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

(1)MD. PhD. Professor of Medicine. Terapia Intensiva Adultos. Obra Social para la Actividad Docente. Argentina.; (2)MD. Physician. Terapia intensiva. Obra social para la actividad docente. Argentina.

**Background and objectives:** The earliest start point of the enteral nutrition (EN), as well as the basal energy expenditure (BEE) achieved in a time space as short as possible seem to benefit a good amount of critical patients.

Objectives: To analyze the time to start the EN and the BEE achieved in the elderly interned with a septic shock diagnose and to verify the association with mortality in these patients.

**Methods:** Prospective cohort hold within 32 months and with 67 patients over 65 years-old in ICU with septic shock where 59 of those had EN. The APACHE II score was carried out in every patient. The following variables were analyzed in this group: the time taken to start the NE, the BEE (achieved or not), the time to reach the BEE in those who got it. These variables were correlated with death and it was still observed if there was correlation between the start time point of EN and the achieved BEE. The statistics tests used were: T test and chi-square, considering 5% as the significance level.

**Results:** The average age was 80 + 7 (min.= 66, max.= 96), the APACHE II average was 18 + 5 (min.= 8, max.= 28), and the time average to start EN was 80 ± 53 h (min. de 12 h e max. de 240 h). The achieved BEE occurred in 69,5% (n= 41) of the patients and the time average to reach it was 115 ± 56 h (min. de 72 h e max. de 360 h). Death was associated with time to start EN (p= 0,001) and with the non-achieved BEE (p< 0,001). However, there was no correlation with time to reach BEE (p= 0,22). The time to start EN did not show association with the achieved BEE (p= 0,08).

**Conclusions:** The EN initiated as soon as possible and the BEE when achieved in this group of patients showed some benefit. The time to achieve the BEE seems not to have correlation with mortality in these patients. The time to start NE did not have association with the BEE achieved in this sample.

**Keywords:** Septic shock, Enteral nutrition, Start nutrition, Mortality

(1)Imai, Eri; (2)Tsubota-Utsugi, Megumi; (3)Sato, Michihiro; (4)Kikuya, Masahiro; (5)Asayama, Kei; (6)Inoue, Ryusuke; (3)Murakami, Takahisa; (7)Metoki, Hirohito; (8)Imai, Yutaka; (9)Ohkubo, Takayoshi.

(1)PhD. RD. Dept of Food Science and Nutrition. School of Human Cultures. The University of Shiga Prefecture. Japan.; (2)PhD. MPH. RD. Dept of Hygiene and Preventive Medicine. Iwate Medical University School of Medicine. Japan.; (3)PhD. Dept of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University. Japan.; (4)PhD. MD. Tohoku Medical Megabank organization. Tohoku University. Japan.; (5)PhD. MD. Dept of Hygiene and Public Health. Teikyo University School of Medicine. Japan.; (6)PhD. MD. Dept of Medical Informatics. Tohoku University Graduate School of Medicine. Japan.; (7)PhD. MD. Department of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University. Japan.; (8)PhD. MD. Dept of Planning for Drug Development and Clinical Evaluation. Tohoku University Graduate School of Pharmaceutical Sciences. Japan.; (9)PhD.MD. Dept of Hygiene and Public Health. Teikyo University School of Medicine. Japan.

**Background and objectives:** To determine the association between dietary patterns identified via a validated food frequency questionnaire (FFQ) and the risk of impaired glucose tolerance in community-dwelling adults.

**Methods:** We followed 798 participants who did not take medication for diabetes treatment and less than 5.4% of HbA1c, completed a self-administered questionnaire at baseline, and participated at least one identical follow-up health check-ups, and who did not develop diabetes (start of medication for diabetes and/or HbA1c 6.5% or more) during the follow-up period. In this study, impaired glucose tolerance was defined as HbA1c concentrations of 5.4-6.4%. The association of dietary patterns with impaired glucose tolerance was examined logistic regression analysis with adjustment for potential confounding variables.

**Results:** During the follow-up period, we identified 378 incident cases of impaired glucose tolerance. Using principal component analysis and dietary data collected through a FFQ, we identified three major dietary patterns: Japanese, high protein, and western breakfast. After adjustment for potential confounding variables, the highest quartile of the high protein pattern was 1.59 times higher risk of developing impaired glucose tolerance (95% confidence interval 1.06-2.40). Other dietary patterns were not appreciably associated with impaired glucose tolerance.

**Conclusions:** Our findings suggest that high protein dietary pattern may be related to increasing the risk of impaired glucose tolerance in Japanese populations.

**Keywords:** dietary pattern, impaired glucose tolerance, community-dwelling adults
## SYSTEMIC RESPONSES OF METHIONINE RESTRICTION IN MICE WITH HIGH FAT DIET BY METABOLOMIC STUDIES

(1)Shi, Yonghui; (2)Yang, Yuhui; (3)yan, biao; (4)Wang, Yanan; (4)Zhang, Jiahong; (4)Guo, Haitao; (3)Le, Guowei.

(1)MSc. The State Key Laboratory of Food Science and Technology. School of Food Science and Technology. China. Jiangnan University. China.; (2)MSc. School of Food Science and Technology. Jiangnan University. China.; (3)PhD. School of Food Science and Technology. Jiangnan University. China.; (4)BSc. School of Food Science and Technology. Jiangnan University. China.

**Background and objectives:** Dietary methionine restriction shows many beneficial effects on health including extends mean and maximum lifespan, improves insulin sensitivity and reduces adiposity, and reduces reactive oxygen species generation and oxidative stress. However, the systemic responses of high fat diet mice to dietary methionine restriction remain largely unknown. This study aims to investigate the effects of dietary methionine restriction on the systemic metabolism of high fat diet C57BL/6 mice.

**Methods:** Mice were fed with a high fat diet containing either 0.86% methionine or 0.17% methionine for 22 consecutive weeks. We analyzed the metabolic alterations in mice plasma and urine using 1H NMR-based metabonomics approaches and coupled with multivariate data analysis methods.

**Results:** We found that dietary methionine restriction caused significant level elevation for albumin, 3-hydroxybutyrate, acetoacetate, citrate, glycerophosphorylcholine, propionate, isobutyrate, ethanol and decline for tyrosine, 1-methylhistidine, lipids (-CH2-, CH2C=C, =CCH2C=), unsaturated lipids, α-glucose, β-glucose, trimethylamine-N-oxide, N-acetyl glycoprotein, O-acetyl glycoprotein in mice plasma. Dietary methionine restriction also caused elevation of citrulline, 3-hydroxybutyrate, acetoacetate, acetone, succinate, α-ketoglutarate, lactate, propionate, valerate, sarcosine, succinimide, taurine in mice urine together with depletion of 2-keto-isovalerate, urea, N-methylnicotinamide, trimethylamine, trimethylamine-N-oxide, allantoin, indoxyl sulfate, 4-hydroxyphenylpyruvate, 2-(4-hydroxyphenyl) propanoate.

**Conclusions:** These observations indicated that dietary methionine restriction caused widespread systemic metabolic changes, including reduced catabolism of amino acids, increased energy expenditure (enhanced fatty acid oxidation, glycolysis and tricarboxylic acid cycle metabolism), reduced oxidative stress and inflammation, altered gut microbiota functions, reduced the risk of atherosclerosis and vascular disease, and improved learning and memory. These findings provide a comprehensive insight into the biochemical consequences and metabolic responses to dietary methionine restriction in high fat diet mice.

**Keywords:** Methionine restriction, High fat diet, Metabonomics, Nuclear magnetic resonance

## EFFECTS OF METHIONINE RESTRICTION ON THYROID HORMONES AND SKELETAL MUSCLES MITOCHONDRIAL CONTENT AND FUNCTION IN HIGH-FAT DIET MICE

(1)Zhang, Jiahong; (1)Wang, Yanan; (1)Guo, Haitao; (2)Le, Guowei; (3)Shi, Yonghui.

(1)BSc. School of Food Science and Technology. Jiangnan University. China.; (2)PhD. The State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University. China.; (3)MSc. The State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University. China.

**Background and objectives:** Dietary methionine restriction (MR) limits fat deposition and expands lifespan without food restriction. Our objective was to investigate the effects of methionine restricted high-fat diet on thyroid hormones and skeletal muscle mitochondria content and function in mice.

**Methods:** A total of twenty-seven male C57BL/6 mice were randomly divided into control feeding diet (CON), high-fat diet (HFD) and methionine restricted-high fat diet (MR-HFD). In 22th week, the energy metabolism was measured by comprehensive laboratory animal monitoring system (CLAMS). Thyroid gland histological analysis was performed by microscopy. The plasma levels of lipids, thyroid hormones and the skeletal muscle levels of deiodinase 2 (Dio2) activity, mitochondrial membrane potential (MMP), ATP content were detected. Mitochondrial DNA copy number, relative mRNA expression of Dio2, mitochondrial biogenesis related genes PGC-1α, Tfam and ATP6 were determined by quantitative reverse transcription-polymerase chain reaction.

**Results:** Compared to HFD group, the average body weight was significantly decreased by methionine restriction (P<0.05), while the level of energy intake and energy expenditure were significantly increased (P<0.05). In plasma, methionine restriction significantly decreased the level of lipids (P<0.05), while the level of thyroid hormones was significantly increased (P<0.05). In skeletal muscle, the level of Dio2 activity, MMP, ATP, mitochondrial DNA copy number and the mRNA expression of Dio2, PGC1α, Tfam, ATP6 were significantly increased in MR-HFD group than those in HFD group (P<0.05).

**Conclusions:** Methionine restriction may enhance skeletal muscle mitochondria content and function by increasing T3 profited from both improvement of thyroid gland function and the high expression of skeletal muscles Dio2 in high fat diet mice. As a consequence, the energy metabolism of skeletal muscle was accelerated and the weight of mice was reduced.

**Keywords:** Methionine restriction, Skeletal muscle, Deiodinase 2, Thyroid hormones, Mitochondria
COMBINED INTERVENTION OF METHIONINE
RESTRICTION AND COLLAGEN PEPTIDES ON
LIPID METABOLISM AND OXIDATIVE STRESS IN
HIGH-FAT DIET-FED MICE

(1)Wang, Yanan; (2)Yan, Biao; (1)Zhang, Jiahong; (1)Guo, Haitao; (3)Shi, Yonghui; (4)Le, Guowei.

(1)BSc. School of Food Science and Technology. Jiangnan University. China.; (2)PhD. School of Food Science and Technology. Jiangnan University. China.; (3)MSc. The State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University. China.; (4)PhD. The State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University. China.

**Background and objectives:** Methionine restriction and col-
lagen peptides are different dietary intervention that both reduces
adiposity and improves oxidative stress. Our present objective was
to elucidate the combined intervention of methionine restriction
and collagen peptides on lipid metabolism and oxidative stress in
high-fat diet-fed mice.

**Methods:** Thirty-six male C57BL/6 mice were randomly equally divided into normal diet (ND) group, high-fat diet (HF) group, high-fat with methionine-restricted diet (MR) group, or MR diet supplemented with 1% collagen peptides (PMR) group, respectively. Mice were fed for 22 weeks. Plasma lipid profiles were examined. The concentrations of total cholesterol (TC) and triglyceride (TG), the levels of total antioxidant capacity (T-AOC), glutathion peroxidase (GSH-Px), malondialdehyde (MDA) and reactive oxygen species (ROS) in liver were determined. The mRNA expressions of FAS, ACC-1, SREBP1c, CYP7A1, CPT1 and PPARα in liver were assayed by real-time PCR.

**Results:** Compared to HF, MR significantly decreased the body weight, the concentrations of TG and TC in plasma and liver, the levels of MDA and ROS in liver, the expressions of FAS, ACC-1 and SREBP1c in liver. MR significantly increased T-AOC and GSH-Px activity in liver, the expressions of CYP7A1, CPT1 and PPARα in liver. Compared to MR, PMR significantly decreased the body weight, the concentrations of TG and TC in plasma, the concentration of TG in liver, the expressions of SREBP1c and ACC-1 in liver. Meanwhile, the activity of GSH-Px and the expressions of PPARα and CPT1 in liver were increased.

**Conclusions:** Dietary methionine restriction can significantly decrease plasma lipid profiles and liver fat content, enhance antioxidant capability in high-fat diet-fed mice. Combined intervention of collagen peptides and methionine restriction can more effectively increase the antioxidant capacity, decrease plasma lipid profiles and liver fat content.

**Keywords:** Methionine restriction, Collagen peptides, Lipid metabolism, Oxidative stress

NON-PROCESSED RED MEAT CONSUMPTION IS
ASSOCIATED WITH A LOWER RISK OF A FIRST
CLINICAL DIAGNOSIS OF CENTRAL NERVOUS
SYSTEM DEMYELINATION

(1)Bowe, Gabrielle; (2)Sherriff, Jill; (3)Pereira, Gavin; (4)Lucas, Robyn;

(5)Black, Lucinda; (6)Investigator Group, Ausimmune.

(1)BSc. Master of Dietetics student. School of Public Health. Curtin University. Australia.; (2)PhD APD. Associate Professor. School of Public Health. Curtin University. Australia.; (3)PhD. Senior Research Fellow. School of Public Health. Curtin University. Australia.; (4)PhD. Professor. National Centre for Epidemiology and Population Health. The Australian National University. Australia.; (5)PhD. Research Fellow. School of Public Health. Curtin University. Australia.; (6)Ausimmune Investigator Group.

**Background and objectives:** The evidence associating red meat consumption and risk of multiple sclerosis (MS) is inconclusive. We tested associations between non-processed and processed red meat consumption and risk of a first clinical diagnosis of CNS demyelination (FCD), a common precursor to MS.

**Methods:** We used food frequency questionnaire data from the 2003-2006 Ausimmune Study (272 cases, 519 controls), an incident case-control study examining environmental risk factors for FCD. We calculated non-processed (beef, veal, lamb, pork) and processed (ham, bacon, salami, sausages) red meat density as grams of meat intake per 1000 kcal of energy intake per day. Red meat density was categorised into quartiles based on the thresholds for control participants. Logistic regression models were adjusted for age, sex, geographical region, smoking, vitamin D status, history of infectious mononucleosis, education and dietary misreporting (n=746).

**Results:** Compared with those in the lowest quartile of non-processed red meat density, the risk of FCD was 5% lower for those in the second quartile (OR=0.95; 95%CI 0.63,1.45; p=0.826), 39% lower for those in the third quartile (OR=0.61; 95%CI 0.39,0.95; p=0.030), and 38% lower for those in the highest quartile (OR=0.62; 95%CI 0.39,0.98; p=0.041). The results suggest a non-linear protective association between non-processed red meat density and risk of FCD, with beneficial effects for non-processed red meat density above 35 g per 1000 kcal/day, and similar effects for the top two quartiles. For a diet consisting of 2000 kcal/day, the strongest FCD risk reduction (approximately 40%) equates to a non-processed red meat consumption of at least 70 g/day. We found no statistically significant associations between processed red meat consumption and risk of FCD.

**Conclusions:** Our results suggest a possible protective effect of higher non-processed red meat consumption and risk of FCD. Further investigation is warranted to understand the important components of a diet that includes at least 70 g of non-processed red meat per 2000 kcal for lower FCD risk.

**Keywords:** Multiple sclerosis, diet, red meat, processed meat, Ausimmune Study
# EFFECTS OF ALLIUM HOOKERI LEAF ON PLASMA GLUCOSE AND LIPID PROFILE IN STREPTOZOTOCIN INDUCED DIABETIC RATS

(1)Kim, Myung Wha; (2)Han, Hye Kyoung; (3)Park, Su Min.

(1)PhD. Professor. Dept of Food and Nutrition. Duksung Women's University. Seoul Korea.; (2)PhD. Lecturer. Dept of Food and Nutrition. Duksung Women's University. Seoul Korea.; (3)BCs. MSc student. Dept of Food and Nutrition. Duksung Women's University. Seoul Korea.

**Background and objectives:** Diabetes mellitus has been one of major health risks in industrialized countries. The first burden of disease is diabetes mellitus in Korea. Allium hookeri (AH) has been used as food and medicine in Southeast Asia. We used AH leaf grown in Korea as an experimental material. This study was designed to examine the effects of AH leaf on plasma glucose and lipid profile in streptozotocin (STZ) induced diabetic rats.

**Methods:** Diabetes mellitus was induced in male Sprague-Dawley rats through injection of STZ dissolved in citrate buffer into tail veins at a dose of 45 mg/kg body weight (BW). Sprague-Dawley rats were fed an AIN-93 recommended diet and the experimental groups were fed a modified diet containing 5% and 10% of AH leaf powder for 4 weeks. The experimental groups were divided into four groups, consisting of a normal control group, STZ-control group, and diabetic groups fed with AH 5% & 10%. Rats' body weights, organ weights, plasma glucose, total cholesterol, HDL-cholesterol, triglyceride (TG), and free fatty acid (FFA) values in plasma were measured along with hematocrit (Hct) values and aminotransferase activities.

**Results:** The organ weights/100g BW of kidney and liver in the STZ-AH 5% and 10% diabetic groups were significantly decreased compared to the STZ-control group. Plasma glucose was significantly reduced in the STZ-AH 10% diabetic group. HDL-cholesterol significantly increased while FFA significantly decreased in the STZ-AH 10% diabetic group.

**Conclusions:** These results indicate that supplementation with Allium hookeri leaf maybe beneficial in management of diabetes mellitus as a potential therapeutic candidate.

**Keywords:** Allium hookeri, STZ diabetic rats, plasma glucose, lipid profile.

# THE EFFECT AND MECHANISM OF OAT BE-TA-GLUCAN ON TYPE 2 DIABETES MELLITUS BASED ON GUT MICROBIOTA

(1)Xu, Meihong; (2)Li, Yong; (3)Mao, Ruixue; (4)Wang, Junbo.

(1)Peking University; (2)liyongbmu@163.com; (3)mxmao@163.com;

(4)bmuwjbxy@bjmu.edu.cn.

**Background and objectives:** It's aims to evaluate the relationship between oat beta-glucan and the rats with T2DM from the gut microbiota's point of view.

**Methods:** A model of SD rats with high fat diet-induced combined low dose STZ was used. AIN93G diets containing 0.275%, 0.55% and 1.1% oat beta-glucan were supplied to normal or diabetic rats for 10 weeks. The proinflammatory and inflammatory markers such as serum lipopolysaccharide, TNF-a, IL-6 were measured using commercially availbale ELISA kits. Expression of CD14 and Toll-like receptor in serum and skeletal were measured by western blot analysis. Gut microbiota were assessed by stand plate counting method and 454 genesanalysis.

**Results:** After 10 weeks feeding, comparing with the model control, the food consumption of 1.1g/kg\*bw oat beta-glucan rats was significantly decreased (P<0.05), whereas urine volume was relatively reduced without significant difference (P>0.05). Oat beta-glucan intervention significantly reduced the blood glucose (P<0.05) and improved insulin resistance (P<0.05). Besides, oat beta-glucan intervention was found to reverse the elevated serum and hepatic lipid profiles in diabetic rats (P<0.05). There were clearly structural differences of gut microbiota between model control and normal control group at both the phyla and genus levels. Bacteroidetes were significantly decreased in diabetic rats compared to normal control group, with Firmicute and Proteobacteria elevated. Our research showed oat beta-glucan supplement could change the diabetic-disrupted gut microbiota to a healthier state by increasing the abundance of Bacteroidetes and reducing the abundance of Firmicute. **Results:** **Conclusions:** This study verified that oat beta-glucan had an benefits effect on T2DM, by reducing blood glucose and decreasing insulin resistance, and Modulation of gut microflora may be one potential mechanism.

**Keywords:** oat beta-glucan, type 2 diabetes mellitus, gut microbiota

**Further collaborators:**

Some issue about the T2DM.
## SOCIODEMOGRAPHIC AND ECONOMIC FACTORS ARE ASSOCIATED WITH WEIGHT GAIN BETWEEN BEFORE AND AFTER CANCER DIAGNOSIS: RESULTS FROM THE PROSPECTIVE POPULATION-BASED NUTRINET-SANTÉ COHORT

**Background and objectives:** While many cancer patients are affected by weight loss, others tend to gain weight, which may impact prognosis and risk of recurrence and of second cancer. The aim of this prospective study was to investigate weight variation between before and after cancer diagnosis and socio-demographic, economic, lifestyle and clinical factors associated with moderate-to-severe weight gain.

**Methods:** 1051 incident cases of first primary cancer were diagnosed in the NutriNet-Santé cohort between 2009 and 2015. Weight was prospectively collected every 6 months since subjects' inclusion (i.e. an average of 2y before diagnosis). Mean weights before and after cancer diagnosis were compared with paired Student's t-test. Factors associated with moderate-to-severe weight gain (≥5% of initial weight) were investigated by age and sex-adjusted logistic regression.

**Results:** Weight loss was observed in men (-3.54±4.39kg in those who lost weight, p=0.0002) and in colorectal cancer patients (-3.94±4.40kg, p=0.001). Weight gain was observed in breast and skin cancers (2.83±3.21kg, p=0.04, and 2.96±2.75kg, p=0.04 respectively). Women (OR=1.75[1.06-2.87], p=0.03), younger patients (2.44[1.51-3.70], p<0.0001), those with lower income (OR=1.30[1.01-1.72], p-trend=0.007), lower education

(OR=1.32[1.03-2.70], p-trend=0.03), excess weight before diagnosis (OR=1.64[1.12-2.42], p=0.01), lower physical activity (OR=1.28[1.01-1.64], p=0.04) and those who stopped smoking (OR=4.31[1.99-9.35], p=0.005)) were more likely to gain weight. In breast cancer patients, induced menopause was associated with weight gain (OR=4.12[1.76-9.67]), but no association was detected for tumor characteristics or treatments.

**Conclusions:** This large prospective cohort provided original results on weight variation between before and after cancer diagnosis, highlighting different weight trajectories. Socio-demographic and economic factors appeared to influence the risk of weight gain, illustrating social inequalities in health.

**Keywords:** Weight gain, weight loss, cancer diagnosis, breast cancer, socio-demographic factors

**Further collaborators:**

Nathalie Druesne-Pecollo, Valentin Partula, Pilar Galan, Hélène Hoarau, Rebeca Gonzalez, Mélanie Deschasaux

## EFFECTS OF METHIONINE RESTRICTED DIET ON BONE FORMATION IN MICE

**Background and objectives:** To investigate the effects of methionine restricted diet on the bone strength and microstructure of the femur in mice and the mechanisms by using the oxidative stress status and micro-CT.

**Methods:** Mice were fed with normal diet (CON) with methionine content of 0.86% and methionine restricted (MR) diet with metnionine content of 0.17% for 22w. After feeding, the femur length, femur dry weight, BMC, BMD, microstructure, bone strength and redox state of femur were determined.

**Results:** Compared with CON group, femur length, femur dry weight and bone mineral density (BMD) of MR group have no difference. BMC, cancellous bone volume and trabecular thickness significantly increased, oxidative stress significantly decreased, while the bone strength significantly decreased.

**Conclusions:** 22w MR diet can significantly increase the BMC and trabecular thickness, improve the microstructure of bone tissue, significantly reduce the body weight of mice and bone strength. There is a tendency to reduce fat cell content of femur, but there is no significant difference in bone strength/body weight.

