesity has more being increasing in all over the world. It is an incurable but controllable chronic metabolic disease, aggravating other conditions, which is currently the major public health problem in many countries. At present, pharmacological therapy is one of the most used tools along with diet and exercise. Mazindol (MZ1mg) is a drug approved by the FDA and ANMAT, in therapy as anorexigenic.

**Objective:** to evaluate for the first time in our country, the efficacy and safety of the MZ1 1mg (Laboratory Produmedix Argentina SA) as an adjuvant in the treatment of obesity in the staff

<footnote>(1)Bronkowska, Monika; (2)Lozna, Karolina; (3)Figurska-Ciura, Danuta;</footnote>

<footnote>(2)Orzel, Dagmara; (2)Styczynska, Marzena; (3)Kucharska, Alicja;</footnote>

<footnote>(4)Sozanski, Tomasz; (2)Piotrowska, Ewa.</footnote>

<footnote>(1)Associate Professor, Head of Department of Human Nutrition, Wrocław University of Environmental and Life Sciences, Poland;</footnote>

<footnote>(2)Dr, Department of Human Nutrition, Wrocław University of Environmental and Life Sciences, Poland; (3)Department of Fruit, Vegetable and Plant Nutraceutical Technology, Wrocław University of Environmental and Life Sciences Poland;</footnote>

<footnote>(4)Department of Pharmacology, Wrocław Medical University, Poland.</footnote>

<footnote>(1)Scacchi, Fabricio; (2)Quintans, Rubén; (3)Sánchez, Natalia;</footnote>

<footnote>(4)D'Onofrio, Francesca; (2)D'Onofrio, Francisco.</footnote>

<footnote>(1)Phd. Nutrition Team investigator. Argentina; (2)Bsc Dietitian at Nutrition Team. Argentina; (3)Bsc, Professor at National University of Tucuman. Argentina.</footnote>
of the Police of Tucumán (18-60 years) with a diagnosis of obesity (BMI ≥30).

**Methods:** We conducted a randomized double-blind study of 100 patients, divided in placebo group (GP) and active drug group (AD) for a period of 3 months. Previously patients were evaluated clinically and through laboratory screening as method of exclusion by having other diseases and/or pregnancy. The drug was administered as one pill daily and subjects controlled every 15 days from the clinical-nutritional and mental health point of view.

**Results:** AD reflected an average loss of weight of 9kg, with a 9% reduction in fat mass percentage. On the average BMI was reduced to 4 points and the circumference of the waist was 9cm for men and 11cm in women. The insulin in blood was reduced by 8 units and the homeostasis model assessment (HOMA) 2 units. GOT were reduced 8 units and the GPT 9 units. Systolic pressure decreased 12 units and diastolic pressure 6 units in women; in men was 7 and 3 respectively. Hemoglobin, glycemia, TC, HDL, LDL, and TG did not reflect significant reductions.

Ultrasound Hepato-biliary reported: Of 22 patients with fatty liver, 30% recovered normal function while 12 AD patients recovered its 50% of their normal hepatic function. There were no adverse effects of importance during the study.

**Conclusions:** The use of Mazindol among Policy members of Tucuman, Argentina, improved their quality and life expectancy by the weight reduction with the reduction the risk factors in relation with the overweight and obesity.

**Keywords:** Mazindol, Obesity, Police, Weight, Cholesterol

144/1948

DIETARY MAGNESIUM RESTRICTION PROMOTES INSULIN RESISTANCE IN RATS FED A HIGH-FAT DIET

**Background and objectives:** Magnesium (Mg) deficiency has been related to pre-diabetic conditions in experimental and human studies. Here, we evaluated in rats, for 24 weeks, the effects of dietary Mg restriction (90% of recommendations) and lipid-overload (a recognized dietary experimental model of obesity) on Mg status and whole body insulin sensitivity.

**Methods:** Male Wistar rats (n = 24; initial body weight 97-123 g) were fed ad libitum semipurified AIN-93-based control (CT) or high-fat (HF) diets (adequate or Mg-restricted; 500 [Mg500] and 50 [Mg50] mg Mg/kg diet, respectively). Magnesium concentrations in plasma, erythrocyte, bone, muscle, urine and feces) were measured by atomic absorption spectrophotometry. An intraperitoneal insulin tolerance test (ipITT) was performed at weeks 8, 12, 16 and 24. TRPM6 expression in the kidney was analyzed by Western-blot.

**Results:** HF intake increased adiposity and body weight gain (p <0.05), irrespective of Mg restriction. Also as expected, Mg concentrations were decreased in plasma (p <0.01), urine (p <0.01) feces (p <0.001) and bone (p <0.001) of rats fed Mg-restricted diets. However, HF [Mg50] rats presents higher concentration of Mg erythrocyte. Compared to controls, HF Mg [50] rats developed insulin resistance (p = 0.007 and p = 0.02 at 16 and 24 weeks, respectively). Preliminary results indicate that dietary Mg restriction enhances kidney expression of TRPM6, regardless of insulin sensitivity.

**Conclusions:** In our experimental model, whole body insulin resistance altered the Mg compartmentalization in response to its dietary restriction without modifying the kidney abundance of the major Mg reabsorption channel. The evaluation of the insulin signaling pathway and other Mg channels in key compartments linked to Mg homeostasis (kidney, intestine) may elucidate the relationship between insulin resistance and Mg status.

**Keywords:** Magnesium deficiency. Lipids. Insulin sensitivity. TRPM6.

**Further collaborators:**

Fabiana da Silva Lima. MSc. Biologist. Department of Food and Experimental Nutrition. University of São Paulo. Brazil.

<footnote>(1)Batista da Rocha Romero, Amanda; (2)Machado Cavassana, Vitor;</footnote>

<footnote>(2)Fragal, Beatriz; (3)De Carli, Eduardo; (4)Rodrigues Lobo, Alexandre;</footnote>

<footnote>(5)Colli, Celia.</footnote>

<footnote>(1)MSc. Nutricionist. Department of Food and Experimental Nutrition. University of São Paulo. Brazil.; (2)Undergraduate student. Department of Food and Experimental Nutrition. University of São Paulo. Brazil.; (3)PhD. Nutricionist. Department of Food and Experimental Nutrition. University of São Paulo. Brazil.; (4)PhD. Nutricionist. Department of Food and Experimental Nutrition. University of São Paulo. Brazil. Municipal Secretary of Education. Pirai do Sul. Parana. Brazil.; (5)PhD. Pharmacist. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil.</footnote>
ADHERENCE TO THE MEDITERRANEAN AND
THE CENTRAL EUROPEAN DIETS IN RELATION
TO WEIGHT LOSS CHANGES IN POSTMENOPAU-
SAL WOMEN WITH DIAGNOSED METABOLIC
SYNDROME

(1)Bajerska, Joanna; (2)Chmurzynska, Agata; (3)Muzsik, Agata;

(4)Menclewicz, Katarzyna; (5)Krzyżanowska, Patrycja; (6)Walkowiak, Jarosław.

(1)PhD. Dietician. Department of Human Nutrition and Hygiene. Poznan University of Life Sciences. Poland; (2)PhD. Nutritionist. Department of Human Nutrition and Hygiene. Poznan University of Life Sciences. Poland. International Society of Nutrigenetics/ Nutrigenomics (ISNN); (3)MSc. Nutritionist. Department of Human Nutrition and Hygiene. Poznan University of Life Sciences. Poland; (4)MSc. Dietician. Department of Human Nutrition and Hygiene. Poznan University of Life Sciences. Poland; (5)MD. PhD. Medical biologist. Department of Pediatric Gastroenterology and Metabolism. Poznan University of Medical Sciences. Poland; (6)Professor. MD. PhD. Pediatric Gastroenterologist. Department of Pediatric Gastroenterology and Metabolism. Poznan University of Medical Sciences. Poland.

**Background and objectives:** It has been demonstrated that the Mediterranean diet (MED) can improve body weight and reduce the incidence of diabetes mellitus and metabolic syndrome. On the other hand, it has also been stated that the adoption of this dietary regimen by populations other than Southern European is difficult, on account of the high cost and limited availability of these unfamiliar food items, as well as cultural differences in food preference. The aim of this study was to assess the level of adherence to MED and the Central European diet (CED) and to examine its association with weight loss changes.

**Methods:** Data were used from 130 free-living postmenopausal women with diagnosed metabolic syndrome (mean (SD); age: 61.0 (5.0) years; body mass index: 33.5 (4.6) kg/m2) participating in 16-week randomized dietary interventions aimed at comparing the effect of hypocaloric MED or CED with different macronutrient compositions on body weight loss. Dietary adherence was calculated as a difference between the reported and recommended distributions of energy intake from macronutrients using a Malhanobis distance equation. This equation generates an adherence score that represents the degree of deviation from the prescribed goals for macronutrients intake; lower scores show better adherence and higher scores indicate greater non-adherence.

