# THE EFFECT OF NUTRITION EDUCATION PROGRAM ON DIET QUALITY SCORES IN POLISH ADOLESCENTS: 3- AND 9-MONTH FOLLOW-UP. ABC OF HEALTHY EATING PROJECT

(1)Kowalkowska, Joanna; (2)Wadolowska, Lidia; (3)Hamulka, Jadwiga;

(1)Danielewicz, Anna; (4)Kostecka, Malgorzata; (5)Jeruszka-Bielak, Marta.

(1)MSc. Nutritionist. Faculty of Food Science. University of Warmia and Mazury in Olsztyn. Poland.; (2)Full Professor. Nutritionist. Faculty of Food Science. University of Warmia and Mazury in Olsztyn. Poland.; (3)Professor. Nutritionist. Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences. Poland.; (4)PhD. Nutritionist. Faculty of Food Science and Biotechnology. University of Life Sciences in Lublin. Poland.; (5)PhD. Nutritionist. Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences. Poland.

**Background and objectives:** The impact of nutrition education programs on adolescents' dietary patterns in short- and long-time perspective is weak known [1, 2]. Objective: Assessment of the effect of nutrition education program on diet quality scores after 3- and 9-moth follow-up in Polish adolescents.

**Methods:** The prospective study involved 464 adolescents aged 11-13 years at baseline. Based on frequency food consumption two diet quality scores (range: 0-100 points) were established: pro-Healthy Diet Index (pHDI) included dairy products, fish, vegetables and fruit; non-Healthy Diet Index (nHDI) included fast foods, sweetened beverages, energy drinks and sweets. After 3- and 9-month follow-up changes in pHDI and nHDI were compared between 'control' group (n=145) and 'educated' group (n=319) in which one-time nutrition education program was implemented.

**Results:** The mean pHDI was insignificantly higher in 'educated' than 'control' group after 3-month (28.0 vs 27.3 points) and 9-month follow-up (28.9 vs 26.4 points). The mean changes in pHDI were insignificant. The mean nHDI was significantly lower in 'educated' than 'control' group after 3 months (12.4 vs 15.7 points) and 9 months (14.0 vs 16.7 points). The mean changes in nHDI were significant. After 3 months nHDI was lower by 1.8 points in 'educated' but higher by 1.1 points in 'control' group, after 9 months lower by 0.2 points and higher by 2.1 points respectively.

**Conclusions:** One-time nutrition education episode can reduce unhealthy dietary habits in Polish adolescents but not improve pro-healthy dietary patterns, both in short- and long-time perspective.

**References:**

[1] Gubbels JS et al. Physical activity, sedentary behavior, and dietary patterns among children. Curr Nutr Rep, 2013, 2(2):105-112.

[2] Tse MM, Yuen DT. Effects of providing a nutrition education program for teenagers: dietary and physical activity patterns. Nurs Health Sci, 2009, 11(2):160-165.

**Keywords:** Adolescent, Diet quality score, Dietary pattern, Education program.

**Conflict of Interest Disclosure:** Project was funded by Carrefour Foundation. Scientists' Team was responsible for all stages of project.

**Further collaborators:**

Magdalena Gornicka (Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences), Renata Biezanowska-Kopec (Faculty of Food Technology. University of Agriculture in Krakow), Monika Bronkowska (Faculty of Food Science. Wroclaw University of Environmental and Life Science), Danuta Figurska-Ciura (Faculty of Food Science. Wroclaw University of Environmental and Life Science), Agata Wawrzyniak (Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences), Barbara Groszczyk (Faculty of Food Sciences and Nutrition. Poznan University of Life Science), Witold Kozirok (Department of Trade and Services. Gdynia Maritime University), Monika Hoffman (Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences).

# MATERNAL NUTRITION EDUCATION OFFERED DURING ANTENATAL, SELF-EFFICACY AND NEEDS OF MIDWIVES IN MULAGO HOSPITAL, KAMPALA, UGANDA

(1)Nankumbi, Joyce; (2)Nankumbi, Joyce; (3)Nalwadda, Gorrette.

(1)MSc. MSN. Midwife and Nutritionist. Department of Nursing, College of Health Sciences, Makerere University. Kampala. Uganda; (2)MSc.MSN. Midwife-Nutritionist. Department of Nursing, School of Health science. Makerere University. Kampala Uganda; (3)PhD. Senior Lecturer. Department of Nursing. School of Health science. Makerere University. Kampala Uganda.

**Background and objectives:** An adequate nutrition during gestation is an important environmental factor influencing pregnancy outcome. Maternal malnutrition during pregnancy affects the health of the mother and baby. Midwives are preferably well placed to offer nutrition education to pregnant women; however they may not be equipped with the knowledge, skills and confidence to deliver nutrition education. The aim of this study was to explore the maternal nutrition education (MNE) in a hospital setting, determine the perceived self-efficacy and identify the nutrition education needs of midwives in Mulago hospital antenatal care clinic.

**Methods:** The study employed an exploratory qualitative design. Six in depth interviews, 6 direct observations for group education, and 12 one on one observations of midwives and pregnant women interaction were conducted. The transcribed interviews and field observation notes were analyzed using the latent content analysis.

**Results:** Maternal nutrition education characteristics, self-efficacy and maternal nutrition education needs of the midwives were the emerging themes. The delivery of MNE was inadequate in scope and depth. Surprisingly, the MNE was offered to only preg-
nant women attending the first ANC visit. The routine antenatal education session lasts 45 minutes to 1 hour, covering a variety of topics but MNE is allotted minimal time (5-15 minutes). The MNE organization, mode of delivery, guidelines, materials/ resources and service environment were grossly deficient. The midwives demonstrated good communication/facilitation skills during the sessions, and highlighted the nutrient rich dietary sources, increased nutrient demand, as well as food safety and hygiene requirements. Overall midwives' MNE competences were limited and had moderate perceived nutrition education self-efficacy. Midwives were ignorant about the maternal nutrition guidelines. Relevance of appropriate weight gain during pregnancy, guidelines for healthy habits, avoidance of substance abuse and nutrition precautions in special circumstances were missing in MNE. Information, MNE resources, infrastructural, and health systems gaps were identified.

**Conclusions:** The scope and depth of MNE is inadequate. There are midwives, health systems related gaps for successful MNE conduct. There is need for alternative innovative MNE delivery models, and strengthening capacity of midwives in MNE.

**Keywords:** Maternal nutrition education, Midwives, Self-efficacy, Education needs.

**Further collaborators:**

Tom Dennis Ngabirano BSN RN, MSN, Lecturer, Department of Nursing, School of Health science, Makerere University, Kampala Uganda

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IMPACT OF AWARENESS CAMPAIGNS IN LOW-
ERING SODIUM LEVELS IN COMMERCIAL WHITE
BREAD IN MOROCCO

(1)Derouiche, Abdelfettah; (2)El-Kardi, Younes; (3)Farhloul, Fatima-Zahra; (4)Mokhantar, Khaoula; (5)Jafri, Ali.

(1)PhD. Professor. Ben M'Sik Faculty of Science. University Hassan II of Casablanca. Morocco.; (2)MSc. PhD Researcher. Ben M'Sik Faculty of Science. University Hassan II of Casablanca. Morocco;

(3)BSc. Master Student. Ben M'Sik Faculty of Science. University Hassan II of Casablanca. Morocco.; (4)MSc. Master Delegate. Ben M'Sik Faculty of Science. University Hassan II of Casablanca. Morocco.; (5)PhD. Post-Doctoral Fellow. Ben M'Sik Faculty of Science. University Hassan II of Casablanca. Morocco.

**Background and objectives:** Sodium over-consumption is closely linked to hypertension, stroke and other cardiovascular diseases (CVD). According to the World Health Organization's estimates, hypertension prevalence Morocco exceeds 30%, and could be responsible, with other CVD, of 34% mortalities in the country. Bread is one of the most important sources of sodium in several countries, including Morocco. This study aims to assess the impact of 5 years of awareness campaigns (2011 – 2016) in reducing the quantity of sodium chloride used in preparing commercial white bread, and in improving nutritional knowledge and practices related to sodium.

**Methods:** Nutritional knowledge, attitudes and practices (KAP) about sodium were assessed using a questionnaire in interviews with 418 bakeries in Casablanca, Morocco. The questionnaire covered topics on the consequences of sodium over-consumption and recommended daily intake. The quantity of sodium chloride in commercial white bread was measured using Mohr's titration method. Bread samples were collected and analyzed from 160 bakeries in 2011 and 2016.

**Results:** The KAP survey revealed that most professional bak- ers are not familiar with the campaign (73%) of salt reduction and do not have sufficient information about the recommendations (78%). Still, 72.8% were committed to start reducing added sodi- um during the preparation of bread. Among the bakers who are familiar with the campaign (27%), up to 14.5% reduced sodium chloride by 33% (from 15 to 10 grams of sodium chloride per kilo- gram of flour). Analysis of white bread revealed that added sodi- um chloride decreased from 17.8 g/kg in 2011 to 13.1 g/kg in 2016, which is equivalent to a decrease of more than 25% over five years (0.94 g per year). Still, sodium chloride levels are very different between bakeries (10.5 to 19.6 g/kg).

**Conclusions:** This study highlights the effectiveness of aware- ness campaigns and the importance of involving the targeted stakeholders and industry professionals. Although the campaign did not reach all the targeted audience, results show that it was effective among those it reached. More efforts should be invested in involving as much as possible in order to have a more balanced sodium intake.

**Keywords:** Sodium, Bread, Hypertension, Morocco.

**Further collaborators:**

Students of Master Biologie et Santé, Biotechnologie et Démarche Qualité, et Master International des Sciences de la Santé, Faculté des Sciences Ben M'Sik.

Fédération Nationale des Boulangeries et Pâtisseries du Maroc.

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TO DESIGN AND TEST EFFICACY OF SCIENTIF-
ICALLY AND CULTURALLY APPROPRIATE, COM-
PREHENSIVE NUTRITION AND HEALTH COMMU-
NICATION PACKAGE FOR RURAL NULLIPAROUS
MARRIED WOMEN OF NORTHERN INDIA TO AD-
DRESS A W

(1)Misra, Puneet; (2)Kant, Shashi; (2)Anand, Krishnan; (2)rai, sanjay.

(1)MD. MPH. Professor. CCM. AIIMS. New Delhi. India; (2)MD. Professor. CCM. AIIMS. New Delhi. India.

**Background and objectives:** Lot of work has been done to reduce LBW and IMR by giving nutritional supplements to pregnant females, but almost no work has been done to address the pre pregnancy issues to deal with this problem, which is more important from health point of view. The study is designed with objective to test an innovative evidence-based package to break the cycle of low birth weight, and high infant mortality. This study
is also innovative in being directed at a population sub-group that has not been targeted

**Methods:** Study was done at rural field practice area of AIIMS, New Delhi, India. All newly married nulliparous females in selected area were included. More than 700 hundred females were recruited for the study. Intervention and Control area was selected randomly. Intervention was given in form of health education, nutritional education, demonstration of preparation of low cost culturally appropriate food, involvement of grass root level workers, health functionaries, local volunteers etc. Data was collected after one year of follow up

**Results:** The results after intervention were found to be significant and there was increase in the overall knowledge of females of intervention group. There was observed difference in the knowledge attitude and practices of the females before and after intervention.

**Conclusions:** Such interventions will lead to better maternal and child health. It will help in breaking the cycle of poor maternal health and thus low birth weight which is a major cause for high infant mortality. We expect to have positive effect of this intervention on women itself and their babies. This is going to influence and will help mothers form a basis for good nutrition to be followed in later years.

**Keywords:** Low birth weight, nutrition package

**Further collaborators:**

Dr. Rahul Srivastava, Dr. Priyanka Kardam, Dr. C S Pandav.

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A STUDY OF CHANGES IN FOOD PREFERENCES

Ueda, Reiko.

PhD. R.D. Professor. Department of Early Childhood Education and Nursing. Faculty of Education and Human Sciences. Teikyo University of Science. Japan.

**Background and objectives:** To identify effective nutrition education ("shokuiku" in Japanese) strategies for preventing picky eating, a survey was conducted to determine changes in food preferences.

**Methods:** A questionnaire survey to assess changes in food preferences was administered to 1,192 university students living in Tokyo between April and July 2016.

**Results:** The students' favorite foods were as follows: chicken, strawberries, eggs, beef, white rice and pork. The students' least favorite foods were as follows: tomatoes, green peppers, celery, carrots and liver. The foods that the students disliked as children but grew to like as they got older are as follows: green peppers, eggplants, tomatoes, natto (fermented soybeans) and carrots. The reasons for growing to like these disliked foods were as follows: i) natural with age (aging); ii) refused to eat it because they disliked the appearance (visual aversion); iii) enjoyed the taste once they tried (aversion without even trying); iv) disliked the texture but grew to like it once they forced themselves to eat it; and v) learned of the health and beauty benefits. The foods that the students liked as children but grew to dislike as they got older are as follows (in

order of least preference): natto, tomatoes, carrots, raw fish and shrimp. The reasons for growing to dislike these foods were as follows: i) overeating; ii) unpleasant experiences such as diarrhea and vomiting after eating; and iii) decreased appreciation for fatty foods due to aging.

**Conclusions:** The results of the present study suggest that the following methods could effectively eliminate food dislikes: i) sit back and wait for growth; ii) prepare visually appealing and appetizing foods; iii) provide health information, and iv) encourage eating even if it is only a small amount (for continued consumption). In addition, to prevent people from developing aversions to foods they once liked, overeating should be avoided.

**Keywords:** Food Preferences, Aging, Overeating, Shokuiku.

**Further collaborators:** Special thanks to the students who answered to the questionnaires.

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CONSUMPTION OF FOOD NOT SUPPLIED BY HOSPITAL IN A PEDIATRIC ONCOLOGY UNIT

(1)Behling, Estela; (2)Martins de Lima, Thaiane.

(1)PhD. Professor. Departament of Nutrition. Faculdade de Medicina. Universidade Federal do Rio Grande do Sul. Porto Alegre. Brazil.; (2)Nutricionist. Residência Integrada Multiprofissional em Saúde. Hospital das Clínicas de Porto Alegre. Porto Alegre. Brazil.

**Background and objectives:** The impact of a good or bad nutrition, allowing appropriate physical and cognitive development is already widely described in the literature. In the specific case of pediatric cancer patients, it is important not only for adequate physiological development but also for nutrition as a means of assisting in the maintenance of appropriate physical conditions to transcend the various phases of chemotherapy, surgery and/ or radiotherapy., As well as supply the demands of the disease itself. Based on this, the hospital diet is elaborated, not only with the purpose of providing the necessary nutrients to these patients, but also, an adequate microbiological condition, emphasizing hygienic-sanitary food quality. In view of the current lack of research on the subject, specifically with immunosuppressed patients, the present study aimed to evaluate the consumption of foods not provided by the hospital for patients of a Pediatric Oncology Unit.

**Methods:** It was an observational, cross-sectional study whose data collection instrument was applied between March and October 2016. This study included legal guardians of patients treated in this Pediatric Oncology Unit for at least seven days and with the oral feeding as the main route of feeding. Those legal guardians of patients receiving an exclusive palliative care or of patients in an exclusive breastfeeding were excluded from the study.

**Results:** Thirty-two responsible were interviewed, 26 (81.25%) of those reported that they had been advised about the risks of offering non hospital food to the patient; however, 31 (96.87%) reported that the patient for whom they were responsible had already consumed some food not provided by the hospital. Also, when asked
about the types of food offered to these patients, the category en-
compassing candies and/or snacks was the most cited (32.4%).

**Conclusions:** Thus, it is suggested that although they had receive guidance, there was not necessarily an appropriation and understanding, showing the necessity to implement effective practices of continued nutritional education, aiming the co-responsibility of patients and their families.

**Keywords:** Diet. Food Service. Hospital. Medical Oncology. Pediatrics.

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ANALYSIS OF THE PRESENCE OF TERMS SUCH
AS HOMEMADE, TRADITIONAL AND SIMILAR
TERMS IN LABELS OF INDUSTRIALIZED FOOD
PRODUCTS COMMERCIALIZED IN BRAZIL

(1)Uggioni, Paula; (2)Muller, Jessica; (2)Machado, Priscila Pereira;

(2)Santos, Andreia Martins dos.

(1)PhD. Assistente Professor. Dept. of Nutrition. Nutrition Postgraduate Programme of Federal University of Santa Catarina; (2)Nutritionist.

**Background and objectives:** Contemporary Western nutrition has been characterized, at the same time, by the increase in the consumption of industrialized food products and the increase in the consumers' interest in traditional food products. The presence of terms such as homemade, traditional, and others in food labels are not foreseen in the Brazilian legislation on food labeling, since such terms may mislead consumers in relation to the real nature or origin of the product. The present study aimed at identifying the use of terms such as homemade, traditional, original, and others in the labels of industrialized food products in Brazil.

**Methods:** For this purpose, food labels (front panel) of all the industrialized products available for purchase in a supermarket that belongs to one of the ten greatest supermarket chains in Brazil were analyzed. The total frequency of the terms by food groups according to the Collegiate Directive Resolution (RDC 359/2003) was observed.

**Results:** From the total of food products, 14.1% (N=778) presented terms in the labels. Terms related to brand age or product age, in different languages, were found with a frequency of 58.1% of labels (N=495), followed by the terms traditional with 20.1% (N=175) and original with 11.0% (N=94) of the labels analyzed. In relation to food groups, group I (bakery products) and II (vegetables and bottled vegetables) presented a higher relative frequency, both with 21.4%.

**Conclusions:** Findings indicate the frequent commercialization of industrialized products with terms that refer to a more traditional or homemade manufacturing method with local ingredients. In this respect, results highlight that the information contained in food labels ought to be clear and correct, so that the consumer is able to make his own conscious choice on food.

**Keywords:** Food labeling, Industrialized food products, Food legislation, Front-of package labeling, Nutrition.

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SURVEY ON FOOD AND HEALTH OF JAPANESE
BRAZILIAN (NIKKEIJIN)

(1)Ishii, Satomi; (2)Kajita, Rutsuko; (3)Otani, Shizue; (4)Masumoto, Simone; (4)Okamoto, Carmen; (4)Ucida Watanabe, Erica.

Affiliation: (1)PhD; (2)Rakuno Gakuen University Graduate Student; (3)Rakuno Gakuen University JICA Trainee; (4)Hospital Nipo-Brasileiro Nutritionist.

**Background and objectives:** It is generally known that the content of daily meal is greatly affect the human health. Today, the average life expectancy of the Japanese people is 83.7 years, which is the world's longest longevity. Those for Brazilian peoples are 75 years. Japanese migration to Brazil began in 1908. The main objective of this study is to determine the relationship between food and health in people of Japanese ancestry living in Brazil.

**Methods:** For this reason, 30 Nikkeijin living in Sao Paulo and 28 workers of Japanese descent that came from Brazil to Japan, residents of Ibaraki Prefecture, were interviewed, using questionnaire and surveyed for the content of daily meal.

**Results:** The average age of Nikkeijin residing in Brazil was 50 years, and the average age of Nikkei residents living in Japan was 33 years. There were many elderly Nikkeijin living alone in Brazil, and those who live in Japan were also lived alone.

For the both groups of Nikkeijin the rice was most commonly eating Japanese food.

Eating habit of the Nikkeijin living in Japan was the Brazilian style, but drinking miso soup was also high. The favorite Japanese food was Sushi and Ramen (Chinese noodles) for those living in Japan. It was characteristic that in comparison with Japanese, the diet of Japanese Brazilian people was that they eat more meat, use more oil and have less intake of fresh vegetables. Salt was mostly used for seasoning.

The amount of sugar ingested from sweets and drinks was high, and accordingly energy intake was also high. Residents in both regions had higher blood pressure and obesity.

**Conclusions:** There is a possibility that illnesses of Nikkeijin who migrated to Brazil and assimilated into a Brazilian style eating with fatty and meat-rich diet may indicate the future disease trend of Japanese.

**Keywords:** Japanese Brazilian, Nikkeijin, Japanese, Nutrition,Health.
## FOOD CONSUMPTION PATTERNS IN ADULT WORKERS OF AN ELECTRONIC COMPANY IN ZAPOPAN, MEXICO

(1)López-Uriarte, Patricia Josefina; (2)Vazquez-Aguilar, Laura Alejandra; (3)Márquez Sandoval, Yolanda Fabiola; (4)Magaña Gonzalez, Claudia Rocio.

(1)PhD. Nutritionist. Centre of Research in Food Behavior and Nutrition. University of Guadalajara. Zapotlán el Grande, Jalisco. Mexico; (2)MD. Nutritionist. University of Specialties. Guadalajara, Mexico.; (3)PhD. Nutritionist. Department of Human Reproduction, Growth and Child Development. Center of Health Sciences. University of Guadalajara. Mexico; (4)PhD. Anthropologist. Centre of Research in Food Behavior and Nutrition. University of Guadalajara. Zapotlán el Grande, Jalisco. Mexico.

**Background and objectives:** The study of food consumption patterns has advantages over the conventional dietary studies, since it allows a global evaluation of consumption of different type of diets and its effect on health. The objective was to describe the food consumption patterns identified in a group of adult workers of an electronic company.

**Methods:** A cross-sectional study was realized in 165 workers. Sociodemographic and clinical data were obtained through personal interviews. Weight, height and body mass index were measured. A food consumption frequency questionnaire was applied and blood samples were collected. Data were grouped by sex and BMI to obtain descriptive and analytical statistics. Principal component analysis was used to determine patterns of food consumption.

**Results:** 74.5% of the sample were women (25.5%, men) averaged on 39.9 years. 78.2% of participants were overweight or obese. Significant differences were observed between BMI (normal weight, overweight, obesity) and consumption of: ethanol (p=0.02); iron(p=0.01); very low-fat animal food (p=0.04); total sugars and fat-free sugars (p<0.01) and alcoholic beverages (p=0.009). Four main patterns of food consumption were identified through principal component analysis: 1) healthy, 2) heterogeneous, 3) whole dairy food/sweet pastry, and 4) red meat/processed foods.