**Keywords:** Methionine restricted, Micro-CT; mice, Oxidative stress

<footnote>(1)Fassier, Philippine; (2)Zelek, Laurent; (3)Bachmann, Patrick;</footnote>

<footnote>(4)Touillaud, Marina; (5)Lécuyer, Lucie; (5)Srour, Bernard; (6)Hercberg, Serge; (7)Cohen, Patrice; (8)Latino-Martel, Paule; (9)Touvier, Mathilde.</footnote>

<footnote>(1)PhD student. Nutritional Epidemiology Research Team (EREN). Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS) Inserm U1153 Inra U1125 Cnam Paris 13 University. France.; (2)Md. PhD. Nutritional Epidemiology Research Team (EREN). Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS) Inserm U1153 Inra U1125 Cnam Paris 13 University. France.; (3)PhD. PU-PH. Cancer. environment and nutrition Unit. Léon Bérard Center. F-69000. Lyon. France; (4)PhD. Cancer. environment and nutrition Unit. Léon Bérard Center. F-69000. Lyon. France; (5)Ms. Nutritional Epidemiology Research Team (EREN). Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS) Inserm U1153 Inra U1125 Cnam Paris 13 University. France.; (6)PhD. PU-PH. Nutritional Epidemiology Research Team (EREN). Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS) Inserm U1153 Inra U1125 Cnam Paris 13 University. France.; (7)PhD. PU-PH. Sociology department. University of Rouen. DySola. EA 4701; (8)PhD. Nutritional Epidemiology Research Team (EREN). Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS) Inserm U1153 Inra U1125 Cnam Paris 13 University. France.; (9)PhD. HDR. Nutritional Epidemiology Research Team (EREN). Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS) Inserm U1153 Inra U1125 Cnam Paris 13 University. France.</footnote>

<footnote>(1)Guo, Haitao; (1)Wang, Yanan; (1)Zhang, Jiahong; (2)Shi, Yonghui;</footnote>

<footnote>(3)Le, Guowei.</footnote>

<footnote>(1)BSc. School of Food Science and Technology. Jiangnan University. China.; (2)MSc. The State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University. China.; (3)PhD. The State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University. China.</footnote>
(¹)Minovic, Isidor; (²)van Zon, Sander K.R.; (³)Reijneveld, Sijmen A.; (⁴)Kootstra-Ros, Jenny; (⁵)Feskens, Edith; (⁶)Navis, Gerjan;

(⁷)Eggersdorfer, Manfred; (⁴)Kema, Ido; (⁶)Bakker, Stephan J.L.

(¹)PharmD. Isidor Minovic. Department of Nephrology. University Medical Center Groningen. The Netherlands.; (²)MSc. Department of Health Sciences. University Medical Center Groningen. The Netherlands.; (³)MD PhD. Department of Health Sciences. University Medical Center Groningen. The Netherlands.; (⁴)PhD. Department of Laboratory Medicine. University Medical Center Groningen. The Netherlands.; (⁵)PhD. Division of Human Nutrition. Wageningen University. The Netherlands.; (⁶)MD PhD. Department of Nephrology. University Medical Center Groningen. The Netherlands.; (⁷)PhD. Nutritional Products. DSM. Switzerland.

**Background and objectives:** Low socioeconomic status (SES) is an established risk factor for cardiovascular disease and for low intake of micronutrients, such as B-vitamins. The latter could adversely affect one-carbon metabolism, especially in populations at increased risk of inadequate nutritional intake, such as pre-elderly and elderly. We therefore evaluated folic acid, vitamin B12, vitamin B6, and homocysteine in plasma of pre-elderly and elderly with high and low SES.

**Methods:** From the population-based LifeLines Cohort and Biobank Study (N=167,729), 1,600 individuals between 60 and 75 years were included to create two gender-matched groups (both N=800) with different socioeconomic status (SES). Since education is more differentiating than income in the egalitarian Dutch population, SES-groups were defined according to highest completed education as high (university degree) and low (no or only primary education)). Parameters of one-carbon metabolism were measured using validated routine assays. Differences between groups were tested with linear regression analysis.

**Results:** Mean±SD age and BMI were 65±4 years and 25.7±3.6 kg/m2 in the high-SES group, compared to 67±4 years and 28.2±4.2 kg/m2 in the low-SES group, respectively (both P<0.001). For high- and low-SES groups, we found similar prevalences of smokers, 86 (11%) versus 105 (13%), and energy intakes, 1865±488 versus 1871±555 kCal/day (P=0.42 and 0.89, respectively). Conversely, concentrations of folic acid, vitamin B12, and vitamin B6 were significantly lower and homocysteine higher in the low SES group, 14.4 [9.7-22.7] nmol/L, 275 [218-347] pmol/L, 48.8 [34.0-72.8] nmol/L, and 14 [12-16] µmol/L, compared to the high-SES group, 18.4 [12.7-27.4] nmol/L, 303 [234-380] pmol/L, 60.0 [40.7-91.2] nmol/L, and 13 [11-15] µmol/L, respectively (all P≤0.001). These differences were independent of potential confounders, such as age, BMI, smoking, and energy intake.

**Conclusions:** Pre-elderly and elderly with low SES have a significantly worse folic acid, vitamin B12, vitamin B6, and homocysteine status compared to those with high SES, independent of

potential confounders. This could contribute to their increased cardiovascular risk, and could provide a logical target for nutritional intervention in this vulnerable group.

**Keywords:** Socioeconomic Status, One-Carbon Metabolism, Vitamins, Elderly, Cardiovascular risk.

(¹)Nybacka, Sanna; (²)Öhman, Lena; (³)Störsrud, Stine; (³)Böhn, Lena;

(⁴)Willpart, Katarina; (⁵)Bengtsson, Ulf; (⁶)Winkvist, Anna; (⁵)Törnblom, Hans; (⁵)Simrén, Magnus.

(¹)MSc. Dietician. Department of Internal Medicine and Clinical Nutrition. University of Gothenburg. Sweden.; (²)PhD. Department of Microbiology and Immunology. University of Gothenburg. Sweden.; (³)Dietician. PhD. Department of Internal Medicine and Clinical Nutrition. University of Gothenburg. Sweden.; (⁴)MD. Department of Internal Medicine and Clinical Nutrition. University of Gothenburg. Sweden.; (⁵)MD. PhD. Department of Internal Medicine and Clinical Nutrition. University of Gothenburg. Sweden.; (⁶)Nutritionist. PhD. Department of Internal Medicine and Clinical Nutrition. University of Gothenburg. Sweden.

**Background and objectives:** It has been proposed that the presence of atopic disease may correlate with more severe symptoms among patients with Irritable Bowel Syndrome (IBS), but few studies have investigated this. We therefore assessed if the presence of self-reported atopic symptoms and serum IgE in patients with IBS was associated with increased symptom severity.

**Methods:** The levels of total and specific IgE in serum were measured in 223 patients with IBS and 47 non-IBS controls. Participants also completed questionnaires assessing the presence of atopic disease (i.e eczema, asthma, and rhinoconjunctivitis), gastrointestinal symptom burden (IBS severity scoring system, IBS-SSS), food intolerance, and somatic (The Patient Health Questionnaire, PHQ-15) and psychological symptoms (Hospital Anxiety and Depression scale, HAD).

**Results:** Presence of atopic disease was reported in 123 (55%) patients with IBS compared to 19 (40%) of the non-IBS controls (N.S.). IBS patients with atopic manifestations had higher median serum IgE levels (31 vs. 16 kU/L, P<0.001) and higher prevalence of self-reported food intolerance than non-atopic IBS patients (28% vs. 9%, P=0.002), but no major difference in gastrointestinal or psychological symptom burden was noted. However, having severe somatic symptoms was more common among atopic than non-atopic IBS patients (38% vs. 27%, P=0.028). Specific IgE to common food allergens was rare and was unrelated to the IBS symptom pattern and self-reported food intolerance.

**Conclusions:** Atopic disease is a common comorbidity in patients with IBS, but our data do not support major differences in
IBS symptoms between atopic and non-atopic IBS patients, except for slightly increased prevalence of self-reported food intolerance and more somatic symptoms in atopic IBS patients.

**Keywords:** Irritable bowel syndrome, atopy, IgE, food intolerance

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## INTAKE AND DIETARY SOURCES OF FATTY ACIDS OMEGA 3 6 AND 9 AND MARKERS OF CARDIOMETABOLIC RISK IN PATIENTS WITH ABDOMINAL ADIPOSITY: PRELIMINARY RESULTS

(1)Defagó, Maria Daniela; (2)Marchiori, Georgina Noel; (3)Flores, David; (4)Pasqualini, María Eugenia; (5)Eraso, Alberto; (6)Carrizo, Lidia Ana del Valle; (7)Perovic, Nilda Raquel.

(1)PhD. Nutritionist. Escuela de Nutrición, Facultad de Ciencias Médicas. Universidad Nacional de Córdoba, Argentina. Instituto de Investigaciones en Ciencias de la Salud de Córdoba (INICSA-CONICET); (2)BSc. Nutritionist. Escuela de Nutrición, Facultad de Ciencias Médicas. Universidad Nacional de Córdoba, Argentina.; (3)MD. Cardiologist. Servicio de Cardiología, Hospital Nacional de Clínicas, Facultad de Ciencias Médicas. Universidad Nacional de Córdoba, Argentina.; (4)PhD. Biologist. Instituto de Investigaciones en Ciencias de la Salud de Córdoba (INICSA-CONICET) Instituto de Biología Celular, Facultad de Ciencias Médicas. Universidad Nacional de Córdoba, Argentina.; (5)PhD. Biochemical. Escuela de Nutrición, Facultad de Ciencias Médicas. Universidad Nacional de Córdoba, Argentina; (6)MSc. Dirección de Alimentación y Nutrición, Hospital Nacional de Clínicas, Facultad de Ciencias Médicas. Universidad Nacional de Córdoba, Argentina.; (7)PhD. Nutritionist. Escuela de Nutrición, Facultad de Ciencias Médicas. Universidad Nacional de Córdoba, Argentina.

**Background and objectives:** Abdominal adiposity is associated with metabolic risk profile such as dyslipidemia and low grade systematic inflammation. Dietary unsaturated fatty acids (FA) could influence metabolic alterations associated with visceral adipose tissue. We aimed to analyze food sources of n-3 and n-6 and n-9 FA and their association with cardiometabolic risk markers in patients with abdominal adiposity.

**Methods:** Participated 47 adults, between 40-80 years old, both sexes, with central adiposity determined by waist circumference (WC), attended in Cardiology Division, National Hospital of Clinics, Córdoba, Argentina, 2014-2016. Medical history and validated food frequency questionnaire were applied. Food information was processed by Interfood v.1.3. nutritional software. FA food sources were classified in: n-9 FA (olive oil, avocado and olives), 20:4 n-6 FA (red meat, chicken and eggs), 18:2 n-6 FA (corn, soybean, sunflower and mixed oil), 20:5 and 22:6 n-3 FA (fish and seafood), and 18:3 n-3 FA (nuts and seeds). Anthropometric measures, serum lipid profile (total cholesterol, LDL-col, col-HDL and triglycerides), glycemia and hs-CRP were determined. Linear regression adjusted by age, sex, total energy intake, body mass-index,

smoking, and physical activity was development to analyze associations between FA food source and biochemical markers.

**Results:** Medium age was 60.4 ± 9.8 in men and 57.1 ± 9.3 years old in women. 40% showed overweight and 41% obesity. According WC, 26% had high-risk and 74% very high risk. Medium total cholesterol was 185.4 ± 37.3 mg/dL, LDL-c 108.6 ± 30.6 mg/dL, HDL-c 50.6 ± 13.1 mg/dL, triglycerides 145.1 ± 65.2 mg/dL, glycemia 113.1 ± 26.2 mg/dL, and PCR-us 4.0 ± 2.5 mg/L. About dietary intake, the consumption for n-9 food was 13.1 ± 12.6 g/day, 20:4 n-6 FA 226,4 ± 122,6 g/day, 18:2 n-6 FA 22.4 ± 16.2 g/day, 20:5-22:6 n-3 FA 13.5 ± 14.2 g/day and 18:3 n-3 FA 11.6 ± 18.6 g/day. Significant positive association was observed between intake of 20:4 n-6 FA and triglycerides concentration (β=0,25; p=0,04) and between 20:5-22:6 n3 FA and HDL-c (β=0,35; p=0,03).

**Conclusions:** These preliminary results show the influence of diet in lipid profile. Dietary intervention are an important tool in patients with cardiometabolic risk factors.

**Keywords:** Food source, fatty acids, markers, cardiometabolic risk.

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## ACUTE EFFECTS OF AGE WINE, SPANISH WHITE WINE, CONSUMPTION INCREASED CIRCULATING ENDOTHELIAL PROGENITOR CELLS AND REDUCED CARDIOVASCULAR RISK FACTORS IN MEN: A RANDOMIZED INTERVENTION TRIAL

(1)Roth, Irene; (2)Casas, Rosa; (3)Medina, Alexander; (4)Ribo Coll, Margarita; (5)Lamuela-Raventós, Rosa Mª; (6)Estruch, Ramón.

(1)PhDstudent. Nutritionist. Department of Internal Medicine, Hospital Clínic, Institut d'Investigació Biomèdica August Pi i Sunyer, Universitat de Barcelona, Spain.; (2)PhD. Nutritionist. Department of Internal Medicine. Hospital Clínic. Institut d'Investigació Biomèdica August Pi i Sunyer, Universitat de Barcelona.Spain.; (3)PhD. Nutritionist. CIBER CB06/03 Fisiopatología de la Obesidad y la Nutrición. (CIBERobn) Instituto de Salud Carlos III (ISCIII). Spain.; (4)PhDstudent. Nutritionist. Department of Internal Medicine. Hospital Clínic. Institut d'Investigació Biomèdica August Pi i Sunyer. Universitat de Barcelona, Spain.; (5)PhD. Professor. Nutrition and Food Science Department-XaRTA, INSA. Pharmacy School. University of Barcelona.; (6)PhD. Doctor. Department of Internal Medicine. Hospital Clínic. Institut d'Investigació Biomèdica August Pi i Sunyer. Universitat de Barcelona, Spain.

**Background and objectives:** Several epidemiological studies suggest that moderate wine consumption have beneficial effects on cardiovascular risk, related to appearance and progression of the atherosclerosis. No previous studies have analyzed the beneficial effects of aged wine (AW), a type of Spanish white wine, on cardiovascular risk factors. The aim of this study was to evaluate the effects of AW and gin on circulating endothelial peripheral cells (EPC) and circulating biomarkers, related to appearance and progression of the atherosclerosis, in high cardiovascular risk subjects.
**Methods:** A total of 38 high-risk male volunteers, between 55-80 years, who received at random 30g of ethanol per day in form of AW or gin. The study was an open, randomized, controlled, crossover trial that aims to compare the effects of moderate consumption of AW and gin after 3 weeks of intervention, in which the diet and physic at activity was monitored. After a run-in period and after interventions, we assessed changes on the expression of EPC and biomarkers related to atherosclerosis.

**Results:** A significantly increased the circulating EPC 39.63% (P=0.03) was observed after intervention AW. We observed a significantly decreased the systolic and diastolic blood pressure (P=0.033 and P=0.030 respectively) and increased HDL cholesterol after AW intake. On the other hand, we observed a significantly increased the LDL cholesterol (P=0.005) and glucose (P=0.025) after the gin intake. However, when analyzed other biochemical and anthropometric parameters, we observed a significantly increased for Apolipoprotein A (P=0.001; both) and protobine time (P=0.022, P=0.018) for both beverages, without changes in triglycerides, homocysteine, fibrinogen or body mass index. Finally we observed a significantly increased for calcium (P=0.001; both), potassium (P=0.006) iron (P=0.044) and folic intracellular (P= 0.050) after AW intake.

**Conclusion:** Fermented alcoholic beverages, such as AG, appear to confer greater cardioprotective effects than distilled beverages (gin), probably due to their higher content of polyphenols. Interventions with AW, showed beneficial changes on cardiovascular risk biofactors, and increases the number of circulating EPC in peripheral blood that increases the ability to repair and maintain endothelial integrity.

**Keywords:** Aged wine; cardiovascular risk; diet; polyphenol.

**Methods:** Prospective study which included 35 children [age: 11(9-13)years] with overweight/obesity who attended the "Servicio de Diabetes y Nutrición Infanto-Juvenil" of the "Complejo Médico Churruca-Visca", Buenos Aires, Argentina. Anthropometric measures were determined and Z-scores were calculated (WHO). Nutritional assessment was performed by the 24-hour dietary recall method using the tables from the "Sistema de Análisis y Registros Alimentarios" (SARA, Ministerio de Salud). GFR was estimated using the Zappitelli formula using serum creatinine and cistatin C levels. Serum lipids and levels of selected micronutrients were recorded. Correlations were evaluated by Pearson or Spearman Correlation tests, according to data distribution.

**Results:** Out of the 35 children studied (18 males), 25 were obese and 10 were overweight. Mean BMI Z-score was 1.9±0.5. None of the children were taking dietary supplements. Median intake of SFA, monounsaturated fatty acids (MUFA) and PUFA were, median(interquartile range), 14.1(10.2-24.7)g/day, 17.6(11.3-20.7) g/day and 4.5(1.9-10.0)g/day, respectively. Mean GFR was 97±15 ml/min.1.73m2. Intakes of SFA and MUFA were only correlated with waist circumference (r=0.36,p<0.05; r=0.37,p<0.05, respectively). PUFA intake was correlated with cistatin C (r=-0.47,p<0.01) and GFR (r=0.41,p<0.01). In order to correct by individual differences in total FA intake the ratio PUFA/totalFA was calculated. The ratio PUFA/totalFA was inversely correlated with Z-BMI (r=-0.37,p<0.05), cistatin C (r=-0.58,p<0.001) and GFR (r=0.52,p<0.005). The correlation between GFR and PUFA/totalFA ratio was independent of age but not sex-independent.

**Conclusions:** In this study of children with overweight/obesity the GFR was associated with PUFA intake. Nutritional advice to substitute SFA by PUFA might be useful to prevent the obesity-associated decline in renal function. Longitudinal studies are needed to confirm this hypothesis.

**Keywords:** Children, obesity, glomerular filtration rate.

**Background and objectives:** Polyunsaturated fatty acids (PUFA) are defined as the sum of ω3 and ω6-fatty acids (FA). Their impacts on health are mainly attributed to anti-inflammatory effects and to the activation of the peroxisome proliferator-activated receptors(PPAR)-γ. In dietary interventions for obesity the substitution of saturated fatty acids (SFA) by PUFA is encouraged. Only few studies addressed the impact of PUFA intake over the glomerular filtration rate (GFR) in patients without renal disease. Our aim was to evaluate the association between dietary FA and GFR in children with overweight/obesity.

<footnote>(1)Peredo, Maria Soledad; (2)Scricciolo, Romina; (3)Alonso, Elizabeth;</footnote>

<footnote>(4)Lando, Inés; (5)Brovarone, Lucrecia; (6)Fernández, Jorgelina;</footnote>

<footnote>(5)Muzzio, Maria Luz; (6)Santucci, Maria Pia; (5)Meroño, Tomas;</footnote>

<footnote>(3)Kabakian, Maria Laura.</footnote>

<footnote>(1)Nutricionist; (2)Biochemist; (3)Physician, Pediatric Nutricionist;</footnote>

<footnote>(4)Nutritionist; (5)PhD Biochemist; (6)Physician, Nutricionist.</footnote>
ALCOHOLIC BEVERAGES, MEDITERRANEAN
DIETARY PATTERN AND CONSUMPTION OF
FOODS RICH IN VITAMIN D IN A POPULATION
WITH HIGH CARDIOVASCULAR RISK. PRED-
IMED STUDY

(1)Ribo Coll, Margarita; (2)Doménech, Mónica; (3)Casas, Rosa; (4)Roth, Irene; (5)Salas-Salvadó, Jordi; (6)Ros, Emilio; (7)Corella, Dolores; (8)Fitó, Montse; (9)Martínez-González, Miguel Ángel; (10)Estruch, Ramón.

(1)PhDstudent. Nutritionist. Department of Internal Medicine, Hospital Clínic, Institut d'Investigació Biomèdica August Pi i Sunyer, Universitat de Barcelona, Spain.; (2)PhD. Doctor. CIBER CB06/03 Fisiopatología de la Obesidad y la Nutrición (CIBERobn). Instituto de Salud Carlos III (ISCIII). Spain.; (3)PhD. Nutritionist. Department of Internal Medicine. Hospital Clínic. Institut d'Investigació Biomèdica August Pi i Sunyer. Universitat de Barcelona. Spain.; (4)PhD student. Nutritionist. Department of Internal Medicine. Hospital Clínic. Institut d'Investigació Biomèdica August Pi i Sunyer. Universitat de Barcelona. Spain.; (5)PhD. Doctor. Human Nutrition Unit. Faculty of Medicine and Health Sciences. IISPV. Universitat Rovira i Virgili. Reus. Spain.; (6)PhD. Doctor. Lipid Clinic. Department of Endocrinology and Nutrition. Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS). Hospital Clínic. University of Barcelona. Spain.; (7)PhD. Doctor. Genetic and Molecular Epidemiology Unit. Department of Preventive Medicine and Public Health. School of Medicine. University of Valencia. Spain.; (8)PhD. Doctor. Cardiovascular Risk and Nutrition Research (REGICOR Group). Institut Hospital del Mar d'Investigacions Mèdiques (IMIM). Barcelona. Spain.; (9)PhD. Doctor. Department of Preventive Medicine and Public Health. University of Navarra. Pamplona. Spain.; (10)PhD. Doctor. Department of Internal Medicine. Hospital Clíni. Institut d'Investigació Biomèdica August Pi i Sunyer. Universitat de Barcelona. Spain.

**Background and objectives:** Background: Epidemiological studies have shown that deficiency of Vitamin D is associated with higher incidence of cardiovascular disease. This deficiency has been related to low sun exposure, reduced intake of some foods, and higher alcohol consumption.

Aims: The aim of this study was to determine the possible relationship between consumption of foods rich in vitamin D, adherence to Mediterranean Diet (MeDiet) and consumption of wine or beer in a population with high cardiovascular risk.

**Methods:** PREDIMED trial is a 5-year parallel group; multicenter, randomized, controlled clinical trial aimed to evaluate the effects of a MeDiet supplemented with extra virgin olive oil (EVOO) or nuts on incidence of cardiovascular disease. We analyzed baseline data from the Food Frequency Questionnaire with 137-items that included the amount and type of alcoholic beverage consumed and foods rich in vitamin D. A validated 14-point score of adherence of MeDiet was also tested.

**Results:** We included data from 7,447 high-risk participants. The mean age was 67.88 ± 6.08 years, 27.7% were males, and the mean BMI was 30.20 ± 4.0 kg/m2. Wine and beer drinkers showed

a significant increased in food rich in vitamin D consumption compared with non-drinkers 5.96 ± 0.81 vs 5.44 ± 0.67 µg/d, p< 0.001). Among different foods rich in vitamin D analyzed, cured cheese, fat fish, and seafood were the more frequently consumed. In the other hand, drinkers showed higher score of baseline adherence of MeDiet compared to non-drinkers (8.79 ± 0.04 vs 8.39 ± 0.04, p< 0.001).

**Conclusions:** Wine and beer drinkers showed a higher intake of foods rich in vitamin D, and a higher adherence to MeDiet than non-drinkers. Therefore, moderate alcohol consumers in the Mediterranean area report a healthier lifestyle compared to drinkers from other cultures.