**Results:** In both groups, the adherence to dietary regimen tended to worsen over time. The 16-week body weight changes in the most and least adherent participants, irrespective of assigned dietary intervention were -9.4 ± 3.7 and -5.8 ± 3.2 kg (p < 0.001).

**Conclusions:** Adherence to the dietary regimen is a stronger predictor of weight loss success than the diet used.

**Keywords:** Adherence, Central-European diet, Dietary intervention, Mediterranean diet, Weight loss,

**Conflict of Interest Disclosure:** The authors declare that they have no conflict of interest.

The project was financed by the National Science Centre award on the basis of decision number DEC-013/09/B/NZ9/02365

EFFECTS OF A 16-WEEK DIETARY INTERVENTION WITH EITHER A MEDITERRANEAN DIET OR A CENTRAL EUROPEAN DIET ON ANTHROPOMETRIC PARAMETERS IN OBESE POSTMENOPAUSAL WITH DIAGNOSED METABOLIC SYNDROME

(1)Bajerska, Joanna; (2)Chmurzynska, Agata; (3)Muzsik, Agata;

(4)Menclewicz, Katarzyna; (5)Krzyżanowska, Patrycja; (6)Walkowiak, Jarosław.

(1)PhD. Dietician. Department of Human Nutrition and Hygiene. Poznan University of Life Sciences. Poland; (2)PhD. Nutritionist. Department of Human Nutrition and Hygiene. Poznan University of Life Sciences. Poland. International Society of Nutrigenetics/Nutrigenomics (ISNN); (3)MSc. Nutritionist. Department of Human Nutrition and Hygiene. Poznan University of Life Sciences. Poland.; (4)MSc. Dietician. Department of Human Nutrition and Hygiene. Poznan University of Life Sciences. Poland.; (5)MD. PhD. medical biologist. Department of Pediatric Gastroenterology and Metabolism. Poznan University of Medical Sciences. Poland.; (6)Professor. MD. PhD. Pediatric Gastroenterologist. Department of Pediatric Gastroenterology and Metabolism. Poznan University of Medical Sciences. Poland.

**Background and objectives:** The high-vegetable-fat Mediterranean diet (MED) is associated with a lower risk of diabetes mellitus and metabolic syndrome. In the Central European region, we can also find traditional beneficial foods items (i.e., apples, plums, black chokeberries, herring, linseed, rapeseed oil, oats, buckwheat, and rye bread), which may have a favorable effect on all features of metabolic syndrome. The aim of this study was to compare the effects of MED and the Central-European diet (CED), based on local healthy foods items, on changes in anthropometric parameters associated with metabolic abnormalities.

**Methods:** One hundred and forty-four free-living postmenopausal women with diagnosed metabolic syndrome (mean (SD); age: 61.0 (5.0) years; body mass index: 37.7 (4.9) kg/m2) were randomly assigned to the hypocaloric MED or CED for 16 weeks. The nutrient goals for the compared diets were: MED: 40% energy from fat, 20% energy from protein, and 45% energy from carbohydrates; CED: 25% energy from fat, 20% energy from protein, and 55% energy from carbohydrates. Body weight, body composition, and waist circumference were assessed before the intervention and 4, 8, 12 and 16 weeks after it.

**Results:** One hundred and thirty participants completed the study (MED, n = 67; CED, n = 63). At 16 weeks, both groups experienced similar reductions in body weight (MED -7.57 (3.6) kg; CED, -7.59 (4.2) kg; P = 0.94 time × group interaction), waist circumference (MED, 9.20 (3.7) cm; CED, -9.31 (4.5); P = 0.15 time
× group interaction) and fat mass (MED, -7.03 (3.4) kg, CED, -7.01 (3.7) kg; P = 0.91 time × group interaction and fat mass).

**Conclusions:** The results of this study show that both MED and CED diets result in significant reductions in body weight, waist circumference, and fat mass over 16 weeks of dietary intervention trial.

**Keywords:** Body weight, Central-European diet, Dietary intervention, Fat mass, Mediterranean diet, Waist circumferences

**Conflict of Interest Disclosure:** The authors declare that they have no conflicts of interest.

The project was financed by a National Science Centre award on the basis of decision number DEC-013/09/B/NZ9/02365

144/2010

IMPACT OF THE CONSUMPTION OF TAMARIND FLOUR (TAMARINDUS INDICA L.) IN METABOLIC SYNDROME AMONG TYPE 2 DIABETIC PATIENTS

(1) Vergara, Clarice; (2) Martins, Diego; (3) Passos, Tatiana; (1) Matos, Maria Rosimar; (1) Sampaio, Helena; (4) Carioca, Antonio Augusto;

(1) Bezerra, Ilana; (1) Arruda, Soraia; (1) Lima, Gláucia; (1) Maia, Carla Soraya.

(1) PhD. Nutritionist. Center for Health Sciences. Ceará State University. Brazil.; (2) BSc. Nutritionist. Center for Health Sciences. Ceará State University. Brazil.; (3) PhD. Nutritionist. Center for Health Sciences. Estacio University Center of Ceará. Brazil.; (4) PhD. Nutritionist. Center for Health Sciences. University of Fortaleza. Brazil.

**Background and objectives:** To investigate the effect of the consumption of tamarind flour on the components of metabolic syndrome (MS) among patients with type 2 diabetes mellitus treated by a reference health center of the Brazilian Unified Health System.

**Methods:** This is a randomized, double-blind clinical trial, placebo controlled. Of the 164 randomly treated diabetic patients, 152 were diagnosed with MS and divided into two groups: placebo and intervention group that received tamarind flour for consumption for a period of 4 weeks. A semi-structured questionnaire was applied to evaluate demographic, socioeconomic, anthropometric, biochemical and food consumption data. SPSS version 20.0 was used for data analysis with descriptive level of test of 0.05.

**Results:** The usual diet of the participants was inadequate with an excess of cholesterol and sodium and low amount of fiber. Regarding the indicators of MS, it was observed a reduction in the waist circumference (p = 0.003) and in triacylglycerol levels (p = 0.016) in the intervention group. Comparing placebo and intervention group, patients who received tamarind flour presented reduction in their triacylglycerol levels.

**Conclusions:** The consumption of tamarind flour was effective in improving two important indicators of MS, with a reduction in WC and in triacylglycerol. This fact evidences a potential role of tamarind meal as an adjuvant in the management of MS indicators among diabetic patients.

**Keywords:** metabolic syndrome. diabetes mellitus. tamarind. cardiovascular diseases.

**Further collaborators:**

Financing support: The study was funded by the National Council for Scientific and Technological Development (CNPq), through the Proposal MCTI / CNPq / MS - SCTIE - Decit No. 07/2013 - National Policy on Integrative and Complementary Practices (PICS) in the Unified Health System.

144/2011

GLUTEN-FREE NOODLES MADE WITH REGIONAL FLOURS: CONTENT, DIALYZABILITY AND POTENTIAL CONTRIBUTION OF IRON CALCIUM AND ZINC

(1) Macías, Sara; (2) Generoso, Silvina; (3) Binaghi, María Julieta; (4) Costa, Karina; (5) Rosas, Domingo; (6) Lescano, Natalia; (7) Villarreal, Myriam.

(1) PhD. Biochemistry. Facultad de Agronomía y Agroindustrias. Universidad Nacional de Santiago del Estero. Argentina;

(2) PhD. Bichemistry. Facultad de Agronomía y Agroindustrias. Universidad Nacional de Santiago del Estero. Argentina; (3) PhD. Bichemistry. Universidad de Buenos Aires. Argentina; (4) Food Engineer. Facultad de Agronomía y Agroindustrias. Universidad Nacional de Santiago del Estero. Argentina; (5) PhD. Food Engineer. Facultad de Agronomía y Agroindustrias. Universidad Nacional de Santiago del Estero. Argentina

**Background and objectives:** Today, celiac disease is the most frequent chronic intestinal disease in Argentina; the official statistic is 1 in 79 for children. The need to have a diet without T.A.C.C. is imperative for celiacs, as well as the incorporation of natural and industrialized apt foods, with good contribution of nutrients. This work aimed to determine the mineral content in noodles made with regional flours without gluten and cooked, as well as dialyzability and potential contribution of them.

**Methods:** MyM: Four prototypes of noodles made with rice flour, control (C) and three formulations, cooked 5 and 7 minutes respectively, were analyzed; In the proportions of flours that are detailed:

F1: Rice flour 66.00%, Quinoa 20.00%, Amaranth 10.00%, Algarroba 3.00%.

F2: Rice flour 66.00%; Quinoa 10.00%, Amaranth 20.00%, Algarroba 3.00%.

F3: Rice flour 56.00%, Quinoa 20.00%, Amaranth 20.00%, Algarroba 3.00%.