**Conclusions:** The diversity of patterns of food consumption identified shows different ways of eating and drinking of this group of workers, as they eat a wide variety of foods and beverages, sometimes healthier or less healthy, which would contribute to explain in part, their food behavior, which could have an impact on health.

**Keywords:** Food patterns, Workers, Food consumption.

## IMPROVED COMPLEMENTARY FEEDING PRACTICES IN THE SELECTED AREA OF DHAKA CITY

(1)Akter, Ferdausy; (2)Hossain, Mariam; (2)Roy, Medha; (2)Khatun, Mahfuza; (3)Sultana, Moffashara; (4)Jahan, Khurshid; (5)Akter, Syeda Mahsina; (6)Roy, Swapan Kumar.

(1)BSc. Food & Nutrition. College of Home Economics. University of Dhaka. Bangladesh; (2)BSc. Food & Nutrition. College of Home Economics. University of Dhaka. Bangladesh.; (3)MSc. Assistant Professor. Dept. of Food & Nutrition. College of Home Economics. University of Dhaka. Bangladesh.; (4)MSc. Director. Bangladesh Breastfeeding Foundation. Bangladesh.; (5)MSc. Assistant Director. Bangladesh Breastfeeding Foundation. Bangladesh.; (6)MBBS, MSc, Dip in Biotech, PhD, FRCP, Senior Scientist, Chairperson, Board of Trustees Bangladesh Breastfeeding Foundation. Chairperson Nutrition Foundation. Bangladesh.

**Background and objectives:** According to Bangladesh DHS 2014, 23% children of 6-23 months properly feed complimentary food (minimum acceptable diet). The main objective of the study was to improve the complementary feeding (CF) practice through nutrition education and to see the effect of five selected improved homemade CF recipes on behavioral practice of CF.

**Methods:** A community based randomized controlled trial was conducted for 3 months among 130 children aged 6-23 months in two areas (Mirpur and Mohammadpur) of Dhaka city. Intervention group (n= 56) received 2 months nutrition education together with recipe trials demonstrating 5 recipes selected from the nationally approved manual titled 'Improved recipes for complementary feeding of children aged 6-23 month, 2013' and followed up for next one month. The control group (n=57) were only observed. Information on infant feeding practice including frequency, quantity, quality, diversity, hygiene practice and anthropometry were collected at baseline and endline in both groups but infant feeding practice and anthropometric data were collected two times more in intervention group.

**Results:** The feeding frequency had significantly increased 33% higher (4 Vs. 3 times) in the intervention group than the control group through nutrition education during the observation period (p<0.001). Weight gain of the children had increased 7% in intervention group (9.02 Vs. 8.42 Kg) compared to the control group after the intervention (p <0.001). The quantity of feeding items had increased 16% (17g vs. 9g) in the intervention group than control group. Feeding of commercially prepared infant food was decreased by 60% in the intervention group. At the end of the follow-up, the highest to lowest consumed recipes were khichuri (32.1%), fruit firni (23.2%), small fish chop (16.1%), chirar polao (14.3%) and Egg-Suzi (14.3%) in intervention group. Percentage of hand washing before feeding and cooking had increased from 33.9 to 80.4 in intervention group and 47.4 to 52.6 in control group.

**Conclusions:** Nutrition education together with introduction of improved recipes can effect positively towards behavioral changes and feeding practices on Complementary Feeding.

**Keywords:** Complementary feeding, Nutrition education, Recipe trial, Behavioral change.
SHORT-TERM SCHOOL BASED ORIENTATION
PROGRAM CAN IMPACT TO CREATE AWARE-
NESS ON NUTRITION AMONG ADOLESCENTS

(1)Roy, Swapan Kumar; (2)Jahan, Khurshid; (3)Israt, Samina; (4)Islam, Sayeda Sumaiya.

(1)MBBS, MSc, Dip in Biotech, PhD, FRCP, Senior Scientist, Chairperson, Board of Trustees Bangladesh Breastfeeding Foundation. Chairperson Nutrition Foundation. Bangladesh;

(2)MSc. Director. Bangladesh Breastfeeding Foundation (BBF). Bangladesh; (3)MSc. Program Manager. Bangladesh Breastfeeding Foundation (BBF), Bangladesh; (4)MSc. Assistant Program Officer. Bangladesh Breastfeeding Foundation (BBF). Bangladesh.

**Background and objectives:** Intervention on adolescent nutrition is recognized as a key intervention to break the inter-generational cycle of malnutrition. Although, The Government of Bangladesh has adopted supportive policies and operational plans, the nutrition scenario of adolescents are still far from optimal.

The aim of the project was to increase knowledge and awareness on nutrition among the adolescent girls through an extensive orientation program.

**Methods:** This orientation program aimed to cover importance of adolescent's growth and nutrition, physical and mental changes, healthy food choice, nutritional requirement, advantages and deficiency disorder of different food/food groups, personal hygiene and sanitation, discourage child marriage and early child bearing.

2-hours long orientation session including video, demonstration of an innovative IEC tool on adolescent's nutrition was conducted through interactive multimedia projection among the adolescent girls' who are studying between VI-XII grade of school/ college/madrasa. The rounded double sided paper disk IEC tool contained information on ideal body weight, height, BMI, and recommended nutrient intake by age group (10-19 yrs). Other side of the tool included best nutrient sources, nutrient composition, benefits and deficiency disorders of 9 food/ food groups and food pyramid of Bangladesh. Demonstration to easily define age wise ideal body weight, height, BMI, energy and nutrient requirements and best food sources was performed as a part of the orientation session.

**Results:** More than 75,000 adolescent school girls aged between 10-19 years were oriented from 350 orientation seminars at the District level. Out of 10, over 95% of the adolescent girls scored full marks in the post test. 100% adolescent girls were able to answer the question about number of nutrient, symptoms of malnutrition and nutrition & hygiene that should maintain during adolescent. Little difference was found in scores by Division.

**Conclusions:** Highest interest and active participation was observed among the adolescent girls. Such orientation program on nutrition targeting adolescent girls should be held regularly as part of school health program of Bangladesh.

**Keywords:** Adolescent, Adolescent Nutrition, School health program, Nutrition, Nutrition education.

ENVIRONMENTAL EDUCATION AND NUTRITIONAL BEHAVIOR BASED ON TRADITIONAL MEDICINE: CASE OF INTERNALLY DISPLACED WOMEN IN THE 2010 POST-ELECTORAL CRISIS IN IVORY COAST

Djane, Kabran Aristide.

PhD.Sociologist. Sociology department. Peleforo Gon Coulibaly University of Korhogo. Ivory Coast.

**Background and objectives:** During the Ivorian crisis, population displacement has been observed across the country with a peak after the post-election crisis of November 2010; Thus, food system have been destroyed. In this case, green nutrition based on their pre-acquired environmental knowledge (Environmental education) was adopted, especially in their feeding behavior, in order to avoid a decline of calories and to allow food cure in such a difficult period. The objective of this scientific production is to understand the determinants and logics that underpin the appropriation of Green nutrition method derived from traditional medicine, based on knowledge of the environment, plants, by internally displaced women due to war from the region of Aboisso, near the border of Ghana, in Ivory Coast.

**Methods:** The data are collected from the International Organization for Migration (IOM) (2009) and from the town hall of Aboisso (2010) in Ivory coast on 213 internally displaced women. Non-probabilistic sampling was used. A questionnaire, an interview guide and the observation grid were also used to allow triangulation of information. Content analysis and statistical processing were carried out on Excel and the Sphinx Lexica V5 software.

**Results:** 73% of displaced women surveyed use traditional food practices due to the military crisis situation. On these, only 13% seek the advice of their spouse. The most used method at 86% is broth of crushed tree pods. The rest in leaf tea, they drink. 37% of women use the advice of a traditional practitioner (specialist in plant medicine), the rest is self-medication (55%) or advice from friends (8%) with a good knowledge of the contribution of Nature to diet and gain in calories. The choice of the traditional method, based on knowledge of environment, stems from the lack of money at 15%, the behavior of the family at 52% and the living conditions at 33%.

**Conclusions:** In times of crisis, traditional medicine based on a good knowledge of the environment (environmental education beforehand) nevertheless supports modern nutritional practices. These methods need to be examined in the different aid programs for displaced persons in order to support psychologically displaced women.

**Keywords:** Environmental education, Nutritional behavior, Traditional medicine, Internally Displaced Women, Ivory coast
## USE OF JOB AIDS TO IMPROVE MATERNAL KNOWLEDGE OF NUTRITION RELATED ANTENATAL MESSAGES IN MOTHER AND CHILD HOSPITALS, ONDO STATE

(1)Ariyo, Oluwaseun; (2)Babatope, Similoluwa.

(1)BSc. MSc. PhD. Nutritionist. Department of Human Nutrition. University of Ibadan. Nigeria; (2)BSc. MSc. Nutritionist. Department of Human Nutrition. University of Ibadan. Nigeria.

**Background and objectives:** Nutrition education is essential to improve nutritional status of pregnant women, yet its delivery is often ineffective in Nigeria's antenatal clinics. Although job aids have been shown to improve delivery of education in health programmes, its use is limited in nutrition education. This study was designed to evaluate the effect of the use of job aids on nutrition knowledge of pregnant women in Ondo State, Nigeria.

**Methods:** This quasi-experimental study involved 200 pregnant mothers attending antenatal services at Mother/Child Hospitals in Akure (experimental-100) and Ondo (control-100). A semi-structured, interviewer-administered questionnaire was used to collect information on socio-demographic characteristics. Knowledge on general health, nutrition content of antenatal messages and nutrient-food association were assessed using a 40-point scale categorized as good (≥23) or poor (<23) knowledge. Job aids was developed from nutrition component of antenatal booklet to support nutrition education in experimental group while control group used conventional nutrition education. Baseline and end-line knowledge were assessed and compared using paired t-tests at $p<0.05$.

**Results:** Age of mothers in experimental (29.0±3.9years) and control group (28.1±4.5years) was similar while 93.0% (experimental) and 86.0% (control) groups had at least secondary education. At baseline, more experimental (34.0%) than control (30.0%) mothers considered colostrum 'poor' for a baby and more control (55.0%) than experimental mothers (47.0%) knew breastfeeding should be initiated within one-hour of birth. More control (44.0%) than experimental (37.0%) knew appropriate attachment during breastfeeding. At endline, fewer experimental (11.8%) than control (37.0%) mothers considered colostrum 'poor' and more experimental (92.9%) than control mothers (60.0%) knew breastfeeding should be initiated within one-hour of birth. More experimental (85.9%) than control (48.0%) knew appropriate attachment during breastfeeding. Knowledge score of control (23.1±3.6) and experimental group (23.6±4.9) was similar at baseline with 60.0% (control) and 57.0% (experimental) mothers having good knowledge. At endline, knowledge score was significantly higher in experimental (27.9±4.3) than control group (23.0±5.2) with 91.8% (experimental) and 61.0% (control) having good knowledge.

**Conclusions:** The use of job aids enhanced nutrition knowledge among pregnant mothers attending mother and child hospitals in Ondo State. The use of job aids for nutrition education during antenatal care visits is hereby recommended.

**Keywords:** Antenatal care, Intervention, Nutrition knowledge, Nutrition education.

## THE FOOD-HEALTH-CULTURE INTERFACE: DIETARY PRACTICES OF SOUTH INDIAN MIGRANTS IN BRISBANE, AUSTRALIA

(1)Thomas, Preetha; (2)Schubert, Lisa; (3)Whittaker, Andrea.

(1)PhD. Nutritionist. School of Public Health. The University of Queensland.Brisbane. Australia; (2)PhD. Nutritionist. School of Public Health. The University of Queensland. Brisbane. Australia;

(3)PhD. Medical Anthropologist. School of Social Sciences. Monash University. Melbourne. Australia.

**Background and objectives:** This paper discusses the relevance of considering the food-health nexus in the dietary practices of South Indian migrants in Brisbane, Australia. Studies of migrant health in Australia, as elsewhere, have shown an increased risk of diet-related non-communicable disease (NCD). Indian migrants in particular have a higher risk of developing conditions such as Type 2 diabetes. Food practices among migrant communities are shaped by many forces, as they seek to retain cultural practices while adopting food influences of the host-country.

Indian food traditions are rooted in medicinal discourses, which comprise food-based prescriptions and proscriptions for health. The aim of this paper is to examine the impact of culture-driven patterns of food choice in the food-health interface for this migrant community.

**Methods:** The findings presented in this paper are part of a larger study, a focused ethnographic exploration of dietary practices among South Indians in Brisbane. Qualitative methods, including in-depth semi-structured interviews, participant observation and photo-elicitation were used to collect data from 21 Indian families originating from the southern Indian states of Kerala and Tamil Nadu, representing diversity in terms of religious background, family size, and life-stages.

**Results:** Dietary practices and food-based remedies are an integral part of ethno-medicinal systems among this migrant community. The paper identifies that the community's understandings of the food-health nexus is strongly underpinned by culture; this in turn informs dietary practices. It describes how these understandings are interpreted and used in today's global food contexts, the use of traditional food-based techniques to ensure good nutrition, and remedies to prevent and treat common ailments and health conditions.

**Conclusions:** The paper provides insights into desirable healthful dietary practices that need to be encouraged, and misconceptions about practices that need to be addressed. The findings present an opportunity to develop culturally-tailored recommendations to promote dietary practices compatible with cultural practices and consistent with food-based dietary guidelines. This could in turn assist in the prevention and/or delay of the onset of diet-related NCDs among South Indian migrants. More broadly, the study identifies aspects to be considered while communicating culturally sensitive, context-based healthy eating messages to minority populations.

**Keywords:** Food, Health, Culture-specific dietary guidelines.
# IS THAT 'KHAJA'? DEFINING SNACKS FOR YOUNG CHILDREN IN KATHMANDU VALLEY, NEPAL

(1)Pries, Alissa; (2)Filteau, Suzanne; (3)Sharma, Nisha; (4)Upadhyay, Atul; (5)Adhikari, Babita; (6)Niraula, Pratik; (6)Thapa, Anushka;

(7)Thebe, Sonia; (2)Ferguson, Elaine.

(1)MPH. Technical Advisor. Helen Keller International. USA.;

(2)PhD. London School of Hygiene and Tropical Medicine.
UK.; (3)MPH. Helen Keller International. Nepal.; (4)PhD. Helen Keller International. Nepal.; (5)MRD. Helen Keller International. Nepal.; (6)BND. Helen Keller International. Nepal.; (7)Helen Keller International. Nepal.

**Background and objectives:** Healthy snacks can be an important source of energy/nutrients and are recommended in most guidelines for young child feeding. While WHO/PAHO defines snacks as 'foods eaten between meals', recent reviews show a range of definitions for snacks, including: time of consumption, portion size, or food type. This qualitative study assessed how snacks are defined among caregivers of young children in Nepal.

**Methods:** Seven focus-group discussion (FGDs) among 32 primary caregivers of children 12-23 months and 10 structured-observations of children were conducted in Kathmandu Valley. FGDs included a guided discussion on caregivers' definitions of snacks (khaja) and participatory exercises based on behavior-centered design. For structured observations, children were observed for a 12-hour period, with details noted for feeding episodes.

**Results:** FGD participants defined khaja in comparison to main meals (khana), with caregivers describing snacks for young children as food/beverages given to 'keep something in the belly'. While khaja portion sizes for adults are smaller/lighter than meals, participants reported that portion sizes for children were often similar to meals. Observations of child feeding found that snacks were served in similar or larger portions than meals. Caregivers fed snacks frequently throughout the day, and not necessarily in accordance with typical Nepali meal patterns. Foods that were commonly identified as snack foods, including biscuits and instant noodles, were sometimes fed during khana, while other foods typical for meals, including rice/lentil porridges, were fed in-between meals.

**Conclusions:** While Nepali caregivers define snacks as foods/beverages fed between meals, this definition was inconsistent in practice and snack foods were fed during meals. Snack definitions commonly used in guidelines and research are not necessarily appropriate when considering diet quality for young children in Nepal, and possibly other contexts as well. Focusing on types of foods eaten by young children may be more appropriate than consideration of portion size or consumption time. Recommendations for snacks should consider child- and context-specific definitions, and further research is needed to understand how varying snack definitions relate to children's overall dietary adequacy.

**Keywords:** Snacks, IYCF, Nepal, Nutrition, Dietary assessment.

# THE EFFECT OF EDUCATION PROGRAM ON NUTRITIONAL KNOWLEDGE IN POLISH ADOLESCENTS: 3- AND 9-MONTH FOLLOW-UP. ABC OF HEALTHY EATING PROJECT

(1)Hamulka, Jadwiga; (2)Kowalkowska, Joanna; (2)Wadolowska, Lidia; (3)Gornicka, Magdalena; (4)Biezanowska-Kopec, Renata;

(5)BRONKOWSKA, MONIKA.

(1)Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences. Poland; (2)Faculty of Food Science. University of Warmia and Mazury in Olsztyn. Poland.; (3)Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences. Poland.; (4)Faculty of Food Technology. University of Agriculture in Krakow. Poland.; (5)Faculty of Food Science. Wrocław University of Environmental and Life Science. Poland.

**Background and objectives:** Educators are still working to design nutrition education programs to improve health outcomes [1, 2]. Effect of nutrition education may decrease through time-span after one-time education episode. Objectives: Assessment of short- and long-term effect of education program on nutritional knowledge in Polish adolescents.

**Methods:** The prospective study involved 464 adolescents aged 11-13 years at baseline. Nutritional knowledge was expressed in points (range: 0-18) and compared between 'educated' group (n=319) and 'control' group (n=145) after 3 and 9 months. In 'educated' group one-time education program was implemented.

**Results:** At baseline the mean nutritional knowledge in 'educated' group was 6.1 points and in 'control' group 5.5 points. The mean nutritional knowledge in 'educated' group was 8.5 points after 3-month and 8.3 points after 9-month follow-up, in 'control' group 6.2 and 7.2 points, respectively. The mean increase in nutritional knowledge was higher in 'educated' than 'control' group: after 3-month follow-up by 1.8 points (p<0.0001), after 9-month by 0.4 points (p<0.05); after 3 and 9 months in rural subsample was higher by: 2.5 points (p<0.0001) and 2.2 points (p<0.0001), in urban subsample was higher by 1.4 points (p<0.0001) and lower by 0.5 points (p≥0.05), in boys higher by: 1.7 points (p<0.0001) and 0.6 points (p≥0.05), in girls higher by: 1.8 points (p<0.0001) and 0.3 points (p≥0.05).

**Conclusions:** One-time education episode improved the nutritional knowledge of adolescents, and the effect was still existing after 3 and 9 months. The strongest long-term effect of education was found in adolescents from rural area. References: [1] Dominguez Rodriguez AD et al. Online platforms to teach Nutrition Education to children: non-systematic review. Nutr Hosp, 2016, 33(6):1444-1451. [2] Davis EM et al. A Fresh Fruit and Vegetable Program improves high school students' consumption of fresh produce. J Am Diet Assoc, 2009, 109(7):1227-1231.

**Keywords:** Adolescent, Education program, Follow-up, Nutritional knowledge.

**Conflict of Interest Disclosure:** Project was funded by Carrefour Foundation. Scientists' Team was responsible for all stages of project.

**Further collaborators:**

Agata Wawrzyniak (Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences),
Marta Jeruszka-Bielak (Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences),

Danuta Figurska-Ciura (Faculty of Food Science. Wroclaw University of Environmental and Life Science),

Malgorzata Kostecka (Faculty of Food Science and Biotechnology. University of Life Sciences in Lublin),

Witold Kozirok (Department of Trade and Services. Gdynia Maritime University),

Anna Danielewicz (Faculty of Food Science. University of Warmia and Mazury in Olsztyn),

Barbara Groszczyk (Faculty of Food Sciences and Nutrition. Poznan University of Life Science),

Monika Hoffmann (Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences).

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## BUILDING ON CULTURE: A GRANDMOTHER-INCLUSIVE STRATEGY YIELDS SIGNIFICANT RESULTS ON MATERNAL CHILD HEALTH AND NUTRITION (MCHN) OUTCOMES IN SOUTHERN SIERRA LEONE

**Background and objectives:** In many African and Asian communities, grandmothers provide care for pregnant and lactating women (PLW), including influencing nutritional practices of PLWs and young children. To date they represent an untapped resource largely overlooked by MCHN programs. World Vision (WV) piloted an innovative grandmother-inclusive approach (GMA) to actively involve grandmothers to promote optimal maternal infant and young child nutrition (MIYCN) practices.

**Methods:** Mixed methods were used to understand family members' roles and establish baseline levels for MIYCN knowledge, attitudes and practices (KAP). The study conducted April 2013 - May 2016, assigned 15 communities to intervention and 7 to comparison groups. Comparison areas received standard Ministry of Health and WV nutrition interventions. In addition to standard interventions, the intervention communities received the GMA, which uses adult education methods to engage grandmothers, including praise sessions, participatory learning activities and

intergenerational discussions. The end-line evaluation (May–June 2016), surveyed 291 mothers of children under two years of age, 101 PW and 219 grandmothers on MIYCN KAP, self-efficacy and birth weight. Analyses compared differences in MIYCN KAP between groups at baseline and end-line.

**Results:** Self-efficacy scores were much higher for grandmothers in intervention (19.6; max=20) than in comparison sites (14.8), paralleling higher nutritional attitudes and knowledge (Max=16 points; 12.0 + 1.7 vs. 9.8 + 3.1), better adequate maternal diet diversity (>5 food groups 95% vs. 65%) and greater meal frequency (2.6 ± 1.4 vs. 1.6 ± 1.3) in intervention versus comparison sites, respectively, at end-line (p<0.001 for all).