**Keywords:** Mediterranean diet; foods; cardiovascular risk; alcohol beverages; vitamin D.

**Further collaborators:** Alexander Medina, Paula Villanueva.

NUTRITIONAL MANAGEMENT OF AN ADULT PATIENT BEFORE, DURING AND AFTER LIVER PARTITION (ALPPS) FOR DIFFUSE HEPATIC EPITHELIOID HEMANGIOENDOTHELIOMA

(1)Cascarón, María Fernanda; (2)Dietrich, Ailen; (2)Quesada, Eliana;

(3)Resio, Nicolas.

(1)Medica especialista en nutrición; (2)Licenciada en nutricion;

(3)Cirujano.

**Background and objectives:** 54-year-old female patient.

Diagnosis: multifocal hepatic epithelioid hemangioendothelioma, treated with two-stage hepatectomy.

- Medical history

- Hypertension

- Dyslipidemia

- Class I obesity

- Hepatic steatosis

- Thyroid failure

- Parathyroid insufficiency

- Appendectomy

- Thyroidectomy + Parathyroidectomy

**Objectives**

This study shows that nutritional support in the perioperative period reduces nutritional complications, shortens hospital stay and improves post-surgical recovery.

**Methods:** Nutritional assessment at an outpatient clinic 60 days prior to surgery. Height: 1.60 m; weight: 79 kg; medium build; class I obesity; no weight loss.

Hospital stay:

First stage of surgery: liver transection + right portal vein ligation + metastasis resection from segments II-III. FLR/TLV: 27%.

Postsurgical period:

- Day 1: parenteral nutrition with SMOF lipid.

- Day 2: liquid diet + TPN.

- Day 3: bland diet + TPN.
Day 4: hepatoprotective diet + TPN.

Day 6: TPN is interrupted due to fever and replaced by oral diet. Hypertrophy: 42% of total increase. FLR/TLV: 38%.

Day 7: right hepatic trisectionectomy + cholangiojejunostomy. Fasting.

Second stage of surgery:

Day 3: liquid diet. Poor tolerance, vomiting.

Day 6: TPN.

Day 7: trophic EN via NGT (semi-elemental formula) + TPN.

Day 10: oral bland diet + EN + reduced PN.

Day 11: TPN is interrupted and replaced by EN and bland diet.

Day 13: NGT is removed, oral feeding + hypercaloric supplement.

Day 18: food intake improvement. Dietary plan to be followed on hospital discharge is created.

**Results:** Parameters Before surgery: 79 kg, hemoglobin (Hb) 13.1, albumin 3.6

Between surgeries: 77kg, Hb 10,9, Lymphocytic cells 1280, Albumin 2,9, total protein 5,6, nitrogen balance +6

At discharge: 76.5 kg, Hb 12,2, lymphocytic cells 1158, albumin 3.3, Total protein: 5.8

**Conclusions:** An interdisciplinary approach is essential for managing highly complex, elective surgical procedures. Timing nutritional interventions to the surgical planning improves therapeutic results.

**Keywords:** nutritional support, hepatectomy, ALPPS.

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EFFECT OF OMEGA-3 FATTY ACIDS ON EN-
DOTHELIAL FUNCTION IN METABOLIC SYN-
DROME: A SYSTEMATIC REVIEW

(1)Bertorello, Natalia Belén; (2)Lerda, Daniel; (3)Eynard, Aldo Renato;

(4)Defagó, Maria Daniela.

(1)BS. Nutritionist. Licenciatura en Nutrición - Facultad de
Medicina-Universidad Católica de Córdoba; (2)PhD. Biochemical.
Facultad de Medicina. Universidad Católica de Córdoba; (3)PhD.
MD. INICSA- CONICET. Córdoba, Argentina; (4)PhD. Nutritionist.
INICSA- CONICET. Escuela de Nutrición. Facultad de Ciencias
Médicas. Universidad Nacional de Córdoba Córdoba, Argentina.

**Background and objectives:** Omega-3 polyunsaturated fatty acids (ω3-PUFA) are increasingly being used in the management of several metabolic pathologies, due to its anti-inflammatory role. The aim was summarize the findings on the effects of ω3-PUFA on endothelial function in patients with metabolic syndrome.

**Methods:** An electronic literature search from 2004-2015 in Medline, Lilacs, Cochrane Library and Scielo, was conducted. We combined search terms related to the exposure (i.e. ω3-PUFA, syndrome metabolic) and outcomes of interest (blood pressure, endothelial dysfunction, endothelial markers). Randomized-controlled interventional trials without language restrictions were considered. PRISMA guidelines were employed. Methodological quality, i.e. study design, sample size, bias, and statistical analysis, was assessed by Jadad scale.

**Results:** 273 references were identified, of which 25 were final-
ly included. Articles were classified in food pattern modification
(i.e. mediterranean-style diet, prudent food pattern, n=7), ω3-PU-
FA supplementation (i.e. fish oil, flaxseed oil, EPA/DHA capsules,
n=10) and mixed interventions (food pattern modification and
ω3-PUFA supplementation, n=8). Five articles with food pattern
modification, reported significantly reduction in systolic (SBP)
and diastolic blood pressure (DBP), and four studies observed
lower levels in C-reactive protein (CRP) with diet change. In clini-
cal trials with ω3-PUFA supplementation, three studies observed a
significant decrease in SBP with reduced circulation levels of CRP,
sICAM-1, PAI-1 and IL-6. About mixed interventions, two studies
reported lower levels of SBP, DBP, CRP and IL-6.

**Conclusions:** Dietary interventions and supplementation with ω-3 PUFA in metabolic syndrome are a relevant strategy to the maintenance of cardiovascular health and prevent future complications.

**Keywords:** ω-3 fatty acids, metabolic syndrome, blood pressure, endothelial dysfunction

144/1135

CORRELATIONS OF SERUM 25(OH) VITAMIN D LEVELS WITH THE METABOLIC PARAMETERS IN SUBJECTS WITH DIFFERENT BODY MASS INDEX

(1)Nikolova, Maria; (2)Boyanov, Mihail; (3)Penkov, Alexandar.

(1)Medical Doctor. Department of Hygiene, Medical Ecology and Nutrition. Medical University of Sofia. Bulgaria; (2)Professor. MD. Phd. Clinic of Endocrinology. Department Internal Medicine. Alexandrovska University Hospital. Medical University of Sofia. Bulgaria; (3)Assoc.Professor. MD. Phd. Department of Hygiene, Medical Ecology and Nutrition. Medical University of Sofia. Bulgaria.

**Background and objectives:** We tried to describe the corre-
lation between serum 25(OH) vitamin D and metabolic parame-
ters in men and womenwith different BMI.

**Methods:** 264 subjects participated – 109 men and 155 wom-
en aged 20-60 years.Body weight and height, waist circumference,
systolic and diastolic blood pressure were recorded. Body com-
position was assessed by bioelectrical impedance (Tanita BC 420
MA, Tanita Inc., Japan).Serum 25(OH)D Total and insulin were
measured by electro-hemi-luminescence (Elecsys 2010 analyzer,
Roche Diagnostics, Switzerland). High-sensitivity C-reactive pro-
tein was measured by an immune turbo-dimetrical method(Co-
bas Integra 400+ analyzer)together with total, HDL-cholesterol
(direct)and triglycerides. Statistical analysis was performed on a
SPSS 23.0 for Windows (SPSS Inc., Chicago, IL).

**Results:** 27.2 % of the participants had normal weight, 24.6 % - overweight, 29.2 % - class I obesity, and 18.9 % - class II or III. 33.3 % had vitamin D deficiency, 40.2 % - insufficiency. Vitamin D was weakly and inversely correlated to many variables in the group as a whole. The most powerful correlations were with weight, WC, WC/Height, % body fat and HOMA-IR index (r=-0.231, -0.283,
-0.307, -0.339, -0.328 respectively, all p<0.001). Fewer correlations were registered in men than in women. Splitting the subjects according to BMIled to loss of significance. Backward analysis revealed Total-C / LDL-C ratio, and LDL-C/HDL-C ratio as strongest predictors (p=0.001; R2=0.204).

**Conclusions:** The association of vitamin D with blood pressure, plasma lipids, glucose and insulin is very weak on an individual level. It might be demonstrated in large surveys.

**Keywords:** Body composition; Obesity; Metabolism; Vitamin D

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## IMPORTANCE OF DIETARY COUNSELING TO PATIENTS WITH DIABETES MELLITUS TYPE 2 FROM AN OUTPATIENT CLINIC IN SÃO PAULO

(1)Barros Pereira Ferreira, Natália; (1)Parise Polo, Gabriela; (1)Silva Gregório, Amanda; (1)Lekevicius Consolin, Brunna; (1)Fonseca Gonçalves, Daniel; (2)Garcia Peloggia de Castro, Adriana.

(1)Nutrition Student. Centro Universitário São Camilo. Brasil;

(2)PhD. Nutritionist. Centro Universitário São Camilo. Brasil.

**Background and objectives:** A healthful eating pattern and regular physical activity are extremely important components of type 2 diabetes mellitus management. For many individuals with type 2 diabetes mellitus, the most difficult part of the dietetic plan is to decide what to eat. Dietary therapy has been recognized as an essencial strategy for helping patients with type 2 diabetes mellitus, improving self-management, developing nutritional education and providing an eating plan. In this context the purpose of this work is to correlate the eating habits of patients who received professional guidance with those who did not receive any guidance.

**Methods:** This is a cross-sectional, descriptive study with primary data collection, sampling done by convenience, approved by the Ethics and Research Committee of Centro Universitário São Camilo, Brazil. A structured questionnaire to characterize food intake was developed for this research and applied to 82 patients with type 2 diabetes mellitus, both male and female, attending an outpatient clinic in São Paulo. Data analyses were performed using descriptive statistic, the Qui-square test with a level of significance of p<0.05.

**Results:** Regarding the interviews, the mean age was 63 ± 10.6 years characterizing an elderly population (64.6%). The majority of respondents (80%) received specific dietary guidance for type 2 diabetes mellitus but only 30% admitted to follow the guidance given by the health professional. It is noteworthy that the main health professionals who carried out dietary counseling were nutritionists (50%) and physicians (46%). People who received guidance showed a slightly more varied diet than those who did not receive guidance. Nevertheless, this result was not statistically significant (p=0.26). The most consumed types of food were: fruits, vegetables and greens (74%), pasta, breads and biscuits (66%) and food of animal origin (59%).

**Conclusions:** Patients who received professional guidance on diet present a more varied food profile in relation to those who did not receive it. Therefore, the professional counseling in this population is extremely important for an adequate management of the disease and quality of life.

**Keywords:** Diabetes mellitus; Dietary counseling; Food intake; Dietary Patterns

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## PLASMA GLUCOSE KINETICS FOLLOWING INGESTION OF TWO CEREAL PRODUCTS DIFFERING BY THEIR SLOWLY DIGESTIBLE STARCH CONTENT IN HEALTHY MALES AND FEMALES

(1)Meynier, Alexandra; (2)Péronnet, François; (3)Rabasa-Lhoret, Remi;

(4)Mignault, Diane; (5)Normand, Sylvie; (5)Sauvinet, Valérie; (6)Laville, Martine; (7)Vinay, Sophie.

(1)Mondelez France R&D; (2)PhD. Department of Kinesiology. University of Montreal. Canada.; (3)MD. PhD. Institut de Recherches Cliniques de Montreal. Canada.; (4)Institut de Recherches Cliniques de Montreal. Canada.; (5)PhD. CRNH Rhône-Alpes. Lyon. France.; (6)MD. PhD. CRNH Rhône-Alpes. Lyon. France.; (7)PhD. Nutrition Research Department. Mondelez France R&D. Saclay. France.

**Background and objectives:** High postprandial plasma glucose concentrations have been implicated in the development of chronic metabolic diseases. Cereal products with a high content in Slowly Digestible Starch (SDS) elicit lower glycemic responses than those with a low SDS content. This has been shown when ingested in a breakfast. The objective of the present study was to describe the kinetics of glucose provided by two cereal products differing by their SDS content and consumed alone in healthy males and females.

**Methods:** Fourty-one young healthy males and females volunteered to consume in a random order ~ 45g of two cereal products differing by their SDS content: co-extruded cereals (0.2% SDS – Lo-SDS) or biscuits (19% SDS – Hi-SDS). Carbohydrate in these products were intrinsically labelled with 13C and plasma glucose kinetics were measured using [6,6-2H2]glucose infusion along with plasma glucose, insulin, Non-Esterified Fatty Acides (NEFA) and glucose-dependent insulinotropic peptide (GIP) concentrations.

**Results:** When compared to the Lo-SDS co-extruded cereals the rate of appearance of exogenous glucose (RaE) was lower with the Hi-SDS biscuits in the first part of the postprandial period. This was reversed 2h following the ingestion of the product with the RaE observed with the biscuits higher than with the co-extruded cereals. The same kinetics was observed for the rate of disappearance of exogenous glucose. This resulted in lower plasma glucose levels in the first 2h of the postprandial period and higher levels in the next 3h following ingestion of the biscuits than the co-extruded cereals. Plasma insulin was also lower with the biscuits than the co-extruded cereals over the first 2h of the postprandial period.
dial period. No difference was observed between the two products for plasma NEFA and GIP concentrations.

**Conclusions:** Substituting Lo-SDS co-extruded cereals with Hi-SDS biscuits slows down the availability of glucose from the cereal product and its appearance in peripheral circulation, reduces the early peak of plasma glucose and distributes the glucose ingested over a longer period following the meal.

**Keywords:** Slowly Digestible starch, cereal products, glucose appearance rate, glycemic response, insulinemic response

**Conflict of Interest Disclosure:** A. Meynier and S. Vinoy are employees of the Nutrition Department, Mondelēz International R&D; F. Péronnet is an occasional consultant for the Nutrition Department, Mondelēz International R&D; R. Rabasa-Lhoret received an unrestricted grant from Mondelēz International R&D to conduct this work. The remaining authors declare no conflict of interest.

SIGNIFICANCE OF SUPPLYING OF INFORMATION ABOUT THE CHANGE OF POTASSIUM CONTENTS IN VEGETABLES BY COOKING DURING THE COURSE OF NUTRITIONAL GUIDANCE FOR DIALYSIS PATIENTS

(1)Toda, Yohko; (2)Sugawa-Katayama, Yohko; (3)Matsumoto, Sadahiro; (4)Kasahara, Harumi; (5)Hasegawa, Hirohito.

(1)Nutritionist. Osaka Aoyama University . Japan; (2)PhD. Osaka Aoyama University. Japan; (3)Nurse. Kasahara clinic. Japan;

(4)MD. Kasahara clinic. Japan; (5)MD. Kasahara clinic. Japan.

**Background and objectives:** During the nutritional guidance for dialysis patients, it is important to be aware of how much they know about potassium and how much they pay attention to cut down its dietary intake in each meal. In the present study, we performed a survey to investigate the patients' awareness of potassium and its dietary control. Furthermore, we determined potassium concentrations in some vegetables to answer the patients' questions such as whether vegetables in season or greener vegetables have higher contents of potassium in comparison to those out of season or less greener vegetables, respectively.

**Methods:** A questionnaire survey was conducted to investigate the patients' knowledge about potassium contents in vegetables and their practical trials to cut down dietary intake of potassium on 41 dialysis outpatients (27 males and 14 females, 65±14 years of age, and 128±123 months of dialysis treatment). In order to improve our knowledge as nutritional advisers to help the patients, we determined potassium contents in some vegetables such as cabbages in and out of season and broccoli and cauliflower as a typical pair of green and white vegetables.

**Results:** There were positive correlations between their knowledge on potassium and their endeavor to cut down their dietary potassium intake and between their lengths of dialysis treatment history and their degrees of concern about dietary intake of phosphate. Potassium determination results: There were no significant differences between the vegetables in and out of season or between

those green and white vegetables, but when they were boiled, broccoli lost potassium faster than cauliflower.

**Conclusions:** Supplying the dialysis patients with those potassium determination data may be helpful therapeutically from the view point of nutritional guidance.

**Keywords:** dialysis patients, dietary management, potassium determination

WEIGHT LOSS AND LONG TERM WEIGHT MAINTENANCE WITH A NON-DIETING APPROACH

(1)Anger, Vanesa Erica; (1)Anger, Vanesa Erica; (2)Rovira, Sergio;

(1)Giannini, Martin; (1)Katz, Mónica.

(1)MD. Centro Katz; (2)BPhEd. Centro Katz.

**Background and objectives:** Classical models of weight loss interventions achieve short-term success, but regain is common. Our objective was to evaluate the efficacy of a non-dieting approach intervention in weight loss and long term weight loss maintenance.

**Methods:** Overweight and obese adult outpatients, who consented for individual treatment, were enrolled. After completed basal evaluation (t0), they underwent to a non-dieting approach weight loss program during at least 6 months (t1). At t0 and t1 weight, height, frequency of physical activity (PA), physically active condition (10,000 steps / day), unhealthy eating patterns (UEP) and emotional eating (EE), were assessed. At least 18 months after ending interventional period (t2), patients were interviewed by phone, about weight, PA, physical active condition, UEP and EE. Weight loss (WL) was defined as a reduction > 3% of baseline weight (BW).

**Results:** Ninety-four patients completed interventional period (44.8 ± 1.5 years of age; 78.7% females, mean BMI 33.4 kg/m2). Mean weight reduction rate (WRR) was 5.9 ± 5.5% of t0 weight; 71.3% lost weight (34% between 5 and 9.9%, and 21.3% ≥10% of t0 weight). Participants significantly lost weight and reduced BMI between t0 and t1, (89.9 ± 18.5 kg vs 84.5 ± 17.7 kg, and 33.4 ± 5.5 kg/m2 vs 31.3 ± 5.4 kg/m2, respectively; p < 0.001). Difference was significant for PA and physically active condition (7.4% vs 57.4% and 16.0% vs 42.6%, respectively; p < 0.001). Forty-two patients answered the telephone interview; time elapsed was 30.6 ± 7.4 months; weight and BMI were significant lower compared to baseline (p < 0.05); WRR was 7,6 ± 8,1%; 45,2% of patients reduce more than 10% of t0 weight, and compared to baseline, there was a significant difference related to PA (16.0% vs 68.9%; p < 0.0001), physically active condition (7.4% vs 64.4%; p < 0,0001), UEP (94.7% vs 62.2%; p < 0,001), and EE (86.2% vs 71,1%; p = 0.033).

**Conclusions:** A non-dieting approach intervention can be considered a long term effective method to treat obese and overweight patients. More studies are needed to confirm this preliminary data.

**Keywords:** obesity treatment, weight loss, non dieting approach, weight loss maintenance.

**Further collaborators:** Lewitan Dalia
# LIPID METABOLISM MARKERS IN CELIAC CHILDREN

(1)Nestares Pleguezuelo, María Teresa; (2)Bonillo León, Rocio; (3)Muriel Neyra, Carlota; (4)Martin Masot, Rafael; (5)Maldonado Lozano, José; (6)Díaz Castro, Javier; (6)López Aliaga, María Inmaculada; (6)Muñoz Alférez, María José; (6)López Frías, Magdalena; (7)de Teresa Galván, Carlos.

(1)PhD. Pharmacy. Department of Physiology. University of Granada. Spain; (2)MSc. Biology. Department of Physiology and Institute of Nutrition and Food Technology "José Mataix". University of Granada. Granada. Spain; (3)MSc. Pharmacy. Department of Physiology and Institute of Nutrition and Food Technology "José Mataix". University of Granada. Granada. Spain; (4)BSc. Doctor. Pediatric Gastroenterology and Nutrition Unit. Virgen de las Nieves University Hospital, Pediatric Department, University of Granada. Granada. Spain; (5)MD. Pediatrician. Pediatric Gastroenterology and Nutrition Unit. Virgen de las Nieves University Hospital, Pediatric Department, University of Granada. Granada. Spain; (6)PhD. Pharmacy. Department of Physiology and Institute of Nutrition and Food Technology "José Mataix". University of Granada. Granada. Spain; (7)MD. Sport Medicine. Andalusian Centre of Sport Medicine. Granada. Spain.

**Background and objectives:** Celiac disease (CD) is an autoimmune disorder characterized by immunologically mediated intolerance to gluten, which is managed with lifelong gluten free diet (GFD). Several dietary surveys had suggested high intakes of saturated fat and sucrose and inadequate intakes of fiber and micronutrients (thiamin, riboflavin, niacin, folate, iron, calcium) in subjects with CD following a strict GFD (Öhlund et al., 2010). Furthermore, some studies have shown a higher rate of cardiovascular disease in patients with CD (Ludvigsson et al., 2011; Assa et al., 2017). Therefore, the objective of this study was to assess the association of CD with lipid metabolism markers, considered as risk cardiovascular factors, and GFD consumption.

**Methods:** 25 children (range 3-15 years) diagnosed as CD and consuming GFD for at least one year, were evaluated for their lipid hematological profile. The diagnosis, according to accepted criteria, and analysis were made at Pediatric Gastroenterology and Nutrition Unit, Virgen de las Nieves University Hospital, in Granada, Spain. Blood was collected from fasting patients by venipuncture into EDTA-containing vacutainer tubes. Samples were centrifuged at 1700 x g for 15 min at 4ºC to obtain plasma. Total plasma-cholesterol (Total-Col), serum high-density lipoprotein cholesterol (HDL-Col) and triglyceride (TG) concentrations were measured by enzymatic colorimetric methods using commercial kits (Spinreact, Barcelona, Spain). LDL-Col was calculated using the Friedewald equation: $LDL-C=total cholesterol-(HDL-C)-(triglycerides/5)$, mg/dL. Study was approved by the Ethics Committee of the University of Granada. The data obtained were processed with the SPSS 20.0 software.

**Results:** Blood lipid concentrations (mean value ± standard deviation) determined were: 176.83 ± 26.34 mg/dl Total-Col, 56.63 ± 12.91 mg/dl HDL-Col, 105.6 ± 26.98 mg/dl LDL-Col and

68.04 ± 17.75 mg/dl TG. These values are between de reference values (140-200 mg/dl, 40-60mg/dl, 100-130 mg/dl and 89-150 mg/dl respectively), although Total-Col and LDL-Col levels are in the limelight of cardiovascular disease.

**Conclusions:** As hyperlipidemia, particularly elevated LDL cholesterol, is an established risk factor for cardiovascular disease (Murphy et al., 2010) and total cholesterol level is an important determinant of the Framingham risk score for cardiovascular disease, our data suggest that blood lipid levels should be monitored in CD.

**Keywords:** Gluten free diet, cardiovascular risk, celiac disease

# MINIMUM EFFECTIVE DOSE OF COMMONLY CONSUMED BEANS REQUIRED TO SIGNIFICANTLY LOWER POST PRANDIAL BLOOD GLUCOSE RESPONSE

(1)Ramdath, Dan; (2)Renwick, Simone; (3)Hawke, Aileen; (4)Wolever, Thomas.

(1)PhD. Research Scientist. Guelph Research and Development Centre. Agriculture and Agri Food Canada. Canada; (2)BSc Student. Guelph Research and Development Centre. Agriculture and Agri-Food Canada. Canada.; (3)BSc. Research Technician. Guelph Research and Development Centre. Agriculture and Agri-Food Canada. Canada.; (4)MD. PhD. President. Glycemic Index Laboratory. Toronto. Canada.

**Background and objectives:** Beans elicit a low glycemic response compared to other starchy foods. However, previous studies have tested serving sizes that may not be achieved in a usual meal. This study compared the blood glucose response of beans consumed at ¼ and ½ cup with that elicited by similar amounts of common starchy foods.

