and 5.3 and 31kg, 31.5%, 0.60, and 5.8, for boys and girls respectively. Using BMIZ, approximately 25% of boys and 16% of girls were classified as obese compared to 5% and 31%, respectively, using the FMI.

**Conclusions:** The use of BMIZ resulted in a higher estimate of obesity among boys and a lower estimate of obesity among girls compared to the FMI. These results are important as population studies and program evaluations using BMIZ may generate inaccurate estimates of childhood obesity. An important policy change could be to promote the use of relatively inexpensive body composition methods to improve estimates childhood obesity by using FMI instead of BMIZ.

**Keywords:** children, nutritional status, obesity, fat mass, BMI, FMI, %FM

**Further collaborators:**

Supported by NIH grants HD-043099, HD-058818 and Grant Sectorial CONACYT 202062

144/2028

IS DRINKING MATE ASSOCIATED WITH POOR DIET QUALITY AND FOOD AND NUTRIENT INTAKES AMONG SOUTH AMERICAN ADULTS?

**Background and objectives:** Mate, a beverage made from the leaves of Ilex paraguariensis, is widely consumed in South America. High intakes of mate, and the habit of adding sugar may affect diet by replacing meals and increasing total sugar intake. We assessed whether mate consumption is associated with diet quality and quantity among adults aged 35-74 years in four South American cities in Argentina (Bariloche and Marcos Paz), Chile (Temuco) and Uruguay (Canelones).

**Methods:** Cross-sectional analysis on data from baseline of CESCAS (Centro de Excelencia en Salud Cardiovascular del Cono Sur) I, a population-based prospective cohort study. We included participants with available socio-demographic and dietary data (n=5458). Diet was assessed using a validated 126-item food-frequency questionnaire. Diet quality was evaluated with the Alternate Healthy Eating Index (AHEI-2010), the Dietary Approaches to Stop Hypertension (DASH) and the Alternate Mediterranean Diet (AMeD) Scores, with higher scores indicating greater adherence to these patterns. Multivariable linear regression models were used to examine the associations of quartiles (Q) of mate consumption with energy-adjusted food and nutrient intakes and diet quality scores (converted to a 0-100 scale) adjusting for age, gender, education, and city. Subgroup analysis was conducted (participants that added sugar/ those that didn't.)

**Results:** 57% of participants drank mate daily; those who drank mate had an average intake of 1.3 liters per day and 34% of them added sugar to at least half of their mate beverage servings. Mate consumption was associated with more bread intake(p<0.001). Among participants who didn't add sugar, diet quality and consumption of other foods were independent of mate consumption. However, participants in Q4 with the habit of adding sugar reported higher intakes of sweet and sugars, energy and carbohydrates, and lower intakes of dairy products, fiber, vitamins C, retinol, calcium, zinc and iron compared to participants in Q1(p<0.001). In addition, in the same subgroup, differences between Q4vs.Q1 in diet quality scores were: AHEI-2010:-3.73 (95%CI -4.95;-2.50); DASH:-3.75(-5.81;-1.81) and AMeD:-8.77(-6.00;-11.56).

**Conclusions:** Higher consumption of mate was significantly associated with higher consumption of bread. When the habit of adding sugar was present, food and nutrient intakes as well as adherence to healthy diet patterns were negatively affected.

**Keywords:** Ilex paraguariensis, South America, mate, diet, diet quality

**Further collaborators:**

Nora Mores. MD. Secretaría de Salud. Municipio de Marcos Paz. Argentina

Matias Calandrelli. MD. Sanatorio San Carlos. Bariloche. Argentina

<footnote>(1)Elorriaga, Natalia; (2)Irazola, Vilma; (3)Gutierrez, Laura;</footnote>

<footnote>(4)Defagó, Maria Daniela; (5)Poggio, Rosana; (6)Lanas, Fernando;</footnote>

<footnote>(7)Ponzo, Jacqueline; (8)Danaei, Goodarz; (9)Mozaffarian, Dariush;</footnote>

<footnote>(5)Rubinstein, Adolfo.</footnote>

<footnote>(1)MSc. BSc. Nutritionist, South American Center of Excellence in Cardiovascular Health. Institute for Clinical Effectiveness and Health Policy. Escuela de Nutrición. Universidad de Buenos Aires. Argentina.; (2)MD. MSc. South American Center of Excellence in Cardiovascular Health. Institute for Clinical Effectiveness and Health Policy. CONICET. Buenos Aires. Argentina.; (3)BSc. MSc. South American Center of Excellence in Cardiovascular Health. Institute for Clinical Effectiveness and Health Policy. Argentina;</footnote>

<footnote>(4)PhD. Nutritionist. South American Center of Excellence in Cardiovascular Health. Institute for Clinical Effectiveness and Health Policy. CONICET. Argentina.; (5)MD. MSc. PhD. South American Center of Excellence in Cardiovascular Health. Institute for Clinical Effectiveness and Health Policy. CONICET. Argentina;</footnote>

<footnote>(6)MD. MSc. Universidad de La Frontera. Temuco. Chile.; (7)MD. MSc. Universidad de la República. Uruguay.; (8)MD. MSc. ScD. Department of Global Health and Population. Department of Epidemiology. Harvard T.H.Chan School of Public Health. United States of America; (9)BS. MD. MPH. PhD. Tufts University Friedman School of Nutrition Science and Policy. United States of America.</footnote>
SODIUM AND IODINE URINARY EXCRETION AND YOUR RELATION WITH BLOOD PRESSURE LEVELS AND NUTRITIONAL STATUS ON SCHOOLCHILDREN IN RIO DE JANEIRO

**Background and objectives:** Excess consumption of iodine and sodium has been studied due to high consumption of ultraprocessed and processed foods and its relation with the development of diseases in early stages of life. The objective of this study was to describe the urinary excretion of sodium and iodine in schoolchildren related to pressure levels and anthropometric profile.

**Methods:** It was a cross-sectional study realized with schoolchildren aged 6-16y at Rio de Janeiro city. Anthropometric data, blood pressure levels, familial historic of arterial hypertension and spot urine samples was collected. The urine samples were analyzed by Flame Photometry to obtain sodium concentration and by Spectrophotometry by the Sandell-Kolthoff method for iodine. Descriptive (mean, SD, median, maximum and minimum) and inferential (Mann Whitney for mean comparison and Pearson and Spearman correlation) statistics were realized. The significance level was 0.05.

**Results:** The sample consisted in 109, which 52,4% were man and 78% adolescents. Overweight and obesity was present in 35,4%. There was 9.2% of changes in BP and 23.6% had parents with AH. The sons of hypertensive parents had an average of SBP higher than those whose parents weren't hypertensive (P=0.012). The daily sodium intake was 2448.4±2186.8mg/day and 41.9% had ingestion above the UL. The daily salt intake was 6.2±5.6g/day and 48.4% was classified with higher intake. The iodine intake was 381.5±185,9µg/day, being classified as insufficient (3.2%), more than adequate (17.2%) and excessive (65.6%). The sodium intake prevalence ≥1500mg/day was about 55,9% and the iodine intake ≥200µg/day was about 82,8%.

**Conclusions:** Sodium and iodine intake weren't different by sex, anthropometric status and blood pressure classification. Schoolchildren which parents had hypertension showed sodium mean intake upper than that which parents hadn't. The sample showed excessive sodium intake like salt and iodine. This fact is a risk factor to chronic noncommunicable diseases, like AH, kidney, heart and thyroid diseases. Studies like that may increase the use of this measure as an indicator of the level of these minerals and can give directions to intervention strategies, in the field of health and education.

**Keywords:** Iodine - Sodium - Urine - Schoolchildren

ANTHROPOMETRIC CHARACTERISTICS, DIET QUALITY AND DIFFERENCE IN FOOD INTAKE BETWEEN WOMEN WITH AND WITHOUT POLYCYSTIC OVARY SYNDROME

**Background and objectives:** Scientific evidence indicates overweight/obesity in women with polycystic ovary syndrome (PCOS). Excess weight aggravates the syndrome through metabolic disorders. It is likely that one of the contributing factors to overweight in women with PCOS is inadequate food intake. The objective of this study was to evaluate the food intake and the nutritional status of patients with and without PCOS treated at School Hospital, Federal University of Uberlandia.

**Methods:** A case-control study was conducted with 67 women (34 cases). For anthropometric evaluation, the measurement of weight and height, used to calculate body mass index (BMI), and waist circumference (WC) were made. Both values obtained were evaluated by the classification of the World Health Organization. To evaluate body composition, especially to quantify lean mass and body fat, electric bioimpedance was performed. To evaluate the quality of food intake, a 24-hour food recall was made. Subsequently, the data was used to obtain the score using the Brazilian Healthy Eating Index (BHEI).

**Results:** There was no significant difference between the mean of the age (25.24±0.68 vs. 25.12±0.71; p=0.899), WC (88.0 vs. 79.0; p=0.158), BMI (25.8 vs. 22.9; p=0.221), percent lean tissue mass (68.4 vs. 70.5; p=0.175) and body fat (31.6 vs. 28.7; p=0.078) of the PCOS group and healthy women, respectively. In dietary analysis, the consumption of total energy (1425 vs. 1666; p=0.075), carbohydrate (627.3 vs. 735.4; p=0.137), protein (269.9 vs. 313.2; p=0.055), fat (407.6 vs. 554.6; p=0.208), cholesterol (150.7 vs. 188.2; p=0.060) and saturated fat (10.6 vs. 9.3; p=0.981) were similar between the groups. However, the PCOS group had lower consumption of fiber compared to the control group (8.8 vs. 11.6, respectively; p=0.018). Regarding the BHEI, in the PCOS group 72% (n=24) showed "needs improvement", 24% (n=8) showed "inadequate diet" and only one participant showed "good diet" while in the control group 76% (n=26) showed "needs improvement" and 24% (n=8) showed "inadequate diet".

<footnote>(1)Rodrigues, Lúcia; (2)Aguiar, Cynthia; (3)Teodoro, Anderson;</footnote>

<footnote>(3)Rodrigues, Maria de Lourdes.</footnote>

<footnote>(1)PhD University Teacher of Nutrition at Federal University of Rio de Janeiro State, Brazil; (2)Nutritionist graduated at Federal University of Rio de Janeiro State, Brazil; (3)MsD University Teacher of Nutrition at Federal University of Rio de Janeiro State, Brazil.</footnote>

<footnote>(1)Bernardes da Cunha, Nayara; (2)Mendes Silva, Catarina; (3)Toffoli Ribeiro, Camila; (4)Japur de Sá Rosa e Silva, Ana Carolina; (5)Abadia De-Souza, Daurea.</footnote>

<footnote>(1)Nutritionist. Postgraduation Program in Health Sciences. School of Medicine. Federal University of Uberlandia. Uberlandia/MG. Brazil.; (2)Nutritionist. Postgraduation Program in Health Sciences. School of Medicine. Federal University of Uberlandia. Uberlandia. Brazil.; (3)MSc. Doctor. Department of gynecology and obstetrics. School of Medicine. Federal University of Uberlandia. Uberlandia. Brazil; (4)PhD. Doctor. Department of gynecology and obstetrics. School of Medicine. University of Sao Paulo. Ribeirao Preto. Brazil.; (5)PhD. Doctor. School of Medicine. Federal University of Uberlandia. Uberlandia. Brazil.</footnote>
**Conclusions:** Both groups showed no significant difference in anthropometric evaluation and dietary pattern. However, women with PCOS presented lower consumption of fiber compared to women without the syndrome. Therefore, women with and without PCOS need to improve eating habits to avoid overweight/obesity.

**Keywords:** Polycystic ovary syndrome. Nutritional status. Food intake. Diet quality.

144/2051

A LATERAL FLOW IMMUNOASSAY FOR QUANTIFICATION OF ALPHA-1-ACID GLYCOPROTEIN AS A DIAGNOSTIC TOOL FOR RAPID, MOBILE-BASED DETERMINATION OF INFLAMMATION

(1)Gannon, Bryan Gannon; (2)Erickson, David; (3)Mehta, Saur.

(1)PhD. Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT). Division of Nutritional Sciences. Cornell University. USA.; (2)PhD. Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT). Sibley School of Mechanical and Aerospace Engineering. Cornell University. USA.; (3)MBBS ScD. Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT). Division of Nutritional Sciences. Cornell University. USA.

**Background and objectives:** Alpha-1-acid glycoprotein (AGP) is an acute phase protein, and its measurement is recommended for adjustment of nutritional biomarkers for inflammation by the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) working group. Traditional AGP quantification is not widely available in resource limited settings and uses assays that require sample processing and shipment, laboratory and personnel resources, and hours to days to complete a test. We sought to develop an inexpensive, mobile-based, and rapid diagnostic test to quantify AGP.

**Methods:** We developed a lateral flow immunoassay (LFIA) designed to work in conjunction with the Cornell NutriPhone platform. In the LFIA, gold nanoparticles are conjugated to anti-AGP antibodies and generate a variable colorimetric signal based on the concentration of AGP in the sample. This can be quantified by the processing of an image captured by a mobile camera. We evaluated whether the LFIA could discriminate a range of concentrations of purified AGP in buffer and subsequently evaluated the assay's ability to quantify AGP and discriminate elevated concentrations (i.e. > 1 mg/mL) in diluted human serum (n=7) and serum spiked with purified AGP (to increase by 2 mg/mL, n=7) relative to an automated immunoturbidimetric assay.

**Results:** The first stage of the LFIA was able to distinguish purified AGP with a quantification range of 0.25 – 2.5 µg/mL (R2=0.89). Mean ± SD unspiked serum AGP concentration by immunoturbidimetric assay was 0.36 ± 0.05 mg/mL (range 0.28 – 0.42 mg/mL). The LFIA results were significantly correlated with the immunoturbidimetric assay for all samples (y=0.76x + 0.37,

R2=0.84). Initial sensitivity and specificity were compliant with World Health Organization specifications for a point of care diagnostic test.

**Conclusions:** The AGP LFIA demonstrated reasonable accuracy when compared to a commercial immunoturbidimetric assay and is inexpensive, portable, and can provide results within 15 minutes. This assay can be integrated into the NutriPhone platform to obtain multiple biomarkers of nutrition and inflammation in diverse and resource limited settings. Further development will focus on evaluating human serum with a wider range of endogenous AGP concentrations and ensuring the LFIA can distinguish elevated AGP concentrations closer to the suggested cutoff.

**Keywords:** AGP, biomarker, lateral flow assay, point-of-care

**Conflict of Interest Disclosure:** DE and SM have equity interest in a diagnostic start up focused on measurement of nutritional biomarkers at the point-of-care utilizing the results from their research.

144/2052

VITAMIN B12 INTAKE AND STATUS IN EARLY PREGNANCY IN WOMEN IN SOUTHERN INDIA

(1)Guetterman, Heather; (2)Kurpad, Anura; (2)Dwarkanath, Pratibha;

(3)Bose, Beena; (2)Thomas, Tinku; (4)Finkelstein, Julia.

(1)BSc. Division of Nutritional Sciences. Cornell University. Ithaca NY. United States.; (2)PhD. St. John's Research Institute. Bangalore. India.; (3)MSc. St. John's Research Institute. Bangalore. India.;

(4)PhD. Division of Nutritional Sciences. Cornell University. Ithaca NY. United States. St. John's Research Institute. Bangalore. India.