Significantly more children in intervention communities were exclusively breastfed in the first week of life (90% vs. 79%, p=0.01), achieved minimum dietary diversity (77% vs. 52%, p<0.001) and minimum acceptable diet at 6-23 months (52% vs. 23%, p<0.001). Pregnant women in intervention groups had better antenatal care attendance and improved food intake, contributing to higher mean birth weights (3.34 ± 0.47 kg vs. 3.08 ± 0.43 kg, p<0.001).

**Conclusions:** These overwhelmingly positive results support the conclusion that the grandmother-inclusive approach can contribute to substantive, community-wide improvements in MCHN. Collaboration with grandmothers, influential in their communities, appears to be key in bringing about optimal cultural changes.

**Keywords:** Breastfeeding, Diet, Maternal, Child, Grandmothers, Nutrition.

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## ELEVATING THE QUALITY OF NUTRITION CARE IN VIP INTERNATIONAL MEDICAL PATIENTS

**Background and objectives:** With the well-developed medical technology and rational price, Taiwan's medical service quality is above par, indicating that Taiwan has advantages in developing health care tourism. Taiwan Adventist Hospital constantly pushes itself to achieve Joint Commission International (JCI) accreditation, which is publicly known as the highest standard in healthcare quality and patient safety, and has been certified by the official institutions in the United States, Canada, Australia, New Zealand, Japan and Singapore nowadays; therefore, Taiwan Adventist Hospital has been recognized for international medical quality. However, with the increasing number of international medical patient, different dietary preference due to regional and cultural differences has become a great challenge, and thus we keep improving the quality of meals, hoping to elevate the VIP international medical patients' satisfaction with the meal to 90%.

**Methods:** Since the VIP ward was established in August 2015, there'd been twice as the satisfaction with the meal is only 66%

<footnote>(1)Aidam, Bridget; (2)Webb Girard, Aimee; (3)MacDonald, Carolyn;</footnote>

<footnote>(4)Wee, Rebecca; (5)Aubel, Judi; (6)Simba, Joseph; (7)Gruenewald, Christina; (8)Bangura, Allieu.</footnote>

<footnote>(1)PhD. Nutritionist. Evidence and Learning Unit. World Vision International; (2)PhD. Nutritionist. Rollins School of Public Health. Emory University. USA.; (3)PhD. Nutritionist. Nutrition Centre of Expertise. World Vision International. Canada.; (4)MPH. Public Health Specialist. Rollins School of Public Health. Emory University. USA; (5)PhD. Anthropologist. Grandmother Project – Change through Culture. Italy; (6)BA. Development Program Effectiveness. World Vision. Sierra Leone.; (7)MSc. Nutritionist. Technical Advisory Unit. World Vision. Germany; (8)MPH. Public Health Specialist. Program Effectiveness Unit. World Vision. Sierra Leone.</footnote>

<footnote>(1)Lin, Shu-Chi; (1)Chen, Jiyuen-Tieng; (2)Tsai, Hsiao-Jung; (2)Jen, Kai-Lin; (1)Chao, Tzu-Ching.</footnote>

<footnote>(1)MSc. Dietitian. Department of nutrition. Taiwan Adventist Hospital. Taiwan.; (2)BSc. Dietitian. Department of nutrition. Taiwan Adventist Hospital. Taiwan.</footnote>
according to the survey by Quality Control Center. In order to
improve the hospital stays of patients in VIP ward, Department
of Nutrition has designed the Food Satisfaction Questionnaire,
served the food with five-star tableware, implemented the nutri-
tion consultation in 24 hours, and provided the customized meals
according to personal preferences from May to December in 2016.

**Results:** 1. Department of Nutrition designed the Food Satisfaction Questionnaire in both English and Japanese version.

2. Results: **Conclusions:** The food supply can be personal-
ized adjusted by the special dietitian according to patients' condi-
tion and eating habits based on food culture differences, therefore
elevating international medical patients' satisfaction, improving
the quality of nutrition care, and further bringing the patients back
to health as soon as possible.

**Keywords:** Quality of nutrition care; International medical patients.

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DESIGN OF WESTERN-STYLE VEGETARIAN DISH-
ES FOR INTERNATIONAL MEDICAL PATIENTS

(1)Lin, Shu-Chi; (1)Chen, Jiyuen-Tieng; (2)Tsai, Hsiao-Jung; (2)Jen, Kai-Lin; (1)Chao, Tzu-Ching.

(1)MSc. Dietitian. Department of nutrition. Taiwan Adventist Hospital. Taiwan.; (2)BSc. Dietitian. Department of nutrition. Taiwan Adventist Hospital. Taiwan.

**Background and objectives:** With the advancement of trans-
portation technology, cross-border travel has become widespread.
However, attaining medical treatment while abroad remains a
challenge, especially for those who are unable to find suitable or
familiar foods during hospitalization. Thus, expanding menu op-
tions to include Western vegetarian dishes would be optimal in
order to improve the hospital stays of international patients.

**Methods:** Dietitians would collect and analyze western rec-
ipes, and review production methods with the chef. Part of the
recipes that include animal products should then be replaced by
vegetarian ingredients such as tofu, and any sauce in Western veg-
etarian dishes can be made with nuts, like almonds and cashews,
in order to increase the flavor. Dietitians should visit the affected
international patients during their hospitalization, introduce the
meal, and provide health and diet advice. Depending on the pa-
tient's status and eating habits, the food content can be adjusted.
Finally, the Food Satisfaction Questionnaire is designed for meas-
uring satisfaction of the international medical patients with West-
ern vegetarian dishes. Questionnaires will be scored by percentage
numerically for each item; the higher the score, the more satisfied
patients are.

**Results:** From July 2016 to March 2017, 40 food satisfaction questionnaires for the international meals were collected. We designed the 7-day Western Vegetarian Cycle menu. The food supply was adjusted according to eating habits based on food culture differences. For instance, we provided more fruit or salad for European and American patients, and soy sauce or miso for Japanese

patients. Results: **Conclusions:** Provide Western-style vegetarian
food to international medical patients in order to improve satisfac-
tion with food and with overall hospital care.

**Keywords:** Vegetarian dishes; International medical patients; Food Satisfaction Questionnaire.

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DEVELOPMENTAL TRIAL OF NUTRITIONAL
EDUCATION PROGRAM ON CALCIUM INTAKE
FOR JUNIOR HIGH SCHOOL STUDENTS

(1)Nakanishi, Yukiko; (2)Kojima, Asako; (3)Ikeda, Takako.

(1)PhD. Nutritionist. Department of Heath Food Sciences.
University of Human Arts and Sciences; (2)Msc. RD. Department
of Health and Welfare. Abiko City Office. Japan; (3)PhD. RD.
Department of Health Design. Showa Women's University.
Japan.

**Background and objectives:** School lunches are required to give consideration to actively ingest calcium, which is particularly needed during the growth period. However, the method of evaluating food education activities at present educational site has not been established. In this research, we aimed to develop and evaluate a food education program on calcium for junior high school students incorporating PDCA cycle.

**Methods:** Survey was conducted in July and December 2016, targeting all 251 students enrolled in F junior high school. Actual condition survey on food, questionnaire survey on dietary habits, mental health survey, and BDHQ 15y (Simple self-registered diet history questionnaire: brief-type self-administered diet history questionnaire) for junior high school students were examined. The effect of grade level on each item and the impact assessment by comparing before and after educational activities were examined using χ2 test (effective response rate 94.8%). The intake of normal milk, low fat milk, yoghurt and cheese was divided into quartiles and a one-way analysis of variance was conducted on the mental health score and micronutrient deficiency score (effective response rate 88.4%).

**Results:** The micronutrient deficiency score and the mental health score both gained higher scores than adults. Significant correlation was found between mental health score and micronutrient deficiency score in yoghurt ingestion and dairy product intake, and in the group with low yoghurt intake, the score of mental health and micronutrient deficiency tends to be high in all students. In the group with low dairy intake, mental health scores in female students and mental health and micronutrient deficiency scores in all students tended to be higher. Students who can correctly select 5 kinds of calcium-rich foods which are particularly necessary for junior high school students was 39.1% before food education, but significantly increased after food education.

**Conclusions:** Development of nutritional education program on calcium accompanied with evaluation based on the concept of health promotion using the PDCA cycle is effective for improving the school's dietary education activity and motivation for student's
calcium intake and increasing student calcium intake can be ex-
pected.

**Keywords:** PDCA cycle, Evaluation, Nutirional education, Junior High School, Calcium

**Conflict of Interest Disclosure:** A part of this study was fund-
ed by Japan Milk Academic Alliance and Japan Dairy Association

**Conclusions:** While caregivers reported health/nutrition bene-
fits influencing their choices of snacks, a child's preferences and car-
egiver's economic status also guided their decisions. These findings
suggest future research is needed to develop snack options that are
nutrient-rich, inexpensive, and appealing to young children.

**Keywords:** Child feeding, Health, Nutrition, perception.

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CAREGIVERS' PERCEPTIONS OF SNACKS AND FACTORS INFLUENCING THEIR USE FOR YOUNG CHILD FEEDING IN URBAN NEPAL

(1)Sharma, Nisha; (2)Pries, Alissa; (3)Upadhyay, Atul; (4)Thapa, Anushka;

(5)Thebe, Sonia; (6)Filteau, Suzanne; (6)Ferguson, Elaine.

(1)MPH. research Coordinator. Helen Keller International. Nepal;

(2)MPH. Helen Keller International. USA.; (3)PhD. Helen Keller International. Nepal.; (4)BND. Helen Keller International. Nepal.;

(5)Helen Keller International. Nepal.; (6)PhD. London School of Hygiene and Tropical Medicine. UK.

**Background and objectives:** Ensuring a nutritious diet dur-
ing the complementary feeding period is vital for preventing child-
hood malnutrition. Prior research in Kathmandu Valley found
high consumption rates of nutrient-poor snack foods among chil-
dren 12-23 months of age. This qualitative study was conducted to
elicit Nepali caregivers' perceptions of snack foods and beverages
and factors influencing their feeding decisions to help understand
why caregivers chose to feed their toddlers these foods.

**Methods:** Seven facilitated discussions and participatory exer-
cises were conducted with 32 primary caregivers of children 12-23
months of age in purposively sampled areas of Kathmandu Valley.
Focus groups were stratified by caregiver type (mother or grand-
mother) and socio-economic status (SES) (low or middle/high).
Discussions were guided by a facilitator, and participatory exer-
cises included: 1) free-listing of foods and beverages consumed by
children as snacks, 2) categorization into similar food groups, and
3) ranking of snacks according to perceived healthiness, conveni-
ence, cost, and child preference.

**Results:** Perceived health and nutritional benefits of foods/
beverages were the most common reasons for caregivers' choices
of snacks for their young children. Fruits, eggs and milk were con-
sidered nutritious while 'market foods', such as instant noodles and
chips, were considered 'junk foods' and not healthy for children.
Despite this distinction, caregivers reported feeding these less
healthy foods if their child demanded them. Certain commercial
foods, such as chocolate and fruit drinks, were considered healthy
by some caregivers; and biscuits/cookies were often categorized as
healthy commercial foods. Commercial snack foods were consist-
ently ranked high on convenience both because of minimal prepa-
ration and ease of feeding, as children 'gobbled them up'. Caregiv-
ers of lower SES reported that their financial situation influenced
the choice of certain snacks for their children, while caregivers of
higher SES reported feeding 'whatever the child wants'.

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ADHERENCE TO THE MEDITERRANEAN DIET OF NUTRITION AND DIETETICS STUDENTS IN CYPRUS

(1)Yücecan, Sevinç; (2)Madencioğlu, Servet.

(1)PhD. Nutritionist. Department of Nutrition and Dietetics. Faculty of Health Sciences. Near East University.; (2)MSc. Nutritionist. Department of Nutrition and Dietetics. Faculty of Health Sciences. Near East University. Cyprus.

**Background and objectives:** Adherence to the Mediterrane-
an diet is associated with significant improvements in health sta-
tus. This study aimed to determine the adherence to Mediterrane-
an diet in Nutrition and Dietetics students at Near East University
in Cyprus.

**Methods:** The study was conducted on 174 Nutrition and Dietet-
ics students, aged 18 to 31 years. The nutritional status and Mediterra-
nean Diet Score (MDS) of individuals were determined by food-fre-
quency questionnaire, and a 72-h dietary record. MDS focuses on the
consumption of non-refined cereals, fruits, vegetables, legumes, po-
tatoes, fish, red meat and meat products, poultry, full fat dairy prod-
ucts, olive oil and alcoholic beverages. MDS was calculated, and then
classified into three groups: good (between 36-55 points), moderate
(between 21-35 points), and poor (0-20 points). General character-
istics, anthropometrical measurements and physical activity levels
(International physical activity questionnaire (IPAQ) short form) of
participants were also determined. The study protocol was approved
by the Ethics Committee at Near East University.

**Results:** According to study results 30.8% of students were found out to have low adherence, while 67.7% of students had moderate adherence and 1.5% of students had high adherence to Mediterranean diet. The results showed that MDS decreased as the students were approaching to senior year. There was significant difference between the first year and the senior year students. There was no significant difference (p=0.609) between the male and female students in terms of adherence to Mediterranean diet. Physical activity evaluation results showed that most of the students (40.2%) were minimally active. Male students were significantly more active than female students (p=0.007).

**Conclusions:** The Mediterranean diet is considered as a die-
tary pattern that contributes to better health and quality of life.
The findings indicate that the eating habits of the Nutrition and
Dietetics students, even those studying nutrition, are in need of
improvement.

**Keywords:** Mediterranean diet, Mediterranean Diet Score, Nutrition and Dietetics Students.
# MAJOR DIETARY PATTERNS OF TWO ETHNIC GROUPS LIVING IN NORTH-WEST OF IRAN BASED ON AGE, GENDER AND ECONOMIC STATUS

Rezazadeh, Arezoo; Omidvar, Nasrin; Eini-Zinab, Hassan.

Department of Community Nutrition. National Nutrition and Food Technology Research Institute. Faculty of Nutrition and Food Technology. Shahid Beheshti University of Medical Sciences and Health Services. Iran.

**Background and objectives:** The aim of this study was to determine major dietary patterns of two major (Azeri) and minor (Kurd) ethnicities living in Urmia, West Azerbaijan, Iran based on age, gender and economic status

**Methods:** In this cross-sectional study, 723 participants (427 women and 296 men) aged 20-64 year old, from two ethnic groups (445 Azeri and 278Kurd) were selected through a multi stage cluster systematic sampling. Economic status (ES) was collected by questionnaire and dietary information was collected by a valid semi-quantitative F.F.Q through interviews. Dietary patterns (DPs) were determined using principal component analysis. Data was analyzed by one-way ANOVA and Chi-square analysis.

**Results:** Three major DPs were extracted including "Traditional High SES (THS)" (high in fruit and vegetables, dairy products, olives, nuts, herbal infusions, traditional Pancake, dolma, thick soup and pickles); "Transitional" (high in fast foods, red and visceral meat, kebab, salty snacks, sauces, sweetened drinks, sweets, poultry, fish, seeds and coffee); and "Traditional Low SES (TLS)" (high in tea, refined grains, potatoes, whole grains, vegetable& hydrogenated oils and animal fat, traditional stew, salt, eggs and legumes). THS and TLS was highly consumed in Azeris and Kurds, respectively. There weren't any significant differences between two groups in consumption of Transitional DP. A greater percentage of Azeri women and those living in middle &high ES households were at the highest tertile of the THS DP. In Kurds, those categorized in the highest tertile of THS had higher per capita income and expenses than those in lower tertiles. Azeris and Kurds who were in the highest tertile of the transitional DP, were younger and kurds had higher income/capita and cost of living / capita. Among Azeri Turks, more men and among Kurds higher percentage of those with lower per capita income and costs were at the highest tertile of TLS DP.

**Conclusions:** Findings suggest that ethnic background, gender and economic status associated with extracted dietary patterns in the studied ethnic groups. Also, age was an important determinant in adhering to a modern or traditional pattern. Therefore, such characteristics should be considered in planning and formulating diet related policies and programs.

**Keywords:** Dietary patterns, Economic status, Gender, Ethnicity, Iran.

# ADVERTISING, MARKETING, SCHOOL AND FAMILY: CO-RESPONSIBLES OF NUTRITION-AL STATUS, FOOD PRACTICES AND HABITS OF CHILDREN AND ADOLESCENTS OF COSTA RICA

(1)Holst Schumacher, Ileana; (2)Nuñez-Rivas, Hilda Patricia; (3)Campos Saborío, Natalia; (4)Chacón Ruiz, Betty; (5)Alfaro Mora, Flory Virginia.

(1)MSc. Microbiologist. Faculty of Microbiology. University of Costa Rica. Costa Rica.; (2)PhD. Nutritionist. Costa Rican Institute for Research and Education on Nutrition and Health. Costa Rica.; (3)PhD. Educator. Vice-Rector of Research, Distance State University of Costa Rica. Costa Rica.; (4)BSc. Nutritionist. Vice-Rector of Research, Distance State University of Costa Rica. Costa Rica.; (5)BSc. Social Worker. Costa Rican Institute for Research and Education on Nutrition and Health. Costa Rica.

**Background and objectives:** Health promotion is a systematic, continuous, integrated and complex strategy for the development of articulated and sustainable procedures that are in permanent transformation. This strategy contributes to the construction of welfare and quality of life of the educational community, especially students, by coordinating different settings (family, community and school) who are called to protect their overall health. This study aims to know if schools and high schools are good or not health promoters in Costa Rica.

**Methods:** A two-stage mixed multimethod (quantitative and qualitative) design was used. A total of 2667 students of both genders from 40 schools and 24 high schools in the seven provinces of Costa Rica was studied. Weight and height were used to obtain BMI (kg / m2). Social determinants related to food and nutritional security of students in their homes, schools and high schools were explored using a validated questionnaire. All children over 12 years old read and signed the Informed Consent Form to participate in the study. Children under the age of 12 signed the Informed Assent Formula and also had parental permission to participate.

**Results:** In the student population prevails the excess and the deficit weight (26.4% and 8.7%, respectively). The availability of sweets and soft drinks in homes and schools is greater than the intake of fruits. A 57.7% of young people are not happy with their body image and 38.1% are "on diet". The 42.2% of parents do not control the consumption of unhealthy food in their children; such as, fast foods and processed and prepared products with high content of salt/sodium, sugar and fat.

**Conclusions:** There is an upward trend in the malnutrition (excess and deficit weight) in the student population. Risk feeding practices were detected in youth that could enhance the development of eating behavior disorders (anorexia and bulimia). Advertising, marketing, school and family are co-responsible environments for customs, practices and habits of children and young people, related to availability, access, consumption and biological utilization of food.

**Keywords:** Environments, Food, Malnutrition, Children, Adolescents.
**Background and objectives:** Introduction: The eating habits of a population are a decisive factor in their level of health. Inadequate food consumption and low physical activity are directly or indirectly associated with diseases of high prevalence and mortality in developed and developing countries.

**Objectives:** To identify the food consumption and physical activity in residents of integral general medicine of the Municipality Plaza de la Revolution. 2017

**Methods:** Material and Methods: **Results:** The 5.3% never ate breakfast, 36.8% ate fruits less than 1 time per day, 26.3% reported consuming 1/2 portions of vegetables per day, 47.4% reported consuming 3 or more servings of legumes a week, 36.8% Reported consuming 2 servings of legumes a week, 15.8% reported not consuming fish, 31.6% reported consuming 2 servings per day of sugary drinks, 57.9% reported not consuming alcoholic beverages, 47.4% consumed fried foods occasionally, 68.4% Does not add salt to food, 36.8% perform physical exercises and 79.1% have an acceptable Body Mass Index.

**Conclusions:** Food consumption shows an acceptable behavior, but not physical activity; Taking into account that the study groups are health professionals.

**Keywords:** Food consumption, Physical activity, Health professionals.

**Further collaborators:**

Dr. Yarisa Domínguez Ayllón MSc. Department of Community Nutrition. National Institute of Hygiene, Epidemiology and Microbiology. Cuba

tion or even treatments. Massive amounts of information about nutrition, dietetics, diets or supplements can be found easily, but this amount of information is not correlated with its quality. That is why it is especially crucial to disseminate dietetic information of high quality in social media. Cochrane reviews are high quality source of reliable information on the effects of healthcare intervention. The aim of presented work is to present results and concerns about dissemination of high quality information about nutrition in social media.

**Methods:** Using data from Cochrane Poland Facebook fanpage and Cochrane Poland Tweeter account we analyzed results of dissemination of information about nutrition. On each social media profile posts based on plain language summaries of Cochrane reviews are published in Polish regularly 3 times a week, since March 2016 (Facebook) and November 2016 (Tweeter).

**Results:** 55 posts being connected with dietetics, supplements and lifestyle were published on Facebook fanpage. 25% were focused solely on vitamins supplementation: on average those posts reached more than 500 individuals, while those focusing on pro-healthy influence of particular food products were more popular (more than 700). The most popular were post about coffee and its properties and interventions to reduce cholesterol level. In comparison to Facebook fanpage, Tweeter posts connected with lifestyle and supplements were the most often displayed topics. Since both profiles were launched the popularity is slowly but constantly growing. The largest groups of the receivers of our information represent young adults (25-34 years old).

**Conclusions:** Raising number of fans and followers shows the need for reliable information, especially among young people. Diversification of dissemination ways allow to reach different people with different interests as it is depicted by different top-topics on both social media profiles.

**Keywords:** Information, Dissemination, Social media, Plain language summaries.

**Background and objectives:** Internet, different forums, social media have become a source of information on health, preven-

**Background and objectives:** The Government of Tanzania recognises that food fortification is a cost-effective mechanism for preventing and alleviating micronutrient deficiencies and its effects, particularly anaemia (prevalence of 39.6% among adult
Tanzanian women). Fortification of salt, wheat flour, maize flour and oil is currently mandatory in Tanzania, with voluntary fortification also permitted. To help increase consumer demand for fortified foods, the government introduced a fortification logo in 2013, which was supported by a public awareness campaign. Little is known about public awareness and understanding of food fortification, which are both direct demand drivers for fortified foods.