**Methods:** Six commonly consumed Canadian beans (pinto, black turtle, cranberry, red kidney, navy and great northern) and starchy control foods (white rice, macaroni, instant potato and corn) were consumed by healthy volunteers in a using an open-lab, randomized cross-over trial. Foods were consumed at either ¼ cup (n=16 to 24) or ½ cup (n=12 to 18) after an overnight fast and blood glucose response was measured over a 2hr period. Incremental area under the blood glucose (iAUC), relative glycemic response and insulin (at ½ cup only) response curves were calculated and analyzed for treatments effects.

**Results:** Overall beans consumed at ¼ cup servings elicited lower glycemic responses than ¼ cup servings of corn, macaroni, potato and rice, although iAUC for individual beans were not significantly different from corn. At ¼ cup serving, mean reductions in blood glucose response elicited by the beans compared to controls were: 34±4% (vs. corn); 59±3% (vs. macaroni); 51±3% (vs. potato) and 61±3% (vs. rice) (paired t-test; all p<0.05). Similarly, at ½ cup serving mean reductions in blood glucose response elicited by beans were: 38±5% (vs. corn); 64±3% (vs. macaroni); 55±5% (vs. potato) and 68±3% (vs. rice) (paired t-test; all p<0.05).
By ANOVA all 6 beans had significantly lower iAUC than the respective starchy control, except for cranberry, which had an iAUC that was not significantly different from corn eaten at ½ cup. Insulin response curve elicited by ½ cup beans was not significantly different from potato indicating that the blood glucose lowering effect of beans is not due to hyperinsulinemia.

**Conclusions:** Beans consumed at ¼ and ½ cup reduce blood glucose response by a minimum of 20%, which is defined as a significant effect. This information can be used for regulatory approval of a health claim for pulse and blood glucose attenuation.

**Keywords:** beans, glucose, glycemic response, human, pulse

**Further collaborators:**

Funded by Agriculture and Agri-Food Canada (J.001513.001.01) and Ontario Bean Growers.

Registered at ClinicalTrials.gov as NCT02907190.

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## FOOD INTAKE AND BODY MASS INDEX OF PATIENTS WITH TYPE 2 DIABETES MELLITUS FROM AN OUTPATIENT CLINIC IN SÃO PAULO

(1)Barros Pereira Ferreira, Natália; (1)Parise Polo, Gabriela; (1)Silva Gregório, Amanda; (1)Lekevicius Consolin, Brunna; (1)Fonseca Gonçalves, Daniel; (2)Garcia Peloggia de Castro, Adriana.

(1)Nutrition Student. Centro Universitário São Camilo. Brasil;

(2)PhD. Nutritionist. Centro Universitário São Camilo. Brasil.

**Background and objectives:** The prevalence of type 2 diabetes mellitus is increasing in all populations worldwide. This increase is accompanied by the rising rates of obesity and overweight observed over the past decade. For this reason, the analysis of the body mass index (BMI) may serve as a powerful tool in the assessment of the risk factor for Diabetes. As overweight is directly related to the lifestyle and eating habits, a better understanding of food intake in patients with type 2 diabetes mellitus is essential in order to correct problems, stimulate healthy habits and foster weight loss of these population. This study objective is to classify the population using the BMI scale and correlate it to food intake.

**Methods:** This is a cross-sectional, descriptive study with primary data collection, sampling done by convenience, approved by the Ethics and Research Committee of Centro Universitário São Camilo, Brazil. A structured questionnaire to characterize food intake was developed for this research and applied to 82 patients with type 2 diabetes mellitus, both male and female, attending an outpatient clinic in São Paulo. BMI was classified according to the World Health Organization. Weight and height were self-reported. Data analyses were performed using descriptive statistic, the Quick square test with a level of significance of p<0.05.

**Results:** Regarding the interviews, the mean age was 63±10.6 years. Mean BMI was 29.6 ± 5 kg/m2 ranging from 28.5 to 30.8 kg/m2 (for a 95% of confidence interval). When BMI was classified as underweight, normal weight and overweight it was possible to find a significant difference (p=0.04) between the groups regarding their eating habits. As for individuals with overweight the most

consumed foods were: fruits, vegetables and greens (86%), pasta, breads and biscuits (82%), foods of animal origin (73%) and sweets in general (27%).

**Conclusions:** Most patients with type 2 diabetes mellitus are overweight and there are significant differences in food choices according to their BMI score. This insight may bring possibilities for dietary changes and may facilitate the translation of findings to public health recommendations.

**Keywords:** Diabetes mellitus. Body mass index. Food intake. Eating habits.

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## EFFECT OF GLUTEN FREE DIET CONSUMPTION ON THE CLINIC PROGRESS OF CHRONIC MUSCULOSKELETAL PATHOLOGY

(1)Nestares Pleguezuelo, María Teresa; (2)Montoya Lozano, Luis;

(3)López Frías, Magdalena; (4)de Teresa Galván, Carlos.

(1)PhD. Pharmacy. Department of Physiology and Institute of Nutrition and Food Technology; (2)MSc. Physiotherapist. Lorca Clinic. Granada. Spain; (3)PhD. Pharmacy. Department of Physiology and Institute of Nutrition and Food Technology "José Mataix". University of Granada. Spain; (4)MD. Sport Medicine Doctor. Andalusian Centre of Sport Medicine. Granada. Spain.

**Background and objectives:** Recently, success in the treatment of some diseases has been associated with the follow-up of a gluten-free diet, in the absence of celiac disease, although there is controversy as to whether this diet is better for subjects who do not need it. Therefore, the objective of this study was to study in subjects with chronic musculoskeletal pathology the effect of consumption of the gluten-free diet on the clinical progress of their disease.

**Methods:** We studied 47 subjects who attended a rehabilitation medical center with more than one year of musculoskeletal pathology progression. In addition all had symptoms of digestive disorders.

The patients had: rheumatoid arthritis (10), irritable bowel syndrome associated with musculoskeletal disorder (15), fibromyalgia (10), osteoarthritis (10) and rheumatic pelvic spondylitis (2).

After informed consent, they began to follow a strict gluten-free diet for 6 months, during which they were followed up weekly with a nutritional study through a 48h reminder survey.

At the beginning and end of the study, a test for the assessment of musculoskeletal signs and symptoms (EVA pain scale, muscle weakness and joint stiffness) and extra-articular muscles (fatigue, gastrointestinal discomfort and perception of their condition) were performed. Study was approved by the Ethics Committee of the University of Granada. The data obtained were processed with the SPSS 20.0 software.

**Results:** The results showed that, in general, all patients improved as gastrointestinal symptoms, pain, weakness, stiffness and tiredness decreased and they perceived a better general condition. This improvement was greater in subjects diagnosed with irritable bowel syndrome. No patient worsened with dietary treatment.
**Conclusions:** We conclude that the non-celiac gluten sensitivity may be the underlying cause of the symptoms raised by the need to conduct a controlled clinical trial for testing.

**Keywords:** Gluten free diet, musculoskeletal disease, non-celiac gluten sensitivity

**Background and objectives:** High body mass index (BMI) is the third largest modifiable risk factor for morbidity and mortality to cancer, cardiovascular disease and diabetes. The early incidence of these diseases raises costs in the health service and reduces the quality of life. To analyze the effect of BMI at the age of 25 years (USA) and 20 years (Brazil) on the early incidence of 3 major chronic noncommunicable diseases [3CND] during adult life.

**Methods:** American NHANES-IV data (2007-2014) [25 to 49 years old] and Brazilians of PNS data (2013) [20 to 49 years] about the age of incidence for 3DCNT, BMI at age 25 (USA) and BMI at age 20 (Brazil), ethnicity, schooling, physical activity, smoking time, and alcohol consumption were modeled in Cox regression to estimate the effect (harzard ratio [HR]) of BMIearly on the time of incidence of any of 3CND.

**Results:** Men with BMIearly above 25 kg/m2 had a risk of 1.78 in the USA and 1.9 in Brazil. The women presented a risk of 2.18 and 1.4, respectively. For BMIearly above 30 kg/m2 in Brazilians man the HR was 2.84 and woman was 2.1. In American man the HR was 4.2 and was 3.13 in woman. High schooling was a protective factor in Brazilian and American women, but not in American men (1.04). In both genders, belonging to the black ethnic group in the USA was a risk factor, but in Brazil non-white women presented protection. In the USA obesity anticipated in 6 years the incidence of one of the 3CND in men and 5 years for women. In Brazil, this anticipation was 10 years for men and 8 years for women, bringing the findings closer in the two countries.

**Conclusions:** BMI of early adulthood is a high and modifiable risk factor for the incidence of one of the 3CND. The effects of BMIearly are direct and indirect, multiplicative, and indicate the relevance of preventing excessive weight gain during and at the end of adolescence. Surveillance and intervention actions are advisable in this age group.

**Keywords:** BMI; Chronic diseases; Morbidity; Survival; Risk.

**Background and objectives:** Agricultural interventions may improve rural household food production and consumption, income, nutrition and health. Animal source foods, such as milk, meat, fish and poultry provide critical nutrients essential to child growth and health. Livestock ownership may also predispose humans to diseases with potential implications for nutrition and health.

This study explored the linkages between cattle ownership, malaria and anemia in children below 5 years.

**Methods:** Panel surveys were conducted in 6 rural districts of Uganda in 2012 and 2014 obtaining comprehensive household and individual data on demographics, agricultural production, dietary consumption, water and sanitation, health, education, and income producing activities. Moreover, we measured child hemoglobin levels and tested for malaria using rapid diagnostic tests. To control for potential observed and unobserved confoundedness, multivariate analyses—including linear probability model, pooled probit and correlated random effects models with and without the control function—were conducted. Coincidentally two of the four agro-ecologically similar districts in Northern Uganda had received multiple rounds of indoor residual spraying (IRS) against malaria within the study period. To able to link our analysis to IRS, we further conducted PCR analysis to compare mosquito species variability across IRS-sprayed and non-IRS districts.

**Results:** Multivariate analyses that conservatively control for confounding showed that cattle ownership was significantly associated with a higher prevalence of malaria in children under five years of age. Cattle ownership was generally associated with a 3% increase in childhood malaria (p<0.05). Malaria was in turn linked to a 28% increase in anemia (p< 0.01). In the 2 IRS districts, both childhood malaria and anemia prevalence were significantly lower (p<0.001). However, in the IRS districts, cattle ownership enhanced childhood malaria prevalence by 4-8% (p<0.01) compared to the non-IRS districts. PCR analysis showed that outdoor mosquito species that feed on livestock are predominant in IRS districts while indoor mosquito species are predominant in non-IRS districts.

**Conclusions:** IRS, which kills indoor mosquito species, may unmask residual malaria transmission by outdoor mosquito species.

<footnote>(¹)Mazzeti, Camila; (²)Cumpian-Silva, Jéssica; (³)G Carvalho, Julia;</footnote>

<footnote>(³)Giatti, Amana; (⁴)Rinaldi, Ana Elisa Madalena; (⁵)Lisboa Conde, Wolney.</footnote>

<footnote>(¹)MD. Nutricionist. School of Public Health. University of São Paulo.; (²)MD. Nutricionist. School of Public Health. University of Sao Paulo.; (³)Student of Nutrition. School of Public Health. University of Sao Paulo.; (⁴)PhD. Nutricionist. Federal University of Uberlandia.; (⁵)PhD. Nutricionist. School of Public Health. University of Sao Paulo.</footnote>

<footnote>(¹)Kabunga, Nassul; (²)Duggan, Christopher; (³)Bashaasha, Bernard;</footnote>

<footnote>(⁴)Agaba, Edgar; (⁴)Webb, Patrick; (⁵)Ghosh, Shibani; (⁶)Griffiths, Jeffrey.</footnote>

<footnote>(¹)PhD. Research Fellow. International Food Policy Research Institute. Kampala Office. Uganda.; (²)Department of Global Health and Population. Harvard T.H. Chan School of Public Health. Harvard University. USA.; (³)College of Agriculture and Environmental Sciences. Makerere University. Kampala. Uganda.; (⁴)Feed the Future Innovation Lab for Nutrition. Friedman School of Nutrition Science and Policy. Tufts University. Boston. USA;</footnote>

<footnote>(⁵)Feed the Future Innovation Lab for Nutrition. Friedman School of Nutrition Science and Policy. Tufts University. Boston. USA.; (⁶)Department of Public Health and Community Medicine. School of Medicine. Tufts University. Boston. USA.</footnote>
cies, which feed on both cattle and humans. Efforts to enhance
nutrition and health by the agricultural intervention of cattle pro-
motion may need to include livestock-oriented vector control.

**Keywords:** Cattle ownership, malaria, anemia, indoor residue spraying, anemia

**Further collaborators:**

David Hoel and William Brogdon of the CDC as well as Mi-
chael Okia of Abt Associates in Uganda provided and analyzed
mosquito data using PCR.

in intervention group. After eight weeks, supplementation of vita-
min D caused ABPM reduction on systolic 24-h (-5.1vs.-0.9 mm
Hg; P=0.025), systolic daytime (-6.3 vs.-0.3 mm Hg; P=0.004), and
diastolic daytime (-4.9vs.-0.1 mm Hg; P=0.006) and office systolic
BP (-6.3 vs. -3.4 mm Hg; P <0.001) measurements than observed
in the control group.

**Conclusions:** Vitamin D supplementation in patients who had hypovitaminosis caused a clinically significant reductions in systolic office BP and ABPM values in hypertensive patients with type 2 diabetes.

**Keywords:** hypertension, type 2 diabetes, vitamin D, hypovit-
aminosis

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SUPPLEMENTATION OF VITAMIN D IN TYPE 2 DIABETIC PATIENTS WITH HYPERTENSION DECREASES OFFICE AND 24-H AMBULATORY BLOOD PRESSURE MONITORING

(1)de Paula, Tatiana; (2)Sperb, Luiza; (3)Moreira, Juliano; (4)de Freitas, Mauren; (5)Miller, Maria Elisa; (6)da Silva, Andressa; (7)Viana, Luciana; (8)Azevedo, Mirela.

(1)PhD. Nutricionist. Federal University of Rio Grande do Sul.
Brazil; (2)Medical Student. Hospital de Clinicas de Porto Alegre.
Porto Alegre. Brazil; (3)Medical Doctor. Hospital de Clinicas de
Porto Alegre. Porto Alegre. Brazil; (4)Nutricionist. Hospital de
Clinicas de Porto Alegre. Porto Alegre. Brazil; (5)Medical Student.
Hospital de Clinicas de Porto Alegre. Brazil; (6)Nutrition Science
Student. Hospital de Clinicas de Porto Alegre. Brazil; (7)Medical
Doctor. Hospital de Clínicas de Porto Alegre. Brazil; (8)Medical
Doctor. Hospital de Clínicas de Porto Alegre. Porto Alegre. Brazil.

**Background and objectives:** Background and Objectives: Data on the potential beneficial effects of supplementation of vita-min D in hypertensive patients with type 2 diabetes mellitus (DM) and hypovitaminosis D are still scarce. The aim of study was to evaluate the effect of a single dose (100.000 IU) of vitamin D on 24-h ambulatory blood pressure monitoring (ABPM) in patients with type 2 DM, hypovitaminosis D and hypertension.

**Methods:** In a double-blind, placebo-controlled trial, 43 hy-
pertensive patients with type 2 DM and hypovitaminosis D were
randomly assigned to vitamin D supplement group (single dose
100,000 IU) or placebo group (single dose). Blood pressure (BP)
was assessed by office measurements (Omron HEM-705CP) and
24-h ABPM (Spacelabs®). Physical activity was evaluated by steps
counter (pedometer – Yamax Digi-Walker®). Clinical, nutritional,
and laboratory parameters were evaluated by a standardized pro-
tocol before and after the supplementation. Body composition was
determinate by bioimpendance In Body*. Results were expressed
as mean, median, or number of patients with the characteristic.
Changes in variables during the study were analyzed by the gener-
al linear model (GLM) for repeated measures.

**Results:** Forty-three 43 patients (age 65.4±9.2 years; 35% males; BMI 30.6±4.4 kg/m², DM duration 12.4±7.7 years; HbA1c 7.6±1.0%) were included. Mean 25(OH)D was 14.1±4.4 ng/ml. Office systolic and diastolic BP were 147.0±17.0 and 82.8±6.8 mmHg, in placebo group and 148.9±18.1 and 84.2±13.7 mmHg

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EFFECT OF A 6-MONTH PERSONALIZED NUTRITION INTERVENTION PROGRAM IN RECENTLY DIAGNOSED BREAST CANCER PATIENTS

(1)Limón-Miro, Ana Teresa; (2)Lopez-Teros, Veronica; (3)Valencia, Mauro E.; (4)Caire-Juvera, Graciela; (5)Pacheco-Moreno, Bertha Isabel; (4)Astiazarán-García, Humberto.

(1)MSc Nutritionist. Department of Nutrition. Centro de Investigacion en Alimentacion y Desarrollo A.C. (CIAD). Mexico.; (2)PhD Associate Professor. Department of Chemical and Biological Sciences, University of Sonora. Mexico.; (3)PhD Professor. Department of Chemical and Biological Sciences, University of Sonora. Mexico.; (4)PhD Professor. Department of Nutrition. Centro de Investigacion en Alimentacion y Desarrollo A.C. (CIAD). Mexico.; (5)BSc Laboratory Technician. Department of Nutrition. Centro de Investigacion en Alimentacion y Desarrollo A.C. (CIAD). Mexico.

**Background and objectives:** During antineoplastic treat-
ment, breast cancer patients' body composition can be negative-
ly affected increasing the risk of tumor recurrence and mortality.
These changes include an increase in fat mass and a decrease in
their muscle mass, known as sarcopenic obesity. The implemen-
tation of a personalized nutrition intervention for breast cancer
patients could prevent these consequences. The aim of this study
was to evaluate the effect of a 6-month personalized nutrition in-
tervention in body composition components of breast cancer pa-
tients.

**Methods:** Anthropometric data was obtained and indexes were developed. Subjects' body composition was measured using dual-energy x-ray absorptiometry and participants' total energy expenditure was estimated using an algorithm for Mexican population. When required, a caloric restriction (500-1000 kcal/d) was considered, according to each patient's nutritional status. The dietary plan followed the NIH guidelines, modifying dietary protein (1.2-1.5 g/kg/d) in order to prevent sarcopenic obesity. Socioeconomic and cultural preferences were considered to develop the personalized nutrient-specific diet. Patients were followed every 2-weeks and a different diet menu was provided by a specialized nutritionist, for 6 months.
**Results:** Nine volunteers have completed the intervention. At baseline, 70% were overweight or obese and after 6 months a significant weight loss of -2.8 kg was observed (p<0.01), -1.9 kg of fat mass (p<0.05), -3 cm hip circumference (p<0.01), and -1 cm arm circumference (p<0.01).

**Conclusions:** A 6-month nutrition intervention program based in a personalized nutrient-specific diet for breast cancer patients had a positive effect in their body composition.

**Keywords:** sarcopenic obesity, personalized diet, dietary assessment, food-based intervention

(1)Mendonça, Raquel; (2)Marçal, Adriano; (3)Gea, Alfredo; (4)Martínez-González, Miguel Ángel; (5)Bes-Rastrollo, Maira.

(1)PhD student. Nutritioner. Universidade Federal de Minas Gerais; (2)PhD. Nurse. Department of Preventive Medicine and Public Health. University of Navarra. Pamplona. Spain. Department of Maternal-Child Nursing and Public Health. School of Nursing. Universidade Federal de Minas Gerais. Brazil;

(3)PhD. Department of Preventive Medicine and Public Health. University of Navarra. Pamplona. Spain.; (4)PhD. Department of Preventive Medicine and Public Health. University of Navarra. Pamplona. Spain. Department of Nutrition. Harvard TH Chan School of Public Health. Boston. USA; (5)PhD. Department of Preventive Medicine and Public Health. University of Navarra. Pamplona. Spain.

**Background and objectives:** Polyphenol-rich diets have been associated with reduced risk of CVD. However, few prospective epidemiological studies have evaluated the relationship between the risk of CVD and total polyphenol intake and classes of polyphenols. To evaluate the association between total intake of polyphenol and classes of polyphenol and the risk of major cardiovascular events in the Seguimiento Universidad de Navarra (SUN) Project, a prospective Spanish cohort.

**Methods:** We included 17,319 Spanish university graduates who were followed-up for a mean of 10.0 years (standard deviation, 4.1 years; total person-years: 172,918). Polyphenol intake was assessed using a validated semi-quantitative 136-item food frequency questionnaire and by matching food consumption data with the Phenol-Explore database. Cox proportional hazards models were used to estimate the adjusted HR and 95%CI for incident cardiovascular events.

**Results:** Cherries, chocolates, coffee, apples, and olives were the major sources of polyphenols. A total of 130 incident cases of cardiovascular events were identified during the follow-up. Among the classes of polyphenol, flavonoids were inversely associated with cardiovascular events, with a 63% reduction in risk observed on comparing quintile fifth with quintile first (adjusted

HR: 0.37; 95%CI: 0.17-0.84; P for trend=0.01) after adjusting for potential confounders.

**Conclusions:** In this large prospective Mediterranean cohort, we observed an inverse association between the intake of flavonoids and the risk of cardiovascular events.

**Keywords:** dietary polyphenols, cardiovascular disease, SUN cohort, prospective studies.

**Further collaborators:**

R.D. Mendonça would also like to thank the Capes Foundation, Ministry of Education of Brazil, for the scholarship to continue his training at the University of Navarra, Spain. The Seguimiento Universidad de Navarra (SUN) study received funding from the Spanish Government-Instituto de Salud Carlos II and European Regional Development Fund (Grants PI10/02993, PI13/00615, PI14/01668, PI14/01798, PI14/1764, G03/140), the Navarra Regional Government (45/2011, 122/2014), and the University of Navarra.

(1)Bamia, Christina; (2)Turati, Federica; (2)Guercio, Valentina; (3)Guha, Neela; (4)Loomis, Dana; (5)Tavani, Alessandra.

(1)PhD. Associate Professor of Epidemiology and Medical Statistics. Department of Hygiene, Epidemiology and Medical Statistics. National and Kapodistrian University of Athens. Medical School. Athens. Greece; (2)PhD. Department of Clinical Sciences and Community Health. University of Milan. Italy;

(3)PhD. Scientist. Section of IARC Monographs. International Agency for Research on Cancer. Lyon. France; (4)PhD. Deputy Section Head. Section of IARC Monographs. International Agency for Research on Cancer. Lyon. France; (5)IRCCS - "Mario Negri" Institute for Pharmacological Research. Milan. Italy.

**Background and objectives:** Cancers of the breast and ovary are important among women worldwide with breast cancer being the most commonly diagnosed and the leading cause of cancer death. Coffee is one of the most frequently consumed beverages worldwide; its association with these gynecological cancers has been investigated since the 1980s but early results were inconsistent. In 2016 a Working Group (WG) for an update of the 1991 IARC Monographs classification of coffee as a possible carcinogen, reported evidence suggesting lack of carcinogenicity and inadequate evidence of carcinogenicity for coffee intake and female breast and ovarian cancer, respectively. We undertook a meta-analysis of all studies included in the WG report, to provide the most updated summary of the collective evidence regarding the association of coffee intake with breast and ovarian cancer risk.