**Background and objectives:** Vitamin B12 deficiency is common during pregnancy and is associated with adverse maternal and child health outcomes. The objective of this study was to examine dietary correlates of vitamin B12 status in a cohort study of pregnant women during the first trimester in Southern India.

**Methods:** Pregnant women (n=419) were enrolled before 12 weeks of gestation and monitored to assess dietary intake and vitamin B12 status during pregnancy. A validated food frequency questionnaire (FFQ) was used to evaluate dietary intake during the past three months. Plasma vitamin B12 concentrations were assessed via electrochemiluminescence in maternal samples at enrollment. Linear and binomial regression models were used to evaluate the associations between dietary intake of nutrients and food groups with vitamin B12 concentrations and deficiency (<150 pmol/L) during the first trimester.

**Results:** Median dietary intake of vitamin B12 was 1.73 g (IQR: 1.10-2.45) per day, and median maternal vitamin B12 concentrations were 126.9 (IQR: 89.6, 172.2) pmol/L at baseline. A total of 64% of women were vitamin B12 deficient (<150 pmol/L) at their first prenatal visit. Increased consumption of refined grains, fish, red meat, egg-based foods, organ meat, and total meat; and vitamin B12, methionine, iodine, cholesterol, saturated fat, and polyunsaturated fatty acids were associated with increased vitamin B12 concentrations (p<0.05). In analyses of vitamin B12 deficien-
cy, animal-source foods, including fish, egg-based foods, and or-
gan meat were associated with lower risk of vitamin B12 deficien-
cy (p<0.05). In nutrient analyses, increased intake of vitamin B12
(RR: 0.87, 95% CI: 0.80-0.93, p=0.0001), methionine (RR: 0.73,
95% CI: 0.54-0.98, p<0.05), selenium (RR: 0.99, 95% CI: 0.99-0.99,
p<0.05), cholesterol (RR: 0.99, 95% CI: 0.99-0.99, p<0.001), and
saturated, monosaturated, and omega-3 (linolenic acid, eicoasap-
entanoic acid, docosahexanoic acid) and omega-6 (docosapenta-
noic acid, arachidonic acid) polyunsaturated fatty acids (p<0.05)
were associated with lower risk of vitamin B12 deficiency.

**Conclusions:** The prevalence of vitamin B12 deficiency was high early in pregnancy in this population. Inadequate dietary intake of animal-based foods and low consumption of vitamin B12, methionine, cholesterol, saturated fat, and polyunsaturated fatty acids predicted increased risk of vitamin B12 deficiency.

**Keywords:** Vitamin B12, dietary intake, pregnancy, India

144/2053

PERCENT BODY FAT PREDICTION USING BODY
MASS, STATURE AND ABDOMINAL CIRCUMFER-
ENCE IN ADULTS SEEN IN THE FAMILY DOCTOR
PRIMARY CARE PROGRAM UNITS IN NITERÓI,
RIO DE JANEIRO, BRASIL

**Background and objectives:** Body mass (M), stature (S) and abdominal circumference (AC) are routinely measured in adults seen in Primary Health Care Units. Indicators are developed from these measures and used in nutritional and risk assessment for diseases. They could also be used to estimate percent body fat (%BF) if validated prediction equations (PE) are available for the specific population. To this end, the purpose of the present study was to validate a series of %BF in adults (≥45y) seen in the Family Doctor Primary Care Program (FD) units in Niterói, Rio de Janeiro, Brasil.

**Methods:** The tested %BF PE were developed in a probability sample of adults (≥20y) from Niterói and included BM, S and AC (R2 between 0.83 and 0.88). A sample of 518 subjects (329 women) seen in the FD units in Niterói participated in the study. BM, S and AC measures were obtained by trained researchers in the FD units. BMI (BM/S2) was used to assess the nutritional status. The subjects were invited to come to the research laboratory where %BF was obtained by DXA. The significance of the difference (bias) between predicted (%BFp) and measured (%BFm) %BF was

determined by paired t-Student tests. The % bias [(%BFp -%BF-
m/%BFm)\*100] was calculated. In addition, multiple regression
models to predict %BF against the anthropometric measures were
conducted with the data from the 518 subjects.

**Results:** Age of the 518 subjects varied from 45-92y (mean±SD, 59.6±9.7y). Mean %BFm was 41.8 (±5.7) and 28.3 (±6.8) for women and men, respectively. Overweight (25≥BMI<30kg/m²) was observed in 38.9% of the women and 39.8% were obese (BMI ≥30kg/m²). In men, these prevalences were 43.9 and 19.6%, respectively. Non-significant %BF biases were observed in 45-60y-old men (-0.5±5.4 representing -0.6±23.0%); 60-70y-old women (0.5±3.3 representing 1.5±8.3%); and ≥70y-old women (0.2±3.7 representing 1.3±10.1%). The developed %BF PE was [31.453-(350.294\*1/BMI)-(12.558\*Sex(Male=1;Female=0))+(0.242\*AC)]; R²=0.82 and SEE=3.75.

**Conclusions:** The population specific %BF PE was not ade-
quate for all segments of patients seen in the FD units. The devel-
oped PE includes BM, S and AC and might be an useful instru-
ment to estimate the %BF using routine anthropometric measures
obtained in adults seen in FD units.

**Keywords:** Nutrition Assessment, Anthropometry, Body Composition, Public Health

144/2056

VALIDITY OF SKINFOLD PREDICTIVE EQUA-
TIONS TO DETERMINE BODY COMPOSITION IN
ADULTS FROM PRIMARY HEALTH CARE UNITS
IN NITERÓI, RIO DE JANEIRO, BRASIL

**Background and objectives:** Body composition (BC) information is important for nutritional assessment but its widespread use depends on accurate and feasible methods. The aim of the present study was to assess the validity of skinfold predictive equations to determine BC in adults (≥ 50 years) seen in Primary Health Care Units or enrolled in physical activity programs.

**Methods:** Two-hundred-eight-six adults (203 women) were recruited. Body mass, stature and skinfolds (triceps, TS; biceps, BS; and subscapular, SS) were measured. Nutritional status was determined by body mass index (BMI). Percent body fat (%BF) density was estimated using the prediction equations developed by Durnin & Womersley (DW_equations) for adults aged 50 to 72 years using one skinfold (TS or BS or SS) or a combination of skinfolds (TS+BS or TS+BS+SS). Fat mass (FM) and fat free mass (FFM) were calculated from the estimated %BF and the obtained

<footnote>(1)Wahrlich, Vivian; (2)Anjos, Luiz Antonio; (3)Contino, Mariana;</footnote>

<footnote>(3)Oliveira, Mariana; (4)Vasconcellos, Mauricio.</footnote>

<footnote>(1)PhD. Laboratório de Avaliação Nutricional e Funcional.
Universidade Federal Fluminense. Niterói. Rio de Janeiro. Brasil.;</footnote>

<footnote>(2)PhD. MD. Laboratório de Avaliação Nutricional e Funcional.
Universidade Federal Fluminense. Niterói. Rio de Janeiro.
Brasil.; (3)BSc. Laboratório de Avaliação Nutricional e Funcional.
Universidade Federal Fluminense. Niterói. Rio de Janeiro. Brasil;</footnote>

<footnote>(4)PhD. Escola Nacional de Ciências Estatísticas. IBGE. Rio de Janeiro. Brasil.</footnote>

<footnote>(1)Wahrlich, Vivian; (2)Anjos, Luiz Antonio; (3)Contino, Mariana;</footnote>

<footnote>(3)Oliveira, Mariana.</footnote>

<footnote>(1)PhD. Laboratório de Avaliação Nutricional e Funcional.
Universidade Federal Fluminense. Niterói. Rio de Janeiro. Brasil.;</footnote>

<footnote>(2)PhD. MD. Laboratório de Avaliação Nutricional e Funcional.
Universidade Federal Fluminense. Niterói. Rio de Janeiro.
Brasil.; (3)BSc. Laboratório de Avaliação Nutricional e Funcional.
Universidade Federal Fluminense. Niterói. Rio de Janeiro. Brasil.</footnote>
by DXA. Paired Student t-tests were used to determine the significance of the means.

**Results:** Mean (SD) measured %BF, FM and FFM was 41.4 (5.7) %, 27.7 (8.2) kg and 38.0 (5.6) kg for women and, 28.9 (7.2) %, 22.2 (9.6) kg e 52.0 (7.0) kg, for men, respectively. %BF and FM mean values were significantly underestimated by all equations in women (bias between 38 and 39.5% for %BF and 39.4 to 40.4 kg for FM), while FFM was overestimated. However, mean skinfold-estimated values of %BF, FM and FFM using BS or SS or BS+SS were not different from DXA in women aged 50 to 60 years or for those with BMI < 25 kg/m². The same occurred in women with BMI between 25-30 kg/m² for BC estimated using only SS. For all men, %BF, FM and FFM mean estimated values using TS, BS or TS+BS combination were not different from DXA. The same pattern was observed for the 50-70y age men and the ones with BMI < 25 or between 25-30 kg/m².

**Conclusions:** DW_equations can be used to estimate BC in groups of men and women depending on age and nutritional status but it is recommended that new equations be developed for this population.

**Keywords:** Nutrition Assessment, Anthropometry, Body Composition, Public Health.

**Background and objectives:** Assessing the rates of exclusive breastfeeding (EBF) until age six months is an important public health priority; however, feeding practices are based mostly on caregiver recall and often affected by self-reporting bias. The deuterium oxide dose-to-the-mother (DTM) technique can be used to distinguish EBF based on a cut-off (<25 g/d) of water intake from sources other than human milk. This value reflects the error (25±62 g/d) associated with the assumptions made in the calcula-

tion but has yet to be verified in mother-infant pairs known to be truly EBF. Thus, the aim of the present study was to estimate the apparent volume of non-milk water intake measured by deuterium dilution for infants known to be EBF.

**Methods:** Healthy, apparently EBF infants (n=121) aged 2.5-5.5 months were recruited from Sumedang, West Java, Indonesia. After administration of deuterium to the mothers, saliva was sampled from mother and infant pairs over a 14-d period. Validation of infant feeding practices was conducted via home observation over six non-consecutive days with recall of foods or liquids consumed by the infant during the respective previous 24 hours. A fully Bayesian approach was used to estimate the marginal posterior distribution of the population non-milk water intake over all mother-infant pairs.

**Results:** Of the 121 infants enrolled, 113 were reported as EBF during the study period, consisting of 1502 observations. Eight infants were administered medicines yet remained in the final sample as per the WHO EBF definition. Seven infants were identified as non-EBF: 3 swallowed bath water, 4 consumed other foods and/or liquids; and one infant was excluded due to physiologically plausible values. Using the 90th percentile of the distribution of the population non-milk water intake distribution, we estimated a cut-off value of 82.6 g/d, with a lower limit 95% CI of approximately 54 g/d.

**Conclusions:** The current study is the first to estimate the distribution region of deuterium exposure in mother-infant pairs using a known EBF infant cohort, with the classification of EBF defined as the proportion of the posterior distribution of non-milk water intake <82.6 g/d. This cut-off is substantially higher than previously recommended (<25 g/d).

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

**Conflict of Interest Disclosure:** None. Funding provided by The Bill & Melinda Gates Foundation.

<footnote>(1)Diana, Aly; (2)Liu, Zheng; (3)Luftimas, Dimas; (4)Rahmannia, Sofa;</footnote>

<footnote>(5)Preston, Thomas; (6)Slater, Christine; (7)Duffull, Stephen; (8)Gibson, Rosalind; (9)Houghton, Lisa.</footnote>

<footnote>(1)MD, MSc, PhD candidate. Department of Human Nutrition. University of Otago. New Zealand; (2)PhD. Pharmacometric modeller. School of Pharmacy. University of Otago. New Zealand.; (3)MD. Lecturer. Faculty of Medicine. Universitas Padjadjaran. Indonesia; (4)MD. MSc student. Faculty of Medicine. Universitas Padjadjaran. Indonesia; (5)PhD. Professor. Scottish Universities Environmental Research Centre. University of Glasgow. United Kingdom.; (6)PhD. Nutritionist. Independent Consultant. United Kingdom.; (7)PhD. Professor. Department of Human Nutrition. University of Otago. New Zealand.; (8)PhD. Emeritus Professor. Department of Human Nutrition. University of Otago. New Zealand; (9)PhD. Associate Professor. Department of Human Nutrition. University of Otago. New Zealand.</footnote>
PREVIOUS STEP TO ANALYZE 24-H DIETARY RE-
CALLS: STANDARDIZATION OF THE FOOD COM-
POSITION DATABASE FOR THE "GROWTH AND
OBESITY COHORT STUDY"

**Background and objectives:** Analyzing 24-h dietary recalls is a enormous challenge when appropriate tools for dietary data collection are not available. Validated nutrition analysis software are often based on foreign database, data from literature sources and/or manufacturer's data. These sources can differ from local food composition and therefore require a previous harmonization process.

Objective: To describe a protocol for adjusting the local food composition to nutritional analysis software database prior analyzing the 24-h dietary recalls applied to children from the “Growth and Obesity Cohort Study” (GOCS).

**Methods:** Nutrition Data System for Research (NDS-R) was used for harmonization process. This database includes over 18.000 foods and 165 nutrient and other food components, and it is updated annually to reflect marketplace changes and new analytic data. Dietitians identified food items reported in the 24-h dietary recalls collected during 2013-2014 and grouped them according to nutritional characteristics. Foods were matched in the NDS-R database through its general description (i.e., by name, type and mode of preparation). Recipes were added for commonly consumed processed foods that were not in the software database. Energy and macronutrient values available in Chilean food composition tables (TCA), local food industry composition tables and/or nutrition labels were compared to values described in the software. A concordance rate between 80 and 120% for each parameter analyzed was required to accept food harmonization.

**Results:** 766 foods, beverages and recipes were harmonized. Major obstacles were observed in local foods, for example, fish and seafood, processed foods, such as cookies, cakes, candies and fast food, among others. In addition, there were problems with the large variety of recipes and preparation of typical Chilean meals; however, NDS-R allows entering new recipes to its database.

Scarce information of new food and lack of updated TCA information constituted additional difficulties.

**Conclusions:** Software adaptation to analyze 24-h dietary recalls is an arduous task that must be performed by trained dietitians to minimize systematic and random errors in nutrient intake estimations. Local updated nutrient composition databases are key to enhance the quality of dietary assessment.

**Keywords:** Assessment dietary, 24-h dietary recall, Nutrition Data System for Research

**Further collaborators:**

Funding DIUV Reg nº 48/2013. Conicyt, Becas Chile 2015.

ASSESSMENT THE NUTRITIONAL STATUS AND
FOOD INTAKE OF ATHLETES OF THE HANDBALL
TEAM OF THE OF GUARULHOS CITY- SP

de Araujo, Mariangela; Korukian Freiberg, Clara; da Silva Jr, Luiz Henrique; dos Santos Novaes, Patrícia; Simões, Juliana; Oliveira, Roberta; de Oliveira Barcellos, Bianca.

MSc. Nutritionist. Nutrition Departament. Guarulhos University.
São Paulo. Brazil.