The objective of this research was to understand the level of consumer awareness and knowledge of food fortification in Tanzania.

**Methods:** A quantitative market research survey, consisting of 23 questions relating to participant's demographic characteristics, food purchasing behaviours, and awareness of and attitudes towards nutrition and food fortification, including awareness of the national food fortification logo. 1087 participants, (18-55 years, 57% female, 80% low socio-economic class) took part in the survey.

**Results:** 53% of survey participants reported a level of awareness of food fortification. Of these 19% correctly defined food fortification, while 34% incorrectly believed that food fortification was the combining of various foods. 217 survey participants (20%) reported prior awareness of the fortification logo rising to 34% (n=371) when shown the logo. For those who were aware of the logo, 70% felt it positively influenced food purchase decisions and 51% trusted the logo. Once provided with a definition of food fortification, 34% agreed that fortification increased the nutritional value of a food; however, 30% believed that fortified foods were for the rich and are expensive.

**Conclusions:** Despite low awareness of fortification and the logo, consumers understood the nutritional benefits of food fortification when provided with a definition. Reported spontaneous awareness of Tanzania's food fortification was consistent with findings of a larger national survey, where 13.3% of respondents reported ever seeing the logo. Further awareness raising campaigns on the role of food fortification and of the national logo are warranted, in order to support increased consumer demand for fortified foods and consequently nutrient intakes.

**Keywords:** Food fortification, Consumer awareness, Logo.

**Conflict of Interest Disclosure:** Conflict of interest disclosure: HT, JS, JT, EM work for the SUN Business Network, one of the four support networks of the Scaling Up Nutrition Movement. The SUN Business Network works to encourage private sector action on nutrition and is made up of more than 350 business members. The SUN Business Network does not receive any fees from business members.

**Background and objectives:** The prevalence of obesity and overweight among women in Uganda is rapidly increasing. Worldwide, one of the major causes of obesity is consumption of excess food servings. In Uganda little research has been conducted in regards to factors associated with obesity hence less knowledge is known. This study was conducted to fill this gap and to chiefly determine if excess staple servings are consumed, knowledge and attitudes toward food servings and to quantify the carbohydrate content in these servings.

**Methods:** A survey of 118 women (15-45 yrs) living in the suburbs of Kampala, Uganda. Semi-structured questionnaire was used to collect dietary and socio-cultural data. Data for nutritional status was collected by taking weight, height, Waist Circumference, Hip Circumference and MUAC using standard WHO procedures. The number of food servings consumed was derived by measuring the usual amounts of staple foods each woman considered a serving and then comparing these amounts to standard serving sizes. Harvest Plus Food Composition tables for Uganda was used to determine the carbohydrate composition of these servings.

**Results:** Based on the WHR, 38.2% were overweight and 32.7% obese. Using BMI, 47.3% had normal body weight while 32.7% were overweight and 20% obese.

Only 17.3% of the women had heard about the term food serving before. Of these 3.6% knew what a food serving is.

Regarding attitude, even after respondents were explained to what a food serving is, 33% insisted it was not important to count food servings due to cultural reasons such as bad food habit to measure food and beliefs like only money should limit food serving size.

The food servings for all the staples usually consumed and considered to be one serving size by the respondents was at least two times higher than the standard serving size.

The highest average carbohydrate content consumed was 439.64 grams found in the presumed one serving of maize porridge.

**Conclusions:** Excess servings of the staple foods were consumed which were the likely cause of overweight individuals. The knowledge and attitudes about food servings were poor. Thus educating individuals about what counts as a serving can be of great strategy in reducing obesity.

**Keywords:** Food serving, Staple foods, Carbohydrate content, Obesity, Standard serving size.
EFFECT OF SHORT-TERM NUTRITION EDUCATION ON PERCEIVED KNOWLEDGE OF URBAN ADOLESCENT GIRLS UTILIZING ‘BBF’S ADOLESCENT NUTRITION CYCLE & DIETARY ADVICE TOOL’

(1)Roy, Swapan Kumar; (2)Urme, Farhana Jubaida; (2)Khatun, Farhana; (2)Jahan, Hasnat; (2)Tamim, Abida; (2)Nupur, Umme Salma; (3)Islam, Sayeda Sumaiya; (4)Ratna, Moffashara Sultana; (5)Israt, Samina; (6)Jahan, Khurshid.

(1)MBBS, MSc, Dip in Biotech, PhD, FRCP, Senior Scientist, Chairperson, Board of Trustees Bangladesh Breastfeeding Foundation. Chairperson Nutrition Foundation. Bangladesh; (2)BSc. Nutritionist. College of Home Economics. University of Dhaka. Bangladesh; (3)MSc. Assistant Program Officer. Bangladesh Breastfeeding Foundation. Bangladesh; (4)MSc. Assistant Professor. Dept. of Food & Nutrition. College of Home Economics. University of Dhaka. Bangladesh; (5)MSc. Program Manager. Bangladesh Breastfeeding Foundation. Bangladesh; (6)MSc. Director. Bangladesh Breastfeeding Foundation. Bangladesh.

**Background and objectives:** There is significant malnutrition among adolescent girls in Bangladesh. A program to improve nutrition is not in place.

The aim of the study was to determine how much short-term nutrition education can increases level of perceived knowledge of urban adolescent girls on health & nutrition.

**Methods:** It was an intervention study with a control group. This study was conducted among adolescent girls aged (11-19) years. The study areas were Azimpur, Mirpur, Dhanmondi & Shaheedbag. Investigators were trained by BBF. Total 384 adolescent girls were selected. Nutrition education was given utilizing ‘Bangladesh Breastfeeding Foundation’s Adolescent Nutrition Cycle & Dietary Advice Tool’.

**Results:** This study shows that at baseline the knowledge about the definition of nutrition was found 24% in intervention and 23.8% in controls. After education 70.8% increased in intervention group and 24.9% in control group. This study also shows that, among intervention group 44.8% adolescent knows about balanced diet whether from control group it was 30.2%. Knowledge about sources of protein was increased from 29.1% to 66.7% in intervention group & 26.5% to 34.2% in control group. At baseline both fast food and beverage in intervention and control group was 19.3% & 17.9% but after nutrition education it increases up to 45.8% & 18.5% respectively. About 10.4% & 10.3 adolescent knew about prevention of anemia in baseline where as in end line it was 28.1% & 10.8% respectively. Significant (P<0.001) improvement were seen in nutritional knowledge after intervention.

**Conclusions:** BBF’s Adolescent Nutrition Cycle & Dietary Advice Tool’ which was used in nutrition education was fruitful to improve the knowledge of adolescent girl’s nutrition and health.

**Keywords:** Adolescent Nutrition, Nutrition Education, Nutrition Cycle, Adolescent, Bangladesh.

PATRIMONIALISATION OF THE QUEBRADA DE HUAMAHUACA: EFFECTS ON HEALTH AND DIET OF TILCARA NATIVES

(1)Arrachea, Maria Jose; (2)Navarrete, Monica Beatriz; (1)Sordini, Natalia.

(1)Nutritionist. Sciences of Health School. FASTA University. Argentina; (2)MD.Nutritionist. Sciences of Health School. FASTA University. Argentina.

**Background and objectives:** Background:Tilcara, a town located in the Quebrada de Humahuaca, Jujuy, Argentina, was named in 2003 as a World Heritage Site. The pattern of food consumption of the local population may have been affected as a result of the patrimonialisation of the region.

**Objective:** To assess the prevalence of cardiovascular risk factors, dietary pattern, nutritional status and social representation on the addition of new foods and forms of preparation into the traditional diet of adults aged 35 to 65 living in Tilcara in 2015.

**Methods:** Quali-quantitative, descriptive cross-sectional study. The data collection was done through interviews and surveys. A non-probability convenience sampling was used based on 31 Tilcara natives aged 35 to 65.

**Results:** The gender ratio is 55 percent female and 45 percent male. More than half of the individuals have cardiovascular risk factors. The main ones are overweight, obesity and higher-than-normal cholesterol levels. There was a high frequency of consumption of legumes, green leafy vegetables, tomatoes and carrots, rice, noodles, bread, sugar, artificial juices and soda. It is worth mentioning that the consumption of quinoa and amaranth was close to none. The sample has knowledge about a large number of regional dishes although they are not frequently prepared. With regard to non-traditional foods awareness rice was not identified as a food belonging to them although it is not a traditional food. As far as beliefs are concerned, most of the sample associates the consumption of foods and preparations outside their traditional diet with negative effects on health. Finally, it was possible to identify that the sample considers the regional meals as important.

**Conclusions:** Foods outside the Andean diet and traditional preparations coexist in the diet of individuals. In this way, they gradually move away from ancestral food mandates and approach the diet of populations living in urban centers. However, they are not completely identified with any of them. Instead, they form a new group characterized by a mix of both having own food identity.

**Keywords:** Tilcara, Nutritional Status, Consumption Pattern, Social Representations, New Foods

**Further collaborators:**

Vivian Minaard
IMPACT OF NUTRITION EDUCATION ON REDUCING
OF OVERWEIGHT IN 6-12 YEARS OLD CHILDREN OF
AFFLUENT SOCIETY IN DHAKA CITY

(1)Luna, Saimon Farhana; (2)Sultana, Syeda Saliha Saliheen; (3)Roy, Swapan Kumar.

(1)1MSc. Food and Nutrition. College of Home economics, University of Dhaka. Research Associate. Committee of Action for Research. Extension and Service (CARES) & Consultant Nutritionist. Ashik Multispeciality Hospital. Shaymoli. Dhaka;
(2)2MSc. Food and Nutrition. University of Dhaka. Associate Professor. Dept. of Food & Nutrition. College of Home Economics. University of Dhaka. Bangladesh; (3)3PhD. Nutrition. University of London. Senior Scientist. Chairperson. Bangladesh Breastfeeding Foundation (BBF).

**Background and objectives:** Nowadays childhood obesity is an emerging problem worldwide, even it is a serious paucity of developing countries. In Bangladesh childhood obesity is rising rapidly in recent age and has emerged as a major public health threat. To the author's knowledge there was no intervention study was done on this issue in this country among this 6-12 years old children. The aim was to see the impact of nutrition education aimed at improving dietary practice to reduce overweight in children at affluent society.

**Methods:** A longitudinal intervention study consisting of an intervention (n=150) and a control group (n=150) was carried out among the children aged between 6-12 years in selected affluent areas of Dhaka city during June-Dec 2012. Intervention group received 3 months nutrition education on avoiding fast food and watching TV while eating (which tends to much more eating), emphasizing on appropriate dietary guideline, physical exercise, participating school sports, eating diversified food and hygiene practice. Education was provided to the parents from intervention group about fortnightly for the 1st month and once for the next 2 months. We collected data from the children and their parents of both groups including both Anthropometric (Height, weight, MUAC of the children) and Dietary intake (using 24 hours recall method) records of the children. Control group was observed only. The results were compared between two groups using student's paired t-test and Chi-squared test using SPSS/Window's version 11.5.

**Results:** Background characteristics of both groups were comparable. 6-12 years school going overweight children's mean body weight reduction was 1.51kg in intervention group while in control group, body weight was increased to 3.05 kg (p < 0.01) after nutrition intervention. Respondent's mean BMI reduction was 1.49 in intervention group while in control group BMI raised up to 0.58 in control group (p < 0.01). After intervention, the total calorie intake was reduced to 1823 from 2265 kcal in intervention group while in control group total calorie intake elevated from 2143 to 2160 kcal in control group.

**Conclusions:** Comprehensive nutrition education was effective for reducing overweight. This education should be scaled up for all affluent society of Bangladesh.

**Keywords:** Overweight, Improved dietary practice, Affluent society

EVIDENCE-BASE LEARNING ALTERNATIVE
EDUCATION COLLABORATION SYNERGY
EDUCATION-POLICY-IMPLEMENTING
PROGRAM (CASE STUDY IN DEPARTMENT
OF NUTRITION SCIENCE, HASANUDDIN OF
UNIVERSITY, INDONESIA)

(1)Machdar Dachlan, Djunaidi; (2)Thaha, Abdul Razak;

(3)Sugihantono, Anung; (4)Izwardy, Doddy.

(1)Dr, MS Nutritionist. Hasanuddin University. Indonesia; (2)Dr. MD. MSc. Prof. Nutritionist. Hasanuddin University. Indonesia; (3)MD. MKes. Health Planning. Ministry of Health Indonesia; (4)Ir. MA. Nutritionist. Minirtry of Health Indonesia.

**Background and objectives:** Evidence-based learning model is a learning process that was developed to encourage the contribution of synergistic collaboration between education, policies and implementing programs as learning outcomes. Purpose: To develop evidence-based learning model in Department of Nutrition Science, Hasanuddin of University

**Methods:** Through the process of review, evaluation, workshops, and a review panel of experts, be continued round table task force, formulated the graduate profile, learning outcomes, matrix courses and great SCU, the structure of the curriculum and learning strategies for competence of undergraduate science of nutrition through a learning process based on evidence in Department of Nutrition Science, Hasanuddin of University.

**Results:** It has been in repositioning and restructuring the curriculum based on problem-solving cycle into evidence-based learning curriculum where family-based sentinel surveillance is used as a reference proof Accelerate learning and scaling-up nutrition is used as a learning theme. In the learning process of each student H will assist and learn at 40-50 HH for 6 semesters learning phase. Each course was served eight classroom sessions, 2 sessions of discussions 10 cases, 4 family field study sessions, 2 sessions of the seminar. Teaching materials have been prepared and 10 cases for discussion on all subjects. This model has been applied since 2016

**Conclusions:** Evidence-based learning will gain convergence and connectivity between educational institutions and stakeholders who will use the results of their students, and ensure the quality of graduates

**Keywords:** Evidence Based Learning; H-H Surveillance; Collaboration-Synergy; Scaling-up Nutrition

**Further collaborators:**
Hasanuddin University and Ministry of Health Indonesia
# CHILDREN'S INDUSTRIALIZED FOOD CONSUMPTION AND THE FACTORS THAT LEADS TO THEIR ACQUISITION

(1)Haddad Caleiro Pereira, Cláudia; (1)Bagatini Saud Ferro, Élen Lúcia;

(2)Moreto, Pryscila Grazielle Silva; (1)Rossi, Camila Manfredi dos Santos.

(1)MD. Nutritionist. Curso de Nutrição. Universidade de Franca. Brasil.; (2)Bel. Nutricionist. Curso de Nutrição. Universidade de Franca. Brasil.

**Background and objectives:** Nowadays, the daily routine favors the consumption of processed food due his practicality. The Media is one of the elements that incite his consumption, reaching, mostly the children. Therefore, the present study aims to identify the main factors that may be leading to the acquisition of processed food, and the media influence on the child's nutritional state.

**Methods:** The main audience were 18 students, aged 6 to 10 years, in a private school, located in Franca, São Paulo. To the parents, a questionnaire with questions about the children's eating habit, and how the Television may be influencing the purchasing of processed food. For the Nutritional state evaluation, the Body mass index (BMI) was calculated, and analyzed according to the 2007 growth curves. And was classified according to the Health Ministry (2009), based on the growth curves of the World Health Organization (WHO).

**Results:** As a result of this research, 22,2% of the childrens who go along with their parents at the supermarket were overweight. 75% of the parents said that they bought what the child wanted, just to avoid tantrums. The offering of gifts is one of the elements that influence the acquisition of processed food, this variant was verified in 38,8% of the cases. The parents must know how to identify this kind of strategies, in order to avoid them, ensuring to their kids a proper nutrition. 94,4% of the parents affirmed that practicity is the main factor to buy this kind of food. 44,4% of the researched childrens watched 1-2 hours per day, 5,5% were overweight. 17% watched 3-4 per day, 11% were overweight and 5,5%, 5-6 hours per day, all of them were overweight.

**Conclusions:** The media know of the vulnerabilities of their target audience and in the case of children, the gift offerings are one of the trickery that influence the purchase. Parents should realize these artifacts and avoid them, guiding children early on about such stratagems and the importance of healthy eating. Often these parents, to avoid tantrums and crying, fulfill all the wishes of their children, regardless of the fact that they may be damaging the child's health in the future.

**Keywords:** Food acquisition, media, nutritional state

# FOLLOW IN MY GREEN FOOD STEPS: CHANGING COOKING BEHAVIOURS IN NIGERIA FOR IMPROVED IRON INTAKE

(1)Lion, Rene; (2)Van Het Hof, Karin; (3)Arulogun, Oyedunni S.;

(4)Musibaau, Titiloye; (5)Godwin, Bamsa; (6)Sidibe, Myriam; (7)Mumuni, Adejumo; (8)Shaver, Dorothy; (9)Jain, Avinish; (10)Schmidt, Peter.

(1)PhD. Unilever R&D Vlaardingen. Vlaardingen. The Netherlands;

(2)PhD. Nutritionist. Unilever R&D Vlaardingen. Vlaardingen. The Netherlands; (3)PhD. Department of Health Promotion & Education. College of Medicine. University of Ibadan. Ibadan. Nigeria; (4)PhD. Department of Health Promotion & Education. College of Medicine. University of Ibadan. Ibadan. Nigeria;

(5)Unilever Nigeria. Lagos. Nigeria; (6)PhD. Unilever Africa. Nairobi. Kenya; (7)PhD. Department of Environmental Health Sciences. College of Medicine. University of Ibadan. Ibadan. Nigeria;

(8)Unilever R&D Vlaardingen. Vlaardingen. The Netherlands; (9)Unilever Africa. Nairobi. Kenya; (10)PhD. University of Giessen. Giessen. Germany. Cardinal Wyszczinski University. Warsaw. Poland.

**Background and objectives:** In Central and West Africa, approximately 50% of women of reproductive age have anaemia. This study assessed whether a theory-based, branded school- and community-based behaviour change programme called “Follow in My Green Food Steps” increased intake of green leafy vegetables and Knorr iron-fortified bouillon cubes in South-West Nigeria in order to improve iron intake.

**Methods:** 603 pairs of mothers and daughters (aged 12-18 years) participated in a field experiment in Ile-Ife (intervention) and Osogbo (control), of which 519 participated in the post-intervention assessment. Determinants were measured based on the Theory of Planned Behaviour and use of iron-fortified cubes and green leafy vegetables were measured as part of an adapted Food Frequency Questionnaire focusing on stews and soups.

**Results:** The intervention positively influenced awareness of anaemia and the determinants of behaviour. It also resulted in a 41% increase in respondents adding the recommended bunch of green leafy vegetables to their stews compared to a 5% increase in the control group. There was also a significant increase of 0.5 cube per soup on average in the amount of iron-fortified cubes added to soups vs. the control group (0.1 cube per stew).

**Conclusions:** The intervention had a positive impact on awareness of anaemia, determinants of behaviour, self-reported intake of Knorr iron-fortified bouillon cubes and intake of green leafy vegetables.

**Keywords:** Behaviour change, dietary intake, iron fortification

**Conflict of Interest Disclosure:** RL, BG, MS, DS, KvhH and AJ are employees and OA and TM received funding of Unilever, a manufacturer of Food and Beverages products (including Knorr bouillon cubes).
(1)Hamulka, Jadwiga; (2)Kowalkowska, Joanna; (2)Wadolowska, Lidia; (3)Wawrzyniak, Agata; (4)Figurska-Ciura, Danuta; (5)Groszczyk, Barbara; (6)Kozirok, Witold.

(1)Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences. Poland; (2)Faculty of Food Science. University of Warmia and Mazury in Olsztyn. Poland; (3)Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences. Poland; (4)Faculty of Food Science. Wrocław University of Environmental and Life Science. Poland; (5)Faculty of Food Sciences and Nutrition. Poznan University of Life Science. Poland; (6)Department of Trade and Services. Gdynia Maritime University. Poland.

**Background and objectives:** Sociodemographic characteristics influence on effectiveness of adolescents' nutrition education [1]. It is weak known how sociodemographic characteristics act on unhealthy dietary patterns in long-time perspective. Objective: Assessment of the effect of nutrition education program on unhealthy dietary pattern in sociodemographic context after 9-month follow-up in Polish adolescents.

**Methods:** The prospective study involved 464 adolescents aged 11-13 years at baseline. Eating habits were assessed based on frequency food consumption. A non-healthy diet quality index (nHDI) including 4 foods (fast foods, sweetened beverages, energy drinks, sweets) was analysed (range: 0-100 points). After 9-month follow-up changes in nHDI were compared between 'educated' (n=319) and 'control' (n=145) groups and analysed in subgroups: boys/girls, rural/urban residence, bottom/middle/upper tertile of family affluence scale (FAS) [2].

**Results:** After 9 months the mean changes in nHDI between 'educated' and 'control' groups were significant in boys and urban subsample. In boys the mean nHDI was lower by 0.9 points in 'educated' and higher by 2.0 points in 'control' group. In girls the mean increase in nHDI was insignificantly lower in 'educated' than 'control' group (by 0.4 and 2.3 points, respectively); in rural subsample the mean decrease was insignificantly higher (by 0.9 and 0.5 points, respectively); in urban subsample the mean increase in nHDI was significantly lower in 'educated' than 'control' group (by 0.2 and 4.0 points, respectively); in bottom FAS tertile the mean increase in nHDI was insignificantly lower in 'educated' than 'control' group (by 2.1 and 4.6 points, respectively); in upper FAS tertile the mean decrease in nHDI was insignificantly higher in 'educated' than 'control' group (by 2.1 and 0.1 points, respectively).

**Conclusions:** The strong effect of one-time nutrition education episode in reducing unhealthy dietary pattern in Polish adolescents in long-time perspective was shown in boys. For girls a special attention should be paid in designing nutrition education.