**Methods:** Case-control and cohort studies were identified by searching the PubMed database as of June 2016, and by reviewing the reference lists of retrieved articles. Random effect models were used to provide summary estimates of individual associations.
**Results:** 40 and 32 studies including, respectively, 76,748 women with breast and 11,411 women with ovarian cancer were considered in the meta-analysis. The combined RR (95% CI) for the study-specific highest vs. lowest coffee consumption was 0.97 (0.93–1.00, I2 5.5%) for breast and 1.03 (0.93–1.14, I2 31.9%) for ovarian cancer. These associations did not differ by study design, geographical location or menopausal status (both cancer sites), ER/PR status and body mass index (breast cancer) or histological type (ovarian cancer). For decaffeinated coffee the respective RR<sub>s</sub> were 1.00 (0.93–1.08) and 0.83 (0.71–0.96) for breast (13 studies) and ovarian (9 studies) cancer. Heterogeneity was medium-to-low but higher among ovarian as compared to breast cancer studies. The association of coffee intake with ovarian cancer risk was higher among studies published before 1990, (RR 1.38 95%CI (1.11–1.71)) compared to after 1990 (RR 0.97 95%CI (0.87–1.07)) (p-heterogeneity 0.004).

**Conclusions:** Findings from this updated meta-analysis suggest a weak inverse association with breast cancer and no association with ovarian cancer risk. Given the high consumption of coffee worldwide these results may be of high public health importance.

**Keywords:** breast cancer; ovarian cancer; coffee; meta-analysis

**Further collaborators:** The IARC Monograph Working Group on the update of the 1991 International Agency for Research on Cancer (IARC) Monographs for the classification of coffee as a carcinogen (Lancet Oncology, 2016)

144/1250

EFFECT OF PROBIOTIC BIFIDOBACTERIUM LACTIS BL-04 ON HOST RESPONSES AND MICROBIOTA IN EXPERIMENTAL RHINOVIRUS INFECTION IN HEALTHY ADULTS

(1) Mukherjea, Ratna; (2) Turner, Ronald; (3) Latvala, Sinikka; (3) Lyra, Anna; (4) Hibberd, Ashley; (3) Lehtoranta, Liisa; (4) Stahl, Buffy; (5) Lahtinen, Sampo; (3) Lehtinen, Markus.

(1) Global Nutrition Innovation. DuPont Nutrition & Health; (2) MD. University of Virginia School of Medicine. US; (3) PhD. Global Health & Nutrition Science, Danisco Sweeteners Oy. Finland; (4) Msc. Genomics and Microbiome Science, Danisco Madison Center. US; (5) PhD. 4Pharma Ltd. ElectroCity. Finland.

**Background and objectives:** Ingestion of probiotics may be beneficial for reducing the risk of upper respiratory tract illnesses. Bifidobacterium animalis subspecies lactis BL-04 (BL-04) significantly reduced the risk of respiratory illness episodes by 27% over 5-month winter season in healthy active adults. The mechanisms of this effect is unknown. The purpose of this study was to determine the effect of probiotic BL-04 administration on host responses to experimental rhinovirus (RV39) challenge and to assess changes in gut and nasal microbiota due to treatment or viral challenge.

**Methods:** 152 seronegative volunteers treated for 28 days, 73 probiotic and 79 placebo, were challenged with RV39. Administration of study treatment continued for five days during collection of specimens for assessment of host response, infection, and symptoms. Fecal samples were collected at baseline and analysed

by qPCR for BL-04 and by sequencing of 16S rRNA gene for microbiota composition.

**Results:** Analysis of nasal lavage IL-8 concentration revealed significantly higher concentrations on Day 0 prior to virus challenge in the probiotic group. In contrast, the IL-8 response to RV39 challenge was significantly reduced in the probiotic group (geometric mean ratio for change, probiotic : placebo=0.65, p=0.03). The administration of probiotic was associated with reduced nasal lavage virus titer and the proportion of subjects shedding virus in nasal secretions (76% probiotic group, 91% placebo group, p=0.04). There was no effect of probiotic treatment on symptom severity, lower respiratory tract inflammation (eNO) or serum antibody responses to the virus. On Day 0, the supplemented BL-04 was detected in 69% of probiotic group participants. The overall composition and diversity of intestinal microbiota remained stable through treatment and viral challenge. **Results:** **Conclusions:** This study demonstrates that ingestion of BL-04 has effects on the baseline state of innate immunity in the nasal mucosa and on the subsequent response of the host to rhinovirus challenge. The gut microbiota appears resilient to both probiotic treatment and viral challenge. These findings provide first evidence in humans on the potential mechanisms behind reduced upper respiratory illness risk in healthy active adults by the probiotic BL-04.

**Keywords:** probiotic, BL-04, respiratory tract, rhinovirus, immunity

**Conflict of Interest Disclosure:** Work of RBT, TK, and SM was funded by and SL, RM, AL, AH, LL, BS, SJL, and MJL were employed at the time of the study by DuPont Nutrition and Health.

**Further collaborators:** Tommi Kauko, Sofia Männikkö, Nicolas Yeung, and Sofia Forssten
4Pharma Ltd. ElectroCity. Finland
Global Health & Nutrition Science, Danisco Sweeteners Oy. Finland
CHRONIC LEUCINE SUPPLEMENTATION REDUCED HYPERCHOLESTEROLEMIA AND HYPERTRIGLYCERIDEMIA, AND REVERSED INSULIN RESISTANCE IN DIABETIC RATS

**Background and objectives:** Diabetes is characterized by hyperglycemia that can be associated or not with insulin resistance. Although the underlying mechanisms are not fully understood, leucine supplementation has been demonstrated to improve lipid and glucose metabolism, to reduce adipose tissue inflammation and to preserve lean body mass. We investigated the effects of leucine supplementation on lipid profile and glycemic control in diabetic rats.

**Methods:** Five days after birth, twenty four male Wistar rats received streptozotocin (120 mg/kg of body weight), and were randomly assigned into two groups at weaning: D – diabetic rats receiving a standard chow; DL – diabetic rats fed a diet supplemented with 5% leucine for nine weeks. A control group (C) consisted of twelve non-diabetics animals that received standard chow. Fasting glucose, insulin, triglycerides (TG), total cholesterol and HDL-cholesterol levels were analyzed in serum and homeostasis model of assessment-insulin resistance (HOMAIR) was calculated.

**Results:** Diabetic rats presented higher serum glucose, triglycerides and total cholesterol levels, and lower serum insulin when compared to control group (p< 0.05). Leucine supplementation significantly reduced serum glucose (131.80 ± 11.66 mg/dl versus 174.90 ± 12.55 mg/dl), total cholesterol (63.50 ± 3.40 mg/dl versus 74.67 ± 3.70 mg/dl), and TG (59.25 ± 3.39 mg/dl versus 86.90 ± 10.16 mg/dl) levels in diabetic rats when compared to D group. The HOMAIR was significantly higher in D group when compared to C group (14.07 ± 1.32, and 8.31 ± 1.55, respectively), indicating insulin resistance in diabetic animals. The HOMAIR was significantly lower in DL compared with D (8.66 ± 1.83 and 14.07 ± 1.32, respectively), but no difference was observed in comparison with C group.

**Conclusions:** We conclude that chronic leucine supplementation reversed insulin resistance and reduced hyperglycemia, hy-

pertriglyceridemia, and hypercholesterolemia without improving hypoinsulinemia in diabetic rats.

**Keywords:** diabetes. insulin resistance. leucine. supplementation.

FASTING AND CALORIC RESTRICTION IN ELDERLY WITH CARDIOVASCULAR DISEASE: A REVIEW

**Background and objectives:** The main chronic diseases for the geriatric population are diabetes mellitus and cardiovascular disease, impacting quality of life and increasing the use of health resources. It has been shown that the main intervention for cardiovascular disease is a change of lifestyle, focused on weight control. The caloric restriction (CR) method has shown effectiveness in the treatment and reduction of costs of diabetes mellitus, obesity and hypertension. Also, it has been found that intermittent fasting has an important positive effect on weight, decreasing cardiovascular risk as a result. Although there are some cases and clinical trials that show the benefits obtained from fasting and CR, it has not been studied enough in elderly population. The objective of this review is to evaluate the clinical evidence of fasting and its benefits in elderly patients with cardiovascular disease.

**Methods:** We performed research using the PubMed database up to March 2017. We included clinical trials, metanalysis and systematic reviews. Search terms comprising Medical Subject Headings were as follows: "fasting", "caloric restriction", "cardiovascular disease", and "elderly". The included criteria

were: studies of intervention in patients with cardiovascular disease (hypertension, dyslipidemia, coronary disease, and heart failure) with fasting or CR, where their outcomes were clinical parameters (blood pressure, lipid profile, weight, body mass index and fat mass). Adult men and women from 60 to 80 years and articles in English language were included in the research.

**Results:** We identified 27 potentially relevant studies. We excluded 10 studies for the following reasons: did not report clinical outcomes or patients of younger age. Finally, we included 11 studies, 4 systematic reviews, 2 metanalysis and 5 clinical trials, which will be evaluated for their full text. The preliminary results show that fasting and CR decreases cardiovascular risk in geriatric population, which is positively influenced by weight and serum lipid levels control.

**Conclusions:** Fasting as an intervention may have a benefit in geriatric patients with cardiovascular disease.

**Keywords:** fasting, caloric restriction, elderly, cardiovascular disease.

<footnote>(1)Lima, Vanessa Batista; (2)Martins, Carlos Eduardo Carvalho;</footnote>

<footnote>(3)Ribeiro, Henrique Quintas Teixeira; (4)Coqueiro, Audrey Yule;</footnote>

<footnote>(5)Bonvini, Andrea; (5)Raizel, Raquel; (5)Hypólito, Thais; (6)Tirapegui, Julio.</footnote>

<footnote>(1)PhD Nutricionist. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil.; (2)MSc. Nutricionist. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil.; (3)PhD. Physical Educator. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil.; (4)PhD. Student. Nutricionist. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil.; (5)PhD Student. Nutricionist. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil.; (6)Associate Professor. Biochemist. Department of Food and Experimental Nutrition. Faculty of Pharmaceutical Sciences. University of São Paulo. Brazil.</footnote>

<footnote>(1)Tello Casillas, Jessica Karen; (2)Lopez-Teros, Miriam; (3)Ochoa Rivera, Teresa; (4)Escalante-Izeta, Ericka; (5)Gamboa-Melendez, Marco Alberto.</footnote>

<footnote>(1)BSc. MD. Health Department. Iberoamerican University. Mexico.; (2)PhD. MD. Health Department. Iberoamerican University. Mexico; (3)PhD. Nutritionist. Health Department. Iberoamerican University. Mexico; (4)PhD. Physcologist. Health Department. Iberoamerican University. Mexico; (5)PhD. QFB. Health Department. Iberoamerican University. Mexico.</footnote>
# THE DIET ADHERENCE IN CARDIOVASCULAR RISK FACTORS PATIENTS IN THE NORTH OF IRAN BASED ON THE MEDITERRANEAN DIET ADHERENCE

(1)Mahdavi-Roshan, Marjan; (2)Salari, Arsalan; (3)Gholipour, Mahboobeh; (3)Naghshbandi, Moona.

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

**Background and objectives:** Before any nutritional intervention, it is necessary to have the prospect of eating habits of people with cardiovascular risk factors. In this study we assessed the adherence of healthy diet and related factors.

**Methods:** This study was conducted on 550 men and women with cardiovascular risk factors that referred to Heshmat hospital in Rasht. Information was collected by interview and reading medical history and measuring anthropometric indexes. The Mediterranean Diet Adherence Screener was used for assessing dietary adherence, this screener was modified according to religious beliefs and culture of Iran.

**Results:** The mean age of participants was 58±0.38years. The mean of body mass index was 27±0.01kg/m2 and the mean of waist circumference was 98±0.2cm. The mean of dietary adherence was 5.76±0.07. Forty three percent of participants had low adherence and just 2% had suitable adherence. The mean of dietary adherence in men was significantly higher that women (p=0.07). There was no significant association between smoking and body mass index and dietary adherence. Participants in rural area and high educational participants insignificantly had an unsuitable dietary adherence

**Conclusions:** Education to different group about dietary intake correction and using a Mediterranean dietary pattern that is similar to dietary intake in the north of Iran, for controlling cardiovascular disease is necessary.

**Keywords:** Dietary adherence, Mediterranean dietary pattern, cardiovascular disease.

# ASSOCIATION BETWEEN DEPRESSIVE SYMPTOMS AND MEDITERIAN DIETARY ADHERENCE IN ADULTS WITH CARDIOVASCULAR DISEASE RISK FACTORS IN THE NORTH OF IRAN

(1)Salari, Arsalan; (2)Ashouri, Asieh; (3)Mahdavi-Roshan, Marjan.

(1)3- Department of Cardiology, School of Medicine, Heshmat Hospital, Guilan Interventional Cardiovascular Research Center, Rasht, Iran.; (2)Biostatistics, School of Health, Guilan University of Medical Sciences; Rasht-Iran.; (3)phD. Nutritionist.School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

**Background and objectives:** Depression is prevalent in cardiovascular patients and may have important effects on patients' adherence to healthy diet that are necessary for their health. We examined the association between depression and dietary adherence in cardiovascular disease risk factors adults in the north of Iran.

**Methods:** This cross-sectional study was performed on 344 participants who were admitted to a tertiary hospital in Rasht. Demographic characteristics, blood pressure, anthropometrics indexes and blood factors were measured. For assessing dietary adherence, we used the 14-point Mediterranean Diet Adherence Screener (MEDAS) and for depression we used Beck Depression Inventory (BDI). All statistical tests were two-sided and P<.1 and P<.05 was used to indicate statistical significance

**Results:** Depressive symptoms was observed in 43% patients. Prevalence of patients with low, moderate and good diet adherence was 44%, 54% and 2%, respectively. In the univariate analysis, there was a relation between depression and diet adherence. Female sex, diabetes, higher waist circumference, higher HbA1C and lower level of hematocrit was associated with lower diet adherence. After controlling for confounders, there was no relation between depression and diet adherence (P=.249). So, odds ratio of the low diet adherence in patients with depression compared with patients without depression was 1.311 (95%CI: .827-2.079).

**Conclusions:** Study showed that depressive symptoms and dietary non-adherence were prevalent in our participants. Depressive symptoms were an independent predictor of dietary non-adherence. Studies are needed to increase our finding of the association between depressive symptoms and both perceived and objectively determined dietary adherence.

**Keywords:** Depressive symptoms, Dietary adherence, Cardiovascular risk factors, North of Iran
# THE INFLAMMATORY POTENTIAL OF DIET IS ASSOCIATED WITH BREAST CANCER RISK IN DIFFERENT CONTEXTS OF URBANIZATION: A MULTILEVEL ANALYSIS

(1)Niclis, Camila; (2)Tumas, Natalia; (3)Shivappa, Nitin; (3)Hebert, James R.; (4)Aballay, Laura; (5)Becaria Coquet, Julia; (4)Reartes, Gabriela; (4)Díaz, María del Pilar.

(1)PhD. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba and Consejo Nacional de Investigaciones Científicas y Técnicas. Argentina.; (2)PhD. Centro de Investigación y Estudios sobre Cultura y Sociedad. Universidad Nacional de Córdoba and Consejo Nacional de Investigaciones Científicas y Técnicas. Argentina.; (3)PhD. Arnold School of Public Health. University of South Carolina. USA.; (4)PhD. Escuela de Nutrición. Universidad Nacional de Córdoba. Argentina.; (5)BSc. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba and Consejo Nacional de Investigaciones Científicas y Técnicas. Argentina.

**Background and objectives:** Habitual dietary choices may influence chronic inflammation and several non-communicable diseases. The dietary inflammatory index (DII) was developed to assess the inflammatory potential of diet of diverse populations. The aim of the present study was to evaluate the association between the DII and breast cancer risk in Córdoba, Argentina.

**Methods:** A case-control study (317 women with BC and 526 controls) was conducted in Córdoba (Argentina) throughout 2008 to 2015. Dietary inflammatory index scores were computed based on dietary intake assessed by a validated food frequency questionnaire. Multi-level logistic regression models were fit to estimate the association between dietary inflammatory index scores and breast cancer. Age, Body Mass Index, age at menarche, number of children, socio-economic status and family history of BC were included as covariates at first level and level of urbanization (Capital city, cities with >30,000 inhabitants [except Capital city], and towns/rural populations with ≤30,000 inhabitants) as the second level variable.

**Results:** Increasing DII score (as continuous variable) showed significant positive associations with BC risk (OR 1.15; 95%CI 1.11 to 1.19). When the DII was used as a categorical variable, women at the third tertile of DII showed a 58% higher risk of BC (1.58; 95%CI 1.42 to 1.75) compared to women at the first tertile. A median OR around 2 indicated that for persons with the same individual-level covariates but belonging to more urbanized contexts, the risk of breast cancer increases, in median, 2 times.

**Conclusions:** Higher DII scores, were positively associated with breast cancer occurrence, suggesting that increasing intake of more anti-inflammatory dietary components, such as plant-based foods rich in fiber and phytochemicals, and reducing intake of pro-inflammatory factors, such as processed foods, or food rich in refined carbohydrates, saturated or trans fatty acids, may be a strategy for reducing BC risk in different contexts (or degree) of urbanization.

**Keywords:** dietary inflammatory index, breast cancer, case-control, urbanization context, Argentina.

**Conflict of Interest Disclosure:** On behalf of all authors, the corresponding author states that there is no conflict of interest. Disclosure: Dr. Hébert owns controlling interest in Connecting Health Innovations LLC (CHI), a company planning to license the right to his invention of the dietary inflammatory index (DII) from the University of South Carolina in order to develop computer and smart phone applications for patient counseling and dietary intervention in clinical settings. Dr. Nitin Shivappa is an employee of CHI.

# GLUCOSE, INSULIN AND METABOLIC RESPONSE TO SOY AND WHEY PROTEIN AMONG NORMAL HEALTHY WEIGHT INDIANS

(1)Kurpad, Anura; (2)Sambashivaiah, Sucharita; (3)Cope, Mark; (4)Selvam, Sumithra; (4)Thomas, Tinku; (3)Mukherjea, Ratna; (5)Kuriyan Raj, Rebecca.

(1)MD. PhD. Physiology & Nutrition. St John's Medical College;

(2)MD. PhD. St John Research Institute; (3)PhD. Global Nutrition Innovation. DuPont Nutrition & Health; (4)PhD. St John Research Institute; (5)Associate Professor. India.

**Background and objectives:** Incidence of metabolic syndrome and type2 diabetes in developing countries is increasing. Intervention strategies including increased physical activity and healthier dietary pattern are needed to improve health status. While high quality dietary protein intake has been linked to the growth and development of lean tissue; it could also be insulinogenic. Acute effect of consumption of different sources and amounts of protein, on glucose homeostasis, in South-Asian Indians, is unknown. This population group has a greater risk of developing diabetes, and a habitually low intake of high quality protein.

**Methods:** Study investigated effect protein type (soy vs. whey) and dose (15% vs. 30% Energy) on glucose homeostasis and energy metabolism, among healthy normal-weight Indians. The study tested Healthy adult males (20-35 years) (n=15) received four test-meals in random order. Energy expenditure (EE) and substrate oxidation (RQ) were measured every 30 minutes for 300 minutes post-meal. Satiety was estimated using visual analogue scale (VAS) at 0, 10, 40 min, and every half hour thereafter. Blood was collected at basal (-10,-5 min), and post-meal (15, 30, 45, 60, 90, 120,180, 240,300 min) and incremental area under the curve (AUC) was measured for plasma glucose and insulin.

**Results:** There were no significant differences in mean weight and BMI between four intervention arms. EE, VCO2, RQ, VAS and glucose did not differ with protein source or dose. AUC for plasma insulin was significantly higher for whey compared to soy at 30% dose (p<0.01). There was no difference in the insulinogenic response between whey and soy at 15% dose (p=0.07). Within a specific protein, only whey demonstrated a higher insulin response with a higher dose (p<0.01).
**Conclusions:** At lower doses, whey and soy do not elicit differ-
ent insulinogenic responses. At higher doses, whey has greater in-
sulinogenic response compared to soy, making soy a better source
for those at greater risk for developing diabetes. Soy, as a source of
high quality protein that is low in fat, saturated fat and cholesterol,
makes it a good protein source to improve dietary patterns that
could impact the development of type2 diabetes and metabolic
syndrome.

**Keywords:** soy, whey, protein, glucose, insulin

**Conflict of Interest Disclosure:** Work was funded by DuPont Nutrition & Health and RM and MC were employed at the time of the study by DuPont Nutrition and Health.

sumes them, with gelatin (54%) and soft drinks (52%) being the
most consumed products. Most reported consuming them due
to the diagnosis of the disease (63,4%). Nutritionists (50%) and
physicians (45,5%) were the professionals who oriented the use
of sweeteners and dietetic products and almost 75% followed the
guidance regarding these use.

**Conclusions:** The majority of individuals with DM2 consumes sweeteners and dietetic products because the diagnosis of the disease. These choices are mainly guided by a health professional, being extremely important to avoid inadequacies in food choices and to improve the quality of life of these patients.

**Keywords:** Diabetes mellitus. Sweeteners. Dietetic products. Nutritional education.

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PROFILE CONSUMPTION OF SWEETENERS AND DIETETIC PRODUCTS BY INDIVIDUALS WITH TYPE 2 DIABETES MELLITUS FROM AN OUTPATIENT CLINIC IN THE CITY OF SÃO PAULO (BRAZIL)

(1)Parise Polo, Gabriela; (2)Barros Pereira Ferreira, Natália; (3)Lekevicius Consolin, Brunna; (2)Fonseca Gonçalves, Daniel; (2)Silva Gregório, Amanda; (3)Garcia Peloggia de Castro, Adriana.

(1)Nutrition Student. Centro Universitário São Camilo. Brazil;

(2)Nutrition Student. Centro Universitário São Camilo. Brazil.;

(3)PhD. Nutritionist. Centro Universitário São Camilo. Brazil.

**Background and objectives:** The consumption of sweeteners and dietetic products is increasing in the last few years. These products play an important role in the diet of patients with diabetes mellitus since they can provide the taste of sweetness, without adding calories. Besides, they can also improve social life, psychological acceptance of the disease and the possibility of increasing the variety of foods. Therefore, the purpose of this work is to analyze the consumption of sweeteners and dietetic products among patients with type 2 diabetes (DM2).

**Methods:** This is a cross-sectional, descriptive study with primary data collection, sampling done by convenience, approved by the Ethics and Research Committee of Centro Universitário São Camilo, Brazil. A structured questionnaire to characterize alternative sweeteners and dietetic products intake was developed for this research and applied to 82 individuals with DM2, both male and female, attending an outpatient clinic in São Paulo. Data analyses were performed using descriptive statistic, the Qui-square test with a level of significance of p<0.05.

**Results:** The majority of the participants consumes sweeteners (79%), usually chooses products according to its flavor (33,8%) and has the diagnosis of DM as the main determinant factor for its use (87,7%). Participants with a lower level of education presented a higher consumption of sweeteners, but this result was not statistically significant (p= 0,12). The higher consumption of sweeteners was found in the lowest-income group, however this result was also not statistically significant (p=0,78). Regarding the consumption of dietetic products, half of the individuals con-

144/1323

ASSOCIATION BETWEEN THE PERCENTAGE OF
FAT MASS AND ANTHROPOMETRIC AND META-
BOLIC INDICATORS: IN THE SEARCH FOR CLIN-
CAL INDICATORS FOR CHILDHOOD OBESITY

(1)Sepúlveda Flores, Cecilia; (2)Cigarroa, Igor; (3)Villegas, Sandra;

(4)Soto, Claudio; (5)Lasserre, Nicole; (6)Sanhueza, Karen; (7)Escobar, Karina.