**Background and objectives:** Handball is a collective, dynamic and fast-growing sport in Brazil. Because it is a high-performance sport and a great caloric expenditure, its practitioners undergo physical stress and great wear and tear, which must be compensated with adequate food consumption that promotes health, improves performance and recovery physical and muscular development of these individuals. The aim was to assess the nutritional status through anthropometric measures and adequate intake of food considering energy, macro and micronutrients of athletes of the handball team of the of Guarulhos City- SP

**Methods:** Cross-sectional study, approved by the committee of ethics in research. For this study, were evaluated Fifteen male handball athletes aged 18 to 26 years. For the determination of body fat, it has applied the sum of nine skin folds between them: subscapular, tricipital, bicipital, axillary, suprailiac, pectoral, abdominal, leg calf and thigh, determined by Heyward and Stolarczyk (1996) and Siri (1961), adapted by Lohman (1986). For the calculation of the caloric expenditure, the formula of Harrys & Benedict was applied, in addition of the calories of daily physical activities (NRC, 1989) and food-induced thermogenesis. For macronutrient suitability, the FAO/OMS recommendation (2003) was considered. For the assessment of the vitamins and minerals intake, it was applied the DRIs, - Dietary Reference Intakes (NRC, 2000).

**Results:** The percentage of fat body found in the majority of the athletes within the values considered adequate (80%). About the food intake showed that 73.33% of the group had a caloric intake below of recommended energetic requirements and 26.67% above of them. Other important point was that they have stayed long periods fasting, not doing an adequate fractionation of meals. It was found predominance of hyperlipidic and hyperprotein diets.

<footnote>(1)Martinez Arroyo, Angela; (2)Palma Molina, Ximena; (2)Ceballos, Ximena; (3)Pereira Scalabrino, Ana; (3)Reyes Jedlicki, Marcela;</footnote>

<footnote>(3)Corvalán Aguilar, Camila; (4)Lopes Pereira França, Jaqueline;</footnote>

<footnote>(5)Mara Fisberg, Regina.</footnote>

<footnote>(1)PhD student. 1. Evaluation of Food Consumption Research Group. Department of Nutrition. School Public Health. University of São Paulo (USP). São Paulo. Brazil.; (2)Msc. Nutritionist. School of Nutrition and Dietetics. Faculty of Pharmacy. University of Valparaíso. Valparaíso. Chile; (3)PhD. Center for Prevention of Obesity and Chronic Diseases (CEPOC). Institute of Nutrition and Food Technology (INTA). University of Chile. Santiago. Chile;</footnote>

<footnote>(4)PhD. Student. Evaluation of Food Consumption Research Group. Department of Nutrition. School Public Health. University of São Paulo (USP). São Paulo. Brazil.; (5)PhD. Nutritionist. Evaluation of Food Consumption Research Group. Department of Nutrition. School Public Health. University of São Paulo (USP). São Paulo. Brazil.</footnote>
Significant correlation were found for fat mass (r = 0.16, p<0.005) (r = 0.15, p<0.005) with systolic and diastolic blood pressure respectively. Whereas BMI showed a stronger association with systolic blood pressure (r=0.21, p<0.001).

**Conclusions:** This study made it possible to notice that the anthropometric indicator that best is related to the existence of high BP is the BMI. This seems to be an easy method that is noninvasive and of low cost to detect the risk of high BP in schoolchildren.

**Keywords:** Blood pressure, hypertension, fat mass, body mass index, schoolchildren.

(SD=332.0) (IC95%=1323.1-1370.0) kcal/day, the mean of protein intake was 57.0 (SD=20.0) (CI95%=55.6-58.5) g/day, the mean lipid intake was 27.3 (SD=10.0) (CI95%=26.6-28.0) g/day and 223.3 (SD=55.7) (IC95%=219.4-227.3) g/day of carbohydrates. The patients had inadequate energy and macronutrient intakes.

**Conclusions:** The patients' dietary intake was inadequate and differed significantly by employment status, socioeconomic class, cancer specialty area, type of treatment, and BMI.

**Keywords:** dietary intake, cancer, nutrients

## ASSOCIATION BETWEEN DIETARY INTAKE AND DEMOGRAPHIC AND CLINICAL ASPECTS OF BRAZILIAN CANCER PATIENTS

(1)Bernardes Spexoto, Maria Cláudia; (2)Serrano, Sérgio Vicente;

(1)Campos, Juliana Alvares Duarte Bonini.

(1)PhD. Departamento de Alimentos e Nutrição. Faculdade de Ciências Farmacêuticas. Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP). Brazil.; (2)MD. Hospital de Câncer de Barretos. Brazil.

**Background and objectives:** Patients with cancer are also compromised by a variety of symptoms like nausea, vomiting, diarrhea, constipation, food aversions, fatigue, dyspnea, and pain, which may construct barriers that make dietary intake challenging. The cancer itself and added to the toxic effects of oncology treatment, it may increase the severity and persistence of symptoms and affect the dietary intake of patients. It is widely known that the tumor site, clinical stage, some symptoms and use of chemo/radiotherapy are factors that are associated with dietary intake. The objective was to estimate the energy and macronutrient intakes of cancer patients and their relationship with the patients' demographic and clinical characteristics.

**Methods:** This is a cross-sectional study of 772 patients with cancer in treatment at Barretos Cancer Hospital. Demographic (personal interview) and clinical's information were collected (patient record). The study used the Food Frequency Questionnaire (FFQ). Univariate analysis of variance (ANOVA) followed by the Tukey post-hoc test determined whether the patients' energy and macronutrient intakes related to their demographic and clinical characteristics. The patients' energy and macronutrient intakes were compared with their nutritional requirements by point estimates and 95% confidence intervals (CI95%). The significance level was set at 5%.

**Results:** Most participants were females (63.1%) with a mean age of 53.2 (SD=12.7) years. Thirty-nine percent of the patients had stage III disease, 72.4% were undergoing chemotherapy, and 40.5% had metastases. Dietary intake differed significantly by employment status (p=0.009; p<0.001), socioeconomic class (p<0.001; p=0.002; p=0.004), cancer specialty area (p=0.008; p=0.003), type of treatment (p=0.023; p<0.001), and body mass index (BMI) (p=0.004). The mean of energy intake was 1346.5

## ANTHROPOMETRIC STUDY BY GENDER IN SEMI-URBAN SCHOOLCHILDREN IN KENITRA CITY-MOROCCO

(1)Agoutim, Naima; (2)Aboussaleh, Youssef; (3)Ahami, Ahmed Ot;

(4)Sbaibi, Rachid.

(1)PhD. Nutrition. Health and environment. University Ibn Tofail of Kenitra. Morocco.; (2)Pr.PhD.Nutrition. Laboratory of Nutrition. Health and Environment. Department of Biology. Faculty of Sciences. University Ibn Tofail of Kenitra. Morocco. BPa;

(3)Pr.PhD.Neurosciences.Behavioral and Cognitive. Laboratory of Neurosciences. Behavioral and Cognitive. University Ibn Tofail. Kénitra. Morocco; (4)PhD.Nutrition. Laboratory of Nutrition. Health and Environment. Department of Biology. Faculty of Sciences. University Ibn Tofail of Kenitra. Morocco.BPa.

**Background and objectives:** The nutritional requirements of school-aged children vary from one age group to another and according to gender, because their energy expenditure is different. For this reason, it was chosen as a study objective to assess the nutritional status of schoolchildren and see if there is a significant difference between girls and boys in anthropometric indicators.

**Methods:** The anthropometric survey was carried out among 239 schoolchildren of average age (10.22 years ± 2.10), weight and height were measured according to the WHO (World Health Organization), Anthropometric indices which adopted are: weight-for-age, and height-for-age and body mass index (BMI), determined by the Z score calculated according to WHO growth references 2007 (5-19 years).

**Results:** Results of anthropometric studies revealed an underweight reach 4.3%: girls (5.6%), boys (6.3%) (10 years), stunting 6.3%: girls (6.1%), boys (5.6%), thinness 3.8%: girls (6.1%), boy (4.8%), low risk for overweight 4.3%: girls (11.3%), boy (10.5%), Obesity 0.9%: girls (3.5%), boys (2.4%). χ2 analysis did not show any significant differences between girls and boys regarding the various anthropometric indicators (P>0).

**Conclusions:** The population studied suffered from a slight malnutrition as well as a lack of influence of sex on the nutritional state of the school children.

**Keywords:** schoolchildren, semi-urban, nutritional status, gender
# DEVELOPMENT OF A NEW TOOL FOR DIETARY DATA COLLECTION: SER-24H, SOFTWARE FOR 24 HOURS RECALL

(1)Quintiliano Scarpelli Dourado, Daiana; (2)Martínez Arroyo, Angela; (3)Jara, Macarena; (3)Cornejo, Catalina; (4)Avendaño, Ramon; (5)Pereira Scalabrino, Ana; (5)Reyes Jedlicki, Marcela.

(1)PhD. Nutritionist. Center for Prevention of Obesity and Chronic Diseases (CEPOC), Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile.; (2)PhD. Student. Evaluation of Food Consumption Research Group. Department of Nutrition. School Public Health. University of São Paulo (USP). São Paulo. Brazil.; (3)Nutritionist. Center for Prevention of Obesity and Chronic Diseases (CEPOC). Institute of Nutrition and Food Technology (INTA). University of Chile. Santiago. Chile.; (4)CITEC®. Santiago. Chile.; (5)PhD. Center for Prevention of Obesity and Chronic Diseases (CEPOC). Institute of Nutrition and Food Technology (INTA). University of Chile. Santiago. Chile.

**Background and objectives:** Analyzing 24-h dietary recalls involves several challenges such as standardized data collection, conversion of household measures, linkage of foods/beverages with nutrient content data, among others. There is no available Software for dietary data collection customized to Chilean needs.

**Objective:** To report the development of the software for dietary data collection "SER-24h" (Software de Encuestas Recordatorio 24 horas).

**Methods:** The software development started in 2015 and it was led by CEPOC at INTA, University of Chile. We build on the dietary data collected on 24-h dietary recalls since 2012. We identified foods, beverages and recipes to organize the food database. The recipes were disaggregated in ingredients. The National Nutrient Database Standard Reference of the United States Department of Agriculture (USDA) was used as nutrient content data. We linked our data to the USDA, assuming a concordance between 80 and 120% of energy and macronutrients, based on the nutrition facts of packaged foods and Chilean food composition data. A private company (CITEC®) provided technological support and generated the software.

**Results:** SER-24h includes a questionnaire designed for collecting interviewer 24-h dietary recalls using the "Automated Multiple-Pass Method". Foods/beverages are selected from a list of 4682 options, with specific portion sizes for each one; the software allows to add new foods/beverages or portion sizes if needed. Recipes can be also selected from the ones available (n=838) or added if necessary. SER-24h provides reports with nutrient information at the food/beverage level, origin from the food or preparation, meal time, location and activities during the meals. The program was ready to collect data after 16 months of preparation and it can be executed online or offline from any operating system previously authorized by the webmaster.

**Conclusions:** The new software allows collecting standardized dietary information and it links it with nutrient content. As far as we know, SER-24h is the only Chilean dietary software which outputs provide dietary analyses discriminating different sources of

nutrients (i.e. at the level of food groups, meals, time of the day, or others). The use of this tool should increase our scarce knowledge on local dietary patterns.

**Keywords:** dietary assessment, food intake, 24-h dietary recall, SER-24h.

**Further collaborators:** Funding: WCRF 2010245

# WORKING ON ATYPICAL SCHEDULES AND ITS NEGATIVE IMPACT ON FOOD INTAKE IN BRAZILIAN SHIFT WORKERS

(1)Cristina Silva, Graciele; (2)Cristina Tibiletti Balieiro, Laura; (3)Alves Guimarães, Rafael; (4)Gonçalves Resende, Sabrina; (5)Bernardes da Cunha, Nayara; (1)Aparecida Crispim, Cibele.

(1)PhD. Nutritionist. Faculty of Medicine. Federal University of Uberlandia. Uberlandia. Brazil.; (2)MSc. Nutritionist. Faculty of Medicine. Federal University of Uberlandia. Uberlandia. Brazil.; (3)MSc. Nurse. Faculty of Nursing. Federal University of Goias. Goiania. Brazil.; (4)MSc. Pharmaceutical. Faculty of Medicine. Federal University of Uberlandia. Uberlandia. Brazil.; (5)Nutritionist. Faculty of Medicine. Federal University of Uberlandia. Uberlandia. Brazil.

**Background and objectives:** Although the shift worker is predisposed to nutritional disorders such as obesity, the association between atypical working hours and food intake patterns is poorly described in the literature. This study aimed to evaluate the associations between shift work and the dietary pattern in Brazilian shift workers.

**Methods:** A cross sectional study was conducted with 1.215 (461 early morning, 233 day, 146 evening and 375 night workers) shift workers. The food intake pattern was evaluated by a semi-quantitative Food Frequency Questionnaire (FFQ) validated for Brazilian adults. The prevalence of inadequate intake of eight food groups was calculated as a reference to the portions recommended using the "Food Pyramid Adapted for the Brazilian Population". Measurements were taken for weight, height, waist circumference, as well as calculations of the Body Mass Index (BMI). Binary logistic regression was performed and adjusted for potential confounding variables in order to verify the association between the shifts worked and inadequate food intake using the day shift as reference.

**Results:** An association was found between working in the early morning shift and inadequate food intake over various food groups, such as milk and dairy products (Adjusted odds ratio [AOR]: 2.49; 95% CI 1.29, 4.81; p < 0.01), meat and eggs (AOR: 1.61; 95%CI 1.07, 2.42; p < 0.05) cereals and pasta (AOR: 1.44; 95% CI 1.01, 2.05; p < 0.05) and fruit and fruit juices (AOR: 2.04; 95% CI 1.06, 3.93; p < 0.05). The night shift present 2.25 times (AOR: 2.25; 95% CI 1.19, 4.25; p < 0.05) greater odds of inadequacy for milk and dairy products, meat and eggs (AOR: 1.62; 95% CI 1.07, 2.45; p < 0,05) and cereals and pasta (AOR: 1.56; 95% CI 1.09, 2.24; p < 0,05).
**Conclusions:** The food intake pattern of all other food groups were not associated with the work shifts. Early morning and night shift workers are more vulnerable to inadequate intake from various food groups. These results demonstrate the need to develop food intervention programs concerning food patterns in workers that work atypical schedules.

**Keywords:** Food intake. Shift workers. Work schedule. Unhealthy eating habits. Poor diet.

and similar in all areas. In contrast, obesity manifests itself in a heterogeneous form and reaches its maximum value, as well as being overweight, in the department of Tafí Viejo. Regarding the presence of stunting and wasting, they are presented differently by area, however, they show their greater value of both indicators, in the department of Lules.

**Keywords:** Nutritional status - youth - rural - Tucumán

(1)Salazar Burgos, Ramiro; (2)Oyhenart, Evelia; (3)Paolasso, Pablo.

(1)BSc. Nutricionist. Instituto Superior de Estudios Sociales. Conicet. Universidad Nacional de Tucumán. Argentina.; (2)PhD. Anthropologist. Cátedra de Antropología Biológica IV. Facultad de Ciencias Naturales y Museo - IGEVET CCT La Plata, CONICET - Facultad de Ciencias Veterinarias. Universidad Nacional de La Plata. Argentina; (3)PhD. Geographer. Instituto Superior de Estudios Sociales. Conicet. Universidad Nacional de Tucumán. Argentina.