References: [1] Gubbels JS et al. Physical activity, sedentary behavior, and dietary patterns among children. Curr Nutr Rep, 2013, 2(2):105-112. [2] Mazur J. Family Affluence Scale – validation study and suggested modification. Hygeia Public Health, 2013, 48(2):211-217.

**Keywords:** Adolescent, diet quality score, dietary pattern, education program, unhealthy diet

**Conflict of Interest Disclosure:** Project was funded by Carrefour Foundation. Scientists Team was responsible for all stages of project.

**Further collaborators:**

Marta Jeruszka-Bielak (Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences),

Magdalena Gornicka (Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences),

Renata Biezanowska-Kopec (Faculty of Food Technology. University of Agriculture in Krakow),

Monika Bronkowska (Faculty of Food Science. Wrocław University of Environmental and Life Science),

Malgorzata Kostecka (Faculty of Food Science and Biotechnology. University of Life Sciences in Lublin),

Monika Hoffmann (Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences).

(1)Osman Mohammed, Shaibu; (2)Kappos, Kristen; (3)LeMay, Philippe;

(3)Abdulai, Yunus; (3)Abu, Seidu.

(1)John Snow Inc. (JSI); (2)JSI Ghana; (3)Global Community Ghana.

**Background and objectives:** Dietary diversity is a challenge for improving nutrition outcomes of women and children in Northern Ghana. According to the 2014 Demographic and Health Survey, only 14.1 percent of children ages 6–23 months in Northern Ghana were fed the minimal acceptable diet. The United States Agency for International Development (USAID)-funded Resiliency in Northern Ghana (RING) Project works with local women farmers to promote the cultivation and utilization of nutrition-sensitive crops such as soybeans, green leafy vegetables, and orange-fleshed sweet potatoes to improve nutritional practices through food production and income generation pathways. Training on food utilization is done through engagement of community groups with participatory cooking demonstrations as a key component of the activity. The RING Project conducted a household survey to identify the consumption and sale patterns of the three crops post-harvest.

**Methods:** Multi-stage sampling method was employed to select beneficiaries for the survey at the interventions levels. The sample size was weighted by district. A total of 2,517 participants' households benefitting from at least one of the agricultural interventions were interviewed. Data analysis was done using SPSS
software version 20 and Microsoft Excel 2013 for cleaning the
data prior to analyses. Categorical variables were summarized into
frequencies and percentages whereas continuous variables were
summarized into ratios, means, minimum, maximum and stand-
ard deviations to infer themes and meanings.

**Results:** Participants reported setting aside portions for household consumption, and reported high level of consumption for all three crops by pregnant and lactating women and children 6 – 59 months. The non-consumed foods were sold by women in local markets and provided additional incomes for the families. Using their new knowledge gained in good agricultural and nutrition practices, most of the farmers reported their intention to continue to cultivate and consume the nutrition-sensitive crops without project support

**Conclusions:** Farmers are incorporating nutrient-dense crops into their local dishes. We will show evidence on how training on crop utilization and cooking demonstrations enabled households to enrich local dishes with nutrient-dense products for complementary feeding and women's diet. We will also discuss the household consumption and sale patterns of the three crops.

**Keywords:** Dietary diversity, nutrition-sensitive agriculture, household consumption, first 1,000 days period

**Methods:** An experimental randomized study containing an intervention (n= 35) and a control group (n=35) was conducted for 4 months among 70 adolescent girls aged 10-19 years in two schools of Dhaka city. At first, screening was carried out through anthropometry (height, weight) to identify 'overweight' following standards of BMI cutoff and enrolled as subjects in both groups. The intervention group received nutrition education of 40-45 minutes long sessions fortnightly for 2 months following a leaflet containing information on healthy life style including food based dietary guidelines, foods to avoid, healthy food choice, demonstration of physical activity, personal hygiene, ideal growth chart, risks and consequence of overweight. The control group was only observed. Data on anthropometry, knowledge, physical activities and food frequency were collected at baseline and end line in both groups.

**Results:** The mean body weight significantly reduced by 910 g in the intervention group while an increase of 160 g was found in the control group (p< 0.05). The percentage of subjects doing physical activities increased almost by 3 fold at the end of intervention compared to baseline.

**Conclusions:** Nutrition education on healthy food habit and life style has a positive impact on overweight prevention among the adolescent girls.

**Keywords:** Overweight, nutrition education, healthy food habit, Physical activities.

IMPACT OF NUTRITION EDUCATION ON OVERWEIGHT ADOLESCENT GIRLS (10-19YEARS) IN THE SELECTED SCHOOLS OF DHAKA CITY

(1)Khatun, Mahfuza; (1)Sonia, Nazmun Nahar; (1)Mou, Mashuda Kabir; (1)Anjum, Rifat; (1)Akter, Sonia; (1)Naharin, Kashfia; (2)Ratna, Moffashara Sultana; (3)Israt, Samina; (4)Akter, Syeda Mahsina; (5)Roy, Swapan Kumar.

(1)BSc. Food & Nutrition. College of Home Economics. University of Dhaka. Bangladesh.; (2)MSc. Assistant Professor. Dept. of Food & Nutrition. College of Home Economics. University of Dhaka. Bangladesh.; (3)MSc. Program Manager. Bangladesh Breastfeeding Foundation. Bangladesh.; (4)MSc. Assistant Director. Bangladesh Breastfeeding Foundation. Bangladesh.; (5)MBBS, MSc, Dip in Biotech, PhD, FRCP, Senior Scientist, Chairperson, Board of Trustees Bangladesh Breastfeeding Foundation. Chairperson Nutrition Foundation. Bangladesh.

**Background and objectives:** Overweight among adolescents (10-19 years) is an emerging public health concern alongside under-nutrition in developing countries, like Bangladesh. Overweight adolescents are more likely to become obese in adulthood as well as the consequences associated risk for cardiovascular disease, hypertension, diabetes mellitus type II, osteoarthritis, some types of cancer (colon, breast, kidney) and complication during pregnancy. So it is essential to develop public policies aimed at preventing overweight and reducing overweight rates in the pediatric population. The aim of the study was to see the impact of nutrition education on reducing body weight of the adolescents.

PERCEPTION AND FAMILIARITY OF FOOD PRODUCTS INCLUDING FRUITS AND VEGETABLES BY ADOLESCENTS. DECLARATION BASED ON EXPERIENCE AND PREFERENCES: ABC OF HEALTHY EATING PROJECT

(1)Gutkowska, Krystyna; (1)Piotrowska, Anna; (1)Kostyra, Eliza;

(1)Wasiak-Zys, Grazyna; (1)Tomaszewska, Marzena; (2)Lozna, Karolina;

(3)Sujka, Monika; (4)Czeczelewski, Jan; (1)Hamulka, Jadwiga.

(1)Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences. Poland; (2)Faculty of Food Science. Wrocław University of Environmental and Life Science. Poland;

(3)Faculty of Food Science and Biotechnology. University of Life Sciences in Lublin. Poland; (4)Faculty of Physical Education and Sport in Biała Podlaska. The Josef Pilsudski University of Physical Education in Warsaw. Poland.

**Background and objectives:** Adolescents have various expectations regarding the quality of food products and their preferences are mainly based on family patterns raised from childhood. The preferences can be also modified by education programme increasing willingness to taste unfamiliar foods. Exploring factors determining perception of food products by adolescent is important for better preparing such programme.

To gain insights into factors determining perception of food products by adolescents using quantitative approach combined with practical task during sensory workshop. Furthermore, ex-
experience and familiarity with various fruits and vegetables were examined together with willingness to consume.

**Methods:** 765 adolescents aged 11-13 years from Poland participated in the study. The questionnaire covered aspects such as perception of food packaging including practical task with 15 s exposure; the desire to learn new flavours; preparing meals with parents/grandparents; preferences and familiarities of fruits/vegetables and the importance of senses in fruits/vegetables choice and consumption.

**Results:** Adolescents declared that the most important information for them on the product packaging was the expiry date and then ingredients, nutritional value, storage conditions. The least important were: brand and appearance. Practical task provided additional information on the relevance of the other attributes. About 80% of all adolescent declared that they are interested in getting to know new tastes/flavours by consuming products and they stated participate in preparing meals at home. Nevertheless many adolescents had a problem with giving examples of spices used in the process of seasoning. Among the listed, most popular spices were salt and pepper. A high share of participants claimed to be familiar with domestic and exotic fruits and they declared the desire to consume some unknown fruit (e.g. carambola, figs, avocados) but were far more reluctant to try unknown vegetables (e.g. chicory, asparagus, patison).

**Conclusions:** The most important information for adolescents on the product's packaging was the expiry date. The variety of spices known and used by participants was relatively low. Adolescents declared less familiarity of some vegetables compared to fruit and less interest in their consumption.

**Keywords:** Adolescent, perception, experience, familiarity, food consumption

**Conflict of Interest Disclosure:** Project was funded by Carrefour Foundation. Scientists Team was responsible for all stages of project

**Further collaborators:**

Monika Hoffmann (Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences. Poland),

Ewa Czarniecka-Skubina (Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences. Poland),

Malgorzata Baczkowicz (Faculty of Food Technology. University of Agriculture in Krakow. Poland)

Lidia Kurp (Faculty of Food Science. University of Warmia and Mazury in Olsztyn. Poland)

**Background and objectives:** Sensory experience as a multi-modal perception, memory aspect, expectations and context of consumption influence the formation of eating habits and food choices. Involving children in various tasks related to food preparation could be an opportunity to increase healthy eating behaviour and reduce the formation of neophobia.

Objectives: 1) Introduce adolescents to the role of the senses in food selection, eating and acceptance of products, 2) Increase the ability to recognize the sensory properties in products, 3) Enrich experiences of adolescents in relation to less known/unknown products (fruits, vegetables).

**Methods:** 765 adolescents aged 11-13 years from Poland took part in the sensory workshops. The workshop consisted of a lecture and a practical tasks. The lecture referred to the role of the senses in the evaluation of product qualities. At practical activities, adolescents described the product's (yoghurt) packaging after 15s of exposure, identified the smell of various herbs/fruits and their acceptability using 5-point facial hedonic scale. They also determined sensory properties of yoghurt took part in preparing the canapes (integration of different senses) and evaluated their eating habits as consumers (now and in the future).

**Results:** Adolescents noticed and remembered various information on the packaging (e.g. storage conditions). They prepared a map of the most important food label cues from the consumers point of view. During olfactory task, it was revealed that the ability of identification and acceptance of odour by participants depended on the type of stimulus. Adolescents showed great creativity when describing their impressions related to the sensory quality of strawberry yoghurt. While preparing canapes, adolescents willingly included in their composition less known fruits and vegetables. They created visually attractive, tasty and acoustic products and enjoyed their consumption. A large group of children declared willingness to change their eating habits (e.g. reduce consumption of sweets).

**Conclusions:** Adolescents willingly participated in the workshops and were absorbed by the tasks. They also declared that the workshop made them more open to the preparation and consumption of new, healthy food products and dishes, including fruits and vegetables.

**Keywords:** Adolescent, senses, impressions, enjoyable consumption

<footnote>(1)Gutkowska, Krystyna; (1)Kostyra, Eliza; (1)Piotrowska, Anna;</footnote>

<footnote>(1)Hoffmann, Monika; (1)Czarniecka-Skubina, Ewa; (1)Wasiak-Zys, Grazyna; (2)Baczkowicz, Malgorzata; (3)Kurp, Lidia; (1)Hamulka, Jadwiga.</footnote>

<footnote>(1)Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences. Poland; (2)Faculty of Food Technology. University of Agriculture in Krakow. Poland; (3)Faculty of Food Science. University of Warmia and Mazury in Olsztyn. Poland.</footnote>
**Conflict of Interest Disclosure:** Project was funded by Carrefour Foundation. Scientists Team was responsible for all stages of project

**Further collaborators:**

Marzena Tomaszewska (Faculty of Human Nutrition and Consumer Sciences. Warsaw University of Life Sciences. Poland)

Monika Sujka (Faculty of Food Science and Biotechnology. University of Life Sciences in Lublin. Poland)

Karolina Lozna (Faculty of Food Science. Wroclaw University of Environmental and Life Science. Poland)

Jan Czeczelewski (Faculty of Physical Education and Sport in Biala Podlaska. The Josef Pilsudski University of Physical Education in Warsaw. Poland)

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## MY HEALTHY SCHOOL PROGRAM

María, Escasany; Casagrande Soria, María Laura; Antún, María Cecilia; Gonzalez, Veronica; Ferrari, María Florencia; Eisenberg, María Paula; Saidman, Natalia; Liguero, María Eugenia; Di Paola, Melina; Icicson, Mariela.

Affiliation: Directorate-General of Health Development. Deputy Mayor's Office. Buenos Aires City Government. Argentina.

**Background and objectives:** The My Healthy School Program (MHS) of the Directorate-General of Health Development of the Deputy Mayor's Office of the Buenos Aires City Government, is an educational program which promotes healthy habits in the entire educational community. It has been in place since 2012 in Buenos Aires City kindergarten and elementary public schools, with a duration of 2 years in each establishment.

**Methods:** Indicators of the Program's scope, as well as the main findings of the general assessment are described.

**Results:** Since its initiation MHS has been implemented in 130 kindergarten schools and 167 elementary schools (one third of all city establishments). This represents a scope of approximately 61 000 children and 6 700 teachers. To date, the Program has carried out 3 236 workshops for children, 662 for teachers and 628 workshops for families. The Recess in Movement component had the participation of 22 342 children, and over 200 articulations with other Government programs were carried out. Furthermore, My Healthy Magazine, a bimonthly publication on MHS key issues, has reached 14 editions and has been distributed to all students of participating schools.

The Program assessment has taken into account the feedback of children, families and teachers. Sixty percent of children who participated in MHS considered they adopted healthier eating habits after the Program, and 55% said they were doing more physical exercise. Among changes in eating habits, children mentioned increase in vegetable (41%), fruit (55%) and water (65%) intake.

In regards to teachers, over 90% expressed being satisfied or very satisfied with the Program, 51% considered MHS generated positive changes in the educational community's habits and 47% said MHS trained and provided them with tools for addressing the

issues in the classroom. The qualitative component of the assessment showed the presence of nutritionists in the establishments stands out as a key advantage.

**Conclusions:** The scope and acceptance of MHS make it a very useful strategy for creating healthier school environments.

**Keywords:** School nutrition education – School – Healthy habits

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## FOSTERING PHYSICAL ACTIVITY DURING CHILDHOOD: A GOVERNMENT SECTOR EXPERIENCE

Antún, María Cecilia; Escasany, María; Casagrande Soria, María Laura; Ferrari, María Florencia; Gonzalez, Veronica; De Ruggiero, Marina; Di Paola, Melina; Eisenberg, María Paula; Mirri, María Eugenia.

BSc in Nutrition. Directorate-General of Health Development. Deputy Mayor's Office. Buenos Aires City Government. Argentina.

**Background and objectives:** Physical activity (PA) has multiple benefits for physical and mental health in children, as well as a positive impact during adult life. Childhood is a critical period for the development of healthy habits; therefore, promotion of PA in this stage is essential.

Since 2012, the Directorate-General of Health Development of the Deputy Mayor's Office of the Buenos Aires City Government has implemented, as part of its Health Stations (HS) and My Healthy School (MHS) programs, diverse strategies for fostering PA in child population. The object of this work is to describe those strategies.

**Methods:** Cross-sectional study.

**Results:** The Recess In Movement Project (RIM) is an initiative of the MHS program, its goal being the promotion of PA during school recesses. For this purpose, a team of PA professors assist the establishment in the implementation of a series of actions. Furthermore, recreational equipment is provided, and older students and teachers are trained as for the continuity of the project. This strategy has had the participation of 100 schools and 22 342 children, and 2 694 children and 179 teachers were trained.

Moreover, Game Zones have been implemented within the HS setting. They consist of an educational recreational space where PA is fostered and bonds with other children and their families are encouraged. Individual and collective active games are offered, and child population healthy eating issues are tackled. PA professors specially trained in healthy eating notions are in charge of the activities. To date, 26 017 children have participated.

**Conclusions:** Both strategies attempt to encourage the acquisition of healthy lifestyles commencing in childhood, in the hope that this behavior will endure in adult life and contribute to improving the quality of life and health of the population.

**Keywords:** Physical activity – health promotion – healthy lifestyles
# PROJECT JA: A NOVEL APPROACH TO STIMULATE POSITIVE ATTITUDE FROM CHILDREN TO FRUITS AND VEGETABLES CONSUMPTION AND TO THE MOVEMENT

(1)Cormillot, Adrian; (2)Verón, Sergio; (3)Pereiro, Romina; (4)Klimovsky, Ezequiel; (4)Olaya Rojas, Angela; (5)Viard, Mónica; (6)Federico, Andrea.

(1)Fundación ALCO; (2)Profesor. Fundación ALCO, CABA. Argentina;

(3)Nutritionist. Fundación ALCO. CABA. Argentina; (4)MD.Quid Consulting. CABA. Argentina; (5)Pharmacyst. Quid Consulting.

CABA. Argentina; (6)BSS. Quid Consulting. CABA. Argentina.

**Background and objectives:** Consumption of fruit and vegetables among children is generally below recommended levels. In addition it has been shown that only 1/3 of high school students get the recommended levels of physical activity. Different interventions have been demonstrated to be of help in stimulating fruit and vegetables consumption and movement in children. The objective of this presentation is to show the methodology, design and participation results of a recreational intervention developed in Argentina during 2016: Project JA

**Methods:** A pilot program was developed during 2015, through 7 presentations in 6 schools. Following this pilot program a definitive interactive workshop has been developed by a team conformed by physician, nutritionist, physical education teacher with the collaboration of a scriptwriter. The workshop includes a performance with dances and interactive games with the children's participation lasted 45 minutes, following by 20 minutes exchange of professionals and children and photographs. Fruits colors and movement games and activities were emphasized

**Results:** From March 2016 to January 2017, 200 workshops were performed in 71 schools and other places (hospitals and sciences expo) at 29 cities in the 24 Argentinean provinces, with participation of around 25000 children aged 6-12. Twenty six thousand brochures and 30000 fruit units were brought to the participants and teachers. A brief video will be shown, including the most popular moments of the workshop and participant's interviews regarding the workshop

**Conclusions:** The methodology chosen for the workshop had a great acceptance by the participant children and the teachers and a positive approach to fruits and vegetables consumption and to movement has been perceived.

**Keywords:** Fruits, vegetables, movement, children

# PORTRAIT OF CONTEMPORARY MOROCCAN LIVES IN CASABLANCA BETWEEN THE ORIGINAL FOOD CULTURE AND MODERNITY

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

(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:** Developing countries, including Morocco, experiencing significant discrepancy in dietary practices between the city and rural area. The objective of this study is to compare between certain eating practices of Casablanca (urban) and people from Souss (rural) due to urbanization.

**Methods:** Our sample includes 149 women and 155 men from Casablanca and 157 women and 152 men from Souss Région. This sample was stratified according to ethnicity (urbans, Casablancan Soussi [CS], and Casablancan not Soussi [CNS]), gender and age.

**Results:** The food consumed varies according to the meal: As for lunch, we note that 35.5% ate traditional dishes (couscous, tagines) and 47.7% consumed fruits and vegetables (salad, sautéed vegetables). We also note a low consumption of fast food during that meal (0.5%). For the dinner, the typology is more diversified, in fact, during the meal, our study population tended to consume more fast food (19.7%) and dairy products (12.4%), in addition to meat and fish grilled (13.2%), fruits and vegetables (13.7%). Also, our data indicated an association between the change in the type of food taken at lunch, and ethnicity (p <0.0001): there is a frequent consumption of fruits and vegetables (51.0%) in rural Soussis at lunch compared to Casablanca (44.2%), relatively the same frequency in both CS and CNS ethnic groups (41.8% and 46.6% respectively). In addition, Casablanca are more likely (48.3%) to eat couscous and tagines (41.8% in CS and 45.9% in CNS) that Soussis 27.1%. The meal / food category consumed at breakfast is different from that consumed at other meals. Therefore, for this meal, our population prefer taking soup (42.3%), bread with garnish (31.4%) and milk / dairy products (20.7%). Similarly, for this meal, the change in the type of food consumed is associated with ethnicity (p <0.05). Indeed, 48.8% of Soussis took dairy products for breakfast; this prevalence is higher than that observed in Casablanca (24.3%) [Higher in CNS (39.7%) than CS (9.0%)].

**Conclusions:** Food style of our urban population has a pendulisme between the Western-style food and that of the original Moroccan culture, particularly the typology of food consumed.

**Keywords:** Food culture. Pendalisme.
# SCHOOL TEACHER'S KNOWLEDGE AND SCHOOL PRACTICES RELATED TO FRUIT CONSUMPTION AND THEIR PERCEPTIONS ABOUT STUDENT'S ATTITUDES TOWARD THE SAME ISSUE

(1)Cormillot, Adrian; (2)Verón, Sergio; (3)Pereiro, Romina; (4)Klimovsky, Ezequiel; (4)Olaya Rojas, Angela; (5)Viard, Mónica; (6)Federico, Andrea.

(1)MD Fundación ALCO. CABA. Argentina.; (2)Profesor. Fundación ALCO, CABA. Argentina; (3)Nutritionist. Fundación ALCO. CABA. Argentina; (4)MD.Quid Consulting. CABA. Argentina;

(5)Pharmacyst. Quid Consulting. CABA. Argentina; (6)BSS. Quid Consulting. CABA. Argentina.

**Background and objectives:** Nutritional education policies in schools have a positive impact increasing the consumption of fruits and vegetables by children. Teachers play an important role in this goal. The purpose of this study is to establish the degree of school teachers' knowledge and their perception about student's attitudes regarding fruit and vegetable consumption

**Methods:** A study was conducted in 22 schools of different provinces of Argentina, during 2016. A survey was carried out on teachers of children between 6 and 12 years of age to collect information regarding knowledge, school practices and perception related to fruits and vegetable consumption in their students. Argentinean region and public/private school were studied as independent variables.