**Results:** The total mineral concentration was determined by atomic absorption spectrometry. The mineral bioaccessibility (D%) was determined in vitro under controlled conditions of pH, after a digestion that simulates the physiological processes. The potential contribution (AP) of minerals was calculated. The determinations were made in quadruplicate, and the statistical analysis was performed using ANOVA, with Tukey's test as a posteriori test. According to the results obtained it was observed that the D% for Fe is higher in F2; For Zn and Ca F1 and F3 with all formula-
tions being greater than C. The AP of Fe was higher in F2 (1.299 ± 0.032 mg%); For Zn there were no significant differences between the three formulations, however the AP was significantly higher than C. Regarding the AP of Ca there was no significant difference between F2 and F3 (33.28 ± 0.55 mg%).

**Conclusions:** From the above, it is concluded that F2 is the formulation that presents the best contribution of the minerals studied. All the proposed formulations constitute a valid alternative to supply the micronutrients Fe, Ca and Zn since they show significant differences with C.

**Keywords:** minerals - bioaccessibility - regional flours - noodes

**Conflict of Interest Disclosure:** DECLARACIÓN DE POSIBLES CONFLICTOS DE INTERÉS Y DUPLICIDADES

NOMBRE DEL TRABAJO: Fideos elaborados con harinas regionales sin gluten: contenido, dializabilidad y aporte potencial de hierro calcio y zinc.

AUTORES: Engineer Karina Costa 1; Engineer Natalia Lescano 1; Engineer Domingo Rosas1; PhD. Julieta Binaghi 2; PhD. Miriam Villarreal1; PhD. Silvina Generoso1; PhD. Sara Macías 1.

El autor SÍ NO

¿Ha recibido algún tipo de subvención, relacionada con el tema desarrollado, por parte de la industria farmacéutica (u otras industrias relacionadas con la salud)? NO

¿Mantiene alguna relación laboral, académica o personal que pueda representar un conflicto de interés respecto al tema desarrollado?

¿Considera que alguna de sus convicciones morales puede representar un conflicto de interés respecto al tema desarrollado? NO

¿Ha publicado, o tiene previsto publicar, en otros medios un trabajo que pueda ser considerado duplicado o redundante respecto al que se adjunta? NO

¿Es propietario de las imágenes que adjunta o dispone de permiso del propietario para publicarlas? --

**Further collaborators:** 7

144/2019

NUTRITIONAL STATUS AND QUALITY OF LIFE OF BREAST CANCER PATIENTS ATTENDING A TERTIARY HOSPITAL IN IBADAN, SOUTHWEST NIGERIA

(1)Morenike, Ogunkunle; (2)Chiedozie John, Ezenwanne.

(1)MSc. Nutritionist/Dietitian. Department of Human Nutrition. Faculty of Public Health. University of Ibadan. Ibadan. Nigeria;

(2)BSc. Nutritionist/Dietitian. Department of Human Nutrition. Faculty of Public Health. University of Ibadan. Ibadan. Nigeria.

**Background and objectives:** Cancer diagnosis in Nigeria is similar to death sentence as survival rates are very low. Attention is mostly focused on the treatment with little or no attention is paid on long term survival and quality of life of the breast cancer patients. Hence, this study was designed to evaluate the relation-

ship between the nutritional status and quality of life (QOL) of the breast cancer patients.

**Methods:** The descriptive cross-sectional study was carried out at the University College Hospital, Ibadan, Southwest, Nigeria among 120 breast cancer patients. Data on sociodemographic and medical history was collected using semi-structured interviewer-administered questionnaires. Weight and height were measured and body mass index (BMI) was determined. Dietary intake was assessed using 24-hour dietary recall. QOL was evaluated using EORTC QLQ-C30 and BR23. Data obtained on dietary intake was analysed using the Total Dietary Assessment software. Chi square test, student-t test and ANOVA were used as appropriate to determine the relationship between variables at p<0.05.

**Results:** The mean age of the participants was 51.7 ±10.9 years, 48.3% were at premenopausal stage, 81.7% were married, 5% had no formal education and 80.0% were employed. About 38.0% were in stage I and 58.7% were in stage II. Approximately 54.0% had chemotherapy + radiotherapy + surgery, 23.7% had surgery only, 10.2% had chemotherapy only while 11.9% had chemotherapy + surgery. Many of the participants were either overweight (32.7%) or obese (38.4%). BMI was observed to have significant relationship with the stage of the disease, treatment option and menopausal status (p<0.05). QOL of the participants was also found to have significant relationship with treatment option, BMI, menopausal status and stage of the disease (p<0.05). Daily energy, protein and fibre intakes were inadequate among 64.7%, 37.26% and 70.6% respectively and vitamin A, C, folate, zinc, calcium and iron intakes were also inadequate among 33.3%, 60.8%, 66.7%, 54.9%, 96.1% and 23.5% respectively.

**Conclusions:** QOL has relationship with BMI, menopausal status, treatment option and the stage of the disease. Dietary intake is mostly inadequate among the participants.

**Keywords:** breast cancer, BMI, Nutritional status, Nigeria

144/2037

THE PREVALENCE OF OBESITY IN A MIGRANT POPULATION LIVING IN CASABLANCA, MO-ROCCO

(1)Hibbi, Nadia; (2)Saile, Rachid; (2)Derouiche, Abdelfettah.

(1)PhD. Nutritionist. Laboratory of Biology and Health-URAC 34- Faculty of Sciences Ben M'Sik. Hassan II University. Casablanca, Morocco.; (2)Professor Laboratory of Biology and Health- URAC 34- Faculty of Sciences Ben M'Sik. Hassan II University. Casablanca, Morocco.

**Background and objectives:** Rural-Urban migration is known as a major factor associated with the increase of obesity prevalence in many countries. In Morocco, obesity prevalence is higher in cities.

In this study, we assessed the influence of ethnicity and migration, through urbanity degree, on obesity prevalence variation, between the ethnic group of Soussi (native of the rural zone of Souss region) and Casablanca in Morocco.
**Methods:** We used a multi-stratified sampling including 615 subjects (305 subjects recruited in metropolitan Casablanca and 310 from the Souss region). The sampling was based on ethnicity, sex and age. We measured anthropometric parameters, using (i) body mass index (BMI), based on cut-off points recommended by the WHO, and (ii) body fat percentage (BF%), based on cut-off points taken from tables provided in the user's manual of a BIA meter (i.e., a bioelectrical impedance device).

**Results:** Obesity prevalence is greater in women than in men (22.5% vs. 19.8%). Women also presented an AO and a higher %BF risk than men (77.6% vs. 33.4% and 71.2% vs. 60.4%, respectively). Adjusted analysis of our data indicated that, in comparison with rural Soussi, the AO is significantly greater in the second generation migrants group (51.0%, OR=0.33, 95%CI [0.17–0.64], p<0.01); Obesity prevalence (BMI and %BF) is also more elevated in Soussi from Casablanca (21.3%, OR=0.53, 95%CI [0.30–0.92], p<0.05 and 71.3%, OR= 0.42, 95%CI [0.28–0.76], p<0.01, respectively). Obesity prevalence and AO are higher in women from Casablanca than in women from Souss region (BMI: 31.0% %, OR= 0.54, 95%CI [0.37–0.92], p<0.05, and AO: 83.9%, OR=0.48, 95%CI [0.27–0.84], p<0.01).

**Conclusions:** Our study showed that anthropometric and body statuses of our study population depend on urbanity degree (second generation migrants) and ethnicity (Soussi from Casablanca) in men. However, in women, it is linked to their residence location (particularly, in Women from Casablanca).

**Keywords:** Obesity. migration. ethnicity. city

144/2055

ALCOHOL CONSUMPTION AMONG ALTERNATING SHIFT WORKERS IS INFLUENCE BY WORK SCHEDULE AND ABDOMINAL OBESITY: A LONGITUDINAL STUDY

(1)Furlan, Luisa; (2)Rosa, Dayane; (3)Fisberg, Regina; (4)Crispim, Cibele.

(1)MSc Student. Faculty of Medicine. Federal University of Uberlandia. Brazil; (2)PhD Candidate.Pharmaceutical.Faculty of Medicine. Federal University of Uberlandia. Brazil; (3)PhD. Nutritionist.Faculty of Public Health. University of Sao Paulo. Brazil; (4)PhD.Nutritionist.Faculty of Medicine. Federal University of Uberlandia. Brazil.

**Background and objectives:** Some evidences from the literature have showed that shift workers consume high alcohol intake to compensate for sleep difficulties associated with work schedules. However, the pattern of alcohol consumption and its association with obesity is little explored between shift workers. The purpose of the study was to investigate the effects of different work schedules, rest periods and abdominal obesity on alcohol consumption in rotating shift workers.

**Methods:** The study included 30 males shift workers (37±5.68 years old; 90% working in shifts for more than 5 years). The working schedule was organized in the following sequence: two first days working in the morning shift (8:00a.m.)- 4:00p.m.); two days

in evening shift (4:00p.m. – 0:00a.m.), one day in a break after evening shift, two days in night shift (0:00a.m. – 6:00a.m.) and 72 hours of rest. Height, weight, abdominal circumference (AC) and blood pressure were measured. The alcohol consumption was assessed using the 24-hour recall questionnaire for all shift days and days off (total=10 days). Generalized estimating equations (GEE) was used to examine the association between alcohol consumption, work schedule and abdominal obesity.