**Background and objectives:** Tucumán has twice the rural population than the national average. A third are young people between 10 and 24 years old and 28% have some basic unmet need. This indicates that they live in conditions of vulnerability, which can have an impact on their health. Nutritional status is the result of the balance between nutrient intake and the requirements of an individual. The imbalance in some of these aspects, due to the deficit or excess, can generate malnutrition. The objective was to evaluate the nutritional status of young people attending rural schools in the province of Tucumán.

**Methods:** The cross-sectional study included 383 cases, ranging from 9 to 15 years old, from seven rural schools in the province of Tucumán, Argentina. Four schools belonging to the department of Rio Chico, two to Tafí Viejo and one to Lules. The selection was for convenience. The exact age was determined from the data in the school records. Anthropometric measurements were performed according to standardized protocols. Portable digital balance (precision of 100g) and vertical anthropometer (precision of 0.1cm) were used. The Who Anthro Plus software was used to process the data.

**Results:** With respect to the nutritional deficit, it was found 3.9% of stunting and 1% of wasting. At the departmental level, the following prevalences were observed, respectively: Lules 5.9% and 2.9%; Tafí Viejo 4.3% and 1.1% and Rio Chico 3.5% and 0.8%. As for overweight, we found 22.2% and 17% of obesity. The analysis by departments indicated the following prevalences of overweight and obesity: Lules 26.5% and 5.9%; Tafí Viejo 27.2% and 19.6% and Río Chico 21% and 17.5%.

**Conclusions:** The presence of malnutrition in rural areas, predominantly due to excess, accounts for the magnitude of the existing nutritional problems. The prevalence of overweight is high

(1)Boushey, Carol; (2)Kerr, Deborah; (3)Delp, Edward; (4)Zhu, Fengqing Maggie.

(1)PhD. Associate Research Professor. Epidemiology Program. University of Hawaii Cancer Center. Honolulu. HI. USA; (2)PhD. Research Academic. Research Leader for Food, Nutrition and Health. School of Public Health. Curtin University. Perth. WA. Australia.; (3)PhD. The Charles Williams Harrison Distinguished Professor of Electrical and Computer Engineering. Purdue University. School of Electrical and Computer Engineering. West Lafayette. IN. USA.; (4)PhD. Assistant Professor of Electrical and Computer Engineering. Purdue University. School of Electrical and Computer Engineering. West Lafayette. IN. USA.

**Background and objectives:** Quantifying how much people eat and drink remains an open research question. Mobile technology development has created a new era for assessment of dietary intake. These new methods show promise with regard to improved cooperation from study participants or patients and translation to more accurate results of energy and nutrient intakes. Benefits of these methods also include the additional detail about food and contextual information surrounding eating occasions. However, the reporting and the repeatability of these methods are hampered by the lack of standardized terminology associated with these new mobile methods. Therefore, the objective of this presentation is to outline a framework for identifying these new promising dietary assessment methods.

**Methods:** Efforts to standardize the language of this transition from traditional to mobile methods are needed

**Results:** Images taken with handheld devices or wearable cameras have been used to assist traditional dietary assessment methods (image-assisted methods). Image-assisted approaches can supplement dietary records or 24-hr dietary recalls. In recent years, image-based approaches using mobile devices or wearable sensors with embedded cameras have been developed (image-based methods). Image-based approaches capture all eating occasions with images as the primary record of dietary intake. The challenges of implementation of these new methods, their benefits, interoperability, and standardization will be covered.

**Conclusions:** Guidance in communicating these new methods will enhance their adoption and progression. The recommendations presented will improve reporting and the ability of
researchers and practitioners to identify best use method based on goals, study design, and sample characteristics.

**Keywords:** Dietary assessment, mobile dietary assessment methods, passive dietary assessment methods

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PREVALENCE OF OVERWEIGHT AND OBESITY AND ITS ASSOCIATION WITH SOCIOGRAPHIC FACTORS AMONG A NATIONAL REPRESENTATIVE SAMPLE OF ECUADORIAN CHILDREN AND ADOLESCENTS

**Background and objectives:** Overweight and obesity during childhood are important risk factors for noncommunicable diseases. We aim to assess the prevalence of overweight and obesity among children and adolescents and its associations with socio-demographic factors in a National representative sample from a middle-income country.

**Methods:** A national representative sample of 2-18 years old children and adolescents from the 2012 Ecuadorian National Health Survey (ENSANUT-ECU) was analyzed. Overweight, and obesity were defined applying the IOTF cut offs. Logistic regression models were set to identify sociodemographic factors (i.e. sex, rurality, geographic region, ethnicity, household income quintile and age) associated with overweight/obesity. The models were adjusted for the cluster design applying the svy command in Stata version 13.0.

**Results:** In total, 24,224 children and adolescents (8.2±5.1 years old) from the four geographic regions in Ecuador (Pacific-Coast, Andean-Region, Amazon-Rainforest and the Galápagos Islands) were included in the analysis. Overweight, obesity and morbid obesity affected 14.5% (95% CI, 13.2-16.4), 3.5% (95% CI, 2.7-4.6), and 2.2% (95% CI, 1.8-2.8) of the studied population. Urban participants were 1.2 times (P=0.001; 95% CI, 1.1-1.3) more likely to be either overweight or obese in comparison with their rural pairs. Similarly, children and adolescents living in households in the higher income quintiles (P<0.001; OR: 1.7; 95% CI, 1.4-2.0) and adolescents (P=0.045; OR: 1.4; 95% CI, 1.0-1.8) were more likely to be either overweight or obese in comparison participants in the lower income quintiles and children respectively. No significant associations were found between overweight and obesity with either sex or geographic region.

**Conclusions:** The reported overweight/obesity prevalence are in line with those reported in the Latin American region. This

health problem seems to affect the whole country and to be predominant among urban and wealthier populations as well as when the population reaches adolescence. Although some actions have been already taken such as such the implementation of traffic light food labels and health promotion programs, more actions are still needed.

**Keywords:** overweight, children, Ecuador, sociodemographic

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NUTRITIONAL STATUS EVALUATION BY ANTHROPOMETRIC ASSESSMENT OF A GROUP OF WORKERS IN SÃO PAULO CITY, BRASIL

**Background and objectives:** Since the 1970s, Brazil has undergone a reduction of malnutrition associated with an increase in obesity, a process called nutritional transition. The aim of the study was to evaluate the nutritional status of adult workers (19-59 years) of a shopping mall in the city of São Paulo, comparing the anthropometric evaluation data between those with sedentary (S) and non-sedentary (NS) work.

**Methods:** This was a descriptive cross-sectional study with primary data collection of 107 volunteers (64 females; 43 males), who met the inclusion criteria and had signed the informed consent. Data included: Weight; height; arm, waist (WC), wrist and hip circumferences; triceps (TSF), bicipital, subscapular and suprailiac skinfolds, arm muscle circumference (AMC), sum of 4 skinfolds (S4SF) and the indexes BMI, central obesity (CO), waist to hip (WHR) and conicity index (CI). The S4SF was used to estimate the percentage of body fat and the results were compared to the BMI. Nutritional status and cardiovascular risk (CVR) was determined.

**Results:** BMI and WC showed a positive correlation with age in both sexes; 62,8% of men of all ages were overweight (46,5%) or obese versus only 34,4% women (29,7% overweight) irrespective of age differences between sex groups. AMC, TSF and S4SF does not correlate with BMI for neither sexes. For women, WC and WHR identified 18% and 3% of CVR respectively. The CI showed positive correlation with age in both sexes and a good correlation and precocity in the identification of CVR, especially for men. Of women at NS (n=38) and S (n=26) type of work, 68,4% and 57,7% presented with normal BMI respectively, even though in both groups a higher than average fat percentage (HPFM) was observed (NS=81,6%; S=92,3%). Similar results were observed for men (NS=9; S=34), with 66,6% of NS and 94,1% of S presenting HPFM.

<footnote>(1)Andrade Tenesaca, Dolores Susana; (2)Ochoa Avilés, Angelica;</footnote>

<footnote>(3)Freire, Wilma; (1)Andrade Tenesaca, Dolores Susana; (4)Donoso Moscoso, Silvana Patricia.</footnote>

<footnote>(1)MSc. PhD. Department of Biosciences. Faculty of Chemistry Sciences. Cuenca University. Ecuador.; (2)MD. PhD. Department of Biosciences. Faculty of Chemistry Sciences. Cuenca University. Ecuador.; (3)MSc. PhD University San Francisco Quito. Ecuador.;</footnote>

<footnote>(4)Bioq. MSc. Department of Biosciences. Faculty of Chemistry Sciences. Cuenca University. Ecuador.</footnote>

<footnote>(1)Pieri, Patricia de Campos; (1)Assis, Gustavo Marchese; (1)Forti, Bruno Luis Peixoto; (1)Giori, Fabiana Ferreira; (1)Camargo, Maria Azevedo de; (1)Neves, Lorena Piquini; (1)Brito, Isabella Aguiar de; (2)Freiberg, Clara.</footnote>

<footnote>(1)Undergraduate Student. Nutrition. Universidade São Camilo. Brasil; (2)MSc. Nutricionist. Nutrition Department. Universidade São Camilo. Brasil.</footnote>
**Conclusions:** BMI is an easy method to evaluate nutritional status of populations, but should be associated to other variables chosen in accordance to the ethnic group studied. The type of work might play an important role in the nutritional status and percentage of fat mass, but the present work fail to show it.

**Keywords:** Anthropometric evaluation. Nutritional Status. Cardiovascular risk.

**Further collaborators:**

Júlia Ferreira Marques da Silva, Carolina Lopes Malta, Valkíria Lúcia Santos da Silva

**Conclusions:** It is concluded that walking at PV can be considered as a moderate activity. Even though the CPA code MET values for walking at PV and EV were correct, their use will significantly overestimate the EE.

**Keywords:** Energy expenditure. Physical activity. Daily activities. Nutrition assessment.

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ENERGY EXPENDITURE OF SELECTED DAILY ACTIVITIES IN ADULTS FROM NITERÓI, RIO DE JANEIRO, BRASIL

(1)Anjos, Luiz Antonio; (2)Mariz, Virginia; (2)Silva, Edimara; (3)Wahrlich, Vivian.

(1)MD, PhD. Professor. Universidade Federal Fluminense,;

(2)Undergraduate student. Laboratório de Avaliação Nutricional e Funcional. Universidade Federal Fluminense.; (3)PhD. Nutritionist. Laboratório de Avaliação Nutricional e Funcional. Universidade Federal Fluminense.

**Background and objectives:** The assessment of the energy expenditure (EE) plays an important role in the assessment of the nutritional status and the treatment strategies of the population. The purpose of the present study was to measure the EE of selected daily activities and to compare the values with the code MET values of the Compendium of Physical Activities (CPA). The activities were: typing, organization of shelves, climb up and down 8 flights of stairs and walk on the treadmill at two self-selected speeds (pleasure, PV and exercise, EV) and PV-0.8.

**Methods:** This is a preliminary analysis of data of 33 adult (≥20y) subjects (25 women) recruited to participate in a larger study aimed to assess total daily EE by various methods. Resting EE (METm) was assessed with the subject sitting during 12'. The EE of each of the selected activities were measured for six minutes and expressed as multiple of METm (MMETm) or estimated MET (METe=3.5mLO2/kg/min). Body mass (BM) and stature (S) were also obtained. Body mass index (BMI) was calculated as BM/S2. Percent body fat (%BF) was measured by DXA.

**Results:** Mean (SD) age and BMI were 26.2 (6.6) and 23.7 (3.7) kg/m². Mean %BF was 32.7 (5.0) and 25.0 (9.3) for women and men, respectively. EE (kcal/min) of organizing shelves, climbing up and down the stairs was 3.0 (1.1), 7.0 (1.5) and 3.7 (1.0), respectively. MMETm was higher than MMETe by approximately 9% for all activities. Organizing shelves and PV-0.8 were classified as moderate activities (≥3 METs) only when METm was used. MMETm was 3.1 (0.6), 3.5 (0.6) and 4.8 (0.9) for PV-0.8 (3.8±0.5), PV (4.6±0.6) and EV (6.1±0.6km/h) and equal to the CPA codes for the last two. However, EE calculated by METe and the CPA codes was significantly greater than measured (mean difference of 0.51±0.69 and 0.65±0.9kcal/min, respectively). Climbing up stairs was the only activity classified as heavy (MMETm=6.9±0.8).

144/2219

REFERENCE INTERVAL FOR METHYLMALONIC ACID IN DRIED BLOOD SPOTS OF YOUNG, ADULT WOMEN TO FACILITATE SCREENING OF VITAMIN B-12 DEFICIENCY IN FIELD SETTINGS

(1)Schroder, Theresa; (2)Quay, Teo; (3)Lamers, Yvonne.

(1)PhD. Nutritionist. Food, Nutrition and Health Program. University of British Columbia. Canada.; (2)MSc. Nutritionist. Food, Nutrition and Health Program. University of British Columbia. Canada; (3)PhD. Professor. Food, Nutrition and Health Program. University of British Columbia. Canada.

**Background and objectives:** Maternal vitamin B-12 (B-12) status in early pregnancy has been inversely associated with impaired fetal development, including neural tube defects, and positively with infant B-12 status. Periconceptional B-12 adequacy is thus critical. Dried blood spots (DBSs) allow for convenient and cost-effective collection of biological samples in field settings. We have developed a method to quantify methylmalonic acid (MMA), the most specific functional B-12 biomarker, in DBSs. The objective was to calculate a reference value of DBS MMA in young adult women suggestive of functional B-12 deficiency.

**Methods:** In a convenience sample of 208 healthy women (19-35 years) living in Vancouver, Canada, DBSs were collected after pricking either middle or index finger. DBS MMA was quantified from an 8-mm spot by liquid chromatography-tandem mass spectrometry; plasma MMA and serum total B-12 and holotranscobalamin concentrations were determined. Dietary B-12 intake was assessed by food frequency questionnaire, and dosage of supplemental B-12 recorded. A reference value was computed from a reference population (mean ± SD age: 26.7±4.2 y), i.e. a subset of women with plasma MMA concentrations <370 nmol/L (92% of study population) and DBS MMA data (n=174), following clinical guidelines (CLSI EP28-A3c).

**Results:** The upper limit (90% CI) of the central 95% reference interval, computed after Box-Cox transformation and removal of 5 outliers (Tukey's test), was 8.9 (8.2-9.6) pmol/8-mm spot. The reference population had a median (IQR) DBS MMA concentration of 5.2 (4.2-6.3) pmol/8-mm spot. DBS MMA concentration was correlated with plasma MMA ($\rho$=0.65; $P<0.0001$) and serum total B-12 ($\rho$=-0.17; $P=0.02$) and holotranscobalamin ($\rho$=-0.22; $P=0.004$) concentrations. The median (IQR) plasma MMA and serum total B-12 and holotranscobalamin concentration of the reference population was 148 (114-185) nmol/L, 278 (200-373) pmol/L, and 66.5 (51.4-87.7) pmol/L respectively; the median (IQR) dietary and total (dietary and supplementary; 30%
supplement user) B-12 intake was 2.7 (1.9-4.0) µg/d and 3.7 (2.4-7.6) µg/d, respectively.