**Results:** 155 from 20 provinces teachers answered the survey.

Knowledge: 47.7% of them knew that at least 3 portions of fruit are recommended per day. 94.8% totally agree that is good to eat fruit and 93.5% totally agreed that it should be eaten every day.

Practices: only 3.9% reported that the school usually offers fruits to children and 3.2% that children usually take fruits to school.

Perceptions: 98.1% think that kids do not consume the adequate portion of fruits. 71.6% think that they consume fewer amounts of fruits than kids of the same age. 93.5% of teachers totally agree that for kids is hard to eat fruit every day.

Evaluating the region as independent variable, it was found that the proportion of teachers who knew that at least 3 portions of fruit is recommended per day, is major in NEA (North East Argentina)-Mesopotamia and Patagonia

**Conclusions:** Teacher's knowledge regarding fruit consumption recommendations should be improved, as well as school strategies to stimulate children's fruit intake.

**Keywords:** Knowledge - Fruits consumption - School teachers

# IMPACT OF A PROMOTIONAL PROGRAM REGARDING HEALTHY EATING IN BMI AND FEEDING HABITS IN HIGH SCHOOL STUDENTS

(1)Ponce y Ponce de León, Gisela; (2)Arizona Amador, María Betzabé;

(2)Rieke Campoy, Ulises; (2)Camargo Bravo, Adriana; (3)Mayagoitia Witrón, José de Jesús; (2)Pimentel Jaimes, José Alfredo; (2)Higuera Sainz, José Luis; (4)Tizoc Márquez, Arodi.

(1)Facultad de Enfermería Universidad Autónoma de Baja California; (2)Facultad de Enfermería UABC; (3)Hospital General, Mexicali; (4)Facultad de Enfermería, UABC.

**Background and objectives:** Introduction: obesity has increased in an epidemic way in the last two decades, presenting itself at earlier ages. Environmental factors like sedentary lifestyle and bad eating habits have become main culprits. Educational interventions focused at providing solutions for feeding and nutritional problems that affect alumni are being recognized as an essential complement to actions aimed at improving feeding security of students.

**Objective:** analyze the impact of a promotional program of healthy eating regarding BMI and feeding habits in high school students.

**Methods:** longitudinal and correlation experimental study, it was performed in 415 high school students in two phases. First phase (preintervention) consisted of weight, waist line and height measuring and a questionnaire regarding eating habits and nutrients knowledge was applied, a promotional program of healthy eating (PPHE) was implemented on the experimental (EG) and the control group (CG). An informative flyer on the subject was handed and informative banners were placed at school. The second phase (intervention) was performed in which weight, height and waistline measuring was done, the previous questionnaire was once again applied on both groups. Data analysis was done using SPSS 20 software.

**Results:** decrease in weight in EG and increase in CG (X2 .001). Better eating habits were observed in the EG after PPHE but no so regarding the consume of fast food and sweets (p=<0.05). Both groups (E&C) showed good knowledge of food and nutrients post intervention, 93% and 94.5% respectively. Regarding good eating habits E showed a good response post intervention in 91.4% (p=<0.05).

**Conclusions:** there was a positive effect over BMI and change of eating habits in EG. The effects on BMI and eating habits were evaluated on the short term but we cannot conclude if these will remain on the long term.

**Keywords:** Program, BMI, feeding habits, high school students
FUNKY FOODS TO REDUCE MALNUTRITION
AMONG YOUNG CHILDREN IN SOTNIKUM
OPERATION DISTRICT, SIEM REAP, CAMBODIA

(1)Blaney, Sonia; (2)Main, Barbara; (3)Chhorvann, Chhea; (4)Vong, Lenin; (5)Menasria, Lylia; (6)Hun, Vannary; (7)Leblanc, Caroline.

(1)Professor or nutrition, Moncton University; (2)Senior Health advisor, World Vision Canada, Mississauga, Ontario, Canada;

(3)Director of National Institute of Public Health of Cambodia,;

(4)Consultant, World Vision Cambodia; (5)Graduate student enrolled in the programme of Master in Nutrition, Moncton University; (6)Technical Health and Nutrition specialist, World Vision Cambodia; (7)Professor of nutrition, Moncton University.

**Background and objectives:** In Cambodia, stunting and wasting affect 32% and 10% of children below five years of age respectively. In Siem Reap province, these proportions are even higher, 36% and 10%. Poor infant and young child feeding (IYCF) practices have constantly been reported as the cornerstone of young child nutritional status and development. In Siem Reap, breastfeeding practices are encouraging as 65% of children 0-5 months are exclusively breastfed. Nevertheless, only 36% of children 6-23 months do benefit from the three recommended IYCF practices. The objective of our research was to assess the impact of a higher consumption and promotion of micronutrient-rich local foods on child nutritional status, dietary intake and practices.

**Methods:** The research is currently ongoing in Sotnikum district area, Southern part of the country. This is a cluster-randomized controlled trial among children 6-23 months old living in 14 villages (cluster) randomly selected and assigned to each treatment group namely: cricket + nutrition education (NE), Moringa oleifera + NE and NE only. The number of villages intends to get a sample size of 120 per group in order to detect a mean improvement of 1 g/ dl of hemoglobin level between baseline and after 6 months of implementation and to take into account a 10% drop-out. Cricket and Moringa are given daily to children. Quantities of each food aimed to add at least 2 mg of iron to their daily diet. Data on nutritional (anthropometry, haemoglobin and ferritin) and health status (c-protein, presence of intestinal parasites in faeces, occurrence of illnesses), dietary intake, food and health practices, household food security and socioeconomics have been collected at baseline and will be collected at endline. On a weekly basis, data on dietary intake, health status, food and health practices including food compliance and responsive feeding are gathered.

**Results:** At the end of July 2017, the endline study will assess the impact of the consumption and promotion of local foods on child nutrition outcomes.

**Conclusions:** To come.

**Keywords:** Complementary feeding, nutrition, Cambodia, young children, local foods

**Further collaborators:**

David Raminashvili: David_Raminashvili@wvi.org

ANTHROPOMETRIC AND LUNCHBOXES COM-
POSITION OF PRIVATE SCHOOL STUDENTS OF
THE CITY OF INTERIOR OF SÃO PAULO

(1)Haddad Caleiro Pereira, Cláudia; (1)Bagatini Saud Ferro, Élen Lúcia; (2)Pacheco, Keroly de Araújo; (2)Gomides, Natália Bertulucci;

(3)Manochio Pina, Marina Garcia.

(1)MD. Nutritionist. Curso de Nutrição. Universidade de Franca. Brasil.; (2)Bel. Nutricionist. Curso de Nutrição. Universidade de Franca. Brasil.; (3)PhD. Nutricionist. Curso de Nutrição. Universidade de Franca. Brasil.

(1)MD. Nutritionist. Curso de Nutrição. Universidade de Franca. Brasil.; (2)Bel. Nutricionist. Curso de Nutrição. Universidade de Franca. Brasil.; (3)PhD. Nutricionist. Curso de Nutrição. Universidade de Franca. Brasil.

**Background and objectives:** In the most cases are the parents who make the acquisition of food that will be part of school lunchboxes and not always care with the nutritional question acquiring less healthy food. The purpose of the work is evaluate the lunchboxes composition of children 6-8 years of a private school municipality of São Paulo and compare the results with nutritional status.

**Methods:** For nutritional assessment of students was used the Growth curves for BMI/Age for children 5-19 years of the WHO 2007 and the classification of Ministry of Health (2009). The lunchboxes evaluate was realized through by observation at play-time for two days a week randomly chosen.

**Results:** Detected a high number of overweight children (overweight and obesity), corresponding to 29% of the total, and no cases of underweight, it was also observed that the incidence of girl's overweight and obesity was higher than boys, which was not detected in any case of obesity, just overweight. The kids who participated of this study presented caloric intake of 522,6 kcal in a just meal, with minimum varying of 125.85kcal and maximum of 1350kcal. It was found a low consumption of fruits (12,9%) and high consumption of artificial juices (71%).

**Conclusions:** The Statistic analysis detects that the snack taken by the students didn't interfere in their status nutritional, however parentes could opt for healthier foods for prevent children eutrophic leave this condition due to inadequate choices in the composition of lunchboxes

**Keywords:** Lunchbox, school, nutritional status
# THE IMPORTANCE OF NUTRITIONIST IN THE PREPARATION AND MONITORING THE MENU IN SCHOOL KINDERGARTEN

(1)Rossi, Camila Manfredi dos Santos; (1)Haddad Caleiro Pereira, Cláudia; (1)Bagatini Saud Ferro, Élen Lúcia; (2)Rodrigues, Talita de Paula Alves; (3)Manochio Pina, Marina Garcia.

(1)MD. Nutritionist. Curso de Nutrição. Universidade de Franca. Brasil.; (2)Bel. Nutricionist. Curso de Nutrição. Universidade de Franca. Brasil.; (3)PhD. Nutricionist. Curso de Nutrição. Universidade de Franca. Brasil.

**Background and objectives:** In Brazil, surveys reveal that the prevalence of overweight children more than tripled, showing the importance of developing school practices that promote healthy eating habits. Consequently, this study aimed to: assess whether the monitoring of school lunches by nutritionist at the institution exerts some influence on the nutritional status of pre-school children from 2 to 5 years, check qualitatively the distribution of macro and micro nutrients in your daily diet during their stay at school and parents' opinions about the presence of the nutritionist.

**Methods:** Through calculation BMI/age assessed the nutritional status of each child. The data obtained with the anthropometric assessment have been classified according to the curves of the World Health Organization (WHO) and the related data results from analysis gathered through the menu prepared by a nutritionist in two early childhood institutions.

**Results:** It was found that 95% of preschoolers were eutrophic and 5% with thinness in school with nutritionist. The institution without nutritionist 66.6% of preschoolers were eutrophic and 33.3% overweight. Through examining the menu it was observed in both schools, low intake of carbohydrates and proteins and in the institution without the consumption of nutritional lipids and sodium was superior to another school. The intake of calcium, vitamin A and iron was lower than recommended. All parents of two institutions stated that the presence of the nutritionist in daily monitoring was essential, but there have been doubts about the professional presence in the institution, because at school with nutritionist, 83% confirmed the monitoring already in school without professional nutritionist 53. 3% say existed and 46. 6% were unsure, no parent replied that there was no nutritional monitoring.

**Conclusions:** The results obtained show that the presence of the nutritionist in the daily assistance influences on children's eating habits and anthropometric profile, being essential for adequate nutritional status.

**Keywords:** Importance of nutrition, food consumption and nutritional status.

# HOUSEHOLD POND-FISH PRODUCTION IN SOUTHERN ETHIOPIA INCREASES FISH CONSUMPTION FREQUENCY AND DIETARY DIVERSITY IN WOMEN OF REPRODUCTIVE AGE

(1)Zello, Gordon; (2)Tamiru, Darasa; (3)Reta, Fikadu; (4)Kefyalew, Tafesse; (5)Zatti, Kyla; (6)Drew, Murray.

(1)PhD. Professor. College of Pharmacy & Nutrition. University of Saskatchewan. Saskatoon Canada.; (2)MSc. Lecturer. School of Nutrition, Food Science and Technology. Hawassa University. Hawassa Ethiopia.; (3)MSc. Head. School of Nutrition, Food Science and Technology. Hawassa University. Hawassa Ethiopia.; (4)MSc. Assistant Professor. Dept of Biology. College of Natural and Computational Science. Hawassa University. Hawassa Ethiopia.; (5)PhD. Research Associate. Dept of Animal & Poultry Science. College of Agriculture & Bioresources. University of Saskatchewan. Canada.; (6)PhD. Professor. Dept of Animal & Poultry Science. College of Agriculture & Bioresources. University of Saskatchewan. Canada.

**Background and objectives:** The National Nutrition Program in Ethiopia focuses on food and nutrition security especially in vulnerable populations (e.g. women and children). In southern Ethiopia, government and university partners have recently (within 5 years) introduced aquaculture in farming practices (i.e. fish ponds) as means to address these security concerns. Evaluation of the aquaculture initiative in improving nutrition security is required. Our objective was to determine the association of household pond-fish production with fish consumption, dietary diversity and nutrition status of women of reproductive age.

**Methods:** Women, 19-49y of age, from fish producing (FP) [n=61] and non-fish producing (NFP) [n=117] households residing in Dila Zuria and Wensho Woredas (i.e. districts) participated. Fish consumption frequency was measured using three consumption patterns (i.e. frequent, occasional and non-fish eaters). Women's dietary diversity score (DDS) was determined by intake of 9 food groups within a 24h period. Nutrition status of the women was crudely assessed by measuring body mass index (BMI). In addition, focus group discussions were performed to obtain in depth information about pond fish production, consumption and usage.

**Results:** Nile tilapia (Oreochromis niloticus) was the most common pond species and species preferred for sale (i.e. income). Respondents from NFP households were less likely to consume fish frequently (OR=0.044, p<0.001) than those FP households. The mean (±SD) DDS in women from FP households (5.50±2.16) was significantly higher than their NFP counterpart (4.09±1.98, p<0.001). No differences (p>0.05) in mean height, weight and BMI were found between women in FP and NFP households.

**Conclusions:** The short period of time (<5 years) since the introduction of fish-ponds in the Woredas and the simple measure used to assess nutrition status (i.e. BMI) may explain the lack of difference observed in the nutrition status of the women. However, aquaculture has great potential in improving the food and nutrition security (e.g. nutrients, income) and our results illustrate some of the benefits of pond-fish production in southern Ethiopia
**Conclusions:** These lifestyle intervention was effective, tri-
pling the proportion of pregnant women who achieve the recom-
mended walking time and reducing the proportion with a high
consumption of soft drinks and industrially processed cookies by
half.

**Keywords:** Health Promotion; Physical Activity; Food Practices; Intervention Studies; Attitudes and Practices in Health.

**Further collaborators:**

São Paulo Research Foundation, FAPESP (grant number 2011/18579-0).

144/1407

NUTRITION EDUCATION AND YOUTH: A TRAIN-
ING AN INTERVENTION INITIATIVE TO PRO-
MOTE SOCIAL CHANGE WITHIN YOUNG WOM-
EN IN SAN MARCOS, GUATEMALA

(1)Barragán Wug, Zandy Mariela; (2)García-Meza, Rosario.

(1)Nutrition Student. Paz Joven Guatemala. Rafael Landivar University.; (2)Nutricionist. Master proofreader. Rafael Landivar. University.

**Background and objectives:** According to the National Institute of Statistics in Guatemala (INE) youth represents the majority among national population. Social context for young women in Guatemala faced challenges in access to education, health and the guarantee of their human rights in general. Poverty and exclusion sum additional stressors to young women nutrition and health wellbeing and access to processes for social change can contribute to improve their opportunities to a better life

**Methods:** This reports from a bigger training and interven-
tion initiative aimed to reduce anemia and nutritional vulnerabil-
ity through capacity building processes. Training was developed
through a guide which took into account the Food and Nutrition-
al Guidelines content developed for Guatemala by the Ministry of
Health. This guide was also adapted based on local context using
the “Vulnerability and Capacity analysis” proposed by the Red Cross
International and UNICEF. 6 participatory workshops with 1,300
young women were implemented and 600 young women were sup-
plement with Iron and folic acid. Pre-post qualitative assessment
was performed to identified impact changes. A follow up with
young women who received supplements is still in need to perform.

**Results:** Improvement in the importance of nutrition percep-
tion was identified among participants. Leadership roles in food
security commissions were performed by young women in 6 com-
munities after completed training processes. Youth groups were
conformed after having the training processes implemented, in-
cluding initiatives at the municipal level

**Conclusions:** Training processes for social change, in the case of nutrition and youth, needs to take into account the context to develop and perform them better. Including decision making fig- ures into training and intervention initiatives can support young women health, nutrition and leadership.

**Keywords:** Youth, Education, Social Change.

144/1435

PROGRAM FOR HEALTHY EATING PRACTICES IN
A RURAL COMMUNITY OF NORTH INDIA

Rai, Sanjay; Misra, Puneet; Kant, Shashi.

MD. Professor. CCM. AIIMS. New Delhi. India.

**Background and objectives:** Women are the main person in the family preparing and managing food for the family and should understand the best dietary practices which fit in their budget and can be available locally, so it is very important that female understand the healthy eating practices with low cost locally available food.

**Methods:** This was part of another study, where we collected data for nutrition related health problem in females in Ballbagarh area of Haryana state in northern part of India. During study we found that most of the females have very poor knowledge about nutrition So we planned an intervention, where live demonstration was given by trained dietician in their own community near their homes about foods which are locally available and part of their food. Self help groups were made and help of grass route level health workers, volunteers were taken to make it sustainable

**Results:** Most of the females were not aware about healthy eating practices, there was high salt intake and fat intake as they were adding lot of extra salt and fat in most of items. Consumption of green leafy vegetables and sprouts was low in the area. After demonstration we have found that most of the females stopped using extra salt and fat in diet and started using sprouts. This program continued for one

**Conclusions:** Due to our efforts during study, the awareness and the overall improvement in the nutrition and health status of the postmenopausal women has increased in the area. We involved ASHA, ANM, AW worker and most importantly volunteers from their community to promote healthy eating practices even after completion of study for long term sustainability and bringing it into day to day practice.

**Keywords:** Nutrition rural females

144/1476

IMPACT ON BODY WEIGHT AND BODY COM-
POSITION OF A NUTRITIONAL INTERVENTION
PROGRAM PERFORMED AT THE WORKSITE:
DATA FROM SI. MEDITERRANEO PROJECT

(1)Vitale, Marilena; (2)Melegari, Camilla; (2)Rapetti, Valeria; (3)Grasso, Annamaria; (4)Cecchini, Chiara; (5)Riccardi, Gabriele.

(1)PhD. Nutritionist. Department of Clinical Medicine and Surgery.; (2)MSc. Nutritionist. Barilla F.Ili S.p.A. Parma. Italy.; (3)MSc. Nutritionist. Department of Clinical Medicine and Surgery. "Federico II" University of Naples. Italy.; (4)MSc. FEAT SrL. Bologna. Italy.; (5)Professor. Endocrinology. Department of Clinical Medicine and Surgery. "Federico II" University of Naples. Italy.

**Background and objectives:** Overweight and obesity are the major risk factors for non-communicable diseases. Worksites have
the potential to become a central element in national efforts to reduce obesity because the majority of adults spend most of their time at work; therefore, worksites provide opportunities for group interventions that could facilitate weight control. Accordingly, the purpose of this study was to investigate the effects on body weight and body composition of a nutritional intervention program based on the promotion of the Mediterranean diet and regular physical exercise at worksite.

**Methods:** Overweight and obese employees (n=58) enrolled in this worksite trial with a 0-6-month nutritional intervention program and a follow-up after six-month. The intervention, collected by a nutritionist, was based on recommendations to reduce energy intake and saturated fat, and increase fiber consumption, according to the features of the Mediterranean diet. An increase of daily physical activity was also promoted. Outcome measurements included changes in body weight, waist circumference and body composition. Dietary habits were investigated by self-administered-24-hour recall. Physical activity was assessed by a validated questionnaire.

**Results:** Significant decreases in body weight were observed during the intervention compared to baseline. The same findings were observed after 6-month of follow-up, even if the majority of the participants showed a tendency to resume their initial weight. A lower body fat and waist circumference was also observed during the intervention compared to baseline (p<.05). However, after 6-month of follow-up, a significant increase of fat mass was observed. The analysis of the habitual diet showed several beneficial dietary changes: fiber and polyunsaturated-fatty-acids intake were increased, while saturated-fatty-acids and added sugar consumption were decreased. The analysis of the physical activity questionnaire showed a significant increase of time spent walking during the intervention. On the contrary, a significant decrease was observed at 6-month of follow-up.

**Conclusions:** A nutritional education program is an effective tool to improve anthropometric measures and body composition in people at work. Unfortunately, most of the benefits tend to disappear when the intervention is discontinued. Systematic nutritional management programs should be developed and implemented at the worksites to help people to control their body weight and improve their food choices.

**Keywords:** Body weight; Body composition; Mediterranean diet; Physical activity; Nutrition education program

and Uttar Pradesh (UP), India to understand the determinants, barriers and facilitators for adopting optimal maternal, infant, and young child nutrition (MIYCN) practices and behaviors at the household level. This poster focuses on two maternal nutrition behaviors: consumption of iron and folic acid (IFA) and calcium tablets, and dietary diversity (intake of specific nutrient-rich food) in pregnant women.

**Methods:** Qualitative and quantitative methods were used including in-depth interviews with pregnant women, husbands of pregnant women, and frontline workers. We also conducted small group discussions, observations, and a set of rapid household trials to test recommended 'small do-able actions' for more than 200 pregnant women.

**Results:** Social norms, affordability, availability, cultural preferences, food habits and support from family members determined actual practice of dietary diversity among pregnant women. Inadequate supply, lack of specific knowledge regarding benefits (e.g. IFA prevents serious risk of death from postpartum hemorrhage) and ways to manage IFA side effects, among pregnant women, husbands, and mothers-in-law were determining factors for low IFA and calcium consumption.

Rapid household trials showed that women were willing to try new nutrition practices with support from family members in procuring necessary food items from the market and reminding them to eat recommended foods in required quantities. An important aspect of the trials which led to uptake in the recommended practice of ensuring IFA and calcium consumption was counselling of women and influencers on its health benefits and specific mortality reducing effects.

**Conclusions:** The capacity of frontline workers needs to be strengthened to provide timely counseling and demonstrate dietary diversity to pregnant women and mothers. Support and engagement of husbands and mothers-in-law can play an important role in motivating and building confidence of pregnant women to improve their nutrition practices and uptake of IFA and calcium consumption.