**Results:** GEE analyses showed a higher daily alcohol consumption in the days off (51.07g), when compared with day, evening, break between evening/night and night shifts (22.09g, 1.42g, 1.50g, 12.26g, respectively (p<005). Individuals who had high abdominal circumference consumed more alcohol than those who had normal abdominal circumference in the evening shift as well as in the break between evening/night shifts (p<0.05). Also, very high abdominal circumference individual consumed more alcohol than those with normal abdominal circumference in the break between evening/night shifts (p<0.05).

**Conclusions:** Rotating shift-work schedules and abdominal circumference had an effect on alcohol consumption among shift workers. These results should be confirmed in future studies.

**Keywords:** Shift-work, abdominal circumference, alcohol consumption.

144/2063

HEMODIAFILTRATION: IMPACT ON PROTEIN-ENERGY WASTING AMONG DIALYSIS PATIENTS

(1)Philippi, Romina; (2)Luxardo, Rosario; (2)Crucelegui, Soledad;

(2)Bedini Rocca, Mariela Ines; (2)Morales Andreau, Leandro David;

(2)Fabriani, Damian Orlando; (2)Ocampo, María Lorena; (3)Escalante, Griselda; (3)Coli, María Luisa; (2)Rosa Diez, Guillermo Javier.

(1)Nutritionist. Servicio de Nefrología. Hospital Italiano de Buenos Aires. Argentina.; (2)MD. Servicio de Nefrología. Hospital Italiano de Buenos Aires. Argentina.; (3)RN. Servicio de Nefrología. Hospital Italiano de Buenos Aires. Argentina.

**Background and objectives:** Hemodiafiltration (HDF) therapy is used in end stage renal disease (ESRD) patients under dialysis and combines the mechanisms of diffusion and convection, unlike conventional hemodialysis, based on diffusion transport. This therapy allows, among other things, an improvement in the hemodynamic stability, a lower resistance to the use of erythropoiesis stimulating agents (ESA) and a better clearance of inflammatory markers. There are no Latin American reports that assess nutritional parameters in this group of patients. Therefore we aimed to determine if HDF could have any impact on the protein-energy wasting characteristic of this population evaluated through biochemical and anthropometric nutritional variables.

**Methods:** We performed a retrospective study with a total of 45 patients, comparing albumin, cholesterol, transferrin, hemoglobin, phosphorus, C-RP, erythropoietin resistance index (ERI) and dialysis dose (Kt/V) at the beginning of HDF treatment and
six months later. 39 of these patients were also measured with high frequency bioimpedanciometry in order to determine the lean tissue index and the fat tissue index.

**Results:** We analized data of 30 men and 15 women >18 years, with a mean age of 52.9 ± 18.22 years, and with a dialysis time of 57.6 ± 46.8 months.

No statistically significant differences were found at baseline and six months after HDF treatment was started for the analyzed nutritional variables. Statistically significant differences were found for Kt/V and ERI (p<0.05).

**Conclusions:** According to what is published internationally, HDF improves the dialysis dose and decreases the use of erythropoiesis-stimulating agents, but no significant impact was observed in the protein-energy wasting of this population.

**Keywords:** Hemodiafiltration, Nutritional Parameters, Inflammation, End Stage Renal Disease

## 144/2068

### NUTRITIONAL PROFILE OF PATIENTS IN THE SECONDARY PREVENTION OF CARDIOVASCULAR DISEASES

(1)Simony, Rosana; (2)Montone Mantovani, Luisa; (2)De Souza Mota, Luís Gustavo; (2)Flammia de Barros Costa, Giovanna; (2)Burmeister, Georgea; (2)Meirelles, Aline; (3)Ragne Torreglosa, Camila; (4)Cymrot, Raquel; (5)Weber, Bernardete.

(1)PhD Nutritionist Assistant Professor of Nutrition Courses from Center for Biological and Health Sciences at Mackenzie Presbyterian University, Sao Paulo, Brazil.; (2)Graduate Student in Nutrition from Center for Biological and Health Sciences at Mackenzie Presbyterian University, Sao Paulo, Brazil.;
(3)Nutritionist of the research Institute of Heart Hospital Center of Sao Paulo.; (4)Master in Biostatistics Professor of Engineering School at Mackenzie Presbyterian University, Sao Paulo, Brazil.;
(5)PhD Nutritionist Lead researcher at Heart Hospital Center of Sao Paulo.

**Background and objectives:** Aging is accompanied by several pathological conditions, such as chronic noncommunicable diseases (CDNT) and, in particular, cardiovascular diseases. The objective of the study was to describe the nutritional, laboratory, food consumption and risk factors of patients who suffered from a cardiovascular event at the collaborating Heart Hospital Center (HCor).

**Methods:** This was a descriptive cross-sectional study in which secondary data from 50 cardiac subjects were used in the study "Effect of the Cardioprotective Food Program on the reduction of events and risk factors in secondary prevention for cardiovascular disease: A Randomized Clinical Trial", known as DICA Br, a project coordinated by the Research Institute of the Heart Hospital and the Support Program for Institutional Development of SUS (PROADI-SUS) of the Ministry of Health.

**Results:** Regarding the nutritional status, 36% (n=18) of the evaluated individuals presented obesity, 18% (n=9) overweight

and 6% (n=3) underweight. The majority of the evaluated patients had hypertension, followed by dyslipidemia. In addition, 48% (n=24) of cardiac patients are former smokers and 55% (n=26) lead sedentary lives. Waist circumference values were increased for both genders (100,87cm and 105,28cm for women and men, respectively), as were means of fasting glycemia (103,89mg/dL; EP=4,37 and 108,44mg/dL; EP=4,25) and triglycerides (168,3mg/dL; EP=28,0 and 170,6mg/dL; EP=29,10). The mean cholesterol level for women was high (172.8mg/dL; EP=15.6) compared to men (145.39; EP=5.33), presenting a significant difference (p=0.045). In addition, the value of HDL was very low for women (42,13mg/dL; EP=2,91), being below the recommended level. Men seem to consume more fatty acid omega 3 and omega 6, sodium, fiber, calcium, selenium and energy when compared to women.

**Conclusions:** Apparently, there was no change in the improvement of the nutritional status of the patients analyzed after the occurrence of a cardiovascular event. It is necessary to carry out more studies aimed at this type of public, for better interventions for treatment secondary to cardiovascular diseases.

**Keywords:** Aging; Cardiovascular diseases; Nutritional profile; Food consumption.

## 144/2085

### IMPACT OF OVERWEIGHT ON LDL OXIDATION AND PLASMA LEVELS OF VITAMIN D IN OLDER PEOPLE IN TERTIARY PREVENTION OF CVD

(1)Santos, Elisa Maia dos; (2)Costa, Mariana Ribeiro; (3)Peçanha, Daniela; (3)Souza, Paula; (4)Cardoso, Carolina Alves; (5)Huguenin, Grazielle Vilas Bôas; (6)Weber, Bernardete; (7)Moreira, Annie Seixas Bello.

(1)Msc. Nutritionist. National Institute of Cardiology. Health ministry. Brazil; (2)Msc. Nutritionist. State University of Rio de Janeiro. Brazil.; (3)Msc student. Nutritionist. State University of Rio de Janeiro. Brazil.; (4)Msc. Nutritionist. Federal University of Rio de Janeiro. Brazil.; (5)PhD. Nutritionist. National Institute of Cardiology. Brazil.; (6)Ph.D. Nutritionist. Hospital do Coração (HCor). Brazil.; (7)Ph.D. Nutritionist. State University of Rio de Janeiro. National institute of Cardiology. Brazil.

**Background and objectives:** The identification of cardiovascular risk factors is fundamental for clinical practice and development of cardiovascular disease (CVD) prevention strategies. The objective of this study is to evaluate classic and emerging cardiovascular risk factors (vitamin D and oxidized LDL) in the elderly with and without overweight in tertiary prevention for CVD.

**Methods:** A cross-sectional study with 93 elderly people with a mean age of 68.9 ± 6.9 years of both sexes, participants of a multicenter randomized clinical trial that studies the effects of a Brazilian Cardio protective Food Program on reduction of events and risk factors in prevention of CVD. The data were collected in the beginning of the nutritional intervention. Anthropometric evaluation (weight, height, waist-perimeter-PC) and blood collection were performed for analysis of lipid profile, plasma concentration
of 25-hydroxy-vitamin D and levels of oxidized LDL (LDL-ox). The elderly included did not use nutritional supplements. Data expressed in frequency and medians (p25-75), analyzed in SPSS 21.0, considering a significance level of 5%.