**Conclusions:** This is the first study to present a reference value for elevated DBS MMA computed from a healthy reference population of young adult women. Analysis of DBS MMA has the potential to be a convenient and field-applicable method that facilitates B-12 deficiency screening in reproductive-aged women.

**Keywords:** vitamin B-12 deficiency, methylmalonic acid, dried blood spots, reference interval, periconceptional

**Conclusions:** The decline in dietary quality with time over the month from receipt of SNAP benefits might be mitigated by their allocations on a bimonthly basis. A more frequent distribution could provide a more even food supply and alleviate inconsistencies over time.

**Keywords:** diet quality, food assistance

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REDUCTIONS IN DIET QUALITY WITH TIME IN SINCE BENEFITS IN LOW INCOME WOMEN PARTICIPATING IN THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM IN THE UNITED STATES

(1)Freeland-Graves, Jean; (2)Sangeevi, Namratas.

(1)PhD. Bess Heflin Centennial Professor. Department of Nutritional Sciences. University of Texas at Austin. United States of America.; (2)PhD Candidate. Department of Nutritional Sciences. University of Texas at Austin. United States of America.

**Background and objectives:** The Supplemental Nutrition Assistance Program (SNAP) is the largest food assistance program in the United States, serving approximately 46 million individuals with program benefits. It transfers financial benefits once a month via an electronic card that can be utilized to purchase foods. Within the first 3 days of the month, a spike in food expenditure is noted, followed by redemption of 80% of the benefits within 2 weeks. The objective is to investigate changes in dietary quality in 151 women that occurred in response to fewer financial resources toward the end of the monthly cycle of SNAP benefits.

**Methods:** Subjects were recruited from low-income housing sites and neighborhood centers, informed consent was obtained, and a demographic survey was administered. At 1 week intervals, four more visits were conducted in which the participants completed a food frequency questionnaire (FFQ). It was validated for a reference period of 1 week and consisted of 95 food items, with varying frequency and serving size options. The initial administration of the FFQ was based on timing of the initiation of the monthly program benefit. The indicator of diet quality was the Healthy Eating Index-2010. Scores ranged from 0-100, based on 12 dietary subgroups, with nine adequacy and three moderation components. A mixed linear model was conducted with time as the independent variable, and diet quality and foods as the dependent variables. When significant main effects were detected, Bonferroni adjustments were conducted.

**Results:** Diet quality scores significantly declined as the month progressed, from 57.4 + 0.9 at week 1 to 45.6 + 1.0 at week 4. This was accompanied by a decrease in intakes of fruits, vegetables and dairy, and a higher consumption of whole grains. Total protein foods remained unchanged. Also, fewer home-prepared meals and increased eating outside the home were reported towards the end of the month.

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EXCESS BODY FAT IN EUTROPHIC ADOLESCENTS AND RISK OF BLOOD PRESSURE CHANGE

(1)de Lucena Ferretti, Roberta; (2)de Pádua Cintra, Isa; (2)Aparecida Zanetti Passos, Maria; (2)Fisberg, Mauro.

(1)PhD Student. MSc. Nutritionist. Federal University of Sao Paulo. Brazil. Department of pediatrics. University of Taubate.; (2)PhD. Nutritionist. Federal University of Sao Paulo. Department of Pediatrics.

**Background and objectives:** The current adolescents lifestyle has collaborated for the body fat accumulation and chronic diseases development, such as hypertension. It is widely known that, in overweight individuals, there is a greater risk of blood pressure change. However, this risk is directly associated with excess body fat, which can occur in eutrophic individuals as well. The main objective of this study is to evaluate eutrophic adolescents body fat and the relation with the risk of development of blood pressure change.

**Methods:** A cross-sectional study that assessed adolescents aged 10 to 17 years old. The collected variables were weight (kg), height (cm) to calculate BMI (kg/m2), and were considered eutrophic adolescents ranked between -1 and +2 z-score of BMI according to the World Health Organization, 2007. To assessment of body fat, were used triceps and subscapular skinfold thickness, according to standard techniques, and body fat percent calculated according to the equations of Slaughter and classified by Lohman. To measurement of blood pressure Measurement protocol was followed, according to the V Brazilian Guidelines on Hypertension. The values of blood pressure were classified according to American Academy of Pediatrics recommendations - The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Crude analysis between excess body fat and the independent variables were performed by univariated logistic regression. The binary regression analysis was used to estimate the values of chance (odds ratio-OR).

**Results:** Among 1774 adolescents assessed, 1123 eutrophic adolescents were selected, and 55.8% (n = 627) were female. The prevalence of excess body fat in eutrophic adolescents, boys and girls, were, respectively, 64.3% e 71.4%. It was verified that the risk of these eutrophic adolescents presenting a change in Sistolic Blood Pressure was 1.43 higher in relation to adolescents who did not present excess body fat (OR: 1.43 (0.98-2.09)), and for Diastolic Blood Pressure, this risk was 2.70 higher [(OR: 2.70 (1.78-4.10)].

**Conclusions:** It is concluded that there is elevated risk of eutrophic adolescents with excess body fat present alterations in
blood pressure, and this outcome is higher for diastolic blood pressure.

**Keywords:** Body fat. Nutricional Status. Eutrophy. Adolescent Blood Pressure

**Further collaborators:**

Roberta de Lucena Ferretti conceived, designed, and implemented the study, collected and interpreted data, wrote and revised the text; Isa de Pádua Cintra helped to implement the study and to write the text; Maria Aparecida Zanetti Passos helped the data collection, helped implement the study, and helped to write the text; Mauro Fisberg was responsible for coordinating original study and contributed to the intellectual content. All authors have sufficiently contributed to the development of this study.

**Conclusions:** Prevalence of overweight and obesity in the studied population (54.62%) is higher than the national average (36.3%). The problem of overweight and obesity is higher in males (57.36%) than in females (52.88%).

High height is very uncommon since no student was reported with this condition, also low height affects 14.36% of this sample, but only 0.73% of them were underweight and 8.03% overweight and obese.

Based on the results, Nutri-Campechada requires a permanent training intervention in the Mediterranean diet and physical activation addressed to the students to improve their nutritional condition.

**Keywords:** Nutrimetry, overweight, obesity, adolescents, nutrition assessment

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NUTRI-CAMPECHADA 2016: NUTRIMETRY APPLICATION TO HIGH-SCHOOL ADOLESCENTS

(1)Selem Solis, Jorge Enrique; (2)Sandoval-Castellanos, Fernando Jose; (3)Alcocer-Gamboa, Alberto; (4)Hattori-Hara, Mónica.

(1)MPH. Medical Doctor. Tenabo's Health Center. Campeche Ministry of Health. México.; (2)MPH. Medical Doctor. Rector. Instituto Campechano. Mexico.; (3)MSc. Medical Doctor. PIAIOY, Ministry of Education of the Government of Yucatan State. México.; (4)PhD. Psychology. PIAIOY, Ministry of Education of the Government of Yucatan State. México.

**Background and objectives:** Mexico is the world's first place in childhood overweight and obesity, four out of ten Mexican adolescents are overweight or obese and the trend is increasing, that's why Mexico is strongly committed to contributing any element that helps curb this epidemic. The objective of the study was to establish the use of Nutrimetry as an instrument for clinical and epidemiological surveillance of malnutrition as the first part of a program called "Nutri-Campechada" in a sample of high-school adolescents.

**Methods:** Nutrimetry is a tool that combines BMI/age with height/age and generates nutricodes that identify groups of nutritional risk allowing a timely malnutrition prevention. According to WHO z-scores values were assigned, for height/age: z≤-2=1, z≥2=5, or 3 to the rest, and for BMI/age: z≤-1=0, 1≤z<2=6, z≥2=12 or 3 to the rest, values were crossed and 12 codes that combine short, normal and high height with underweight, normal-weight, overweight and obesity were obtained.

**Results:** Data of 822 students of the "Instituto Campechano" between 15 and 18 years of age were evaluated. Weight and height were measured, BMI/age and height/age were calculated, and applying Nutrimetry, risk groups were classified in odd (1/3/5: underweight, 7/9/11: overweight and 13/15/17: obese) and even (4/6/8: normal weight) numbers. Prevalence were: 1 (n=6) 0.73%, 3 (n=29) 3.53%, 5 (n=0) 0.00%, 4 (n=46) 5.60%, 6 (n=292) 35.52%, 8 (n=0) 0.00%, 7 (n=44) 5.35%, 9 (n=222) 27.01%, 11 (n=0) 0.00%, 13 (n=22) 2.68%, 15 (n=161) 19.59%, and 17 (n=0) 0.00%.

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DEVELOPMENT OF AN INTERACTIVE TECHNOLOGICAL TOOL THAT USE THE LEAP MOTION CONTROLLER, AS A TOOL TO ESTIMATE FOOD PORTION SIZE: A VIABILITY PILOT STUDY

(1)Gutierrez Gomez, Yareni Yunuen; (2)Escarcega Centeno, David Alejandro.

(1)PhD. MSc. Nutritionist. Nutrition Department. School of Medicine and Health Sciences. Tecnologico de Monterrey. Mexico City. Mexico.; (2)PhD. Software Engineering. Computer Department. Engineering School. Tecnologico de Monterrey. Mexico City, Mexico.

**Background and objectives:** Estimation of food portion sizes has been a big challenge in dietary assessment. The aim of this work was to design and develop an interactive technological tool for the estimation of food portions through a virtual reality based on the Leap Motion® controller.

**Methods:** The interactive technological tool development was carried out in three phases: 1) Creation of food portions and photographs. We include 121 food portions sizes (fruits, vegetables, cereals, legumes, animal foods and fats). The food was cooked, weighed and in some cases measured before taking photographs. 2) 3D modeling of food. In this phase the food portion sizes were 3D modeling with the next software: MAYA Autodesk 2016, Autodesk Mbox 2016 and Adobe Photoshop. 3) Software development. To create the functional prototype of the Virtual Reality based in the Leap Motion® controller, we used the Unity software that is used for the creation of videogames.

**Results:** We designed and developed an interactive technological tool for estimation of food portion size based on the Leap Motion controller. Anyone can model with his/her bare hands a food portion size and the software could predict the portion size in grams. The first validation tests showed small differences between the food portion size estimated by the software and the real food portion size (weighed) for some food (watermelon, beans, cottage cheese, shredded coconut, read meat and chicken). The average differences was 8.4 g (SD 12.7 g) for the food mentioned before.
**Conclusions:** The interactive technological software that use the Leap Motion controller developed here, is a promising tool for a better food portion sizes estimation. Further work and investigation is needed in order to improve our development.

**Keywords:** Portion size estimation, dietary assessment, leap motion.

are under the recommended levels in 42% of the women. The goal of 90% of salt containing iodine ≥15ppm at household levels was not achieved. A preventive official plan must be implemented

**Keywords:** micronutrients, deficiency iodine, urine iodine, iodized salt.

**Further collaborators:**

Alejo Ramos. PhD. Medic. Ministry of health. Province of Jujuy. Argentine

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## LODINE NUTRITIONAL STATUS IN FERTILE AGE WOMEN IN THE PROVINCE OF JUJUY, ARGENTINA

(1)Lopez Linares, Sonia; (2)Lopez Linares, Sonia; (3)Silva Croome, Maria del Carmen.

(1)PhD. Biochemistry. Centro Nacional de Investigaciones Nutricionales-ANLIS; (2)PhD. Biochemistry, Center National of Nutritional Research-ANLIS "Malbrán". Salta. Argentine; (3)PhD. Endocrinology. Hospital Ramos Mejias. Province of Buenos Aires. Argentina.

**Background and objectives:** INTRODUCTION: An iodine deficient diet is cause of hypothyroidism, mental retardation and IDD (iodine deficiency disorders). During pregnancy, iodine requirements increases. Adequate iodine supply must be achieved in preconception. Previous survey reported that pregnant population in Jujuy was iodine deficient.

**OBJECTIVE:** To establish iodine nutritional status in women of childbearing age in the province of Jujuy measuring urinary iodine concentration (UIC) and salt for consumption iodization levels

**Methods:** MATHERIAL AND METHODS: We randomly selected 98 healthy women between 14 and 40 years, living in Jujuy (without thyroid disease, pregnancy or taking iodine containing supplements). After informed consent, urinary casual sample and a household salt sample were obtained. The UIC was quantified by Persulfate method and iodine in salt by qualitative kit. A subsample (n = 77) by titration with thiosulfate. Median and percentiles of UIC were calculated and percentage of salts with adequate low or absent iodine content. We compared UIC of women taking salts of national and regional salts. We considered indicators of sustained IDD elimination if UIC median was between 100 to 199 UImg/l and > 90% of household salt iodine ≥15ppm. Statistic SPSS

**Results:** RESULTS: UIC median: 119 µg/L, range: 12-365 µg/L, distribution: 41.2% < 100ug/L, 52.6% between 100-199 µg/L, 4.1% between 200-299 µg/L and 2.1% > 300 µg/L; percentile 20: 54.4 µg/L, percentile 80: 165 µg/L.

Regional salts were consumed by 71.3%. The Kit detected 84.5% positive iodine and 15.5% without iodine (only detected in regional salts). Iodine content: 22.4 ± 15.39 ppm; 0.0-95.2 ppm range, >15 ppm the 74.0% between 20-40 ppm 61% and 17% without iodine measurable. UIC median was significantly higher in women consuming salt of national origin compared to regional salts (123 ug/L vs 117 ug/L respectively, p = 0.001).

**Conclusions:** CONCLUSIONS: Median urine iodine concentration in this study indicate iodine sufficiency. But iodine levels

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## NEW DIETARY ASSESSMENT TECHNOLOGY FOR INDIVIDUAL-LEVEL DIETARY DATA COLLECTION IN LOW-INCOME COUNTRIES: THE DEVELOPMENT PROCESS OF INDDEX24

(1)Coates, Jennifer; (2)Colaiezzi, Brooke; (3)Bell, Winnie; (4)Wafa, Sarah;

(5)Prata, Cathleen; (6)Rogers, Beatrice.

(1)PhD. Associate Professor. Tufts University Friedman School of Nutrition Science and Policy. USA.; (2)MSc. Assistant Researcher. Tufts University Friedman School of Nutrition Science and Policy. USA.; (3)MSc. MPH. PhD Candidate and Assistant Researcher. Tufts University Friedman School of Nutrition Science and Policy. USA.; (4)MPH. RD. Assistant Researcher. Tufts University Friedman School of Nutrition Science and Policy. USA.; (5)MPH. Project Manager. Tufts University Friedman School of Nutrition Science and Policy. USA.; (6)PhD. Professor. Tufts University Friedman School of Nutrition Science and Policy. USA.

**Background and objectives:** Large-scale individual-level dietary surveys are infrequently conducted in low-income countries (LICs). Barriers include high resource requirements and limited research infrastructure for dietary assessment. As part of a multi-year effort to scale-up dietary assessment in LICs, the International Dietary Data Expansion (INDDEX) Project is investing in INDDEX24, a novel dietary assessment platform modeled on a multiple pass 24-hour dietary recall (24HR) and targeted to users in LICs. This study presents the systematic process used to identify INDDEX24's technical specifications and the results of preliminary testing carried out Bangladesh and Burkina Faso.