**Keywords:** Formative-Research, Maternal-Nutrition, Diet-Diversity, Determinants, Influencers
sufficient to meet the nutritional requirements of infants ne-
cessitating the introduction of other foods and liquids along-
side the breast milk. The WHO recommends that the process
continues from 6 months up to 24 months of age; although
breastfeeding may continue beyond 2 years. This is a criti-
cal growth phase for children whereby if appropriate care is
not given nutrient deficiencies and frequent illnesses contrib-
ute to a vicious cycle of under-nutrition and disease. Poor
complimentary feeding practices also contribute to negative
growth outcomes such as stunting, underweight and obesi-
ty among children below five years of age; which can be risk
factors for ill health during early childhood, adolescence and
adulthood.

The objective of this study is to review published literature
on the complementary feeding practices; comparing those prac-
ticed in rural areas with those practiced in urban areas in order to
enhance knowledge that can help promote best practice when it
comes to complementary feeding in Kenya.

**Methods:** This study adopts a systematic literature review approach. A search for literature published from 2007 to 2017 was carried out on PubMed and Google Scholar. Search results were screened for eligibility in a multi-stage process. Inclusion criteria included year of publication, location of study (Kenya), age group studied (children between 6 and 24 months) and outcome of interest (complimentary feeding).

**Results:** Out of 593 search results, only 46 studies were re-
viewed. This paper outlines complementary feeding strategies
practiced in Kenya both in rural and urban settings. Sorghum and
millet porridge, mashed potatoes, plantain and pumpkin are the
most common foods introduced. Juices, fruits, milk and water are
also given additionally. Diets of children in rural areas is more
rich in natural foods compared to diets of those in urban areas.
However it less diverse.

**Conclusions:** Kenya being a middle-income country, certain barriers both in rural and urban areas limit practical adherence to optimal complementary feeding guidelines.

**Keywords:** Some of the key words used included: “complimentary feeding practices”, “rural and urban” “early childhood feeding” and “Kenya”

**Conflict of Interest Disclosure:** No financial or non-monetary support has been received from any organization for the conduct of this study. Therefore I wish to declare no conflict of interests.

THE KITCHEN IS OURS: DEVELOPING COOKINGS KILLS IN THE COMMUNITY

(1)Gines Geraldo, Ana Paula; (2)Rabello Chechi, Larissa Isabele;

(2)Sousa, Julia Favaretto de; (2)Mello, Arthur Thives de; (3)Vieira, Francilene Gracieli Kunradi; (3)Assis, Maria Alice Altenburg de; (3)Di Pietro, Patricia Faria; (3)Boaventura, Brunna Cristina Bremer; (4)Pinto-e-Silva, Maria Elisabeth Machado.

(1)PhD. Nutritionist. Federal University of Santa Catarina.
Department of Nutrition.; (2)Undergraduate student. Department of Nutrition. Federal University of Santa Catarina. Florianópolis. Brazil.; (3)PhD. Nutritionist. Department of Nutrition. Federal University of Santa Catarina. Florianópolis. Brazil.; (4)PhD.
Nutritionist. Department of Nutrition. University of Sao Paulo.
São Paulo, Brazil.

**Background and objectives:** The ability to prepare food can impact on people's food choices. Cooking skills have been devised, developed and perfected in all societies, and improved from generation to generation. However, it is of concern that young people are not acquiring the basic skills of cooking that enable them to have autonomy over the foods they choose. Given this scenario, it is necessary to develop strategies aimed at sensitizing people on the importance of cooking and improving culinary skills. The objective of the present study was to show a food and nutritional education program developed with audio-visual resources, to encourage the development of cooking skills in the community.

**Methods:** The selection of themes to compound the program was based on a review of cooking techniques (cutting, chopping, peeling, tempering, and cooking methods like roasting, grilling, frying, steam cooking) involved in pre-preparation and preparation of foods. The elaboration of theoretical content used in the videos was based on books of gastronomy and scientific articles. The videos were recorded by three students of the undergraduate nutrition course of the Federal University of Santa Catarina, Brazil, supervised by teachers of disciplines related to food preparation. All videos were developed in the Dietetic Technique Laboratory of the university, using a semiprofessional camera and the program Final Cut Pro for Windows to edict the videos.

**Results:** Twenty-five videos were developed on the follow-
ing topics: cleaning fruits and vegetables, measuring techniques
and ingredients weighing, types of knives, mise en place, use and
functions of utensils in the kitchen (sieve, vegetables peeler, kitch-
en brush, sharpening steel, cutting board, fouet, spatula) use and
functions of stand mixer, food processor, blender and oven. Up
to now 15 videos have been posted weekly in a youtube channel
developed for this purpose and they were shared in social net-
working's Facebook and Instagram for the dissemination of the
activities developed in the program. The average video views on
Facebook and Instagram were 259.27 and 103.42, respectively.

**Conclusions:** The activities developed allowed the develop-
ment of materials on topics of culinary practice that are funda-
mental for the development and improvement of the culinary
skills of the community.

**Keywords:** Cooking skills, healthy eating, culinary confi-
dence, food preparation
# DO "EMPOWERED" WOMEN AND THEIR CHILDREN HAVE BETTER NUTRITION OUTCOMES THAN THEIR LESS-EMPOWERED PEERS?

(¹)Nordhagen, Stella; (¹)Nordhagen, Stella; (²)Klemm, Rolf.

(¹)PhD. Africa Regional Monitoring and Evaluation Advisor. Helen Keller International. Senegal.; (²)Vice President Nutrition. Helen Keller International. & Senior Associate. JHU School of Public Health. USA.

**Background and objectives:** Women's empowerment is considered key to improving women's and children's nutrition, but issues of measurement and complexity mean that direct evidence of a link is limited. This research examines the association between different domains of empowerment and dietary and nutrition status outcomes among women and their young children in Burkina Faso.

**Methods:** We examine cross-sectional data on married women and their young children from a 2014 household survey (designed by the International Food Policy Research Institute, n=2468) across 60 villages in rural Eastern Burkina Faso. Based on a set of questions about women's status, a set of "empowerment scores" were created covering seven domains (1) spousal communication, (2) purchasing decisions, (3) healthcare decisions, (4) family planning decisions, (5) infant and young child feeding decisions, (5) meeting with other women, and (6) social support, as well as an aggregate women's empowerment score. Using simple and multivariate regression analysis, we examine unadjusted and adjusted associations between each empowerment domain and the aggregate score and woman-based outcomes including dietary diversity, consumption of key nutrient-rich foods, anemia prevalence, hemoglobin concentrations, BMI, and underweight status. We repeat similar analyses to examine associations with child-based outcomes, including exclusive breastfeeding through 6 mo of age, consuming nutrient-rich foods, dietary diversity, and HAZ, WAZ, and WHZ scores. Multivariate regressions control for potential confounding variables, such as educational attainment and wealth, as well as clustering of results by village.

**Results:** The results show moderate but not systematically positive associations between women's empowerment and child/ maternal nutrition outcomes. For example, women's hemoglobin levels, BMI, and likelihood of early breastfeeding are found to be positively associated with the empowerment scores, whereas children's growth outcomes are uncorrelated with empowerment. Certain domains of empowerment were more commonly positively associated with outcomes: interaction with women in community, social support, and healthcare decisions.

**Conclusions:** While women's status is associated with nutrition outcomes, the relationships found here are not clear-cut. This may be due to the cross-sectional nature of the data or the way in which empowerment was measured in this study.

**Keywords:** Gender, empowerment, women's nutrition

**Further collaborators:**

Deanna K. Olney, PhD. Senior Research Fellow. Poverty Health and Nutrition Division. IFPRI. USA.

# DOES ENHANCED HOMESTEAD FOOD PRODUCTION (EHFP) AND NUTRITION EDUCATION HAVE AN IMPACT ON WOMEN'S DIETARY DIVERSITY AND NUTRITIOUS FOOD AVAILABILITY? A CASE FROM PROJECT LEASER BEAM (PLB) IN BANGLADESH

(¹)Afroz, Shirin; (²)Asif, Chowdhury Abdullah Al; (³)Waid, Jillian;

(⁴)Stormer, Ame; (⁵)Mundy, Gary; (⁶)Hannan, Abu; (⁷)Talukder, Aminuzzaman.

(¹)Shirin Afroz. MSC. MPH. Director Nutrition. Chowdhury Abdullah Al Asif. MDS. Research and Evaluation Manager. Jillian L. Waid. Director Research Learning and Evaluation. Ame Stormer. PhD. Regional Director for Programs. Gary Mundy. MA. Regional Monitorin; (²)MDS. Research and Evaluation Manager. Helen Keller International. Dhaka. Bangladesh.; (³)MSW. Director Research Learning and Evaluation. Helen Keller International. Dhaka. Bangladesh.; (⁴)PhD. Regional Director for Programs. Regional Office. Helen Keller International. Phnom Penh. Cambodia.; (⁵)MA. Regional Monitoring and Evaluation Advisor. Regional Office. Phnom Penh. Cambodia; (⁶)B. Sc. Ag. (Hons.). Helen Kellen International. Dhaka. Bangladesh.; (⁷)MPH. Country Director. Helen Keller International. Dhaka. Bangladesh.

**Background and objectives:** Micronutrient inadequacy is a major challenge faced by individuals in resource-poor countries such as Bangladesh where the diet is predominantly plant and rice based. Women and children face higher levels of malnutrition than men. In partnership with the Mondelez Foundation, Helen Keller International (HKI) implemented Project Laser Bean (PLB) from 2012 to 2016 in four upazilas of Satkhira District, in the southwestern coastal area. PLB provided training to households to increase the amount and diversity of garden production. We introduced poultry-rearing practices for egg production, formed marketing committees with links to market actors, built business skills to market agricultural products, and educated mothers through nutrition education.

**Methods:** Data were collected from project participants as a panel survey at baseline (n=207) during 2012 and end line (n=197) at 2016. A pre-post comparison was done to analyze the changes in key outcome measures among beneficiary households.

**Results:** We observed a significant reduction in inadequate dietary diversity from 76% at baseline to 23% at end line (p<0.001). We also saw an increase in the knowledge of vitamin A rich foods from 14% at baseline to 93% at the end line (p<0.001). While knowledge of anemia symptoms was high in the beginning of the project, it also increased from 85% to 99% (p<0.001). We observed a reduction in the average number of months in the year that households reported having an insufficient amount of food to eat as well from 1.24 months at baseline to 0.47 months at endline.

**Conclusions:** We observed positive changes in both food security and dietary diversity among mothers over the program period, with substantial improvements in knowledge. As change in knowledge did not act as a mediator in the increase in dietary diversity, future research should investigate other pathways to dietary improvement. Moreover, since we had no comparison pop-
ulation, we cannot attribute these changes to the program alone,
but the program was likely a contributor. Further research should
explore these issues utilizing a control group to be able to deter-
mine program impact and attribution.

**Keywords:** Food security, Dietary diversity, Nutrition knowledge, Months of adequate food sufficiency

**Further collaborators:**

Mondelez Foundation

144/1760

DIET SODA CONSUMPTION AND ITS RELATION-
SHIP WITH OVERWEIGH IN ADULTS AND ELDER-
LY IN BRAZIL

(1)Gines Geraldo, Ana Paula; (2)Pinto-e-Silva, Maria Elisabeth Machado.

(1)PhD. Nutritionist. Federal University of Santa Catarina.
Department of Nutrition,; (2)PhD. Nutritionist. Departament of
Nutrition. University of Sao Paulo. Brazil.

**Background and objectives:** Recent studies suggested that diet soda consumption may also be associated with health consequences, particularly type 2 diabetes and the metabolic syndrome. The objective of this study was to analyze the relationship between DS consumption and overweight in adults and elderly.

**Methods:** A cross-sectional study involving adult employees of two public universities in São Paulo state, Brazil. An online questionnaire was applied containing questions on the diet soda consumption and information about demographic, socioeconomic, anthropometric and health characteristics. The statistical analyses performed included: the chi-square test to determine association between explanatory and dependent variables, adopting a level of significance of p<0.05.

**Results:** A total of 1323 individuals took part in the study. The prevalence of DS consumption was 36.8%. 64.2% were women, 83.3% were aged between 30 and 40 years old, with ≥16 years of schooling (76.6%) and income above $ 11900.00 (83.7%). 59.4% of the DS consumers had some degree of overweight and 63.6% reported having difficulty maintaining body weight. Among the obese, the prevalence of consumers was 45.6 times higher than those who did not consume. The frequency of difficulty in maintaining body weight was higher in consumers (63.6%) than in non-consumers (46.5%). In the evaluation of DS consumption and overweight, consumers were divided into three groups according to the amount and frequency of DS consumption frequency: "low" (mean frequency of consumption less than once per week and average amount of less than a glass), "moderate" (mean frequency of consumption once a week and average amount of one glass) and "intense" (mean frequency of consumption 2 to 3 times a week and average amount of consumption of two glasses). There was a statistically significant association between DS intake and nutritional status (p = 0.004). 41.8% of the obese individuals were present in the "intense" group while 23.8% of the eutrophic subjects were in this group, while on the other hand, the situation is reversed in the

group "low", since the eutrophic individuals were the most present
in this group.

**Conclusions:** The majority of DC consumers presented some degree of overweight and DS consumption was associated with overweight.

**Keywords:** Diet soda, overweight, consumption, artificial sweeteners, beverages

144/1801

FACTORS OF RELEVANCE FOR HEALTHY EATING
FROM THE PERSPECTIVE OF NUTRITION COL-
LEGE STUDENTS OF STATE OF SAO PAULO

(1)Koritar, Priscila; (2)Alvarenga, Marle.

(1)MSc. Nutrition Professor. UNIP. Brazil. PhD fellow. Public Health School. University of São Paulo. Brazil; (2)PhD. Professor. Nutrition Department. Public Health School of University of São Paulo. Brazil.

**Background and objectives:** Alimentation is an important determinant of health. The concept of healthy eating, however, is variable and suffers multiple influences nowadays. In the case of experts in nutrition, the perception of what is healthy eating can influence their professional conduct. The purpose was to evaluate factors considered relevant for healthy eating between nutrition college students of state of Sao Paulo participants of the Brazilian cohort Nutritionist Health Study - NutriHS

**Methods:** A sample of 412 nutrition college students (18 and 30 years) of 34 public and private institutions in 22 cities of the state of São Paulo answered online questionnaires indicating the importance of 14 factors for healthy eating and eating disorders (ED) risk behavior. They related age, weight, height, type of institution and graduation year. The nutritional status were assessed by means of Body Mass Index. Factors of importance for healthy eating were evaluated with respect to type of institution, nutritional status and ED risk behavior by weighted frequency.

**Results:** Students were on average 22.7 years (SD 2.9), 70.1% had normal range weight, 48.8% were in the first two years of graduation and 28.4% presented ED risk. The main factors of relevance to healthy eating - the consumption of natural or minimally processed foods, pleasure and respect for signals of hunger and satiety - are in line with the Guideline for the Brazilian population, independent of type of institution, year of graduation, nutritional status and ED risk behavior. Some differences were observed in others factors of relevance to healthy eating. Caloric restriction was considered less important among students in the fifth year and more important among students with obesity caloric restriction. Have contact with food, cook and eat in appropriate environments were considered more important among public institutions students.

**Conclusions:** Characteristics strongly defended by the Guideline for the Brazilian Population as consumption of natural or minimally processed foods and pleasure have been incorporated as important by nutrition college students. Despite this, several
other characteristics related to healthy eating are different among
students and need to be better worked during the college.

**Keywords:** Health, feeding, nutritional sciences, students

144/1849

DESIGNING CULTURALLY APPROPRIATE MESSAGES AND APPROACHES FOR MATERNAL, INFANT, AND YOUNG CHILD NUTRITION IN MOZAMBIQUE: USE AND ADAPTATION OF TRIALS OF IMPROVED PRACTICES

(1)Barros, Iracema; (2)Picolo, Melanie; (3)Victor, Leonor; (4)Kavle, Justine.

(1)BSc. Nutrition Advisor. Maternal, Newborn, and Child Health and Nutrition Division. Maternal and Child Survival Program/PATH. Mozambique.; (2)BSc. Senior Nutrition Advisor. Maternal, Newborn, and Child Health and Nutrition Division. Maternal and Child Survival Program/PATH. Mozambique.; (3)BSc. Nutrition Officer. Maternal, Newborn, and Child Health and Nutrition Division. Maternal and Child Survival Program/PATH. Mozambique.; (4)PhD, MPH. Senior Nutrition Advisor. Maternal, Newborn, and Child Health and Nutrition Division. Maternal and Child Survival Program/PATH. USA.

**Background and objectives:** The United States Agency for International Development-funded Maternal and Child Survival Program (MCSP) is implementing an integrated reproductive, maternal, newborn, and child health and nutrition project in Northern Mozambique. The nutrition component focuses on preventive and curative interventions, both at facility and community level, with the goal of improving maternal, infant, and young child nutrition (MIYCN) practices. Despite the breadth of nutrition programs in Mozambique, little is known about behaviors, cultural beliefs, and perceptions that influence MIYCN, yet the Mozambique Ministry of Health recommends locally contextualized nutrition messages. We conducted a formative assessment to ascertain: 1) cultural beliefs, perceptions, and challenges related to infant and young child feeding (IYCF) for children 0-23 months of age using the Trials of Improved Practices (TIPs) methodology; 2) the role of fathers and grandmothers in influencing IYCF; and 3) cultural beliefs and perceptions related to maternal food consumption.

**Methods:** TIPs consists of 3 home visits to mothers of children 6-23 months of age. The first visit is to understand current feeding practices and ascertain challenges, the second is to counsel the mother on the feasible IYCF practices to try in a 7-day period, and the third visit is to discuss their experiences with the trial period. In-depth interviews (IDIs) and food frequency questionnaires were conducted with 26 mothers of children 6-23 months of age. IDIs were also conducted with mothers of children 0-5 months of age, pregnant women, and key influencers, including husbands and grandmothers. IDIs were recorded, transcribed, and coded by theme.

**Results:** A counseling guide was rolled out by MCSP in Mozambique. Targeted approaches and messages were aimed at

dressing challenges to exclusive breastfeeding, increasing quality and quantity of food intake, increasing adherence to maternal iron and folic acid supplementation, and using local foods for recipes in cooking demonstrations.

**Conclusions:** TIPs is an innovative approach that allows mothers to test feasible practices at home and can inform program design and implementation to improve IYCF practices.

**Keywords:** Trials of Improved Practices, behavior change, infant and young child feeding, counseling messages, Mozambique

144/1866

STUDY OF THE REASONS OF THE LOW CONSUMPTION OF VEGETABLES IN A POPULATION OF URUGUAYAN CHILDREN OF SCHOOL AGE

Raggio Aonso, Laura Maria; Raggio Alonso, Laura María.

Affiliation: Student PdD Chemistry, Food engineering, Food Department, School of Nutrition, UDELAR, Uruguay.

**Background and objectives:** The low intake of fruits and vegetables that children eat is becoming a cause of growing concern around the world. A low intake has been linked to a higher risk of developing noncommunicable diseases. Uruguay does not escape this world situation.

The objective of the present study is to explore the reasons and barriers of low consumption of vegetables in Uruguayan children of school age, in order to find strategies to promote the consumption of these foods.

**Methods:** A database of children from 6 to 12 years old interested in participating in the research was generated.

From the first study with the group of parents, we categorize the main reasons for the low consumption of vegetables that were obtained, which were grouped in 14 sentences.

With the sentences obtained in study 1, we sent a second survey, along with the list of the 20 most consumed vegetables in our market. For each sentence, they selected the vegetables that responded to the same one.

The frequency of mention of each vegetable was calculated for each sentence, followed by a Correspondence Analysis (CA) to visualize the relationship between the sentences and vegetables and a Hierarchical Agromerative Clustering of the vegetables.

**Results:** Factors 1 and 2 of the CA explained 81.63% of the variance of the results obtained from 260 parents.

Of the 20 listed vegetables, they were categorized into 5 groups, each associated with different sentences.

For Example:

Cauliflower was considered a vegetable that many children do not consume because their parents never offered it, because someone in the family does not like it or because they do not know how to prepare it, so that vegetable is not usually part of the family diet.

Peas, spinach, chard, and zucchini are vegetables that children used to consume when they were young, but not today, and most parents do not know why they do not like them now and therefore must “force” them to consume them.
**Conclusions:** The results obtained allowed us to obtain a first approximation aimed at proposing future working hypotheses, with the aim of increasing the consumption of vegetables among children of school age.

**Keywords:** Children, low cosumption, vegetables

**Further collaborators:**

L. Raggio 1 and A. Gámbaro 2

1. Departamento de Alimentos, Escuela de Nutrición, Universidad de la República, Montevideo, Uruguay.

2. Área Evaluación Sensorial, Departamento de Alimentos, Facultad de Química, Universidad de la República, Montevideo, Uruguay.

**Conclusions:** These results indicate that community video is an effective approach for improving responsive feeding behaviors that contribute to improved nutrition through the concept of nurturing care. This work provides an opportunity to strengthen linkages between nutrition and early childhood development by highlighting nutrition and care behaviors that can potentially help to enhance child development and positive parenting skills.

**Keywords:** Nutrition, IYCF, responsive feeding, SBCC, nurturing care

**Further collaborators:**

Alix Harou, Avinash Upadhyay

144/1888

## ROLE-MODELING CULTURALLY APPROPRIATE NURTURING CARE PRACTICES TO IMPROVE INFANT AND YOUNG CHILD NUTRITION

(1)Granger, Kristina; (2)Moreaux, Marjolein; (3)Koniz-Booher, Peggy.