**Results:** 65,5% were male, 93,5% hypertensive, 92,3% dyslipidemic, 63,4% diabetics and 66,7% had a history of a heart attack. The mean BMI was 28,7 ± 4,5 kg/m² and 82,2% were overweight. Eutrophic individuals had no differences in LDL-C levels when compared to "overweight" [93,5 (77,5-113,0) mg/dl)] vs 89,5 (72,7-116,0) mg/dl; p=0,9] respectively, but LDL-ox concentrations were higher in the overweight elderly [6.691,0 (5.058,0 – 9.584,0) mU / mL vs 5.409,0 (3.411,7-7.572,5) mU/mL; p=0,032]. Overweight was associated with lower plasma levels of 25OH vitD, [62,0 (50,7-80,8) mmol/l vs 74,2 (62,3-97,3) mmol/l; p=0,06]. No significant differences were found in the evaluation of food consumption and had no correlations between LDL-ox and 25OH vitD.

**Conclusions:** Overweight had higher lipid peroxidation even reaching the established lipidic goals, and tends to lower plasma levels of 25OH vitD. These results shows the importance of non-pharmacological therapeutic measures aimed at lifestyle modification should be intensified, in order to contribute to reduction of the risk of a new cardiovascular event.

**Keywords:** Cardiovascular disease, overweight, elderly, nutritional sciences, low density lipoproteins.

**Conflict of Interest Disclosure:** Elisa M. dos Santos, Maria na R. Costa Portugal, Daniela O.Peçanha, Paula Borges M. Souza, Carolina Alves, Grazielle V.B. Huguenin, Annie S.B. have nothing to disclose. Bernadete Weber reports grants from Hospital do Coração (HCor), during the conduct of the study.

**Further collaborators:**

To the scientific initiation students, post-graduation and master's students, who contributed to the elaboration of this study.

144/2088

NUTRITIONAL STATUS IN CHILDREN WITH CYSTIC FIBROSIS IN PARAGUAY

(1)Sanabria, Marta; (2)Ortiz, Lourdes; (3)Gonzalez, Laura; (4)Ascurra, Marta.

(1)MsC Facultad de Ciencias Medicas; (2)MsC Dr Ministerio de Salud Pública y Bienestar Social. Programa de Detección Neonatal.; (3)Facultad de Ciencias Químicas. Universidad Nacional de Asunción.; (4)Ministerio de Salud Pública y Bienestar Social. Programa de Detección Neonatal.

**Background and objectives:** Introduction: Adequate nutritional status is essential in patients with Cystic Fibrosis (CF) due to its influence on lung function and mortality.

**Objective:** To characterize the nutritional status of children and adolescents with Cystic Fibrosis (CF) who attend the National Neonatal Detection Program, under the Cystic Fibrosis Program, under the Ministry of Public Health and Social Welfare (MSPyBS), from February to November 2016.

**Methods:** Material and method: A cross-sectional, observational, descriptive study with an analytical component with confirmed CF diagnosis. Socio-demographic variables, clinical form at diagnosis and presence of pancreatic sufficiency, anthropometric variables and nutritional status, biochemical, dietary and lung function variables (FEV1) were studied.

**Results:** A total of 84 children, 56% were female. The mean age was 7.5 ± 4.7 years; 64% diagnosed ≤6 months of life). Thirty-one percent had a mixed clinical form at diagnosis and 22% had neonatal screening. The standardized mean values of z weight, z height and z BMI were -0.6, -1 and -0.2 respectively. In <2 years, 11% presented moderate acute malnutrition. At ≥ 2 years (n = 75), 60% had adequate nutritional status, 11% overweight and 3% obesity (BMI/Age). 17.3% of the total showed low height and 42% fulfilled the nutritional goal in CF; 41% presented chronic colonization by Pseudomonas Aeruginosa. Mean pulmonary function (FEV1) was 77.8%; 58.1% had some degree of pulmonary involvement; the most affected were those with malnutrition or at risk (p = 0.0266, Student's t test). Children/adolescents with Pseudomonas Aeruginosa had significantly lower BMI than those who did not (p = 0.0324, Student's t test) and those with a lower BMI had lower lung function (Pearson correlation positive and significant p = 0.001).

**Conclusions:** Conclusion. In children older than 2 years, 6 out of 10 have an adequate nutritional status. The height was compromised in more than half of the children.

**Keywords:** cystic fibrosis, nutritional status

144/2112

GLYCEMIC INDEX AND GLYCEMIC LOAD ARE ASSOCIATED WITH PROSTATE CANCER RISK IN CÓRDOBA, ARGENTINA: A MULTILEVEL ANALYSIS

(1)Niclis, Camila; (1)Román, María Dolores; (2)Aballay, Laura;

(3)Haluszka, Eugenia; (3)Dávila, Valentina; (4)Massobrio, Esteban;

(4)Barale, Adrián; (1)Muñoz, Sonia; (2)Díaz, María del Pilar.

(1)PhD. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba and Consejo Nacional de Investigaciones Científicas y Técnicas. Argentina.; (2)PhD. Escuela de Nutrición. Universidad Nacional de Córdoba. Argentina.;
(3)Student. Escuela de Nutrición. Universidad Nacional de Córdoba. Argentina.; (4)BSc. Escuela de Nutrición. Universidad Nacional de Córdoba. Argentina.

**Background and objectives:** The dietary glycemic index (GI) and glycemic load (GL) would increase the risk of diverse cancers, including prostate cancer (PC). The aim of the present study was to evaluate the association of dietary GI and GL with the risk of PC occurrence in male population, assessing the urban-rural context variability in Córdoba province in 2008-2015 period.

**Methods:** A case-control study of PC including 163 cases and 324 controls -matched by age and residence- was conducted. All subjects were interviewed with a validated food frequency questionnaire. The average daily dietary GI for a subject was computed by summing the products of the GI value of each food times the
amount of available carbohydrate (CH); then divided by the total amount of available CH consumed daily. The average GL was calculated by summing the products of the GI value of each food times the amount of available CH consumed daily divided by 100. Multilevel logistic regression models were estimated including GI or GL, age, Body Mass Index, energy and fat intake as covariates at the individual level, and level of urbanization of subject's residence as clustering factor (<29,999; 30,000-200,000; >200,000 inhabitants), with the disease status (presence/absence of PC) being the response variable.

**Results:** Odds of PC increased linearly with increasing GI and GL (OR 1.04; 95%CI 1.02-1.05 and OR 1.01; 95%CI 1.003-1.01). Moreover, men at the third tertile of GI showed a higher risk for PC occurrence (OR: 1.51; 95%CI 1.30-1.75) compared to men in the first tertile. The promoting effect was stronger when comparing the highest vs. the lowest tertile of GL (OR 2.06; 95%CI 2.01-2.11). There was not aggregation linked to the level of urbanization.

**Conclusions:** Our results suggest that a diet with high GI and GL is associated with an increased risk of PC. Hence, more attention must be given to the quality of dietary carbohydrates when promoting healthy dietary habits in men.

**Keywords:** glycemic index, glycemic load, prostate cancer, case-control, Argentina.

**Methods:** Retrospective, descriptive study made through analysis of electronic patient records from a private hospital in the city of Curitiba-PR.

**Results:** Data were collected from January to December 2015, totaling 5962 medical records, 54% of female patients and 46% of male patients aged 63,5±18,2 years old. The average length of hospital stay was 9,5±6,3 days and 97% of the surveyed patients were classified in secondary and tertiary level. Regarding the time of nutritional triage, 65,2% (n=3893) of the patients were triaged within 24 hours of hospital admission. When comparing the level of care with the number of visits during hospitalization, it was observed that 28.7% (n = 1714) of the patients did not receive the recommended number of visits. It is suggested that the possible causes for this inadequacy may be the limited number of professionals or the fact that patients are not available at routine schedules for nutritionists, due to specific surgical procedures and/or tests. According to CFN Resolution No. 380/2005, a nutritionist is recommended for caring 60 patients at the primary level, or up to 30 patients at secondary level or to care up to 15 patients at tertiary level.

**Conclusions:** The adequate number of professionals allows applying and maintaining recommendations and protocols regarding professional care.

**Keywords:** Nutritional care level, triage, nutritional monitoring.

144/2133

LEVEL OF CARE AND FREQUENCY OF NUTRITION VISITS FOR PATIENTS HOSPITALIZED IN PRIVATE HOSPITAL FROM CURITIBA - PR

**Background and objectives:** The patient's impact on hospitalization may not only aggravate his/her general condition but it may also complicate him/her through loss of appetite, difficulty in proper dietary intake or due to imposition of fasting procedures. According to the Brazilian Nutrition Association (ASBRAN), the triage identifies the nutritional risk aiming at performing early intervention and its application is indicated within 24 hours from the admission of the patient at the hospital level and at the first consultation at the ambulatory and home level. The objective of this research was to verify the frequency of the nutritional care levels of patients triaged and the adequacy of the number of nutritionist visits, received by patients during hospitalization.