**Methods:** A multi-pronged approach was used to draft the INDDEX24 technical specifications. First, an initial list of technical specifications was drafted by a dietary assessment expert with in-depth knowledge and experience conducting 24HR surveys in LICs. Second, a literature review and qualitative research on existing 24HR platforms were conducted. Third, the INDDEX Project's Technical Advisory Group (TAG) and external technology experts evaluated the feasibility and validity of the technical specifications in terms of their appropriateness in the context of LICs.

**Results:** The INDDEX24 platform consists of a mobile application (app) for data collection and an integrated database website app for housing context-specific information required for processing 24HR data. It contains an interviewer-administered format, offline data collection capability, and is designed to be easily adapted to new contexts. INDDEX24 will also facilitate dietary
data processing by enabling researchers to link their food list to a contextually appropriate food composition database. A beta-version of INDDEX24 was developed and then evaluated by members of the INDDEX Project and TAG. Following revisions to the beta-version, the performance and user experience of a beta version of INDDEX24 was assessed in Bangladesh and Burkina Faso. Researchers in these countries suggested modifications to improve the usability of the platform. Additional in-depth feedback from cognitive debriefing with both survey respondents and enumerators was incorporated.

**Conclusions:** INDDEX24 has been developed by integrating feedback from a broad range of stakeholders and through extensive testing in a range of contexts. The efforts will help ensure INDDEX24 is a high quality, evidence-based tool for dietary assessment researchers in LICs.

**Keywords:** Dietary assessment. Food consumption data. 24-hour dietary recall. Low-income countries.

**Conflict of Interest Disclosure:** This research was conducted as part of the International Dietary Data Expansion (INDDEX) Project, which is implemented by Tufts University's Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy with funding from the Bill & Melinda Gates Foundation. The authors declare no conflicts of interest.

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# BIG DATA METHODS AND PUPILLARY RESPONSE: CRACKING THE CODE OF DARK ADAPTOMETRY FOR VITAMIN A DEFICIENCY

**Background and objectives:** The World Health Organization estimates that 9.7 million pregnant women exhibit night blindness, a severe form of dark adaptation, due to vitamin A deficiency (VAD). We have developed an innovative digital, quantitative field method leveraging pupillary responsiveness to structured light stimuli to assess functional VAD. Breakthroughs in image analysis and pattern recognition have revealed details of pupillary dynamics of up to 3000 consecutive data points on each subject's pupillary response over a 90 second window among pregnant women in rural Bangladesh.

**Methods:** We conducted an individually randomized, controlled trial among 488 women in late pregnancy in Gaibandha, Bangladesh from April 2015 to May 2016, supplementing half the women with a daily dose of 5,000 IU of vitamin A for 15 days. A blood sample was collected and women were assessed pre-and post-supplementation using a portable field dark adaptometer to record pupillary response to varying light stimuli (-2.9 to 0.1 c/m2). We present results of both conventional statistical analysis and machine learning and image analysis approaches to identify characteristic pupillary dynamic signatures associated with VAD and possibly, specific serum Vitamin A levels.

**Results:** 241 control and 247 supplemented women participated in the trial. Gestational age (28 weeks) and plasma retinol (0.34 ± 0.1µg/mL) levels did not differ between groups at baseline, though we see an intervention effect of increased plasma retinol levels among the supplemented group (difference of +0.03 ± 0.08 versus -0.01 ± 0.08, p=0.002). Pupillary responsiveness was similar across groups at baseline and is being analyzed at follow-up. We have captured 1800-3000 pupillary response diameters on women with an example of early data on an individual participant included at this link (https://tinyurl.com/pupildata) to illustrate the heretofore uncaptured granularity and precision of pupillary dynamics captured in a rural, remote population.

**Conclusions:** We hope to demonstrate the practicality of digital field dark adaptometry as a method for point-of-population vitamin A status determination using the dynamics of pupillary responsiveness. Breakthroughs in mobile computing capacity and analytics continue to improve the feasibility of the method.

**Keywords:** Vitamin A deficiency, dark adaptometry, pupillary response, night blindness,

**Conflict of Interest Disclosure:** The authors have no conflict of interest to declare. Supplements were donated gratis by DSM Limited through the Sight and Life Foundation, but they had no access to the data, and were not involved with the analysis or conclusions reached.

**Further collaborators:**

Maithilee Mitra - Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University

Rezwanul Haque - The JiVitA Project, Johns Hopkins University, Bangladesh.

Rashidul Haque - The JiVitA Project, Johns Hopkins University, Bangladesh.

<footnote>(1)Mehra, Sucheta; (2)Healy, Katie; (3)Shaikh, Saijuddin;</footnote>

<footnote>(4)Soltanianzadeh, Amir; (2)Zeller, Kelsey; (3)Ali, Hasmot; (2)Schulze, Kerry; (2)Wu, Lee; (2)West, Keith; (5)Labrique, Alain Labrique.</footnote>

<footnote>(1)Nutritionist, Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University; (2)Center for Human Nutrition Department of International Health Bloomberg School of Public Health Johns Hopkins University; (3)The JiVitA Project, Johns Hopkins University, Bangladesh.; (4)Masters Student, Department of Bioengineering Innovation, Whiting School of Engineering, Johns Hopkins University; (5)Global Disease Epidemiology and Control, Department of International Health Bloomberg School of Public Health Johns Hopkins University.</footnote>
IODIZATION OF SALT AS SUCCESSFUL STRAT-
EGY, COMBATING IODINE DEFICIENCY DISOR-
DERS (IDD) IN AFGHANISTAN

(1)Aminee, Ahmadwali; (2)Hassam, Wasiullah; (3)Samadi, Khalil.

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

**Background and objectives:** Iodine Deficiency Disorder (IDD) is serious public health problem among Afghan school aged children and reproductive age women. The Universal Salt Iodization (USI) program as main strategy combating IDD started in 2003 by operating of the first salt iodization factory and became a great success in Afghanistan, currently there are 31 salt iodization factories functioning in 14 out of 34 provinces with the capacity of 5-8 Metric Ton /hour each. The iodization of salt for edible consumption becomes mandatory in 2011 after enactment of national regulation by the government. The objective of this study is to present the success effect of salt iodization program on reduction of iodine deficiency in Afghanistan.

**Methods:** Reviewing the results of two National Nutrition Surveys (NNS) conducted in 2004 and 2013, to assess the impact of USI program, over the reduction of iodine deficiency in the country.

**Results:** According to the NNS 2013 reports, up to 66% of the households all over the country have access to and are using adequately iodized salt (>15 ppm) in the diet, and a significant improvement from 28% reported by the NNS 2004, the report also indicated that the prevalence of iodine deficiency among children 7-11 years and reproductive age women decreased to 29.5 % and 40.7% respectively, remarkable progress from 72% and 75% respectively among the same age groups. The comparisons of two data showing a remarkable iodine deficiency reduction of 35 percentage points (55%), as a result of 10 years successful salt iodization program implementation, furthermore, it will contribute to saving the brine damage and preventing the reduction of 10-15 IQ points of almost 395,000 out of 94, 2000(72% of total live births/year) afghan new-born children each year, causing as iodine deficiency.

**Conclusions:** since there is no any national program influenc-
ing the reduction of iodine deficiency, the salt iodization has been
a successful strategy combating IDD in Afghanistan.

**Keywords:** Iodine Deficiency Disorder ,Brain damage ,10-15
IQ points ,salt iodization

DIET, ANTHROPOMETRY AND GUT PERMEA-
bILITY IN MEXICAN CHILDREN WITH AUTISM
SPECTRUM DISORDERS

(1)Pedroza García, Karina Alejandra; (1)Ronquillo, Dolores; (2)Anaya-Loyola, Miriam Aracely; (2)Rosado, Jorge L.

(1)MD. Facultad de Ciencias Naturales. Universidad Autónoma de Querétaro. México; (2)PhD. Facultad de Ciencias Naturales. Universidad Autónoma de Querétaro. México.

**Background and objectives:** Autistic Spectrum Disorders (ASD) comprise a group of developmental disorders, characterized by deficits in social interaction, communication, and behavioral patterns. Children with ASD may present nutritional challenges, specially as a result of their restrictive behaviors such as selective food intake, increased sensory sensitivity leading to rejection of food, disruptive behavior to specific foods and refusal to accept new foods. Additionally, nutritional status can be affected by gastrointestinal problems that may be related to a leaky gut. The aim of the study was to evaluate diet, anthropometry and intestinal permeability of ASD children and teenagers.

**Methods:** A cross-sectional study was crried out in 22 ASD children and adolescents aged 4 to 18 years from the cities of Aguascalientes and Querétaro, México. Diet was evaluated by means of three 24-hour recalls a food frequency questionnaire. Weight and height were measured by duplicate and BMI was sti- mated and compared with WHO z score. Intestinal permeabili- ty was evaluated by a lactulose/mannitol test and its subsequent measurement in urine by HPLC.

**Results:** At the end of the study it was observed a high prevalence of malnutrition, 18.2% of the participants have low weight for height and 50% have overweight or obesity; the diet was unbalanced with a high content of fat and refined sugar, and a poor consumption of fiber (13.0g ± 5.2), vitamin E, vitamin D, potassium, calcium and zinc. Intestinal permeability was in average 0.01 ± 0.02 and it was adequate in 80% of the sampe.

**Conclusions:** In this study it was found that participants have deficient consumption of some vitamins and minerals, but high ingestión of fat and sugar, and a hight percentage of participants have overweight or obesity, its advisable to develop food coun- seling strategies for children with ASD. In contrast with previous studies, intestinal permeability was adeucate in Mexican children with ASD.

**Keywords:** Autism spectrum disorders, anthropometry, diet, gut permeability.
# ASSOCIATION BETWEEN INDIAN DIABETES RISK SCORE (IDRS) AND NON IDRS COMPONENTS AMONG INDIAN ADULTS

(1) Joshi Reddy, Kejal; (2) Takalkar, Siddhi.

(1)Assistant Professor. Nutrition and Dietetics Department. Symbiosis School of Biomedical Sciences. Symbiosis International University. India; (2)B.Sc.,M.Sc.Nutrition and Dietetics Department. Symbiosis School of Biomedical Science. Symbiosis International University. Pune-412115. Maharashtra. India.

**Background and objectives:** Prevalence of Type 2 diabetes is increasing at an alarming rate globally. It is a major risk factor for death and other non-fetal complications. WHO reports that one fifth (19%) of the total diabetics, reside in India (35 million). It is projected that it will increase to 80 million 2030. Indian Diabetes Risk Score is a simple, cost effective tool devised by MDRF to determine high risk individuals at an early stage. There is a need to assess a correlation between the risk score and other modifiable non-IDRS components which can be further focused on to reduce the risk of Diabetes and CHDs in future. Thus, a study with an aim to derive an association between IDRS and Non-IDRS components in urban population of Pune was developed.

**Methods:** A cross-sectional study involved N=185 healthy individuals aged between 20 and 50 years, randomly selected from a free living setting in Pune city. Other than IDRS components (Age, Waist Circumference, physical activity and family history), non IDRS components like anthropometric measurements, dietary data, random blood sugar level (BSL), blood pressure (BP) and lipid profile were also assessed.

**Results:** The findings revealed that 24.9% of the population had high risk of diabetes; where as 33% had moderate risk of diabetes. IDRS showed a significant positive association (p<0.01) with BMI, carbohydrate intake, blood pressure, random BSL, change in appetite and FRS. However, a negative association (p<0.05) was found between IDRS and protein and fat intake, flax seed consumption and nature of physical activity.

**Conclusions:** IDRS and non-IDRS components are strongly associated, which indicates an increased risk of Diabetes, if not modified with due attention. To reduce ever increasing burden of diabetes in the community, it is essential to undertake mass screening program. So that appropriate interventions can be delivered to prolong occurrence of Type 2 diabetes in productive population.

**Keywords:** IDRS, Body Mass Index, Waist Hip ratio, Framingham Risk Score

# SELENIUM PATHWAY GENOTYPES ARE ASSOCIATED WITH COLORECTAL CANCER RISK AND MODIFIED BY SELENIUM STATUS

(1)Hughes, David; (2)Fedirko, Veronika; (3)Méplan, Catherine;

(3)Hesketh, John; (4)Schomburg, Lutz; (5)Jones, Jeb; (4)Hybsier, Sandra;

(6)Riboli, Elio; (7)Jenab (on behalf of EPIC group), Mazda.

(1)PhD. Department of Physiology and Centre for Systems Medicine. Royal College of Surgeons in Ireland. Dublin. Ireland;

(2)PhD. Rollins School of Public Health. Emory University. Atlanta. USA.; (3)Phd. Institute of Cell and Molecular Biosciences. Newcastle University. Newcastle. UK.; (4)PhD. Institute for Experimental Endocrinology. Charité – Medical University. Berlin. Germany.; (5)MSc. Rollins School of Public Health. Emory University. Atlanta. USA.; (6)MD, PhD. School of Public Health. Imperial College London. London. UK.; (7)PhD. Section of Nutrition and Metabolism. International Agency for Research on Cancer. Lyon. France.

**Background and objectives:** Suboptimal intakes of the essential micronutrient selenium (Se) and selenoprotein genetic variation may contribute to colorectal cancer (CRC). Here, we examined the associations of single nucleotide polymorphisms (SNPs) in the Se pathway and their Se status interactions with CRC risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

**Methods:** Using an Illumina Goldengate assay, we simultaneously genotyped all SNPs in 164 Se pathway genes (comprising all 25 selenoprotein genes, selenoprotein biosynthesis / transport genes, and metabolic pathway genes) using 1264 candidate functional and common tagging SNPs. From these assays, 1040 variants in 154 genes were successfully assayed in DNA samples from 1478 CRC case-control pairs matched within EPIC. Multivariate logistic regression was used to determine the association of SNPs in the Se pathway with CRC risk. Pathway and gene based analyses were also performed using the PIGE package Adaptive Rank Truncated test.

**Results:** Genotypes for 144 SNPs in 63 genes were associated with an altered CRC risk. However, none of the associations in the selenoprotein genes remained significant after Benjamini-Hochberg multiple-testing correction, although the Thioredoxin Reductase 1 (TXNRD1) rs11111979 SNP retained significance with gene-wide PACT (P values adjusted for correlated tests) considerations. SNP genotypes in cell-signaling pathway genes (FRZB, SMAD3, and SMAD7) known to be affected by Se intake were also significantly associated with CRC risk after multiple testing adjustments. Additionally, genetic variations were shown to interact with biomarkers of Se status (as assessed by serum Se and Selenoprotein P concentration) to alter CRC risk. Pathway analyses also suggest that SNP only and SNP X Se interactions in selenoprotein, antioxidant, apoptosis and TGF-beta signaling pathways may alter CRC susceptibility risk.

**Conclusions:** Detailed investigation of Se intake levels and metabolism is needed to further explore relevance for CRC
were preschoolers; Age range 1-59 months (average 15.2 m). 7
Days of hospitalization: 7.1 days (2-47 days) At admission, the
prevalence of global malnutrition was 25.8%, acute malnutrition
22.4% and chronic malnutrition 28.8%; Hospital malnutrition:
8.2%. Children with malnutrition were characterized by: low
birth weight, breastfeeding of less than five months, parents with
a monthly family income of a minimum wage, who consulted for
a basic pathology. The association of enteral nutrition use and
weight gain was significant (p = 0.02). No child presented kwashi-
orkor. No deaths were recorded.