(1)MD. Nutritionist. Nutrition and Dietetics Department. School of Health. University Santo Tomás. Chile; (2)PhD.Physiotherapist. Physioterapy Department. School of Health. University Santo Tomás. Chile; (3)PhD.Chemist. Basic Science Department. School of Health. University Santo Tomás. Chile; (4)MSc. Physiotherapist. Physioterapy Department. School of Health. University Santo Tomás. Chile; (5)MSc. Nutritionist. Nutrition and Dietetics Department. School of Health. University Santo Tomás. Chile;

(6)MD. Nutritionist. Nutrition and Dietetics Department. School of Health. University Santo Tomás. Chile; (7)Nutritionist. Nutrition and Dietetics Department. School of Health. University Santo Tomás. Chile.

**Background and objectives:** In childrens, the general and visceral obesity are associated with an increased cardiometabolic risk. The measure of fat mass is the most objective indicator to diagnose obesity, however its high cost and low availability make it necessary to have new clinical indicators for its estimation. Insulin resistance is a co-morbidity present in most obese children but its measurement is expensive. The Single Point Insulin Sensitivity Estimator (SPISE) is a tool easy to use that includes circulating lipids and the BMI to estimate insulin resistance. The aim of this study was to determine the relationship between the percentage of fat mass with anthropometric and metabolic indicators to determine which variable can best predict the percentage of fat mass.

**Methods:** Correlation-causal design study in 40 children (12 females, 28 males), aged from de 11 to 14 years overweight and obese from an educational center in the province of Biobío.

Anthropometric measurements (weight, height, waist circum-
ference, body fat percentage, body mass index (BMI) and Waist
to height ratio (WHtR), were performed, fasting blood glucose,
insulin and lipid profile levels (TC, LDL, HDL and TG), were measured. Insulin sensitivity was calculated using SPICE and Homeostasis Model Assessment – insulin resistance (HOMA-IR). The association between variables were assessed by Pearson correlation and linear regression.

**Results:** The means of fat mass was 36.1±5.9, from BMI 27.5±3.6, WHtR 0.6±0.1, TC 153.1±28.2, HDL cholesterol 44.7±10.6, LDL cholesterol 86.2±21.4, TG 108.1±61.1, fasting blood glucose 83.3±6.8, insulin levels 16.9±7.3, HOMA-IR 3.6±1.7 and 5.9±1.2 from SPISE. The percentage of fat mass presented a high correlation with WHtR (R=0.707;p=0.000) and a significant correlation with BMI (R=0.671;p=0.000), insulin levels (R=.409;p=0.009) and SPISE index(R=-0.558;p=0.000). The other variables did not present a significant correlation. In the multiple linear regression analysis, the model that included only the WHtR was the better predictor for changes in fat mass (50%).

**Conclusions:** The SPICE Index present a higher correlation with fat mass than insulin levels while WHtR present a high association with fat mass achieving a high percentage in its prediction, that suggest his possible application as a clinical predictor of obesity and cardiometabolic risk in Chilean childrens.

**Keywords:** Waist to height ratio (WHtR), childhood obesity, body fat, body mass index (BMI), The Single Point Insulin Sensitivity Estimator (SPISE)

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BOCAIUVA FLOUR (ACROCOMIA TOTAI MART.) REDUCES BODY FAT AND HEPATIC STEATOSIS OF RATS SUBMITTED TO A HYPERCALORIC DIET

**Background and objectives:** The prevalence of people suffering from obesity and overweight has increased worldwide. In 2014, there were approximately 1.9 billion overweight adults, 600 million of which were obese. Thus, the purpose of this study is to evaluate the effects of bocaiuva flour on body fat and hepatic steatosis of rats submitted to a hypercaloric diet.

**Methods:** A total of 38 male Wistar rats were distributed in a control group on a hypercaloric diet: HC (n=9), and treatment groups on a hypercaloric diet supplemented with 5%, 10% and 15% bocaiuva flour (BF): HC5BF (n=10), HC10BF (n=9) and HC15BF (n=10), respectively. After the animals were euthanized, fat depots were obtained and weighed: retropreperitoneal, epididymal and visceral (omental, mesenteric and perirenal). To evaluate the density of steatosis in the liver, point-counting method was used in histological slides stained with H&E (haematoxylin and eosin). The data was interpreted using analysis of variance, followed by Tukey post hoc analysis, considering statistical significance p<0.05.

**Results:** Regarding body fat, there was a difference between groups (p=0.01), being: HC (12.99g), HC5BF (10.96g), HC10BF (9.10g) and HC15BF (8.36g). There was a significant difference between groups HC, HC5BF, HC10BF and HC15BF analyzing the following fat depots: epididymal 4.36g, 3.51g, 2.83g and 2.65g (p=0.01); mesenteric 3.54g, 3.19g, 2.64g and 2.58g (p=0.02) and retroperitoneal 3.45g, 2.94g, 2.45g and 2.04g (p=0.04), respectively. The following values were obtained from the histological analysis of the hepatic steatosis density: HC (17.32±3.63), HC5BF (13.72±2.42), HC10BF (7.08±2.47) and HC15BF (6.96±3.33). The animals of the HC10BF and HC15BF treatment groups were statistically different from the control group, since these animals showed a reduction of 59.12% and 59.82% of hepatic fat deposition when compared to the HC group.

**Conclusions:** The group that received the supplementation of 15% of bocaiuva flour showed a 35% reduction in body fat and preserved hepatic tissue when compared to the control group. In conclusion, these results are extremely important, since there is no other scientific evidence associating the consumption of bocaiuva flour for controlling damages caused by obesity.

**Keywords:** Obesity; Cerrado; Fruit.

**Further collaborators:**

Bruna Larissa Spontoni Do Espírito Santo.

144/1336

EFFECT OF MORINGA OLEIFERA LEAF POWDER ON BIOCHEMICAL AND HAEMATOLOGICAL PARAMETERS OF WEANING WISTAR ALBINO RATS

**Background and objectives:** The world is under the heavy yoke of malnutrition and in the developing world, the statistics are grim. The nutritional properties of Moringa are now so well known that there seems to be little doubt of its substantial health benefit. Nonetheless, the outcomes of well controlled and well documented clinical studies are still clearly of great value. Thus, the study was designed to evaluate the effect of Moringa oleifera

<footnote>(1)Marques Romeiro Santos, Mirelly; (1)Caroline Da Silva, Érica;</footnote>

<footnote>(2)Aparecida Vinci Carlos, Suellen; (2)Monteiro Santee, Cynthia;</footnote>

<footnote>(3)Ferreira Da Silva, Nayara; (4)Candeloro Portugal, Luciane; (5)dos Santos Freitas, Deisy; (6)Braz Alcantara, Glaucia; (7)Aiko Hiane, Priscila; (8)Freitas dos Santos, Elisvânia.</footnote>

<footnote>(1)Doctorate Student in the Health and Development in the Brazilian Midwestern Region Post Graduate Program. Nutritionist. Federal University of Mato Grosso do Sul. Brazil.; (2)Nutritional Science Undergraduate Student. Federal University of Mato Grosso do Sul. Brazil.; (3)Pharmacy Undergraduate Student. Federal University of Mato Grosso do Sul. Brazil.; (4)PhD. Professor of Histology. Federal University of Mato Grosso do Sul. Brazil.; (5)Chemist. Federal University of Mato Grosso do Sul. Brazil.; (6)PhD. Professor of Chemistry. Federal University of Mato Grosso do Sul. Brazil.; (7)PhD. Professor of Pharmacy. Federal University of Mato Grosso do Sul. Brazil.; (8)PhD. Professor of Nutritional Science. Federal University of Mato Grosso do Sul. Brazil.</footnote>

<footnote>(1)Yetunde, Alozie; (2)Bassey, Emma.</footnote>

<footnote>(1)PhD. Nutritionist. Department of Human Ecology.Nutrition and Dietetics Unit. University of Uyo. Nigeria.; (2)MSc. Nutritionist. Department of Human Ecology.Nutrition and Dietetics. University of Uyo. Nigeria.</footnote>
leaf powder on biochemical and hematological parameters of weaning wistar albino rats as a means of food diversification in terms of protein source.

**Methods:** Proximate and antinutrient components of the leaf were determined. Twenty four rats of three weeks old were obtained from the Animal House of the College of Health Sciences, University of Uyo and divided into four groups of six rats each with average weight of 52.58kg. The rats were assigned dietary treatment categorized as Moringa Diet (MD), Protein Free Diet (PF), Synthetic Diet (SD) and Normal Diet (ND) for 21 days and the effect of these diets were determined.

**Results:** Proximate composition of the leaf revealed protein content as 29.6%, and dietary fiber 22.6%. The presence of antinutrient showed: HCN 0.06mg/100g, Oxalate 2.85 mg/100g, Phytate 1.39 mg/100g and Tannin 0.13 mg/100g were at insignificant levels. Food intake rate of rats fed with synthetic and normal diet were significantly higher (P<0.05) than that of the rats fed moringa diet. Effect of the diet on body weight showed that rats on SD (126), ND (117.67), and MD (92.66) gained significantly (P<0.05) higher weight than those on PF 23.33). Haematological parameters showed no significant difference (P>0.05) in WBC, RBC, HGB, PCV, MCV, MCH, and MCHC of moringa diet with synthetic diet. Moreover, moringa diet was significantly (P<0.05) higher than synthetic in platelet value. However, these parameters were all significant (P<0.05) against the PF. **Results:** **Conclusions:** Moringa leaf powder is of high biological value and could serve as a nutritional complement against protein deficiency.

**Keywords:** Moringa, Proximate, Anti nutrient, Protein deficiency

**Conflict of Interest Disclosure:** We declare that this work has not been published either in part or whole anywhere else and that this work was solely financed by the authors without any financial support from any organisation or the University.

144/1341

## OBESITY PREVALENCE IN A MIGRANT POPULATION LIVING IN CASABLANCA, MOROCCO

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

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

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

In this study, we assess the influence of ethnicity and migration, through urbanity degree, on obesity prevalence variation, between the ethnic group of Soussi (native of the rural zone of Souss region) and Casablanca in Morocco.

**Methods:** We used a multi-stratified sampling including 615 subjects (305 subjects recruited in metropolitan Casablanca and 310 from the Souss region). The sampling was based on ethnicity, sex and age. We measured anthropometric parameters, using (i) body mass index (BMI), based on cut-off points recommended by the WHO, and (ii) body fat percentage (BF%), based on cut-off points taken from tables provided in the user's manual of a BIA meter (i.e., a bioelectrical impedance device)

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

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

**Keywords:** Obesity, migration, ethnicity, city

144/1351

## IMPACT OF EARLY ENTERAL NUTRITION WITH IMMUNONUTRIENTS IN MORBIMORTALITY IN PATIENTS WITH TRAUMATIC BRAIN INJURY IN THE INTENSIVE CARE UNIT OF MEXICALI'S GENERAL HOSPITAL

(1)Ponce y Ponce de León, Gisela; (2)Cornejo Bravo, José Manuel;

(2)Pérez Morales, María Eugenia; (3)Mayagoitia Witrón, José de Jesús;

(4)Rieke Campoy, Ulises; (4)Camargo Bravo, Adriana.

(1)Universidad Autonoma de Baja California; (2)Facultad de Ciencias Químicas e Ingeniería UABC; (3)Hospital General de Mexicali Mexico; (4)Facultad de Enfermería UABC.

**Background and objectives:** Introduction: early enteral nutrition is initiated in the first 24-48 hours after injury or admission to the Intensive Care Unit (ICU), it is a method of nutritional support with beneficial effects for the patient that improve outcome. Traumatic brain injury (TBI) is the third cause of death in Mexico caused by accidents or violence, therefore it is considered a serious public health problem.

**Objective:** to determine if early enteral nutrition with immunonutrients (EENI) supplied to patients with TBI decreases morbimortality in the ICU of the General Hospital of Mexicali.

**Methods:** random systematic, longitudinal and comparative clinical study in 22 patients with severe TBI, 11 patients in the con-
trol group with Early enteral modular nutrition (EEMN) and 11 in the intervention group supplied with EENI, that were admitted to the ICU and complied with inclusion criteria, from August 1st, 2015 to June 30, 2016.

**Results:** 16 (72.7%) males and 6 (27.3%) females with a mean age of 34.7 years. The main causes of TBI were run over and motor vehicle accident in 54.6%. The group with EENI showed increase in weight (T of Student 23.737, p=.001), total proteins (T de Student 13.40, p=.001), leukocytes (T Student de 2.05, p =.002) and lymphocytes (T de Student 7.09, p=.001) at discharge from the ICU. Length of stay in the ICU, mechanical ventilation, infections, mortality and days of enteral nutrition were less in the EENI group.

**Conclusions:** EENI impacts in a positive way by decreasing the incidence of infectious complications as length of stay in the hospital by which it is possible to improve in less time patient's health and diminish hospital costs.

**Keywords:** Early enteral nutrition, Enteral nutrition with immunonutrients, traumatic brain injury, Intensive Care Unit.

144/1354

FASTING, INTERMITTENT FASTING OR CALORIC RESTRICTION AS NUTRITIONAL MANAGEMENT OF ADULTS WITH TYPE 2 DIABETES. A SYSTEMATIC REVIEW (PRELIMINARY RESULTS)

(1)Ochoa Rivera, Teresa; (2)Lopez-Teros, Miriam; (3)Escalante-Izeta, Ericka, (4)Gamboa-Melendez, Marco Alberto; (5)Tello-Casillas, Jessica Karen; (6)Méndez-Montoya, Angel Francisco.

(1)PhD. Nutritionist. Health Department. Iberoamerican University. Mexico City. Mexico.; (2)MSc. MD. Health Department. Iberoamerican University. Mexico City. Mexico.; (3)PhD. Physcologist. Health Department. Iberoamerican University. Mexico City. Mexico.; (4)PhD. QFB. Health Department. Iberoamerican University. Mexico City. Mexico.; (5)BSc. MD. Health Department. Iberoamerican University. Mexico City. Mexico.; (6)PhD. Theologist of Food. Religious Sciences Department. Iberoamerican University. Mexico City. Mexico.

**Background and objectives:** Type 2 diabetes encompasses individuals who have insulin resistance and usually have relative insulin deficiency. Pharmacological treatment usually has adverse effects on the body in addition to the high cost it produces, so alternative strategies are necessary. Intermittent fasting improves metabolic health and many other physiological and molecular markers of health in animal and humans models. Also, recently it has been studied that patients with diabetes type 2 with continues caloric restriction show metabolic improvement. However, further studies are still needed to understand the effect of fasting on the physiological, metabolic and clinical mechanisms in the diabetic patient. The aim of this systematic review is to evaluate the clinical evidence that fasting is beneficial to patients with type 2 diabetes.

**Methods:** We performed a research of PubMed database up to February 2017. We included clinical trials, meta-analysis and sys-

tematic reviews. Search terms comprising Medical Subject Headings (MESH) as follows: "fasting", "intermittent fasting", "caloric restriction", "diabetes type 2" and "adult".

**Results:** According to the criteria established for the words MESH, we found 743 articles. However, 686 were excluded after reviewing the titles of these publications for the following reasons: did not report clinical outcomes about type 2 diabetes (fasting glucose and insulin, glycosylated hemoglobin, lipid profile and measures of weight, body mass index, fat and muscle mass) or without any intervention of fasting or caloric restriction. Actually, we are reviewing the abstracts of the remaining 57 studies. Publications that do not meet the established criteria will be excluded from the systematic review, while the remaining studies will be evaluated for their full text.

**Conclusions:** The preliminary results show the increased in recent years of clinical trials about the study of fasting as a possible intervention in patients with diabetes without negative consequences. It is recognized the cost-benefits of this therapy. Therefore, it is necessary to perform a systematic review of these studies as a tool for decision-making in evidence-based medical practice.

**Keywords:** fasting, caloric restriction, adult, type 2 diabetes

144/1363

OBESITY AND CLINICAL OUTCOME OF HOSPITALIZED CHILDREN UNDER TWO YEARS OLD WITH LOWER RESPIRATORY TRACT INFECTIONS

(1)Barja, Salesa; (2)Bustos, Edson; (3)Franulic, Yasna; (3)Messina, Javiera.

(1)MD. MSc in Pediatric Nutrition. Josefina Martinez Hospital. Department of Gastroenterology and Pediatric Nutrition. Division of Pediatrics. Faculty of Medicine. Pontificia Universidad Católica de Chile.; (2)Nutritionist. MSc. School of Nutrition and Dietetics. Faculty of Medicine. Universidad Finis Terrae. Chile.; (3)Nutritionist. Josefina Martinez Hospital. Chile.

**Background and objectives:** Obesity is associated with increased morbidity and mortality in adults with respiratory infections.

**Aim:** To study an association between overweight and clinical evolution in children under two years old, hospitalized for lower respiratory tract infections (LRTI).

**Methods:** Retrospective study with clinical records review of children younger than two years old with LRTI hospitalized in Josefina Martinez Hospital, during winter (2009 to 2015). Demographic data, anthropometry, nutritional status (WHO 2006 reference) and clinical outcome were recorded: Hospital stay (days/hours), use and length (days) of oxygen and noninvasive ventilatory support (NIV), use of corticosteroids, and antibiotics.

**Results:** The sample was constituted by 678 children, 10.96 ± 5.65 months old, 62.3% younger than 12 months, 55% boys. The commonest admission diagnosis was viral pneumonia (67%), 54.7% received basic care, 98.7% oxygen therapy, 35.4% NIV, 26.1 antibiotics and 47.5% corticoids. Nutritional status: 10% had malnutrition and 34.8% overweight or obesity. Boys with overweight
or obesity had higher frequency of viral pneumonia (75.4% vs. 60.2%, p = 0.014), need for more complex care (27.7% vs. 19.9%, p = 0.018) and length of NIV (Median 4.5 (3 to 5.5) vs. 3.0 (2 to 5) days, p = 0.007), than eutrophic. Boys with malnutrition had higher need of NIV than eutrophic (56.2% vs. 34.6%, p=0.02). In girls, there was no association between nutritional status and clinical outcome.

**Conclusions:** In this sample of children younger than two years old, hospitalized for LRTI, boys with malnutrition had a higher need of NIV but those with overweight or obesity needed a more complex care and longer NIV than the eutrophic ones.

**Keywords:** Obesity, overweight, lower respiratory tract infections, children, hospital.

**Further collaborators:**

Mireya Méndez

144/1369

CAN WHO GUIDELINES FOR MALNUTRITION REDUCED THE MORTALITY IN CHILDREN RECEIVING NUTRITION REHABILITATION AT THE HOSPITAL: CLINICAL STUDY IN MOROCCAN MALNOURISHED CHILDREN

**Background and objectives:** Protein-energy malnutrition is a major cause of mortality among young children in Africa hospital. objective was to assess the outcome of children with protein-energy malnutrition after treatment by World Health Organization guidelines.

**Methods:** Eighty-three children with protein-energy malnutrition (PEM) and aged from 6-60 months were admitted to the paediatric service in University Hospital Hassan II, Fez, Setting: The study was carried out in the paediatric service at Hassan II University Hospital, Fez, Morocco, from 1 January 2002 to 30 July and 30 July 2005. Eighty-three children with protein-energy malnutrition (PEM) and aged from 6-60 months were admitted to the paediatric service in University Hospital Hassan II, Fez, Morocco, from 1 January 2002 to 30 July and 30 July 2005. Children were divided in two groups oedematous malnutrition (OM) and non-edematous malnutrition (NM). The main outcomes measures were the recovery rate, relapse post-discharge and rate death during treatment. All children received nutrition rehabilitation by using the World Health Organization protocol during 21days.

Dietary treatment was based on using a formula-fed (Guigoz 2) containing 498kcal/100g of energy, 9.9g/100g of protein and 23.5g/100g of fat. At initial phase we begin with energy density of 75Kcal/kg/day and 1.2g/kg/day of protein without stopping both breast-feeding and oral micronutrient supplement. At rehabilitation phase the energy dens 100-150Kcal/kg/day and 3g/kg/day of protein were used. A plasma concentration of CRP, AAG and Hemoglobin were assessed.

**Results:** The overall case fatality rate was 13(15.66%) split between the NM with (6.02%) and OM with a rate of 9.63% early death and late death. The recovery rate was (84.33%) and the relapse rate post-discharge was lower (4.81%). Overall rate recovery was divided among 38(45.78%) in the non-edematous group and 32(38.55%) in the oedematous. The overall weight gain was 7.16±0.62 and 58.57% gained over 5g/kg/day. 70.73% of oedematous malnutrition gained over.

**Conclusions:** Despite the case fatality rate above target levels <5% of WHO, the use WHO guidelines provided an acceptable level of care indicated by high recovery rate (84.33%), lower relapse post-discharge 4(4.81%) and over half of children (58.57%) had weight gain >5g/kg/day.

**Keywords:** outcome, WHO guidelines, hospital, nutrition rehabilitation

144/1373

CARDIOVASCULAR RISK IN CHILDREN AND ADOLESCENTS WITH CEREBRAL PALSY

**Background and objectives:** Patients with Cerebral Palsy (CP) have a growing prevalence of overweight but evidence of associated cardiovascular risk factors is scarce.

**Aim:** To study metabolic complications of obesity in CP children and adolescents and look for an association to different conditions.

**Methods:** Cross-sectional study in 69 children with CP, under follow-up in units of special health care needs children (CSHCN) from two Public Hospitals (Padre Hurtado and Sótero del Río, in Santiago, Chile). Demographic data were obtained, Anthropometry was performed (Brooks 2011 reference), gross motor function classification system (GMFCS) was applied and a fasting sample for measuring plasma triglycerides (TG), total cholesterol (TC), glycaemia (Gli) and insulinemia was obtained. HOMA index was

<footnote>(1)Barouaca, Hassan; (2)Santhanakrishnan, Vimaleswaran Karani;</footnote>

<footnote>(3)Hida, Moustapha; (4)Squali Houssaini, Fatima Zahra.</footnote>

<footnote>(1)Higher Institute of Nursing Profession and Techniques of Health; (2)Prf. Nutrigenitic. Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research. Department of Food and Nutritional Sciences. University of Reading. UK.; (3)Prf, Head of Pediatrics. Faculty of Medicine. Paediatrics Ward Hassan II. University Hospital. Morocco;</footnote>

<footnote>(4)Prf. Biochemist. Faculty of Sciences. Biology Department. Biochemistry Laboratory. Nutritional Biochemistry Unit. Morocco.</footnote>

<footnote>(1)Barja, Salesa; (2)Le Roy, Catalina; (3)Sepúlveda Flores, Cecilia;</footnote>

<footnote>(4)Guzmán, María Luisa; (5)Olivarez, Maritza; (6)Figueroa, María José.</footnote>

<footnote>(1)MD. MSc Pediatric Nutrition. Josefina Martinez Hospital. Division of Pediatrics. Faculty of Medicine. Pontificia Universidad Católica de Chile.; (2)MD. Pediatrician. Division of Pediatrics. Faculty of Medicine. Pontificia Universidad Católica de Chile.;</footnote>

<footnote>(3)RD. Dietitian. NINEAS Program. Padre Hurtado Hospital. Medicine Faculty. Universidad del Desarrollo. Chile.; (4)Nurse. Center of human genetics. Medicine Faculty. Universidad del Desarrollo. Padre Hurtado Hospital. Chile.; (5)Nurse. NINEAS Program. Sótero del Río Hospital. Chile.; (6)MD. MSc Pediatric Nutrition. NINEAS Program, Sótero del Río Hospital. Chile.</footnote>
calculated. Frequency and association analysis of metabolic pa-
rameters with age, sex, neonatal history, nutritional status, GM-
FCS, use of anticonvulsant drugs were studied. Approved by ethics
SSMSO Committee, parents signed an informed consent.