144/2148

NUTRIGENOMIC AND PHARMACOGENETIC PROTOCOL IN THE CONDUCT IN THE TREATMENT OF BREAST CANCER

**Background and objectives:** Breast cancer is one of the most common diseases among women, and has a high incidence and mortality, especially in developing countries. The therapeutic success of this type of cancer can be better conducted when considering pharmacogenetic aspects and drug interactions. Another approach is to observe an optimized diet to avoid changes in this pharmacokinetics. The presence of bioactive compounds with inhibitory or cytochrome-inducing action involved in the treatment may interfere with drug metabolism. This approach may prevent possible adverse reactions, with discontinuation of treatment or failure of therapy. Objectives: To develop a protocol of dietary and

<footnote>(1)Gebara, Telma; (2)Camargos, Bibiane; (3)Thomaz, Ana Cláudia;</footnote>

<footnote>(4)Tarzia, Andréa; (5)Mastella, Paula; (6)Theiss, Petra.</footnote>

<footnote>(1)BSc. Nutritionist. Department of Biological and Health Sciences. Tuiuti University of Parana. Brazil; (2)BSc.Nutritionist. Department of Biological and Health Sciences. Tuiuti University of Parana. Brazil.; (3)BSc. Nutritionist. Department of Biological and Health Sciences. Tuiuti University of Parana. Brazil.; (4)PhD. Nutritionist. Department of Biological and Health Sciences. Tuiuti University of Parana. Brazil.; (5)PhD. Department of Biological and Health Sciences. Tuiuti University of Parana. Brazil.; (6)MSc. Nutritionist. Department of Biological and Health Sciences. Tuiuti University of Parana. Brazil.</footnote>

<footnote>(1)Aparecido da Silva, Silvano; (2)Renata dos Santos Barros, Cláudia;</footnote>

<footnote>(3)Ferreira Ribeiro, Caroline; (4)de Souza Cordeiro, Heloisa; (3)Antonio Marassi Guariento, Vitor; (3)Oliveira Silva, Willian.</footnote>

<footnote>(1)PhD Student. Pharmacist. Institute of Scientific and Technological Research. Catholic University of Santos. Brazil;</footnote>

<footnote>(2)PhD. Physical Educator. Institute of Scientific and Technological Research. Catholic University of Santos. Brazil.; (3)BCs. Student. Nutricionist. Institute of Scientific and Technological Research. Catholic University of Santos. Brazil.; (4)BCs. Student. Pharmacist. Institute of Scientific and Technological Research. Catholic University of Santos. Brazil.</footnote>
pharmacological behavior considering the aspects of drug interac-
tions, interactions between nutrients, pharmacogenetics and cy-
tochrome metabolism in the treatment of breast cancer.

**Methods:** The protocol was developed using the databases of PharmGKB (The Pharmacogenomics knowledgebase), CIPIC (Clinical Pharmacogenetics Implementation Consortium) and USDA (United States Department of Agriculture) National Agricultural Library.

**Results:** Single nucleotide polymorphisms (SNPs) in transporters such as ABCB1 (3435C> T) were shown to have low disease control in the use of taxanes. Dihydropyrimidine dehydrogenase has SNPs that affect the effectiveness of the metabolism of Fluoropyrimidines such as 5-fluorouracil, capecitabine, and tegafur increased its toxicity. The metabolism of tamoxifen in CYP2D6 can be affected by several SNPs, changing their concentrations. The use of other drugs concurrently inhibiting CYP2D6 and the presence of bioactive compounds such as garden cress, kale and resveratrol should be avoided as there is a high risk of relapse of the disease. Other compounds such as green tea, black tea and cruciferous vegetables also act inhibiting CYP2D6.

**Conclusions:** Genotypic analyzes of transporters and metabolizers in the treatment of breast cancer allow a better management of recommended drugs. In addition to avoiding drugs that act concomitantly on the same cytochromes and provide dose adjustments, the practice of developing a warning diet, either in the neoadjuvant phase or in the metastatic phase, that does not inhibit important cytochromes, cooperates for success of treatment and cure of the disease.

**Keywords:** Breast Cancer; Pharmacogenetics; Nutrigenomics; Bioactive Compounds; Tamoxifen.

(1)Bonvini, Andrea; (2)Coqueiro, Audrey Yule; (2)Raizel, Raquel; (3)Bella, Leonardo Mendes; (4)Makiyama, Edson Naoto; (5)Fock, Ricardo Ambrósio; (5)Borelli, Primavera; (6)Rogeró, Marcelo M.; (7)Tirapegui, Julio.

(1)PhD Student. Nutricionist. Department of Food and Experimental Nutrition. Faculty of Farmceuticals Sciences. University of Sao Paulo; (2)PhD Student. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil.; (3)PhD Student. Department of Clinical Analysis. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil; (4)BSc Environmental Chemist. Department of Clinical Analysis. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil; (5)PhD Professor. Department of Clinical Analysis. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil; (6)PhD Professor. Department of Nutrition. School of Public Health. University of São Paulo. Brazil; (7)PhD Professor. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil.

**Background and objectives:** BCAAs have a unique place in protein synthesis stimulation, serving as energetic substrates for synthesis of intracellular signaling molecules. However, in inflammation and intense catabolic state, such as sepsis and cancer, the supply of these amino acids must be increased to preserve individual's immunocompetence. In vitro studies have demonstrated that immune cells use isoleucine, valine and especially leucine as substrates for production of cytokines and antibodies, besides having a modulating effect on cellular functions, as in nitric oxide synthesis. Also, studies have found that the absence of any of these amino acids in culture medium results in complete suppression of protein synthesis and cell proliferation. The aim of this study was to investigated the effect of BCAAs supplementation on cell viability and nitric oxide production in LPS-stimulated RAW 264.7 macrophages.

**Methods:** Cells were cultured in DMEM (with 2 mM glutamine, 10% FBS and 1% penicillin-streptomycin). After reaching 90% confluence, cell cultures were distributed into five groups: CTL - without supplementation with BCAA; LEU - supplemented with leucine (2 mmol/L); ISO - supplemented with isoleucine (2 mmol L); VAL - supplemented with valine (2 mmol/L) and LIV - supplemented with leucine (2 mmol/L), isoleucine (2 mmol/L) and valine (2 mmol/L). The inflammatory state was induced by LPS (1 µg/ml) for 24 hours and then cell cultures were supplemented with the respective amino acids for another 24 hours. The cell viability assay was performed by MTT test and the indirect nitric oxide was measured by Griess reaction.

**Results:** The LIV group presented higher percentage of cell vi-
ability in comparison to CTL group (p <0.05). There was no statis-
tical difference between other groups related to macrophage via-
bility, evidencing that the sinergy among BCAAs is the responsible
for increasing cell viability. Regarding production of nitric oxide, there was no significant difference between groups.

**Conclusions:** Supplementation with BCAAs association shows to be more effective in increasing cellular viability of LPS-stimulated cells compared to supplementation with isolated BCAAs. In addition, there was no difference in nitric oxide synthesis by macrophages in any of the supplemented groups.

**Keywords:** branched-chain amino acids, macrophages, inflammation, cell viability, nitric oxide.

**Further collaborators:**

Vanessa Batista de Sousa Lima. PhD. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil.

Henrique Quintas Teixeira Ribeiro. PhD. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil.

Carlos Eduardo Carvalho Martins. MSc. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil.

Thais Hipólito. MSc. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil.

lowest infection prevalence rates in Northern Europe while the highest infection rates were found in Eastern and Southern Europe, up to 84% in Portugal and Poland. Studies on smoking, salt and meat consumption demonstrated increased risks of developing stomach cancer among Helicobacter pylori infected individuals, while studies relating the intake of fruit, vegetables and vitamins demonstrated decreased risks but the levels of significance differed importantly between studies. No significant interaction could be found for alcohol consumption or physical activity.

**Conclusions:** Recent data showed still high Helicobacter pylori infection rates in several European regions. Moreover, this systematic review suggests that the following correctable lifestyle factors could impact the disease progression towards Helicobacter pylori associated stomach cancer: the consumption of salt, (processed) meat, fruits, vegetables, vitamins and smoking. However, more qualitative studies are required to draw justified conclusions.

**Keywords:** helicobacter pylori, stomach cancer, prevention, dietary intervention, nutrition

144/2180

THE EPIDEMIOLOGY OF HELICOBACTER PYLORI INFECTION IN EUROPE AND THE IMPACT OF LIFESTYLE ON ITS NATURAL EVOLUTION TOWARDS STOMACH CANCER: A SYSTEMATIC REVIEW

**Background and objectives:** Helicobacter pylori is a recognized cause of stomach cancer. This systematic review (1) summarizes the prevalence of infection with this bacterium in Europe, and (2) reviews the possible impact of particular lifestyle factors towards the progression of the associated cancer.