**Conclusions:** The prevalence of hospital malnutrition in chil-
dren under five years of age is 8.2% in a referral hospital. It is high-
er in the infants group.

**Keywords:** hospital malnutrition, nutritional status, Infants

144/2397

NUTRITION AND HEALTH MONITORING SYSTEM
DEVELOPMENT IN THE US AFFILIATED PACIFIC:
THE CHILDREN'S HEALTHY LIVING NETWORK

(1)Novotny, Rachel; (2)Techur-Pedro, Angela; (3)Coleman, Patricia;

(⁴)Fialkowski, Marie; (⁵)Wilkens, Lynne; (⁶)Delacruz-Talbert, Elise;

(7)Leon Guerrero, Rachael; (8)Deenik, Jonathan; (9)Tufa, Aifili;

(¹⁰)Greenberg, Joshua.

(1)PhD. Professor. College of Tropical Agriculture and Human Resources. University of Hawaii a Manoa. Hawaii USA; (2)PhD. Epidemiologist. Pacific Island Health Officers Association. Hawaii. USA; (3)BS. Program Coordinator. Northern Marianas College. Commonwealth of the Northern Marianas. USA; (4)PhD. Assistant Professor. College of Tropical Agriculture and Human Resources. University of Hawaii. Hawaii USA; (5)DrPH. Specialist. University of Hawaii Cancer Center. Hawaii. USA; (6)MPH. Data Coordinator. College of Tropical Agriculture and Human Resources. University of Hawaii. Hawaii.; (7)PhD. Professor. College of Natural and Applied Sciences. University of Guam. Guam.; (8)PhD. College of Tropical Agriculture and Human Resources. University of Hawaii. Hawaii.; (9)MPH. Epidemiologist. Pacific Island Health Officers Association. American Samoa.; (10)PhD. Professor. School of Natural Resources and Extension. University of Alaska at Fairbanks. Alaska.

**Background and objectives:** The US Affiliated Pacific Islands are underserved by the US national health and nutrition monitoring system. The importance of having reliable anthropometric data was highlighted with the recent Zika virus outbreak in the region, with critical sequelae identified with infant head circumference measurements (microcephaly), and for monitoring obesity in a region with the highest rates of obesity and non-communicable disease in the world. The Children's Healthy Living (CHL) Network has expanded its partnership beyond Colleges and Headstart programs to include Departments of Health, in partnership with the Pacific Island Health Officers Association (PIHOA)(CHL USDA/AFRI Grant#: 2011-68001-30335, Novotny R, PI; PIHOA CDC/NACDD Cooperative Agreement # 1412016, Techur-Pedro

A, PI). The CHL Network aims to develop and maintain a regional
anthropometric monitoring system through partnerships of land
grant colleges and health departments to provide data for deci-
sion-making.

**Methods:** Training, standardization and coordination of research and health program personnel in anthropometric measures were done in 11 jurisdictions, according to protocols developed by CHL and later expanded to 3 age groups: 0-1 y (length, weight, head circumference), 2-10 y (height, weight, waist circumference at the umbilicus), 11+ y (height, weight, waist circumference at the iliac crest)(Li et al. 2015).

**Results:** Each US affiliated Pacific jurisdiction now has at least 1 standardized anthropometric measurer in at least 1 age group. With a core of regional anthropometric measurers in the 2-10 y range (145 height, 154 weight, 109 waist), measurers are now being trained in infant (24 length, 24 weight, 24 head circumference) and adult measures (52 height, 50 weight, 1 waist circumference). Increasing the number of standardized measurers and developing a sustainable anthropometric monitoring system that includes quality assurance is in process for the region.

**Conclusions:** College and health leaders in the US affiliated Pacific region have formed a network to provide on-going training and skill development in order to gather and maintain standardized anthropometric information useful for decision making related to non-communicable and communicable diseases critical to the region.

**Keywords:** Pacific, anthropometry, height, weight, circumferences

144/2407

THE IMPACT OF TASTE PREFERENCES ON MA-
CRONUTRIENT INTAKE

(1)Dikmen, Derya; (1)Inan-Eroglu, Elif; (2)Ozdemir, Aslihan; (2)Madali, Berna; (3)Ellahi, Basma.

(1)PhD, Nutrition and Dietetics Department, Hacettepe University, Turkey.; (2)MSc, Nutrition and Dietetics Department, Hacettepe University, Turkey.; (3)Prof, PhD, Faculty of Health and Social Care, University of Chester, United Kingdom.

**Background and objectives:** Recent evidence has suggested that there are multiple links between taste preferences and food choices and the amount of food consumed. In this study, we aimed to investigate whether there is an impact of taste preference on macronutrient consumption in healthy adults.

**Methods:** This study compromised 46 adults aged between 18-40. Socio-demographic characteristics and anthropometric measurements of the individuals were taken by dietitians. Participants' 24 hour food recall was also taken for determining the nutrient intakes by specialized dietitians. The results were evaluated by the statistical program SPSS.

**Results:** The great majority of participants reported that they like sweet taste (93.5%). Participants 69.6 % like soury taste and 60.9 % salt taste. Because umami taste is a new taste for consumers, it was found that 50.0% of the participants did not have an idea
about the taste of umami and 28.3% disliked it. The mean energy intake of the participants was 2038.4 ± 678.34 kkal. According to the participants' 24-hour food recalls, the average percentage of energy from carbohydrate, fat and protein intake were 47.9 ± 9.31%, 37.2 ± 8.66% and 14.9 ± 3.50% respectively. The fat intake of the participants who like sweet taste (37.%) was higher than non-likers of the sweet taste (26.3%) (p=0.02). Also participants who like bitter taste fat intake were higher than non-likers of bitter taste (p>0.05). Fat intake levels were lower who likes mostly soury and salty taste when compared to sweet and bitter taste likers. Daily protein intake of the salty (p>0.05) and soury taste (p<0.05) likers were higher than the sweet and bitter taste likers. The participants like salty taste daily protein intake were 5 g higher than the non-likers salty taste (p>0.05).

**Conclusions:** There was a relation between fat, protein intake of the participants with taste preferences. There are evidence on oral and pharyngeal recognition of the nutrients is proposed as a mechanism for regulating nutrient intake. Further experimental studies need to investigate the taste preference and its affect on nutrient intake.

**Keywords:** taste, nutrient intake, food choice

144/2426

## USE OF COMPUTER VISION TECHNIQUES FOR AUTOMATIC FOOD CLASSIFICATION BY SIZE

**Background and objectives:** Computer vision (VC) techniques are a novel tool for the food and nutrition area. The classification of foods according to size using VC techniques would allow the estimation of portion sizes and grams, optimize the evaluators time and reduce subjectivity, but research in this area is still incipient. Therefore, we set out to develop an automatic and reproducible method of food classification by size.

**Methods:** To evaluate the method we used oranges, which are much consumed and are available in the local market. We measured the dimensions (greater diameter) of the oranges with a caliber and weighed each one of them, later we classified them in: small, medium and large. We created a closed environment to obtain high quality images, and developed a program that takes the obtained images as input data and we applied VC techniques which includes image processing, segmentation, extraction of characteristics and classification using the algorithm KNN. Finally we estimated the sensitivity and specificity of the results obtained through the program.

**Results:** We obtained photographs of 207 oranges (124 used for training of the program (60%) and 83 for the corresponding

tests of the same (40%)), the average greater diameter according to the measurements of the expert was 69.1 ± 4.4 millimeters and the obtained from the program was 68.9 ± 4.1. The Pearson correlation showed r = 0.68 (p <0.001). The average difference between the expert and the program measurements was 0.20 ± 3.4 (p> 0.05). After 100 training with random assignment of oranges in the ratio of 60% to 40%, the program had a sensitivity and specificity equal to 1.0.

**Conclusions:** The proposed method could provide assistance to nutrition professionals in the process of estimating the size of foods and consequently portions and grams. The database of images and physical measurements generated would enable more studies in the area.

**Keywords:** Computer vision, Food, food classifications

144/2428

## IDENTIFYING DIETARY STRATEGIES TO IMPROVE NUTRIENT ADEQUACY AMONG ETHIOPIAN INFANTS AND YOUNG CHILDREN USING LINEAR MODELLING

**Background and objectives:** Optimal Infant and Young Child Feeding practices are crucial for child survival but lack guidance from local food-based dietary guidelines, that incorporate fortified products, to ensure nutrient adequacy in Ethiopia.

**Methods:** Based on data from the Ethiopian National Food Consumption Survey, linear programming (LP, Optifood) was used to identify nutrients lacking in local diets of young children (6-8, 9-11 and 12-23 months) and to formulate realistic Food Based Dietary Recommendations (FBDR) for improved nutrient adequacy in four regions by comparing alternative approaches of local complementary foods, micronutrient powders (MNPs), Small quantity Lipid based Nutrient Supplement (Sq-LNS) and combinations of these.

**Results:** Optimised local diets provided inadequate zinc in all regions and age groups, inadequate iron for infants < 1 year of age

<footnote>(1)Miranda, Juan Carlos; (2)Gonzalez Cespedes, Laura Elizabeth;</footnote>

<footnote>(3)Aguilar Rabito, Ana Carolina; (4)Vázquez Noguera, José Luís;</footnote>

<footnote>(4)Legal Ayala, Horacio.</footnote>

<footnote>(1)Facultad Politécnica. Universidad Nacional de Asunción; (2)San Lorenzo; (3)Department of Nutrition Research. Facultad de Ciencias Químicas. Universidad Nacional de Asunción; (4)Facultad de Politécnica. Universidad Nacional de Asunción.</footnote>

<footnote>(1)Samuel, Aregash; (2)Osendarp, Saskia; (3)Ferguson, Elaine;</footnote>

<footnote>(4)Borgonjen, Karin; (5)Alvarado, Brenda M.; (6)Neufeld, Lynnette M.;</footnote>

<footnote>(7)Adish, Abdul Aziz; (8)Kebebe, Amha; (9)Weuhler, Sara; (10)Brouwer, Ingeborg.</footnote>

<footnote>(1)Msc. Nutritionist. Division fo Human Nutrition. Wageningen University. The Netherlands. Ethiopian Public Health Institute. Addis Ababa. Ethiopia.; (2)PhD. Nutritionist. Division of Human Nutrition. Wageningen University. The Netherlands. Micronutrient Initiative. Canada.; (3)PhD. London School of Health and Tropical Medicin. United Kingdom; (4)Bsc. Research Dietician. Division of Human Nutrition. Wageningen University. The Netherlands.;</footnote>

<footnote>(5)MSc. Division of Human Nutrition. Wageningen University. The Netherlands; (6)PhD. Global Alliance for Nutrition. Geneva. Switserland; (7)Micronutrient Initiative. Addis Ababa. Ethiopia;</footnote>

<footnote>(8)Ethiopian Public Health Institute. Addis Ababa. Ethiopia;</footnote>

<footnote>(9)Micronutrient Initiative. Canada.; (10)PhD. Nutritionist. Division of Human Nutrition. Wageningen University. The Netherlands.</footnote>
in all regions, and inadequate calcium, niacin, thiamin, folate, vit-
tamin B12 and B6 in some regions and age-groups, but not in all.
The set of regional FBDRs were significantly different for the four
regions thus development of one general national FBDRs will be a
challenge. Promoting a more diverse diet such as increasing veg-
etables, legumes and animal source food consumption improves
nutrient profile of the diet to a certain extent. Nevertheless even
after the FBDRs; some nutrient intakes remain suboptimal.

**Conclusions:** The best nutritional option to solve the nutri-
ent gaps identified is a combination of regional FBDRs with MNP
supplementation. It is important to emphasize that MNP should
not replace the feeding recommendations, but should be promot-
ed in addition to these FBDRs together with breast-feeding on de-
mand during the first two years of age.

**Keywords:** Complementary food, Optifood analysis, food based dietary recommendations, problem nutrients, young children.

144/2431

NUTRITIONAL STATUS BY GENDER, AGE RANGE,
SEL AND REGION AMONG ARGENTINE POPULA-
TION. RESULTS OF ELANS STUDY

(1)Guajardo, Viviana Beatriz; (2)Favieri, Andrea Lorena; (3)Nogueira Previdelli, Agatha; (4)Gerardi, Alejandro; (5)Gómez Salas, Georgina;

(6)Fisberg, Mauro; (7)Kovalskys, Irina.

(1)BSc. Psychologist. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina; (2)BSc. Nutritionist. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina; (3)PhD. Professor. Faculdade de Ciências Biológicas e da Saúde. Universidade São Judas Tadeu São Paulo. Brazil; (4)BSc. Sociologist. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina; (5)MSc. Professor. Departamento de Bioquímica. Escuela de Medicina. Universidad de Costa Rica. Costa Rica; (6)MD. Instituto Pensi. Fundação Jose Luiz Egydio Setubal. Hospital Infantil Sabara. São Paulo. Brazil PhD. Professor. Departamento de Pediatria. Universidade Federal de São Paulo. São Paulo. Brazil; (7)MD. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina.

**Background and objectives:** Obesity's comorbidities are the major cause of morbidity and less quality of life in adult population all over the world. The aim of this study was to evaluate the prevalence of overweight (OW), obesity (OB) and underweight (UW) in a representative sample population of Argentina.

**Methods:** Data were obtained from 1266 Argentines par-
ticipating in The Latin American Health and Nutrition Study
(ELANS), a multicenter study of a nationally representative ran-
domized sample of urban population of 8 LA countries between
November 2014 and July 2015. The sample had a multistage de-
sign stratified by geographical location (6 regions), age (15-65 y),
gender and Socio Economic Level (SEL). A standard study pro-
tocol was designed to evaluate 6 anthropometric measurements
including weight and height. A questionnaire to classify SEL was

administered. Sample expansion factors were calculated and de-
scriptive statistical data analysis was performed with SPSS Sta-
tistics 20.

**Results:** Overall OW, OB and UW prevalence were 32.2%, 23.2% and 4.9% respectively. Analyzing by gender, up to 20 years of age, the prevalence of OW including OB was higher for men, but OB prevalence was higher for woman between 35 and 49 y (32.1% vs. 23.3%). On the other hand, the prevalence of UW, up to 20 years old, was higher for women (12.4% for 20-34 y). Comparing by SEL (high, medium and low) OW including OB prevalence was 61.8%, 57.4% and 52.7% respectively, while the highest prevalence of UW (5.7%) was observed on low SEL population. Analyzing by region the prevalence of OW including OB was higher for men in Buenos Aires Metropolitan Area, Cuyo and South regions (65.2%, 72.8%, 65.2%), while for women was higher in Pampeana, Northwest and Northeast regions (58.5%, 56.8%, 55.7%). South region had the highest prevalence of OW including OB (63.1%) while Pampeana region had the highest prevalence of UW (8.1%).

**Conclusions:** More than 50% of the Argentine population is above the BMI considered healthy. Minimal differences were found between genders and regions but a special public health consideration should be centered in the trans-generational tracking of adiposity in woman.

**Keywords:** Nutritional Status, Argentine population, multi-center study

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

**Further collaborators:**
on behalf of the ELANS Study Group
# REPORTED DIETARY INTAKE: ANALYSIS OF CALCIUM USUAL INTAKE AMONG ARGENTINE POPULATION. RESULTS FROM ELANS STUDY

(¹)Guajardo, Viviana Beatriz; (²)Favieri, Andrea Lorena; (³)Nogueira Previdelli, Agatha; (⁴)Gerardi, Alejandro; (⁵)Gómez Salas, Georgina; (⁶)Fisberg, Mauro; (⁷)Kovalskys, Irina.