**Results:** 69 patients were included, of 11.1 + 4.9 years old, 62.3% were boys. Motor function: 81.2% grade IV-V, 50.7% with enteral feeding, 83.9% receiving anticonvulsant treatment. Nutritional status (BMI /Age): 15.4% (Percentile, Pc<10), 73.8% (Pc10-75) and 10.8% (> Pc75). Metabolic parameters: 5.8% had CT≥200mg/dL, 20.3% TG≥110 or 130 mg/dL (according to age), 4.3% Gli≥100 mg/dL and 18.8% HOMA≥3. Children with a BMI > Pc90 had higher TC (ANOVA; p = 0.05), with a direct correlation between BMI and CT (Spearman, R=0.11, p = 0.036). Girls and patients with anticonvulsants had a higher prevalence of insulin resistance (p = 0, 001 and p = 0, 023) and those with less mobility, a higher prevalence of elevated TG (Chi2, p = 0.032).

**Conclusions:** The prevalence of hypercholesterolemia, hypertriglyceridemia and insulin resistance was high in this sample of children with CP; Hypercholesterolemia was associated with overweight, hypertriglyceridemia with immobility and insulin resistance was more frequent in girls and users of anticonvulsants.

**Keywords:** Cerebral Palsy, nutrition, children, obesity, metabolic complications.

**Further collaborators:**

María José Figueroa

Maritza Olivarez

**Results:** No significant differences in MMSE and MoCA scores and scores of all domains in males among different BMI groups (p>0.05). However, in females, the MMSE score, language ability and language use ability were obviously different in different BMI groups (p<0.05) and the MoCA score, attention and abstract thinking ability were also different among groups (p<0.05). The partial correlation analysis revealed that hip circumference was negatively correlated with language skills (p<0.05), that the waist-to-hip ratio was negatively correlated with orientation but positively associated with language skills (p<0.05), and that BMI had a negative correlation with both memory and language skills (p<0.05) in the MMSE scale. In the MoCA scale, the waist circumference was negatively correlated with orientation but positively associated with delayed memory (p<0.05); the hip circumference was positively associated with delayed memory (p<0.05); the waist-to-hip ratio was negatively correlated with both orientation and thinking ability (p<0.05). A cross-sectional linear correlation between BMI and MMSE and MoCA scores was established in females in a univariate linear regression analysis. In a univariate logistic regression analysis, a linear correlation between BMI and MMSE and MoCA scores was found in females. In multivariate logistic regression analysis, BMI was only correlated with MMSE score in women.

**Conclusions:** Overweight and obesity were associated with higher risk of cognitive decline among midlife population in China.

**Keywords:** overweight, obesity, cognitive function, body mass index, The mini-mental state examination, montreal cognitive assessment scale

144/1392

RELATIONSHIP BETWEEN BODY MASS INDEX
AND DECLINE OF COGNITIVE FUNCTION IN
MIDDLE-AGED AND ELDER OBESE AND OVER-
WEIGHT POPULATION

(1)Ma, Weiwei; (2)Yuan, linhong; (2)Yu, Huanling; (2)Yang, Chun; (2)Xiao, Rong.

(1)Department of nutrition and Food hygiene, School of Public Health, Capital Medical University; Beijing, China (2)School of Public Health, Capital Medical University. Beijing, China.

**Background and objectives:** The correlation between body mass index (BMI) and cognitive function remains controversial. This study aimed to compare the cognitive function among normal weight, overweight and obese population and to explore the relationship between obesity and cognitive impairments in the midlife obese and overweight people in China.

**Methods:** A total of 676 adults, aged from 35 to 60, were recruited from Beijing, China. The mini-mental state examination (MMSE) and montreal cognitive assessment scale (MoCA) were carried out to assess the cognitive function of the subjects. We then compared the cognitive function among healthy, overweight and obese population using covariance analysis. The correlation between BMI and risk of cognitive impairments was assessed using the partial correlation, linear regression and multiple logistic regression models.

144/1399

BODY COMPOSITION OF PEOPLE LIVING WITH
HIV/AIDS WITH CLINICAL DIAGNOSES OH
HIV-RELATED LIPODYSTROPHY SYNDROME

(1)Justina Papini, Silvia; (2)Sacilotto, Lívia Bertazzo; (3)Mendes, Adriana Lúcia; (4)Corrente, José Eduardo; (5)Manechini, João Paulo Vieira; (6)Pereira, Paulo Câmara Marques.

(1)PhD. Nutritionist. Department of Nursing. São Paulo State University (UNESP). Botucatu Medical School. Brazil.; (2)MD. Nutritionist. Department of Tropical Disease and Imaging Diagnosis. São Paulo State University (UNESP). Botucatu Medical School. Brazil.; (3)PhD professor. São Paulo State University (UNESP). Botucatu Medical School. Brazil.; (4)Adjunct professor. Department of Bioestatisc. São Paulo State University (UNESP). Institute of Biosciences. Botucatu. Brazil.; (5)MD student. University of São Paulo (USP), Ribeirao Preto Medical School, Brazil; (6)Adjunct professor. Department of Tropical Disease and Imaging Diagnosis. São Paulo State University (UNESP). Botucatu Medical School. Brazil.

**Background and objectives:** People living with HIV/AIDS (PLHA) may develop body composition alterations (or HIV-associated lipodystrophy syndrome - HALS), with body fat redis-
tribution related or not to metabolic alterations, classified among:
lipohypertrophy (fat accumulation on abdominal area and/or
localized), lipoatrophy (fat reduction in peripheral regions) and
mixed lipodystrophy (association of both). The purpose was to
characterize PLHA with HALS diagnoses according to their sub-
type, clinical-metabolic profile and body composition.

**Methods:** The study was observational and transversal, with its sample selected by convenience and performing clinical immunological characterization, anthropometric assessment, nutritional diagnosis, body composition of PLHA with a clinical HALS diagnosis from July 2015 to July 2016, in regular ART use for at least a year, ranging from 18 to 60 years old.

**Results:** Forty individuals were distributed equally by gender, with age of 45,5 ± 8,2 years, diagnostic time of 15,3 ± 6,2 years and antiretroviral therapy usage time of 13,8 ± 5,7 years. HALS mixed form was the most prevalent (n = 17; 42,5%). There was significant difference for TCD4+ cell counting (p=0,0115) when comparing mixed form and lipohypertrophy groups. The main differences found among subtypes are related to body composition and anthropometric measures: body mass index, abdominal and neck circumference comparing mixed form and lipohypertrophy groups (p = 0,0007; p = 0,0018; and p = 0,0062, respectively), as well as between mixed form and lipoatrophy groups (p < 0,0001; p < 0,0001; and p = 0,0019, respectively). Concerning body composition differences were observed for all analyzed parameters: lean body mass was different between mixed form and lipohypertrophy groups (p = 0,0252); fat body mass and percent of fat body mass were different between lipoatrophy and lipohypertrophy groups (p = 0,0008 for both variables); fat visceral area values were different both between mixed form and lipohypertrophy groups (p = 0,0025) and between lipoatrophy and lipohypertrophy (p < 0,0001).

**Conclusions:** The diagnoses, sub-classification and identification of metabolic alterations are important as specific strategies may be elaborated, since the body changes detected reaffirm that HALS must not be seen as an unique syndrome, but as three different impairments that should be managed in particular ways.

**Keywords:** People living with HIV/aids, lipodystrophy, body composition, metabolic syndrome.

**Further collaborators:** Support: FAPESP (process 2015/10103-7)

**Background and objectives:** Trimethylamine-N-oxide (TMAO), a gut-flora-dependent metabolite of choline, is associated with cardiovascular diseases and bile acids (BAs) metabolism. BAs played a critical role in lipid metabolism and increased plasma BAs level was found in NAFLD patients. The aim of this study was to identify potential interactions between TMAO and BAs metabolism in NAFLD.

**Methods:** We performed a case control study including 60 biopsy-proven NAFLD cases and 35 controls. Serum TMAO and BAs concentrations were quantified by high-performance liquid chromatography with online electrospray ionization tandem mass spectrometry (HPLC-MS/MS). The associations of TMAO and BAs with pathological progress of NAFLD were studied by covariance and receiver operating characteristic (ROC) calculation was used to elaborate the predictability of NAFLD. Male C57BL/6 mice were fed either a high-fat diet (HFD) or HFD supplemented with 0.2% TMAO in water (wt/vol) for 18 weeks. Serum biochemical parameters and genes expression were quantified and compared between groups.

**Results:** In the case control study, median serum TMAO level was 2.02µM (interquartile range, 1.15, 3.18) and median serum BAs level was 8.70µM (interquartile range,5.84, 12.79µM) in NAFLD patients, which were significantly higher than controls (median [interquartile range]: 0.98[0.33, 1.57]µM, 6.34[4.20, 8.63] µM, serum TMAO and BAs levels respectively). Higher scores for steatosis, inflammation and NAFLD activity were associated with greater ln-transformed levels of TMAO and BAs (all P trend <0.05). To predict NAFLD versus control, area under the ROC of serum TMAO and BAs combination was 0.767 (P<0.001). The mRNA expression of the key BAs synthetic enzyme cholesterol 7 alpha-hydroxylase (Cyp7a1) was significantly higher in NAFLD patients while the mRNA level of BAs transporters remained unchanged. In the animal study, TMAO supplemented accentuated hepatic steatosis and upregulated the mRNA levels of lipogenesis genes. Hepatic BAs level and the expression of Cyp7a1 were significantly increased in TMAO supplemented group. Increased hepatic BAs activated farnesoid-X-receptor (FXR) and resulted in the elevation of fatty-acid synthase expression.

**Conclusions:** Serum TMAO and BAs levels were elevated in NAFLD patients and positively correlated with disease severity in NAFLD. TMAO aggravated hepatic steatosis through up-regulation BAs synthesis and activation of FXR.

<footnote>(1)Zhu, Hui-lian Zhu; (2)Zhu, Hui-lian Zhu.</footnote>

<footnote>(1)PhD, Department of Nutrition, School of Public Health, Sun Yat-sen University, People's Republic of China; (2)PhD, Nutritionist, Department of Nutrition, School of Public Health, Sun Yat-sen University, People's Republic of China.</footnote>
**Keywords:** trimethylamine N-oxide, hepatic steatosis, nonal-
coholic fatty liver disease (NAFLD), bile acids, farnesoid-X-recep-
tor (FXR)

**Further collaborators:**

Xu-ying Tan, BSc

PhD student, Department of Nutrition, School of Public
Health, Sun Yat-sen University, People's Republic of China

144/1415

BODY COMPOSITION, ANTHROPOMETRIC
MEASURES AND CLINICAL-NUTRITIONAL PA-
RAMETERS OF PEOPLE LIVING WITH HIV/AIDS
WITH CLINICAL DIAGNOSES OF HIV-ASSOCIAT-
ED LIPODYSTROPHY SYNDROME SUBDIVIDED
BY GENDER

(1)Sacilotto, Lívia Bertazzo; (2)Pereira, Paulo Câmara Marques;

(3)Mendes, Adriana Lúcia; (4)Corrente, José Eduardo; (5)Manechini,

João Paulo Vieira; (6)Justina Papini, Silvia.

(1)MD. Nutritionist. Department of Tropical Disease and Imaging Diagnosis. São Paulo State University (UNESP). Botucatu Medical School. Brazil.; (2)Adjunct professor. Department of Tropical Disease and Imaging Diagnosis. São Paulo State University (UNESP). Botucatu Medical School. Brazil.; (3)PhD professor.

São Paulo State University (UNESP). Botucatu Medical School.

Brazil.; (4)Adjunct professor. Department of Bioestatisc. São Paulo
State University (UNESP). Institute of Biosciences. Botucatu.

Brazil.; (5)MD student. University of São Paulo (USP), Ribeirao
Preto Medical School, Brazil; (6)PhD. Nutritionist. Department of
Nursing. São Paulo State University (UNESP). Botucatu Medical
School. Brazil.

**Background and objectives:** HIV-associated lipodystrophy (HALS) is characterized by morphological changes due to fat tissue heterogeneous disorders, with body fat redistribution associated or not to metabolic alterations. Such alterations are consequences of the chronic inflammatory state due the viral infection and the usage of specific therapy to treat the sickness. The HALS is described as a syndrome which consider the fat loss and/or accumulation, classified in three subtypes. The impairments due these metabolic and morphological alterations go beyond esthetic consequences, once there may be an increased risk to the development of other disturbances, such as the Metabolic Syndrome. Considering the existence of body composition differences per gender, the objective of the present study was to verify, among genders, the clinical-nutritional and anthropometric differences of people living with HIV/AIDS (PLHA) with clinical diagnoses of HALS.

**Methods:** The study was observational and transversal, with its sample selected by convenience and performing clinical immunological characterization, anthropometric assessment, nutritional diagnosis, body composition of PLHA during the follow-up of specialized outpatient service in infectiology with a clinical HALS diagnosis from July 2015 to July 2016, in regular antiretroviral

therapy use for at least a year, ranging from 18 to 60 years old.
Pregnant women, people with chronic kidney failure, nephrotic
syndrome, B and C virus chronic infection, uncontrolled hypothy-
roidism were excluded from the study.

**Results:** Forty individuals were distributed equally by gender, with age of 45,5 ± 8,2 years, diagnostic time of 15,3 ± 6,2 years and antiretroviral therapy usage time of 13,8 ± 5,7 years. The results showed significant difference on lipid profile to female gender, with increased values, except for HDL-cholesterol. No statistical differences were observed for fasting blood glucose and clinical-immunological parameters between genders.

**Conclusions:** Despite the lack of differences, body fat and anthropometric indicators presented higher alterations among women living with HIV/AIDS. Lipid profile significant alterations and high body fat values (even without statistical significance) among women suggests an increased risk for cardiovascular diseases when compared to men in the aforementioned population, highlighting the importance to adopt different follow up strategies for those patients.

**Keywords:** People living with HIV/aids, lipodystrophy, body composition, metabolic syndrome

**Further collaborators:**

Support: FAPESP (process 2015/10103-7)

144/1431

GLYCEMIC INDICES OF STANDARDIZED TRADITIONAL COCOYAM AND CORN BASED DISHES CONSUMED IN NSUKKA LOCAL GOVERNMENT AREA OF ENUGU STATE, NIGERIA

(1)Davidson, Gloria; (2)Ene-Obong, Henrietta.

(1)PhD. Nutritionist. Department of Home Science, Nutrition and Dietetics. University of Nigeria. Nsukka; (2)PhD. Department of Biochemistry (Nutrition and Dietetics Unit). University of Calabar. Cross.

**Background and objectives:** Glycemic index (GI) is an important parameter of food quality that compares the hypoglycemic effect of a test meal with pure glucose. Low glycemic index diets have been recommended for diabetics. There is however scarcity of data on the glycemic index of traditional Nigerian diets. The study was to determine the glycemic indices (GIs) of standardized cocoyam and corn based traditional dishes consumed in southern Nigeria.

**Methods:** Focus group discussions were conducted in eight randomly selected communities in Nsukka LGA to document the variations of each dish and their recipes. These were standardized and prepared. Proximate compositions of the prepared dishes were determined using standard procedure. A serving portion of each dish containing 50g of available carbohydrate was served to ten healthy adult subjects. Glucose was used as the reference food. The postprandial blood glucose response of the test and the reference meals were measured over two hours at 30 minutes interval. Blood glucose curves were plotted, area under each curve
and corresponding glycemic index value for each dish determined. Data were analyzed using Statistical Product for Service Solution (SPSS). Analysis of variance was used to compare the means.

**Results:** Three variations of cocoyam-based dishes were documented: “achicha” (dried cocoyam chips, soaked and steamed) with pigeon pea”, “achicha” with fresh “akidi” (fresh cowpea pod) and “achicha” with vegetable (Solanum melongena). The corn-based dish had two variations: “ayaraya oka” (coarsely ground soaked, steamed corn) with pigeon pea” and “ayaraya oka” with fresh “akidi”. The dishes had appreciable proximate composition though the protein content of the cocoyam based dishes were low 0.7 – 1.0%. The GI of the cocoyam based dishes were within the range of 38.7 and 78.1 being highest in “achicha with vegetable (78.1) and lowest in “achicha” with fresh “akidi” (38.7). “Ayaraya oka” with fresh “akidi” also had lower GI (51.0) when compared with “ayaraya oka” with pigeon pea (75.3).

**Conclusions:** “Achicha” with fresh cowpea pod and “ayaraya oka” with fresh cowpea pod had low and moderate glycemic indices, respectively and could be recommended for diabetics.

**Keywords:** Traditional dishes, glycemic index, diabetics, variation, Nigeria

144/1432

NEUROPROTECTIVE EFFECTS OF VITAMIN D VIA THE MODULATION OF NLRP3 INFLAMMASOME ACTIVATION

(1)Wu, ChHao; (2)Kung, Ming-Ya; (3)Shen, Szu-Chuan; (4)Lin, Shih-Xiang; (4)Jhang, Yu-Yuan.

(1)PhD; (2)MS. School of Nutrition & Health Sciences, Taipei Medical University. Taiwan; (3)PhD. Department of Human Development and Family Studies, National Taiwan Normal University. Taiwan; (4)Department of Human Development and Family Studies, National Taiwan Normal University. Taiwan.

**Background and objectives:** Ischemic stroke (IS) accounts for approximately 70% of the total cases of strokes. Accumulating evidence suggests that inflammasome is involved in the pathogenesis of IR by regulating proinflammatory cytokine interleukin-1β (IL-1β) secretion following tissue ischemia. According to the link between stroke severity and vitamin D status has been clinically proven in studies. The object of this study was to investigate the neuroprotective effect of vitamin D on cerebral ischemia-reperfusion (IR) injury and the possible mechanism of action.

**Methods:** Eight-weeks-old male Sprague-Dawley rats were assigned to (1) control group (sham), (2) ischemia/reperfusion group (I/R) (3) vitamin D deficiency group (VDD), and (4) vitamin D supplements group (VDS). Transient cerebral ischemia was induced in rats by middle cerebral artery occlusion (MCAO) for 1 h followed by reperfusion to investigate the effect of vitamin D on brain IR injury. Cerebral infarct volume, and the levels of oxidative stress and inflammatory markers were evaluated.

**Results:** Results showed that vitamin D deficiency exacerbated the severity of brain damage, and the levels of IL-1β and lipid per-

oxidation. By contrast, intraperitoneal administration of vitamin D improved the brain injury and these results were accompanied by attenuated NLRP3 inflammasome signaling.

**Conclusions:** In conclusion, vitamin D might reduce cerebral ischemic-reperfusion injury, possibly via its anti-inflammatory activity.

**Keywords:** Ischemic stroke, vitamin D, inflammasome, oxidative stress, IL-1β

144/1437

BODY COMPOSITION PROFILES AND METABOLIC DISEASE RISK PATTERNS IN NEW ZEALAND WOMEN - THE WOMEN'S EXPLORE STUDY

(1)Kruger, Rozanne; (2)Whitford, Amanda; (3)Richter, Marilize; (3)Breier, Bernhard.

(1)PhD. Dietitian. School of Food and Nutrition. Massey University. New Zealand.; (2)MSc. Student. School of Food and Nutrition. Massey University. New Zealand.; (3)PhD. School of Food and Nutrition. Massey University. New Zealand.

**Background and objectives:** In New Zealand, 31.6% of adults are obese. Significant ethnic inequalities exist where Pacific Islanders and Māori have the highest rates. Despite the association between obesity and metabolic dysfunction, there is limited research comparing body composition and metabolic health status for these groups. Understanding how their body composition relates to metabolic health will be an important part of determining avenues for improving the associated health inequalities. The aim of this study was to investigate the body compositional and metabolic health profiles of healthy NZ European, Pacific and Māori women participating in the women's EXPLORE study, and to identify ethnic specific patterns between these profiles.

**Methods:** In this cross sectional study we recruited 233 European, 91 Pacific and 84 Māori women. Different body mass index (BMI) and body fat % (BF%) defined body composition profiles were analysed for anthropometric measurements, body fat location, and metabolic biomarkers.

**Results:** Obese (BF%) Māori women had higher android fat mass than obese (BF%) NZ European women (2.53kg vs 2.23kg), with no difference in waist circumference. Non-obese (BMI) Māori women had higher waist circumference than non-obese (BMI) NZ European women (78cm vs 73.5cm) with android fat differences. Regardless of body composition grouping, no ethnic differences were found for BF%. Obese Pacific women had higher HOMA-IR (5.12-5.45) and insulin (24.28-23.28mU/L) than obese NZ Europeans (2.10-2.61 and 10.07-11.24mU/L respectively), as did obese Māori women (3.64-4.35 and 16.76-19.41mU/L respectively). Body composition measures with highest sensitivity across all biomarkers assessed were BF% ≥30 for NZ European, both BF% ≥30 and BMI ≥25 for Pacific, and BMI ≥25 for Māori women respectively.

**Conclusions:** Māori and Pacific women had significantly higher glucose metabolism markers than NZ Europeans despite
no differences in BF%. When comparing Māori to NZ European women, a higher waist circumference was not always related to a higher android fat mass or vice versa, suggesting that WC may not be an accurate representation of abdominal fat for Māori women. In spite of ethnic differences, BF% ≥30 and BMI ≥25 appear most sensitive to detect high biomarkers compared to abdominal measurements.

**Keywords:** Obesity, Metabolic health, Body fat, Body mass index, Women

144/1439

EFFECT OF INTRAVENOUS IRON SUCROSE ADMINISTRATION ON LEVEL OF ANTIOXIDANT STRESS MARKERS AMONG MODERATELY ANEMIC PREGNANT WOMEN ATTENDING A SUB-DISTRICT HOSPITAL, HARYANA

(1)Kant, Shashi; (2) Jacob, Olivis; (2)Haldar, Partho; (2)Kaur, Ravneet;

(2)Dadwal, Vatsala.

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

**Background and objectives:** Oxidative stress is known to increase during pregnancy, and also after supplementation of iron. The free iron particles released into blood following iron administration are known to produce Reactive Oxygen Species (ROS) which could lead to destruction of cells. We measured the level of antioxidant stress markers following administration of intravenous iron sucrose (IVIS) to moderately anemic pregnant women.