**Methods:** A systematic literature search was conducted in two databases by two independent investigators. Studies relating infection prevalence among European healthy adult populations and worldwide studies relating the impact of lifestyle factors in association with Helicobacter pylori on stomach cancer risk were included.

**Results:** Data throughout time showed variable Helicobacter pylori infection outcomes depending on region. Data showed the

144/2182

ASSOCIATION BETWEEN BREAKFAST CONSUMPTION AND CHRONOTYPE IN BRAZILIAN UNDERGRADUATE STUDENTS

**Background and objectives:** Current studies have demonstrated that chronotype – which reflects diurnal preferences for the times of rest and activities, and usually classified into “morning”, “intermediate” or “evening” types –, may influence feeding behavior of individuals. However, the relationship between these variables and the consumption of breakfast – which is currently considered a marker of health – is little explored by studies. The aim of this study was to investigate, in undergraduate students, the association chronotype and overweight and food consumption, with special focus on breakfast.

**Methods:** The study included 721 undergraduate students (68% female) from a Brazilian public university. Chronotype was determined by Horne and Ostberg (witch score was expressed as a continuous variable and lower score indicate a preference for eveningness). Dietary intake was assessed by applying a 24-hour recall. The usual consumption of breakfast and mealtimes were identified in the 24-hour recall and, subsequently, confirmed by specific questions to the volunteers. Body weight, height and waist circumference were measured by trained researchers. For determination of whether chronotype was associated with food intake and overweight, linear and logistic regression was performed while controlling for confounding factors.

<footnote>(1)Huybrechts, Inge; (2)Venneman, Kimberly; (3)Gunter, Marc J;</footnote>

<footnote>(4)Vandendaele, Lieve; (5)Van Herck, Koen.</footnote>

<footnote>(1)PhD. Nutritional epidemiologist. International Agency for Research on Cancer (IARC). Lyon. France; (2)MsC. Medical doctor. Ghent University. Department of Public Health. Ghent. Belgium; (3)PhD. Molecular epidemiologist. International Agency for Research on Cancer (IARC). Lyon. France; (4)PhD. Ghent University. Department of Public Health. Ghent. Belgium; (5)PhD. Medical Doctor. Ghent University. Department of Public Health. Ghent. Belgium.</footnote>

<footnote>(1)Mota, Maria; (2)Teixeira, Gabriela; (2)Furlan, Luisa; (3)Crispim, Cibele.</footnote>

<footnote>(1)PhD Student. Nutricionist. Federal University of Uberlândia, Uberlândia, Minas Gerais. Brazil.; (2)Master Degree student. Nutritionist. Federal University of Uberlândia, Uberlândia. Minas Gerais. Brazil.; (3)PhD. Nutritionist. Federal University of Uberlândia, Uberlândia. Minas Gerais. Brazil.</footnote>
**Results:** After adjustments for confounding variables it was found a negative association between chronotype and: caloric (kcal/kg/day) (β=-0.23, p=0.007); carbohydrate (g/day) (β=-0.19, p=0.04) and lipids intake (g/day) (β=-0.18, p = 0.04) in the breakfast skippers. Evening (OR=1.8, CI=1.1-2.8, p=0.01) and overweight individuals (OR=2.3, CI=1.3-3.6, p=0.001) presented a significant odds ratio of being a skipper breakfast.

**Conclusions:** These results suggest that students who tend to eveningness consumed a highest amount of calories, carbohydrates and fats. In addition, skip the breakfast is associated with a higher risk of overweight and eveningness. Future studies are needed to confirm these findings, which could justify the inclusion of chronotype on the nutritional approach to individuals.

**Keywords:** Breakfast. Food intake. Chronotype. Sleep.

144/2186

## OBESITY IN A GROUP OF HIV-INFECTED PEOPLE FROM BUENOS AIRES, ARGENTINA

(1)Stambullian, Marcela; (2)Girimonte, Patricia; (3)Slobodianik, Nora H.

(1)PhD. Nutritionist. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Argentina.; (2)BSc. Mathematics. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica y Facultad de Ciencias Económicas. Argentina.; (3)PhD. University of Buenos Aires, School of Pharmacy & Biochemistry. Dept. Nutrition & Food Science. Argentina.

**Background and objectives:** Since the introduction of highly active antiretroviral therapy (HAART), a significantly reduction in AIDS-related deaths was observed. Despite, metabolic diseases are increasing and are one of the major problems that suffer HIV-infected patients. Obesity is affecting people with HIV infection who starts HAART and in some countries, its prevalence is similar to that in the general population. The aim of this study was to learn about the trend in obesity in a group of HIV-infected people under HAART treatment in Buenos Aires.

**Methods:** It was performed a descriptive, retrospective, cross-sectional study at 3 different years: 2005, 2010 and 2015. Inclusion criteria were asymptomatic adults under HAART, without any nutritional support. Data of age, sex, CD4 count, viral load, time since used of HAART, height and weight were collected from medical records. BMI was calculated and nutritional status was categorized as WHO classification. Obesity was defined as BMI ≥30 kg/m2. Descriptive statistical analysis was applied.

**Results:** 106 (69.8% men), 100 (70% men) and 110 (66.4% men) HIV-infected patients were included for the years 2005, 2010, 2015 respectively. CD4 cell count media (SD) were 461 (235), 622 (366.5) and 691 (292) cell/mm3 for the different years. Obese people increased along the years. Obesity prevalence was 5.8% (95% CI: 0.9%, 10.8%) for 2005, 11% (95% CI: 4.9%, 17.1%) for 2010 and 21.8% (95% CI: 14.1%, 29.5%) for 2015. The same tendency was observed by sex. For women, 8% (95% CI: 0%, 18.6%), 6.7% (95% CI: 0%, 15.9%) and 24.3% (95% CI: 10.5%, 38.1%) and for men, 4.9% (95% CI: 0%, 10.3%), 12.9% (95% CI: 5.0%, 20.7%) and

20.5% (95% CI: 11.3%, 29.8%) for years 2005, 2010 and 2015, respectively.

**Conclusions:** Obesity should be considered en HIV-infected people, preferably those under HAART therapy. In this group of Argentinean people with HIV, prevalence of obesity was the same as the prevalence for the general population (20.1%) for the year 2013.

**Keywords:** HIV infection, obesity, nutritional status, adults, HAART

144/2187

## VITAMIN D MODULATE THE HUMAN NEUTROPHILS RESPONSE AGAINST CANDIDA ALBICANS

(1)Mejía de los Ríos, Susana Pamela; (2)Rendon Marín, Juan Pablo;

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

(1)Msc. Biologist. Medical Mycology Group and Experimental Corporation for Biological Research (CIB). Colombia.; (2)BSc. Microbiologist. Medical Mycology and Experimental Group. Corporación para Investigaciones Biológicas (CIB). Colombia.;

(3)PhD. Microbiologist. Medical Mycology and Experimental Group. Corporación para Investigaciones Biológicas (CIB). Colombia; (4)PhD, Microbiologist. Medical Mycology and Experimental Group. Corporación para Investigaciones Biológicas (CIB). School of Microbiology, University of Antioquia, Colombia.

**Background and objectives:** Beyond its classical role in calcium and bone metabolism, vitamin D (Vit-D) is known to exert a protean influence on the immune system. The main source of Vit-D is through the action of UVB rays on the skin and from the diet in a much lesser extent. The prevalence of Vit-D deficiency is higher, even in tropical countries like Colombia, where sun exposure is higher. Several studies have shown that Vit-D plays an immunomodulatory role and its deficiency has been associated with higher risk to developing infectious diseases. Candidemia is the 4th most common bloodstream infection with mortality rates of up to 40%, and one of the main causes is Candida albicans. Neutrophils are the first immune response against Candida infections; however, there are no reports about the direct activity of Vit-D3 on the neutrophil response. The objective for this study was to evaluate the Vit-D effect on the human neutrophil response against C.albicans.

**Methods:** The effect was evaluated on two group of healthy individuals: 1) Vit-D deficient, and 2) Vit-D normal. The serum levels of 25-OH-D3 were measured by HPLC-UV. Neutrophils of each individual were obtained from peripheral blood. Co-cultures with C.albicans were performed and treated with different concentrations of 25-OH-D3 (25, 100, 200 ng/mL). The efficiency to eliminate C. albicans in each treatment was determined through colony forming units (CFU) counts. Additionally, the immunomodulatory effect of neutrophils was assessed through the burst response of cytochrome C assay.

**Results:** Significant differences between groups were observed in both, CFU and cytochrome C assay. Individuals from normal
group showed a higher elimination of CFU with respect to deficient group. Individuals with normal level of Vit-D had a low response in contrast to deficient individuals. The tested concentrations of 25-OH-D3 did not caused differential effect between groups.

**Conclusions:** Neutrophils from individuals with normal levels of Vit-D showed an immunomodulatory response against C.albicans. The immunomodulatory effect in cytochrome C was negative; however, the neutrophil from normal individuals could eliminate the fungus more efficiently. The fungicidal effect against C.albicans could be due to production of antimicrobial peptide LL-37 as previously reported.