(1) MPH. SBCC Technical Manager. Strengthening Partnerships, Results: **Background and objectives:** The 2016 Lancet early childhood development series highlighted the importance of nurturing care (combining health, nutrition, and caregiving), indicating that improper nutrition and lack of stimulation can lead to irreversible developmental and health outcomes. The period from birth to three years is a critical time for brain development, and caregivers often interact most with children this age during mealtime. Based on this evidence, SPRING promotes nurturing care practices that help improve caloric intake and diversify young children's diets during this critical window of opportunity.

**Methods:** SPRING uses a community-led video model to promote nutrition, hygiene, and nurturing care through videos starring local early adopters who role-model positive behaviors. This approach begins with qualitative formative research, which is used to prioritize culturally-specific nurturing care practices to improve maternal, infant, and young child nutrition (MIYCN). Community members are then trained in production and early adopters star in locally produced videos that demonstrate positive nutrition practices, including responsive feeding and nurturing caregiving interactions by both men and women. The local videos are screened during community group meetings and always involve facilitated discussions. This model was first implemented in India and then adapted for Niger.

**Results:** In India, the complementary feeding videos highlighted feeding young children patiently, not force-feeding, and encouraging the child to self-feed with finger foods, along with messages on food consistency and dietary diversity. In Niger, the videos focused on promoting a responsive caregiver feeding style and using a separate plate because formative research showed children ate from a family plate, with little interaction with a caregiver. Monitoring data has shown an increase in nurturing care behaviors in both countries, and qualitative research findings indicate that seeing the practices modeled in the videos helps caregivers to adopt them.

144/1932

## PREVALENCE OF FOOD AND NUTRITION SECURITY IN VULNERABLE GROUPS (MOTHERS AND THEIR CHILDREN (7-36 MONTHS)) FROM URBAN SLUMS OF VADODARA, GUJARAT, INDIA

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

(1)PhD. Nutritionist. Department of Foods and Nutrition. The Maharaja Sayjirao University of Baroda. Vadodara, India; (2)PhD. Nutritionist. Department of Foods and Nutrition. The Maharaja Sayjirao University of Baroda. Vadodara, India.

**Background and objectives:** Urban poor, dwelling in slums, are at higher risk of Food and Nutrition insecurity and women and children are the most vulnerable group. Hence, the present investigation aimed at mapping the prevalence of food and nutrition insecurity among vulnerable individuals (mothers and their children (7-36 months)) living in urban slums of Vadodara city.

**Methods:** Two Hundred Ninety Seven slum households from two out of five zones of Vadodara city were assessed for Food and Nutrition Security (FNS). Four dimensions of Food and Nutrition Security namely, accessibility, availability, utilization and stability were assessed for mothers and children 7-36 months of age by WFP VAM method (2010).

**Results:** Mothers were found to be moderately secure using 1890 Kcal energy/consumer unit/day as the indicator for availability. Using optimal breastfeeding practices as indicator of availability the children were categorised as having low FNS. Presence and availing of safety net programs namely food through public distribution system and take home ration through government feeding programs for mothers and children indicated high FNS while the marginal to poor utilisation of same threatened the FNS in the vulnerable groups. Accessibility as studied using Individual Dietary Diversity Score (IDDS) of mothers showed that 91%, 9.1%, and 0.3% were moderately secure, secure and insecure, respectively while 82%, 6% and 12% of children were moderately secure, secure and insecure respectively. Although 89% of the mothers were literate no significant correlation was found between IDDS of mother and child with the education level of mother. FNS measured by utilization namely presence of chronic energy deficiency (CED) indicated that 29% of the mothers had CED, 43% were nor-
mal and 28% were overweight. About 54% were stunted, 25% were wasted and 45% were underweight.

Presence of safety net programmes indicated stability of FNS.
The composite index for overall FNS in study households indicat-
ed moderate security.

**Conclusions:** Though the presence of safety net program en-
sured availability of food and stability, the mothers and children
from the urban slum households experienced moderate to low
FNS due to poor utilization of the same.

**Keywords:** Food and Nutrition Security, Vulnerable Groups, Urban Slums, Individual Dietary Diversity Score

**Background and objectives:** Therapeutic compliance of pa-
tients suffering from chronic diseases requires a multidisciplinary
approach. Health professionals should develop awareness son the
problem in patients and their families. Not only the family, but the
community and also patient organizations are key factors for the
success of treatment.

To describe aptitudes and styles of living, in Type II Diabetes
adult patients admitted in the Medical Clinic I ward of the Social
Security Central Hospital in Asunción.

**Methods:** Descriptive design and transversal analysis. One hundred patients withType II Diabetes Mellitus were part of the study. The IMEVID questionnaire was applied to all of them. Variables studied were. Age, sex, lifestyles, level of Glycated Hemoglobin. Statistics: Parametric and non Parametric Measurements. Pearson Correlation Test. Significance: p <0,05.

**Results:** 100 patients were admitted. Female subjects: 66 %. An inappropriate lifestyle was confirmed in 58 % of the patients admitted with Type II Diabetes Mellitus. Female subjects were predominant treaching 66% of the total. 47 % of the patients had Glycated Hemoglobin above 7%. Pearson correlaction reached 0.03207 (p<0,05).

**Conclusions:** A high percentage of the patients admitted to the Hospital withType II Diabetes Mellitus leadanin appropriate lifestyle and present a high value of Glycated Hemoglobin.

**Keywords:** Diabetes Mellitus, lifestyle, glycated hemoglobin.

(1)Barouaca, Hassan; (2)El Hassouny, El Hassan; (3)Bour, Abdellatif.

(1)PhD. Nutritionist. Higher Institute of Nursing Professions and Techniques of Health of Errachidia. Morocco; (2)PhD. Nutritionist. Equipe de Transition Alimentaire et Nutritionnelle (ETAN). Laboratoire des Essais Biologiques. Université Ibn Tofail. Kenitra. Maroc; (3)Prf. Nutritionist. Equipe de Transition Alimentaire et Nutritionnelle (ETAN). Laboratoire des Essais Biologiques. Université Ibn Tofail. Kenitra. Maroc.

**Background and objectives:** It is now well established that nutritional factors are the major determinants of food behavior and the emergence of chronic diseases. In Morocco, there is no data on food behavior in rural population as Moroccan population now is in epidemiological transition.

This research aims to study the food pattern in rural popula-
tion (Bani Zeroual) of Taounate region.

**Methods:** We used a well-known analysis method: Focus Groups (FG) to determine all items that may be characteristics of this population. Also we have assessed the diet over a period of three to five days during which the respondent is asked to recall and describe all food and drinks consumed in the 24 hour prior to the interview

**Results:** The data obtained showed that the Mediterranean diet was not the diet commonly followed by the whole population studied. Moreover, the phenomenon of nutritional transition whose specificity in Bani Zeroual population is the maintenance of certain traditional foods such as cereals and vegetables in addition to the introduction of westernized foods such as dairy products. These profiles were associated with the socio-demographic characteristics of individuals

**Conclusions:** It becomes clear that the use of focus groups is an effective tool for studying the behavior of food and health status of a population. Therefore, focus groups can be used not only for Behavioral Study Food and health status of a population, but also in other areas.

At the end of this study, this method of idea generation: FG
can be an “indicative” diagnostic tool for the behavior of food and
the health status of a population that can act as a “smoke detec-
tor”. Subsequently, the obstacles and problems detected are to be
verified and confirmed by conventional diagnostic methods of 24
recall and frequency questionnaire.

**Keywords:** Focus groups, dietary pattern, health status of a rural population
PILOT STUDY TO ASSESS PREFERENCE AND AC-
CEPTABILITY OF RECIPES USING BIOFORTIFIED
SWEET POTATOES AMONG WOMEN IN PANA-
MANIAN RURAL COMMUNITIES

(1)Britton, Adela; (2)Chu, Jenny; (3)Barria, Maika; (4)Rios- Castillo, Israel;

(5)Vergara, Eira.

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

(3)Nutritionists, Research and Innovation Division in Genetic and Biodiversity Resources, The Institute of Agricultural and Livestock Research of Panama (IDIAP), Panama City, Panama;

(4)MSc, Nutritionists, Nutrition and Dietetic Department,
Medicine School, University of Panama, Panama City, Panam;

(5)MPH, Nutritionists, Nutrition and Dietetic Department,
Medicine School, University of Panama, Panama City, Panama.

**Background and objectives:** Undernutrition and micronu-
trient deficiencies among rural indigenous and non-indigenous
communities remain as a public health problem in Panama. The
present study is aimed to determine the preference and accepta-
bility of recipes with biofortified sweet potatoes with housewives
from the communities of Chichica and El Copé, two rural Pana-
manian communities.

**Methods:** A descriptive cross-sectional observational pilot study was conducted through a survey of acceptability, using a hedonic scale, and one of preference. This study is part of a muti sectoral nutrition- sensitive agriculture project leaded by IDIAP in Panama (AgroNutre). Four recipes based on usual consumption patterns were selected, two with a salty taste and two with a sweet taste. The sample had a total of 50 housewives from Chichica and El Copé. Data on dietary diversity and frequency of consumption of vitamin A source foods were also obtained through the USAID Home Dietary Diversity Indicator (HDDS).

**Results:** The four recipes evaluated in this study were accepted by both communities. In addition, the most preferred salty recipe was sweetpotato tamale in both communities. As for the sweet recipe, the most preferred in Chichica was sweet potato soda; and in El Cope, it was the sweet potato weevil

**Conclusions:** Biofortified sweet potato was well accepted in both communities, which supports the use of this biofortified item as a strategy to combat vitamin A deficiency.

**Keywords:** Panama, indigenous, biofortified crops, nutrition, food security.

MEDITERRANEAN DIETARY MODEL FOR PRE-
VENTION OF FOOD-RELATED DISEASES AND
FREQUENCY OF CONSUMPTION SELECTED
PRODUCTS IN ITALIAN AND POLISH STUDENTS

(1)Bronkowska, Monika; (2)Piotrowska, Ewa; (2)Lozna, Karolina;

(2)Figurska-Ciura, Danuta; (3)Habanova, Marta; (4)Del Core, Guseppina.

(1)associate professor, Department Of Human Nutrition, Wroclaw University of Environmental and Life Sciences; (2)Dr. Department Of Human Nutrition, Wroclaw University of Environmental and Life Sciences; (3)associate professor, Department of Human Nutrition, Slovak University of Agriculture in Nitra; (4)Pontificia Facoltà di Scienze dell'Educazione delle Figlie di Maria Ausiliatrice.

**Background and objectives:** Traditional Mediterranean diet was characterized by an abundance of vegetable, fruit, cereals and legumes, dairy products consumed in moderate amounts, olive oil as the principal source of fat, red meat consumed in low amounts, fish consumed in moderate amounts, and wine consumed in moderate amount, normally with meals.

Currently, there is a growing interest in the possibility of over-
all dietary patterns' complex influence on the risk of ischemic
heart disease, arterial hypertension, diabetes cancers, biomarkers
of obesity, and cardiovascular disease because some food items
and nutrients could have synergistic or antagonistic effects when
they are consumed in combination.

**Methods:** The study was conducted between 2015 and 2016 at three Roman universities. 454 students aged 20-25 from Italy and Poland participated in the study. The QEB Questionnaire was developed by the Behavioral Nutrition Behavioral Team, the Committee on the Science of Human Nutrition, the Polish Academy of Sciences. Students answered questions in the questionnaire designed to study nutritional behaviors and opinions on food and nutrition placed on the g mail platform.

**Results:** 47% from of students Italy and Poland consumed 3 meals a day, and over 48% consumed them irregularly. Approximately 43% of the respondents dripped fish once a week and 24% several times a week. In this group was the majority of Italian students. Only 42% consumed fruit and 44% vegetables a few times a day, the majority of them were Italian students (34%). Students from Poland (36% of the respondents) were more likely to eat white bread than the Italian ones. Italian students (45% of the respondents) consumed whole wheat pasta more often than students from Poland. 61% of students do not use any fat to spread the bread, mainly Italian students. Students from Poland (43% respondents) more often eat red meat several times a week than Italian students.

**Conclusions:** Polish students although they are studying and currently live in Italy do not apply the rules of the Mediterranean diet. There is a large group of Italian students who also do not follow the rules recommended in this diet.

**Keywords:** Mediterranean diet, dietary patterns, nutritional behaviors, food-related diseases,

**Further collaborators:** Marzena Styczynska
144/2043

ATTITUDES TOWARD BEEF AMONG NUTRITION
COLLEGE STUDENTS

(1)Koritar, Priscila; (2)Alvarenga, Marle.

(1)MSc. Nutrition Professor. UNIP. Brazil. PhD Fellow. Nutrition Department. Public Health Schol of University of São Paulo. Brazil.; (2)PhD. Professor. Nutrition Department. Public Health Schol of University of São Paulo. Brasil.

**Background and objectives:** Although meat consumption be indicated as part of healthy eating, attitudes toward meat are diverse in society. Eating attitudes - beliefs, thoughts, feelings, be- havior and relationships with food - of nutrition college students will guide professional practice. The purpose was to evaluate at- titudes toward beef among nutrition college students of state of São Paulo participants of the Brazilian cohort Nutritionist Health Study - NutriHS.

**Methods:** A sample of 613 nutrition college students (from 18 to 30 years) of 34 public and private institutions in 22 cities of the state of São Paulo answered online, in free association, the first word that comes to mind when they think in the word “beef” and a questionnaire about eating disorders (ED) risk behavior. They related age, weight, height, type of institution and graduation year. The nutritional status was assessed by means of Body Mass Index. The frequency of the words that came to mind when students were prompted to free associate to the word “beef” was evaluated and compared according to ED risk behavior, type of institution and graduation year.

**Results:** Students were on average 22.9 years (SD 3.0), 70.5% had normal range weight, 50.9% were in the first two years of graduation and 28.4% presented ED risk. Of the ten most frequent associations 34.4% reported some nutrient, 23.9% some type of meat, 20.9% culinary association, 7.9% appreciation, 3.1% meal, 2.5% animal, 2.5% disapproval, 1.6% blood, 1.3% death and 1.0% frequency of consumption. Some differences between groups were observed as associations with type of meat were more frequent among students of fifth year and culinary associations were more frequent between students with low weight.

**Conclusions:** Attitudes toward beef are varied among nutri- tion college students. Although this variation is expected, the re- sults indicate that attitudes toward food should be better discussed during the college, since they can directly influence professional practices.

**Keywords:** Attitudes, beef, nutritional sciences, students

144/2061

EFFECT OF NUTRITION EDUCATION TO MOTH-
ERS ON IMPROVED PULSE CONSUMPTION BY
YOUNG CHILDREN AGED 6-24 MONTHS IN RU-
RAL SIDAMA, SOUTH ETHIOPIA

(1)Whiting, Susan; (2)Berhanu, Getenesh; (3)Henry, Carol; (4)Green, Timothy J.

(1)PhD. College of Pharmacy and Nutrition. University of Saskatchewan. Canada; (2)MSc. University of Saskatchewan. College of Pharmacy and Nutrition. Canada; (3)PhD. University of Saskatchewan. College of Pharmacy and Nutrition. Canada; (4)PhD. Healthy Mothers Babies and Children Theme. South Australia Health and Medical Research Institute. Australia.

**Background and objectives:** Poor feeding practice is not al- ways lack of food but lack of knowledge of caregivers on appropri- ate feeding practices. Households with low income consume large amounts of starchy staples and little protein in low income coun- tries. Pulse crops are rich in protein and key micronutrients yet pulse consumption is very low in Ethiopia, especially in SNNPR. The aim of the current study was to evaluate the effect of nutrition education for mothers on the consumption of pulse among their children aged 6-24 months.

**Methods:** 771 mothers-child pair (386 intervention, 385 con- trol) randomly selected from 12 villages were participated in the educational intervention study from Sidama Zone, South Ethio- pia. Nutrition education given for mothers for 9 months on key messages about pulse benefits, household pulse processing tech- niques and incorporating pulse in the complementary food (CF). Health Extension Workers (HEWs) were trained on the key mes- sages, and then provided group education and house-to-house counseling for mothers for 9 months. In control sites HEWs gave usual lessons. Frequency of pulse consumption as well as moth- ers' practice of incorporating pulse in complementary food was assessed using a standard pre-tested questionnaire at baseline, midline and endline.

**Results:** Using pulse for CF improved at midline and endline compared to baseline. At baseline 49.9% of mothers from inter- vention group reported that they have used pulse for CF and this increased at midline (94%) and endline (98.4%). Used haricot bean was most common: 46.4% at baseline of which 73% give once or twice a week; 96.3% at midline of which 37% give more than one per day and 94.6% at endline of which 57% give more than one per day. At endline nearly 3% of mothers from the intervention group also started using faba bean in CF. At baseline 64.2% mothers from control group reported that they have used pulse for CF which did not increase midline (67%) or endline (67.7%).

**Conclusions:** Nutrition education intervention improved pulse consumption among children in rural communities of Ethi- opia. Thus, promoting of pulse crops for incorporating in comple- mentary food should be encouraged.

**Keywords:** Pulses, legumes, complementary feeding, malnu- trition, Ethiopia

**Conflict of Interest Disclosure:** This work supported by
Global Affairs Canada.
# TRANSFORMATIONS AND SOCIO-CULTURAL ASPECTS OF THE MEDELLIN SCHOOL DINING PROGRAM FROM 1961 TO 2010

(1)Arboleda, Luz Marina; (2)Velasquez, John Edinson.

(1)Nutritionist dietitian, PhD in social Sciences Coordinator of the Socio-anthropology on Food Research Group School of Nutrition and Dietetics - University of Antioquia; (2)Nutritionist dietitian school of nutrition and dietetics, University of Antioquia, Medellin Colombia.

**Background and objectives:** Diet is a complex sociocultural act providing biological, nutritional, political and social dimensions. Interlocking them creates inequalities such as food shortages and access to food through social programs. The aim of this study is to identify the changes in the program of school restaurants in Medellin (Colombia), and to interpret the perception of the program's beneficiaries.

**Methods:** Qualitative and historical perspectives; ethnography and history of the present time. Ethnography was conducted with school beneficiaries and their parents, councilors, program coordinators, food handlers and nutritionists. Historical Archives of Medellin and Minutes Archive Medellin Municipal Council were reviewed to collect the historical information, reports and correspondence.

**Results:** The program has different models of service provision and different coverage; it has retained the sympathy of the mayors and officials of the various secretariats. This was set up at the beginning, in 1935, from a perspective of charity school by elite women, and then it had a hygienist and nutritional vision of right to food; and finally, a food and nutrition safety vision. In the supplied speeches and preparations, the absence of cultural references is identified.

**Conclusions:** School Restaurants programs help to reduce the suffering caused by hunger, but they are not always designed thinking about the cultural aspects that involves food.

**Keywords:** School restaurants, hunger, food, Medellín

**Further collaborators:** Only two authors

# EFFECT OF THE SCHOOL-BASED HEALTH PROMOTION INTERVENTION ACTIVITAL ON DIETARY INTAKE AND WAIST CIRCUMFERENCE: A CLUSTER RANDOMIZED CONTROLLED TRIAL

(1)Ochoa, Angelica; (2)Ochoa Avilés, Angelica; (3)Andrade Tenesaca, Dolores Susana; (4)Verstraeten, Roosmarijn; (5)Huybregts, Lieven;

(6)Lachat, Carl; (7)Ramírez Jimbo, Patricia Liliana; (7)Andrade Muñoz, Diana Jesús; (8)Donoso Moscoso, Silvana Patricia.

(1)Universidad de Cuenca; (2)MD. PhD. Department of Biosciences. Faculty of Chemistry Sciences. Cuenca University. Ecuador.;

(3)MSc. PhD. Department of Biosciences. Faculty of Chemistry Sciences. Cuenca University. Ecuador.; (4)MSc. PhD. Consultant.

Ghent-Belgium; (5)MSc. PhD. Poverty Health and Nutrition Division. International Food Policy Research Institute.

Washington DC-USA; (6)MSc. PhD. Department of Food Safety and Food Quality. Ghent University-Belgium.; (7)Eng. MSc.

Department of Biosciences. Faculty of Chemistry Sciences.

Cuenca University. Ecuador.; (8)Bioq. MSc. Department of Biosciences. Faculty of Chemistry Sciences. Cuenca University.

Ecuador.

**Background and objectives:** Unhealthy diet and abdominal obesity during childhood are important risk factors for chronic diseases at adulthood. We report the effect of a school-based intervention on the nutritional value of dietary intake and waist circumference after 28 months; and explore if the effect varied within important subgroups (weight and socioeconomic status).

**Methods:** A cluster randomized controlled trial (10 intervention/10 control schools) including 1430 adolescents (12-14 years old) was conducted in Ecuador. The intervention aimed to decrease adolescents sugar intake and unhealthy competitive food (rich in sodium, fat or added sugar) intake, as well as to promote fruit and vegetable intake (primary outcomes). Waist circumference was a secondary outcome. Primary outcomes were estimated by means of two twenty-four-hour recall. All outcomes were measured before and after the intervention. The interventions consisted of healthy eating classes with adolescents, healthy eating workshops with parents and canteen staff, and social events. The effect of the intervention was assessed using linear mixed effects models. A subgroup analysis by weight and socioeconomic status was performed including all the outcomes with a significant intervention effect.

**Results:** The analysis involved data from 1046 adolescents. Students from the intervention group consumed less unhealthy competitive food during snacks (-23.32 g; 95% CI: -45.25,-1.37) and less added sugar (-5.66g; 95% CI: -9.63,-1.65). Daily fruit and vegetable intake decreased compared to baseline, albeit significantly less in the intervention group (23.88 g; 95% CI: 7.36, 40.40). Waist circumference (-0.84 cm; 95% CI: -1.68, 0.28) was lower in the intervention group. The intervention effect on fruit, vegetables, added sugar, and, competitive food was independent of the weight and socioeconomic status of the participants. The effect on waist circumference, was larger among overweight-obese (-1.35 cm; 95% CI: -2.25, -0.45) but similar for different socioeconomic backgrounds.