**Methods:** A total of 66 women in 2ndor 3rd trimester of pregnancy with moderate anemia (Haemoglobin level between 7.0-9.9 gm/dL) attending a Sub District Hospital, Ballabgarh, Haryana were recruited. Total iron requirement was calculated using Ganzoni's formula. IVIS was administered as 300mg in 300mL of Normal Saline over 30 minuteson alternate days till complete dose. Antioxidant stress markers were measured at the time of recruitment (baseline) and 4 weeks after the last dose of IVIS (endline) and included serum malondialdehyde (MDA), serum superoxide dismutase (SOD), and ferric reducing ability of plasma (FRAP)

**Results:** At baseline, mean(SD) levels of MDA, SOD and FRAP were 3.5(0.9) ng/mL, 2.1(0.4) U/mL and 655.9(178.6) µM/L respectively; and the same at endline were 3.1(0.9) ng/mL, 1.6(0.5) U/mL and 761.3(166.4) µM/L respectively. Paired follow-up information was available for 37, 39, and 39 women for MDA, SOD and FRAP respectively. Mean(SD) for MDA, SOD and FRAP changed from 3.3(0.9) ng/mL, 2.2(0.4) U/mL and 679.3(188.8) µM/L at baseline and to 3.1(0.9) ng/mL, 1.6(0.5) U/mL and 745.4(166.7) µM/L respectively; and with p values 0.6009, <0.001, and 0.1284 respectively. No serious adverse effects occurred during the study period

**Conclusions:** A significant decline in the level of SOD was seen at four weeks after IVIS administration. There was no significant change in the levels of MDA and FRAP after the administration of IVIS.

Hence, IVIS could be a safe alternative for the management of moderate anemia in pregnancy

**Keywords:** Anemia iron sucrose

144/1440

FRACTIONS FROM RUELLIA TUBEROSA L. EXTRACT IMPROVES GLUCOSE UPTAKE IN TNF-Α INDUCED INSULIN RESISTANT MOUSE FL83B HEPATOCYTES

(1)Wu, ChHao; (2)Jhang, Yu-Yuan; (3)Shen, Szu-Chuan; (4)Huang, Wei-Jan; (2)Wu, Pei-Chin; (2)Tu, Meng-Shiuan; (2)Lin, Shih-Shiang; (5)Chang, Wen-Chang; (5)Ting, Yu-Wen; (5)Wu, James Swi-Bea.

(1)PhD. Department of Human Development and Family Studies, National Taiwan Normal University; (2)Department of Human Development and Family Studies, National Taiwan Normal University; (3)PhD. Department of Human Development and Family Studies, National Taiwan Normal University; (4)Graduate Institute of Pharmacognosy, Taipei Medical University, Taiwan.; (5)Graduate Institute of Food Science and Technology, National Taiwan University.

**Background and objectives:** Diabetes mellitus (DM) is characterized by insulin resistance, caused by inadequate production of insulin or by the ineffectiveness of insulin activity. Ruellia tuberosa L. (RTL) is a plant herb and has been used as folk medicine for the treatment of diabetes in Asian countries for decades. The previous study confirmed that ethyl acetate extract of RTL possesses hypoglycemic potential in diabetic rabbits. However, the detail mechanism was still unclear. The aim of this study was to investigate the effect of the ethyl acetate fraction (EAF) from RTL methanol extract on cytotoxicity and glucose uptake in tumor necrosis factor-alpha (TNF-α) induced insulin resistant mouse FL83B hepatocytes.

**Methods:** RTL was first extracted with methanol, and followed by partitioned with n-hexane and ethyl acetate, respectively. The ethyl acetate layer was then isolated into eight fractions by sephadex LH20 column chromatography. The EAF containing elements were collected and lyophilized to be powder samples. MTT assay was conducted to measure the cytotoxicity of EAF in FL83B cells. EAF was further co-incubated with TNF-α treated FL83B cells, and flow cytometry was used to assess glucose uptake ability in cells.

**Results:** The results showed that no significant cytotoxicity effect was observed for eight EAFs at the concentration of 25 µg/ml in FL83B cells. Moreover, EAF2, EAF3, EAF5 significantly enhances the uptake of 2-NBDG in TNF-α treated FL83B cells.

**Conclusions:** In conclusion, the present study suggests that RTL may alleviate insulin resistance without cytotoxicity and has potential for developing into anti-diabetic drugs or dietary supplements.

**Keywords:** Ruellia tuberosa L., glucose uptake, TNF-α, insulin resistance, FL83B hepatocytes
# EFFECT OF CONSUMING PRELOADS WITH DIFFERENT ENERGY DENSITY (LOW VS. HIGH) AND TASTE QUALITY (SAVOURY VS. SWEET) ON POSTPRANDIAL BLOOD GLUCOSE AND ENERGY INTAKE

(1)Forde, Ciaran; (2)Tey, Siew Ling; (2)Henry, Jeyakumar; (2)Forde, Ciaran.

(1)Clinical Nutrition Research Center, A*STAR Singapore Institute for Clinical Sciences, Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore; (2)Clinical Nutrition Research Centre, A*STAR Singapore Institute for Clinical Sciences, Singapore.

**Background and objectives:** Consumption of reduced energy dense foods and drink has potential to reduce energy intakes and reduce postprandial blood-glucose concentrations. Recent studies suggest a meals taste quality (e.g. savoury/sweet) may play a role in satiation and food intake. This study sought to examine the effect of consuming preloads with different energy density (low or high) and taste quality (savoury or sweet) on postprandial blood glucose response and energy intake.

**Methods:** Thirty-two healthy lean males participated in a randomised crossover study with four treatments: low energy dense sweet preload (50kcal), higher energy dense sweet preload (248kcal), low energy dense savoury preload (58kcal), and higher energy dense savoury preload (256kcal). On each test day, participants consumed a standardised breakfast in the morning and later received one of the study preloads an hour before eating an ad libitum lunch. Blood glucose concentrations were measured at baseline (just before preload) and 15, 30, 45, 60, 90, 120, 150, and 180 minutes after consumption. Participants left the lab 3-hours after preload consumption and completed a food diary for the rest of the day.

**Results:** There was a significant difference in ad libitum lunch intake between treatments (P = 0.012) with higher intake in sweet LED (763kcal) and savoury LED (762kcal) compared to sweet HED (722kcal) and savoury HED (693kcal). Energy intake at subsequent meals was not significantly different between the treatments (P = 0.284). The total daily energy intake was 2056kcal for sweet LED, 2197kcal for sweet HED, 2171kcal for savoury LED, and 2194kcal for savoury HED. The glucose response over three-hour period was 249mmol/L.min for sweet LED, 355 mmol/L.min for sweet HED, 253mmol/L.min for savoury LED, and 328mmol/L.min for savoury HED, representing a significant difference between treatments (P < 0.001).

**Conclusions:** Participants compensated primarily for energy differences and were less influenced by taste quality. Participants compensated for the energy in savoury LED preload, but not the energy in sweet LED preload. Consumption of high energy dense preloads resulted in a larger spike in postprandial glucose response compared with low energy dense preloads, irrespective of taste quality. Potential mechanisms and reasons for these differences will be discussed.

**Keywords:** Energy density. Taste. Glycaemic response. Energy intake

# EFFECT OF WATER SUPPLEMENTATION ON COGNITIVE PERFORMANCES AND MOOD AMONG MALE COLLEGE STUDENTS IN CANGZHOU, CHINA

(1)Zhang, Na; (2)Du, Songming; (3)Ma, Guan-Sheng.

(1)National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention; (2)PhD. Chinese Nutrition Society, China.; (3)PhD. Department of Nutrition and Food Hygiene. School of Public Health. Peking University. China.

**Background and objectives:** The effect of water-supplementation on cognitive performances was investigated.

**Methods:** Totally 68 male college students aged 18-25 years were randomly assigned into water-supplementation (WS) and no water-supplementation (NW) group. In the test day, urine osmolality, thirst, cognitive performances and mood were measured before water-supplementation. Then, subjects in WS group were asked to drink 400 mL purified water within 5 minutes. One hour later, same tests were measured. Mixed model of repeated measures analysis of variance were analyzed.

**Results:** Water-supplementation has effect on dehydration, Z = -2.63, P = 0.0086, with percentage of dehydration in NW group increased 5.8% without statistically significance, whilst decreased 50% in WS group, $\chi^2 = 17.752$, P = 0.000. There were also interactions on fatigue, depression, vigor and TMD (total mood disturbance) between time and group, F (1, 61) = -4.93, P < 0.0001, F (1, 61) = -2.06, P = 0.0438, F (1, 61) = 5.56, P < 0.0001, F (1, 61) = -2.16, P = 0.0346. Significant interactions effect on total score of digit span, digit span forward and backward were found between time and group, F (1, 61) = 4.27, P < 0.0001, F (1, 61) = 2.26, P = 0.0275; F (1, 61) = 3.24, P = 0.0019. The total score of NW group decreased 0.03 without statistically significance, whilst increased 1.53 in WS group after water-supplementation, t (29) = -3.64, P = 0.0011.

**Conclusions:** In conclusion, water-supplementation has beneficial effect on hydration status, short-term memory, fatigue, depression, vigor and TMD among male college students.

**Keywords:** Hydration; Water supplementation; Cognitive performances
EFFECTS OF DJULIS (CHENOPODIUM FORMOSANUM) ON COLITIS-ASSOCIATED COLON CANCER IN RATS

(1)Shih, Chun-Kuang; (2)Huang, Pin-Yu; (2)Chien, Yu-Hua.

(1)PhD. Associate Professor. School of Nutrition and Health Sciences. Taipei Medical University. Taiwan.; (2)MD. School of Nutrition and Health Sciences. Taipei Medical University. Taiwan.

**Background and objectives:** Colon cancer is a disease close-
ly associated with diet and inflammation. Many studies have in-
dicated that high consumption of whole grains may decrease the
risk of colon cancer. Djulis (Chenopodium formosanum), a native
cereal crop in Taiwan, is rich in betalains, polyphenols and dietary
fiber. Previous studies showed that betalains in djulis had an an-
ti-oxidative effect and both polyphenols and dietary fiber had an-
ti-inflammation and anti-tumor activities. This study investigated
the effect of djulis on colitis-associated colon cancer and its related
mechanisms.

**Methods:** Experimental colitis-associated colon cancer was induced in F344 rats injected with 3 doses of 1,2-dimethylhydrazine (DMH, 40 mg/kg BW, i.p) during the first week and then fed with dextran sulfate sodium (DSS, 3% in drinking water) for 7 days. Djulis-treated groups were given AIN-93G diet containing 5, 10 or 20% djulis. Animals were sacrificed after 10 weeks of experimental period and colons were collected for analyses of preneoplastic lesions and inflammatory markers.

**Results:** Djulis at 5, 10 and 20% levels significantly decreased the numbers of aberrant crypt foci (ACF) and sialomucin-producing ACF (SIM-ACF). Mucin depleted foci (MDF), an advanced preneoplastic lesion of colon cancer, were also inhibited by djulis treatment. Furthermore, djulis at 5, 10 and 20% levels significantly decreased the expression of cyclooxygenase-2 (COX-2) in colonic mucosa.

**Conclusions:** Djulis may suppress the progression of colitis-associated colon cancer by reducing the formation of preneoplastic lesions and the expression of pro-inflammatory protein.

**Keywords:** djulis, colon cancer, aberrant crypt foci, mucin depleted foci, inflammation

COMBINATION OF LACTOBACILLUS ACIDOPHI-
LUS AND DJULIS REDUCED EARLY LESIONS OF
COLON CANCER IN RATS

(1)Shih, Chun-Kuang; (2)Chien, Yu-Hua; (2)Huang, Pin-Yu.

(1)PhD. Associate Professor. School of Nutrition and Health Sciences. Taipei Medical University. Taiwan.; (2)MSc. School of Nutrition and Health Sciences. Taipei Medical University. Taiwan.

**Background and objectives:** Colorectal cancer is the third commonly diagnosed cancer worldwide. Dietary pattern is strongly associated with cancer risk. Previous studies showed that synbiotics had an inhibitory effect on colon cancer. Djulis (Chenopodium formosanum) is a native cereal crop planted in Taiwan. It has been reported that djulis contains high level of prebiotic dietary fiber. The aim of this study was to investigate the anti-cancer effect of Lactobacillus acidophilus and djulis on 1,2-dimethylhydrazine (DMH)/dextran sulfate sodium (DSS)-induced colon cancer in a rat model.

**Methods:** Rats were randomized into 5 groups: B (AIG-93G), C (AIN-93G), D (10% djulis), DLA (10% djulis plus 0.083 g/kg of L. acidophilus) and DHA (10% djulis plus 0.83 g/kg of L. acidophilus). All rats except those in group B were given three i.p. injections of DMH (40 mg/kg) and 3% DSS in drinking water after DMH injection for one week. All rats were sacrificed after 10 weeks of feeding and colons were examined for cancer-related lesions and markers.

**Results:** D, DLA and DHA significantly increased the weights of cecum and its content compared with B and C. DMH/DSS treatment induced the formation of preneoplastic aberrant crypt foci (ACF), especially in the distal colon. D, DLA and DHA significantly decreased the numbers of ACF and sialomucin-producing ACF in the distal colon compared with C. In addition, DLA and DHA significantly decreased the expression of proliferating cell nuclear antigen (PCNA) in colons.

**Conclusions:** Combination of Lactobacillus acidophilus and djulis as synbiotics showed the best inhibitory effect on early lesions of colon cancer.

**Keywords:** Lactobacillus acidophilus, djulis, synbiotics, colon cancer, aberrant crypt foci
# EFFECT OF MATERNAL WEIGHT AND GESTATIONAL WEIGHT GAIN ON LOW GRADE INFLAMMATION DURING PREGNANCY

(1)Kalaimani Rabindrakumar, Miruna Sudharshani;

(2)Wickramasinghe, Pujitha; (3)Arambepola, Carukshi; (4)Karunaratne, Veranja; (5)Thoradeniya, Tharanga.

(1)Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Colombo; (2)MBBS. DCH. MD. PhD. Professor in Paediatrics. Department of Paediatrics. Faculty of Medicine. University of Colombo. Sri Lanka.; (3)MSc. MD. Senior lecturer. Department of Community Medicine. Faculty of Medicine. University of Colombo. Sri Lanka.; (4)BSc. PhD. Senior Professor. Department of Chemistry. University of Peradeniya. Sri Lanka; (5)PhD. Senior lecturer. Department of Biochemistry and Molecular Biology. Faculty of Medicine. University of Colombo. Sri Lanka.

**Background and objectives:** Early life exposure to low-grade inflammation has received extensive attention due to its association with developmental programming and neuro-development of offspring. We aimed to study the association between low-grade inflammation, maternal body mass index (BMI) and weight gain during pregnancy.

**Methods:** A cohort study was conducted among 110 women aged 18-36 years who were apparently healthy and attending the first antenatal community-based clinic in Colombo, Sri Lanka. Women of >12 weeks of gestation and already on nutritional supplements were excluded. To detect low-grade inflammation, high sensitive-C Reactive Protein (hs-CRP) was assessed at recruitment, third trimester (≥34 weeks POA) and at delivery in mother, and in cord blood using sensitive immunoturbidometric assay. Personal information, BMI and weight gain were also recorded at each visit.

**Results:** At baseline, the mean concentration of hs-CRP in women was 3.4 mg/L. Further, the overweight (BMI >25kg/m2) women had significantly higher mean concentration of hs-CRP (4.7 ± 3.3mg/L) than the normal weight women (2.9 ± 3.1mg/L) (p=0.04).

From baseline, the hs-CRP concentration was increased significantly to 6.1 ± 5.0mg/L by third trimester (p=0.03) and to 9.2 ± 6.2mg/L (p=0.019) at delivery.

The women who gained excessive weight during pregnancy had significantly higher hs-CRP concentration at third trimester (5.9 ± 2.5mg/L; p=0.03) compared to the women with recommended weight gain (3.5±2.8mg/L) by same time point. Similarly, the women who gained excessive weight had a significantly higher hs-CRP concentration at delivery (12.9±7.0mg/L; p=0.019) compared to women with recommended weight gain (7.8±5.4mg/L). The hs-CRP concentrations of cord blood were significantly correlated with mothers' blood at third trimester (Spearmen correlation; r=0.32, p=0.04) and at delivery (r=0.46, p=0.003).

**Conclusions:** Women with higher BMI at early pregnancy and excess weight gain during pregnancy have an increased tendency towards low-grade inflammation, which may create an inflammatory environment and thereby adverse health outcomes to the fetus.

**Keywords:** high sensitive C-reactive protein, Body mass index, weight gain, pregnancy

# EFFECT OF NUTRIENT QUALITY ON VISCERAL AND SUBCUTANEOUS ADIPOSE TISSUE MASS AND INTRAHEPATIC LIPID ACCUMULATION DURING 12 WEEKS OF ENERGY-RESTRICTION IN ABDOMINAL OBESE MAN AND WOMEN

(1)Mensink, Marco; (2)Schutte, Sophie; (3)Esser, Diederik; (4)Siebelink, Els; (5)Afman, Lydia.

(1)PhD. MD. Assistant Professor. Division of Human Nutrition. Wageningen University. Wageningen. The Netherlands; (2)MSc. PhD-student. Division of Human Nutrition. Wageningen University. Wageningen. The Netherlands; (3)PhD. Post-Doc fellow. Division of Human Nutrition. Wageningen University. Wageningen. The Netherlands; (4)RD. Dietician. Division of Human Nutrition. Wageningen University. Wageningen. The Netherlands; (5)PhD. Assistant Professor. Division of Human Nutrition. Wageningen University. Wageningen. The Netherlands.

**Background and objectives:** Excessive abdominal fat, e.g. visceral and subcutaneous adipose tissue (VAT and SAT), and intrahepatic lipid (IHL) accumulation are closely associated to insulin resistance and glycaemic control. Weight-loss via energy restriction (ER) results in a reduction in abdominal fat and intrahepatic fat accumulation, but whether enhancing nutrient quality of an ER-diet might further improve this is not well established.

**Methods:** We examined the additional effects of nutrient quality over ER on abdominal fat distribution and IHL in a 12-week intervention study, in which participants with abdominal obesity were randomized over three groups; a Western-type (WD n=40) or Targeted (TD n=40) 25%ER dietary advice group, or a control group (no advice, no energy restriction; n=30,). VAT and SAT were measured with MRI; IHL was evaluated with 1H MRS. Body weight and metabolic parameters (insulin, glucose and HOMA-IR) were assessed before and after intervention in the fasted state. The Targeted Diet aimed to improve health beyond weight-loss by including MUFA, n-3 PUFAs, soy protein and dietary fibres.

**Results:** Although the same level of ER was applied in both groups, weight loss was enhanced in the TD (-6.3 and -8.3 kg for WD-ER and TD-ER respectively; p<0.05), while the control group was weight stable. VAT, SAT and IHL were dramatically reduced in both ER groups, with no difference between TD and WD (VAT:-44.1 and -61.5 cm2; SAT:-45.3 and -54.1 cm2; IHL -3.5 and -4.1% of H2O peak for WD-ER and TD-ER respectively. p=NS). Also the VAT/SAT ratio was significantly reduced in both ER-groups, indicating a preferential loss of VAT over SAT, without a clear effect of nutrient quality of the diet. Reductions in VAT and IHL, but not SAT, were strongly correlated with improvements in metabolic parameters, i.e. fasting insulin, fasting glucose and insulin resistance (HOMA-IR).
**Conclusions:** Energy restriction is the most important factor for reducing abdominal fat and intrahepatic lipid accumulation. There was no additional beneficial effect of nutrient quality on fat accumulation beyond weight-loss. VAT turned out to be more responsive to weight-loss than SAT; and changes in VAT and IHL were associated with improvements in metabolic parameters.

**Keywords:** Energy restriction, Weight-loss, abdominal fat, intrahepatic lipids, nutrient quality

**Background and objectives:** The role of yoghurt, respectively probiotics, in the treatment and prevention of obesity has been discussed. The aim of our study was to investigate the effect of yoghurt fermented by Bifidus essensis (0.5% fat) in the treatment of patients with obesity.

**Methods:** A total of 57 subjects with central type obesity (21 men and 36 women) were enrolled in the study. Baseline mean subject characteristics were: age-46.2 year old, body mass index (BMI)-35.4, fat mass- 39.4%, visceral fat-14.1, waist circumference-109 cm, hip circumference-120.2, and sagittal diameter-27 cm. All obese patients underwent a dietary regimen, included 290 g yoghurt fermented by Bifidus essensis for dinner for a 6-month period. The product consisted of proteins-4.3 g, carbohydrates (lactose)-3.9 g, fat-0.5 g, and 37 kilocalories per 100 g product. At the beginning and at the end of the study several anthropometric parameters have been measured by bioimpedance device (Tanita 420).

**Results:** The study demonstrated a decrease of BMI with 9.8%, of fat mass with 9.6%, of visceral fat with 14% as well as a decrease of waist circumference-11.9%, hip circumference-5.8%, and sagittal diameter-10.3%.

**Conclusions:** The regular consumption of yoghurt fermented by Bifidus essensis (0.5% fat) in the diet of obese patients leads to improvement of the studied anthropometric parameters as well as to significant decrease in the cardio-vascular risk.

**Keywords:** Yoghurt, obesity, metabolic syndrome

**Background and objectives:** Parents with children suffering from spastic cerebral palsy (CP) face various challenges regarding their child's health, nutritional status, growth, development and quality of life (QOL). The nutrition-related challenges that these children encounter are not well described in the South African setting. These concerns, its management, current feeding practices and parental perspectives were investigated.

**Methods:** This cross-sectional, quantitative research study made use of a self-administered, validated questionnaire to obtain information from participants at three various facilities: the Pretoria Centre for Cerebral Palsy (PCCP), the Baby Therapy Centre (BTC) and New Hope School (NHS) situated in the Gauteng Province in South Africa. Recruitment and data collection took place over a period of three months. Data was captured and the information was statistically analysed and extracted for interpretation.

**Results:** Thirty-four questionnaires were completed by parents and returned. The most common nutrition-related concerns reported were constipation (47.1%), underweight (32.4%) and poor appetite (20.6%). Nutrition-related problems were mostly managed by consulting a healthcare professional (HCP). Most children were seen by a multidisciplinary team (MDT) of therapists, but only 44% consulted a registered dietitian (RD). Information pertaining to the current feeding practices showed that most children required assistance at mealtimes (61.8%). Nutritionally poor food choices such as deep fried food and sugary drinks were reported. Solids (64.7%) and pureed food (23.5%) were mostly tolerated. Most parents (55.9%) spent less than two hours daily on feeding their child. Parents lacked confidence when dealing with nutrition-related problems. Most were, however, content when preparing meals, feeding their child and with how their child was growing, developing and their overall health.

**Conclusions:** Nutrition-related concerns that these parents encountered with their spastic CP child were common concerns. The role of the RD in addressing and managing nutrition-related problems, advising on healthy feeding practices and parental support needs to be emphasized and remains a crucial part of treatment in this group of disabled children.

**Keywords:** Cerebral palsy, nutrition-related problems, feeding practices, parental concerns, dietitian

<footnote>(1)Handjieva-Darlenska, Teodora; (2)Handjiev, Svetoslav.</footnote>

<footnote>(1)MD, PhD, Department of pharmacology and toxicology, Medical university, Sofia, Bulgaria; (2)MD, PhD, Bulgarian association for the study of obesity and related diseases (BASORD).</footnote>

<footnote>(1)Dolman, Robin; (2)Lourens, Lucinda; (3)Van Graan, Averalda.</footnote>

<footnote>(1)PhD. Dietetics. Centre of Excellence for Nutrition. North-West University. Potchefstroom. South Africa; (2)M.Sc. Dietetics. Centre of Excellence for Nutrition. North-West University. Potchefstroom. South Africa; (3)PhD. Nutrition. South African Medical Research Council, Western Cape, South Africa.</footnote>