Financial support: Grant Number FP44842-374-2014

**Keywords:** Vitamin D, Candida albicans, Neutrophil, Normal Vitamin D level and Deficient Vitamin D level.

(1)Villa, Roberto; (2)Clochiatti, Natalia.

(1)MD. PhD. Professor of Medicine. Intensive Care Unit. Obra Social para la Actividad Docente. Argentina; (2)MD. Physician. Intensive Care Medicine. Obra Social para la Actividad Docente. Argentina.

**Background and objectives:** Human beings need nutrients in adequate quality and amount in order to satisfy their needs. Sometimes this offer can not be achieved by oral intake and should be done by enteral route. The aims of this study were to evaluate the frequency of tube feeding related complications in critically ill patients and evaluate the relation between complications frequency and enteral feeding nutrition regarding nutrients sources and type of container (open or closed system).

**Methods:** 364 cases from one single centre in one intensive care unit were reviewed. 166 cases meet the study criteria. Data were analyzed in two separated groups, depending on nutrition solution used. Nutrition solutions were similar in all characteristics except type of container and nutrients sources. The following complications had been analyzed: diarrhea, aspiration, regurgitation, vomits, constipation and abdominal distention.

**Results:** The incidence of complications was different between groups (22.8% and 38.5%, p< 0.05), being diarrhea the only complication that occurred with different incidence (13.8% and 45.8%, p< 0.05). Tube feeding had an incidence of complications of 27.7% and this may compromises the caloric intake of patients.

**Conclusions:** Container system does not seem to influence the incidence of complications; however the use of only one or two sources of macronutrients (100% of proteins from casein and 100% carbohydrates from maltodextrin) can be an important factor to predispose diarrhea.

**Keywords:** Enteral nutrition. Critical ill patients. Complications.

(1)Mejía de los Ríos, Susana Pamela; (2)Díaz Buenaños, Beyfan;

(3)Rendon Marín, Juan Pablo; (4)Restrepo Moreno, Angela; (5)Cano Restrepo, Luz Elena.

(1)MSc Biology, Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB); (2)Student of Microbiology and Bioanalise Program, Microbiology School. Universidad de Antioquia. Colombia; (3)BsC. Microbiologist. Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB). Colombia; (4)PhD. Microbiologist. Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB). Colombia; (5)PhD. Microbiologist. Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB). Microbiology School. Universidad de Antioquia (UdeA). Colombia.

**Background and objectives:** Candidiasis is one of the most frequent nosocomial infections affecting humans. It is caused by one of the fungus in the genus Candida with C. albicans being the most prevalent species. This yeast is considered as a commensal organism for the human being and one that, under certain altered conditions such as changes in the host immune system, behaves as an opportunistic pathogen. Such altered circumstances can be multifaceted with some being related to the nutritional status of the individual and in particular, with deficiencies in vitamin D, molecule that plays an important role. In this sense, it has been demonstrated that vitamin D contributes to the control of infections and is converted into an essential nutrient for the invading microorganism. Up to this moment, studies related to the role of vitamin D in Candida infections reveal no conclusive findings concerning the direct effect of this vitamin on the invading microorganism.

**Objective:** To determine vitamin D direct effects on C. albicans growth.

**Methods:** The effect of the 25-OH-D3 (25-Hydroxy-vitamin D3) on C. albicans growth was measured through: a) determination of the Colony Forming Units (CFU) after 2 hours incubation of the fungus in the presence of three different concentrations of 25-OH-D3 (25, 100 and 200ng/ml), and b) the plaque microdilution test with a yeast suspension placed in front of different vitamin D concentrations (25, 100, 200, 400, 600, 800, y 1000ng/ml) with a 22 hours kinetics run.

**Results:** The CFU values revealed that the treatment with 200ng/ml of vitamin D, induced a significant proliferative effect by doubling (2,16X) the number of CFU in comparison with the control with no vitamin. According to the growth kinetics obtained through the microplate technique, an important increase in growth was noticed starting at 14h post-incubation in the presence of concentrations of 25-OH-D3 ≥ 200ng/ml

**Conclusions:** Vitamin D induces a direct and dose-depending proliferative effect on C. albicans possibly due to the fungus capacity to develop metabolic pathways related to the P450 enzymatic complex that allows to process the 25-OH-D3.
(1)Manochio Pina, Marina Garcia; (2)Pilot Pessa, Rosane; (3)Cristina Marques Costa, Lauane; (4)Meneghetti Miguel, Raphaela; (4)Lara Garcia, Caroline.

(1)Dr. Nutricionista. Universidade de Franca. Brasil.; (2)Dr. Nutricionista. Pontifícia Universidade Católica de Campinas. Escola de Enfermagem de Ribeirão Preto USP. Brasil.;

(3)Graduanda em Nutrição. Universidade de Franca. Brasil.;

(4)Nutricionista. Universidade de Franca. Brasil.

**Background and objectives:** Eating disorders are psychosomatic diseases resulting from a conflicting relationship of the individual with the food and the primary symptoms are concern about body weight and shape. Generally mothers are very present since the childhood of the children and can be great allies in the treatment of their daughters with feeding disorder. The objective of the study is to investigate the eating behavior and to evaluate the perception and satisfaction of the body image of mothers of patients with eating disorders.

**Methods:** A quantitative research, performed in a public and specialized service in the interior of São Paulo, currently serving 18 patients. The methods used were a 24-hours Recall, test "How Is Your Feeding?" EAT-26 and Scale of Figures of Silhouettes. Data collection was done in individual and reserved rooms, and the mothers' identity was kept confidential. All the tests were answered by the mothers themselves and the collection lasted about 30 minutes for each participant.

**Results:** Thirteen mothers of the 18 patients participated during the study. EAT-26 showed a negative result, with an average of 17.23 points, the "How is Your Feeding" test showed an average of 38.85 points, showing that the mothers' diet is practically within what is considered healthy. Regarding body image, mothers were dissatisfied.

**Conclusions:** The study concludes that mothers present body image dissatisfaction, although they do not present eating behaviors similar to the habits of patients with eating disorders, however, this group should be considered, since it may be a group of risk. It is necessary to include mothers in support groups and further studies with them so that more information about the family's eating behavior can be obtained and other forms of treatment for the disorder can be sought.

**Keywords:** Eating disorders, food behavior, mother, mother-child relationships, eating habits.

**Further collaborators:** UNIFRAN (University of Franca) and GRATA (Assistance Group on Eating Disorders)

(1)Du, Shufa; (2)Liu, Liping; (3)Wang, Huijun; (1)Mendez, Michelle A;

(4)Popkin, Barry M.

(1)PhD. Department of Nutrition and Carolina Population Center, The University of North Carolina at Chapel Hill; (2)Beijing Municipal Center for Disease Control and Prevention; (3)MD. National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention; (4)Phd. Nutrition. Department of Nutrition. University of North Carolina. United States.

**Background and objectives:** Diabetes has rapidly increased in past two decades in China. Recent studies reported that manganese may help regulate glucose metabolism, while little is known about the relationship between manganese concentrations and the risk of diabetes.

**Methods:** We used a subsample (n=5,587 adults aged 18 – 65 years) who provided blood and toenail samples in 2009 from the China Health and Nutrition Survey, a study covering 9 provinces varying in environment and urbanization in China. We measured manganese on toenail samples with inductively coupled plasma mass spectroscopy (ICP-MS), hemoglobin A1c (HbA1c) on fresh whole blood samples with high performance liquid chromatography, insulin on serum samples with radioimmunology method, and glucose on serum samples with Hitachi 7600 Auto-analyzer. We estimated the association between manganese concentrations and diabetes by using logistic regression models in which we controlled for age, gender, body mass index, education, social-economic status, residential region (urban/rural), and urbanization index.

**Results:** The median manganese concentration was 3.86 mg/kg with a range of 0 – 60.58 mg/kg. The prevalence of diabetes defined as HbA1c ≥ 6.5% was 8.15%, 6.88%, 6.20%, and 4.36% from the 1st to 4th quartile of manganese concentration (p trend <0.001), respectively, and the average prevalence was 6.38%. Compared to the 1st quartile, the odds ratio of diabetes from 2nd to 4th quartile was 0.81 (95% CI: 0.59 – 1.11), 0.83 (95% CI: 0.60 – 1.17), and 0.58 (95% CI: 0.40 – 0.84), respectively. The average serum glucose was 95.87 mg/dL. Serum glucose decreased with increased manganese, but it was significantly lower in the 4th quartile only, compared to the 1st quartile (94.06 vs. 97.68 mg/dL, p trend =0.01).

**Conclusions:** Manganese is an important element for human health. Our findings suggest that low manganese may increase the risk of diabetes. Manganese may play an important role in preventing the development diabetes.

**Keywords:** Diabetes, manganese, toenail, hemoglobin A1c, China