(¹)BSc. Psychologist. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina; (²)BSc. Nutritionist. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina; (³)PhD. Professor. Faculdade de Ciências Biológicas e da Saúde. Universidade São Judas Tadeu São Paulo. Brazil; (⁴)BSc. Sociologist. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina; (⁵)MSc. Professor. Departamento de Bioquímica. Escuela de Medicina. Universidad de Costa Rica. Costa Rica; (⁶)MD. Instituto Pensi. Fundação Jose Luiz Egydio Setubal. Hospital Infantil Sabara. São Paulo. Brazil PhD. Professor. Departamento de Pediatria. Universidade Federal de São Paulo. São Paulo. Brazil; (⁷)MD. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina.

**Background and objectives:** The consumption of calcium is associated both with the prevention of many diseases and also with quality of life (1). This study aimed to identify the adequacy of calcium intake among Argentine population.

(1) Mueller, N. T., & Appel, L. J. (2017). Attributing Death to Diet: Precision Counts. Jama, 317(9), 908-909.

**Methods:** Data were obtained from 1266 Argentines participating in Latin American Health and Nutrition Study (ELANS), a multicenter study of a nationally representative randomized sample of urban population of 8 LA countries, developed between November 2014 and July 2015. The sample by country had a multistage design stratified by region, age (15-65 y), gender and SEL. A standard study protocol was designed to evaluate nutritional intake assessed by two 24-hour recalls, analyzed with the Nutrition Data System for Research (NDS-R) from Minnesota University, after a standardization process between local food and NDS-R database. Calcium usual intake was estimated with the Multiple Source Method (MSM) statistic package (https://nugo.dife.de/msm) and adequacy estimated in comparisons with Recommended Dietary Allowances (RDA) (IOM standards). Sample expansion factors were calculated and descriptive statistical data analysis was performed with SPSS Statistics 20.

**Results:** Median of usual consumption of the whole sample was 777 and 689 mg/day in men and women respectively. Both female adolescents and women above 50 consume a median of 50% of RDAs: 646.1 and 655,4 mg/day respectively, adding that 99% and 98,5% of the population of those groups of ages were below recommendations. Although the RDA decreases at 20-49 y, the prevalence of inadequate usual intake was 90.9%-86.9%. Younger males (15-19) and older ones (50-65) consume more calcium than women of same ages (855.7 mg/day and 746,7 respectively) but, the prevalence of inadequate usual intake was 94.4% and 90.3% respectively, for equal RDAs.

**Conclusions:** The prevalence of inadequate usual intake of calcium for Argentine population, at every age range and gender is very high. These results reinforce the importance of public health programs focused on increasing calcium consumption and implementing micronutrients fortification specially in women.

**Keywords:** Calcium, inadequate usual intake, Argentinian population, multicenter study.

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

**Further collaborators:**

on behalf of the ELANS Study Group

# CHARACTERISTICS OF THE DIET IN THE ARGENTINE POPULATION. RESULTS OF ELANS STUDY

(¹)Favieri, Andrea Lorena; (²)Guajardo, Viviana Beatriz; (³)Nogueira Previdelli, Agatha; (⁴)Gerardi, Alejandro; (⁵)Gómez Salas, Georgina; (⁶)Fisberg, Mauro; (⁷)Kovalskys, Irina.

(¹)BSc. Nutritionist. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina; (²)BSc. Psychologist. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina; (³)PhD. Professor. Faculdade de Ciências Biológicas e da Saúde. Universidade São Judas Tadeu São Paulo. Brazil; (⁴)BSc. Sociologist. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina; (⁵)MSc. Professor. Departamento de Bioquímica. Escuela de Medicina. Universidad de Costa Rica. Costa Rica; (⁶)MD. Instituto Pensi. Fundação Jose Luiz Egydio Setubal. Hospital Infantil Sabara. São Paulo. Brazil PhD. Professor. Departamento de Pediatria. Universidade Federal de São Paulo. São Paulo. Brazil; (⁷)MD. Nutrition and Health Area. International Life Science Institute (ILSI). Buenos Aires. Argentina.

**Background and objectives:** The diet is determinant in the development of chronic diseases. The aim of this study was to assess energy intake (EI) and macronutrients intake (MI) and distribution (MD) of the Argentine population

**Methods:** Data from 1266 Argentine people (15-65 y) participating in the Latin American Health and Nutrition Study (ELANS), a multicenter study developed in urban areas of 8 LA countries. Intake was assessed by two face to face 24-hour recalls (November 2014-July 2015), and processed by the software Nutritional Data System for Research (NDS-R). Daily intake was analyzed by age, gender, socioeconomic level (SEL) and region (Buenos Aires Metropolitan Area, Cuyo, Pampeana, Northwest,
Northeast and South). The median values of EI and MI and percentages of MD were calculated. Sample expansion factors were calculated and descriptive statistical data analysis was performed with SPSS 20.

**Results:** The median of EI was 2154 kcal/day (2434 kcal/day in men and 1911 kcal/day in women). The MI was 271 g/day of carbohydrates, 85 g/day of protein and 78 g/day of fat (51%, 16% and 33% of EI respectively). Saturated fats accounted for 11.5%, monounsaturated fat 10.3% and polyunsaturated fat 7.7% of EI. The cholesterol intake was 375 mg/day. The added sugar was 15% of the EI. It was observed that EI decreased inversely with age (2667 kcal/day in men aged 15 to 19 years and 1712 kcal/day in women between 50 and 65 years), EI values showed no differences by SEL. In men, differences were found in MD: high SEL men increased proportion of fats and proteins (35% and 17% respectively) in comparison with low SEL men (32 and 15%). EI was not different due to a compensation effect of CHO. By region, EI ranged from 1994 kcal/day in the Pampeana region to 2307 kcal/day in the Northwest. No significant differences were found in MD by age.

**Conclusions:** In Argentina, population diet showed high levels of critical nutrients as saturated fats, cholesterol, and added sugars, all related to cardiovascular disease and metabolic syndrome. Differences by region and by SEL were found and should be taken into account by public health stakeholders.

**Keywords:** Energy intake, macronutrients, Argentine population, multicenter study.

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

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

fat distribution. In this regard, a new index, called the Lipid Accumulation Product (LAP), has been proposed. The aim of this study was to compare LAP and BMI measurements and to determine cutoff point values for LAP and BMI in apparently healthy Brazilian adults men.

**Methods:** A cross-sectional study was conducted with 130 apparently healthy Brazilian adults men (20-59 years). Anthropometric data, including weight, height and waist circumference, were determined. Triglycerides were determined by enzymatic colorimetric method. The lipid accumulation product was calculated as (waist circumference [cm] - 65) x (triglycerides concentration [mM]). Percentage of body fat mass was obtained by Tetrapolar Bioelectrical Impedance Analysis. It was considered as cutoff point for elevated percentage of body fat mass values ≥ 25%. The statistical analysis consisted in construction of ROC curves (Receiver Operating Characteristic Curve) and was carried out using Medcalc version 12.7.

**Results:** A strong correlation was found between BMI and percentage of body fat mass (r=0.71; p<0.001). BMI and LAP also showed a strong correlation (r=0.67; p<0.001), as well as, LAP and percentage of body fat mass (r=0.69; p<0.001). According to these results, the ROC curve analysis showed accuracy for BMI (AUC=0.886±0.057) and for LAP (AUC=0.823±0.068) regarding the discriminatory ability for detect elevated percentage of body fat mass. The cutoff point value of 39.3 cm.mmol/L for LAP provided a sensitivity of 73.3% (95% CI: 44.9-92.0%) and specificity of 81.7% (95% CI: 73.4-88.3). Whereas, the cutoff point value of 27.1 kg/m2 for BMI provided a sensitivity of 86.7% (95% CI: 59.5-98.0) and specificity was 88.7% (95% CI: 81.4-93.8%).

**Conclusions:** The LAP may be an alternative to measure adiposity; however, the BMI is a simple, inexpensive and reliable tool that showed great ability in discriminating elevated values of percentage of body fat mass in apparently healthy Brazilian adults men.

**Keywords:** Adiposity. Body Mass Index. Lipid accumulation product. Obesity.

**Background and objectives:** Obesity (defined as an excess accumulation of body fat) is a complex multifactorial condition that has reached epidemic proportions. The Body Mass Index (BMI) is the most commonly used indicator to assess obesity. This indicator evaluates generalized obesity, but does not measure body

<footnote>(1)de Carvalho Vidigal, Fernanda; (2)Enriqueta Frandsen Paez de Lima Rosado, Lina.</footnote>

<footnote>(1)PhD in Nutrition Science. Professor of Nutrition. Faculty of Nutrition. Universidade Federal de Alfenas. Brazil.; (2)PhD in Nutrition. Nutritionist. Brazil.</footnote>
**Background and objectives:** Morocco, in full economic, social and cultural transition, experiencing urbanization increasingly greater causing changes in lifestyle and dietary habits. The objective of this study was to evaluate nutritional status by Anthropometry and determines the meal patterns of university students in Kenitra city, Morocco.

**Methods:** The anthropometric survey was conducted on 150 university students with average age (24.15years ± 4.6). Body Mass Index (BMI) was adopted to evaluate nutritional status by Anthropometry. A self-administered questionnaire was used to collect data about sociodemographic features of the students and their families, as well as meal habits of students.

**Results:** The finding showed an average Height of subject (1,64m ± 0,1 cm), the mean weight was (60.9 kg ± 10.7 kg); the mean of IMC (22.36+3.5); stunting (10%), thinness (9.3%), a risk of overweight (16%) and obesity (1.3%). About 73.7% of students eat three meals per day (70,7% for breakfast, 87,7% for lunch and 62,7% for diner). Snacks were eaten daily by 60 % of students. The majority drinks at breakfast tea (39.3%), coffee (13.3%) and eat Bread, cheese and olive oil (53. 3%).At the lunch, students eat bread (84%) with Tajine of meat (39%) and fruits (71.3%). At the dinner, most students eat bread)66.7%( and the pasta or tajine with meat (48%). 68.7% hydrate daily (1.7L per day),62% consume daily fruits and vegetable.

**Conclusions:** Students practice meals based on cereals. Interventions are needed to promote healthy eating habits among students.

**Keywords:** Anthropometry, nutritional status, meal patterns, university students, Morocco

**Background and objectives:** Obesity has a great impact on health, due to its complications. Anthropometric measures are able to identify the upper-body subcutaneous fat accumulation, such as neck circumference (NC), which presents a strong correlation with adiposity. The objectives of this study was to evaluate the prevalence of adult and elderly patients hospitalized with excess adiposity through NC, and verify the correlation of NC with BMI (Body Mass Index) in these patients.

**Methods:** A cross-sectional study, with secondary data from a hospital in the city of Taubate, Sao Paulo, which evaluated hospitalized adults and elderly, among February 2015 and May 2016. The variables analyzed were weight, height, BMI, NC, sex and age. For classification of nutritional status, the cutoff points proposed by the World Health Organization (1995), for adults and Lipschitz for the elderly (1994), were used. The cutoff points for elevated NC were 37 and 34 cm, for men and women, respectively. Data analysis was performed using descriptive statistics. Pearson's correlation test was performed to verify the correlation between NC and BMI.

**Results:** Among 628 patients selected, 579 were the final sample, of which 53.88% (n = 312) were female. The mean age, for the female and male sex was 66.2 ± 15.78 and 63.48 ± 13.88, respectively. It was verified that 76% of the female patients and 67.4% of the male patients presented elevated NC. Considering the groups of patients with and without overweight by BMI, 65.82% and 34.17% of the women, 64.44% and 35.55% of the men presented elevated NC, respectively. There was a strong correlation between NC and BMI for males (r = 0.85) and female (r = 0.90).

**Conclusions:** It was concluded that there was high correlation between NC and BMI for both sexes, and higher prevalence of overweight women who presented elevated NC. In relation to the non-overweight patients, there was a higher prevalence of males for this outcome.

**Keywords:** Neck Circumference, Anthropometry, Excess Adiposity, Hospitalized Patients.

**Further collaborators:**

Adriana Aparecida da Silva Alvarenga helped to implement the study and to write the text; Adriana Lisboa Mendes Roman helped the data collection, helped implement the study, and helped to write the text; Roberta de Lucena Ferretti conceived, designed, and implemented the study, collected and interpreted data, wrote and revised the text was responsible for coordinating original study and contributed to the intellectual content. All authors have sufficiently contributed to the development of this study.

Anjos, Luiz Antonio.

MD, PhD. Professor. Universidade Federal Fluminense.

**Background and objectives:** Energy intake (EI) is an important measure in detailed nutritional assessment in clinical and re-

<footnote><sup>(1)</sup>madane, salwa; <sup>(2)</sup>Sbaibi, Rachid; <sup>(2)</sup>Aboussaleh, Youssef.</footnote>

<footnote><sup>(1)</sup>PhD.Laboratory of Nutrition Health and Environment.
Department of Biology. Faculty of Sciences. University Ibn Tofail.
Kénitra. Morocco; <sup>(2)</sup>PhD. Nutritionist. Laboratory of Nutrition
Health and Environment. Department of Biology. Faculty of
Sciences. University Ibn Tofail.Kénitra. Morocco.</footnote>

<footnote><sup>(1)</sup>Aparecida da Silva Alvarenga, Adriana; <sup>(1)</sup>Mendes Lisboa, Adriana;</footnote>

<footnote><sup>(2)</sup>de Lucena Ferretti, Roberta.</footnote>

<footnote><sup>(1)</sup>Nutritionist. University of Taubate. University Hospital of Taubate. Sao Paulo. Brazil; <sup>(2)</sup>PhD student. MD. Federal University of Sao Paulo. Department of Pediatrics. University of Taubate. Sao Paulo. Brazil.</footnote>
search settings. However, there has been recent strong criticism on the self-reported methods used to obtain EI in populations, which yield low, unexplained, and sometimes unusable, values primarily in women and obese. The EI/basal metabolic rate (BMR) ratio has been suggested to provide clues on who underreports EI. In 2008, EI was obtained in a probability sample of the Brazilian 10y+ population by a 24h dietary recall (24HDR). This study reports the relationship between EI and BMR of the sub-sample of Brazilian adults (≥20y) in an attempt to quantify the level of EI underreporting.

**Methods:** Data from 25949 subjects (14052 women) aged 20-104y were used in the analysis. BMR was estimated by two set of equations: 1) the Schofield equations using body mass and stature (SCHO) suggested to be used internationally by FAO/WHO and 2) equations developed in a probability sample of the adult population of Niterói, a urban area in the Metropolitan area of Rio de Janeiro, Brazil (BRA). The latter equations have been validated in adults from the same town. EI/BMR of 1.53 was used as the cutoff to identify underreporting. The values were weighted to represent the Brazilian adult population.

**Results:** Overall mean (95%CI) EI was 1728.6 (1719.3;1737.9) kcal/day, being higher in men (1941.4, 1926.4;1956.5) than in women (1521.6, 1510.9;1532.2) kcal/day. Estimated BMR by the SCHO equations (1523.6, 1520.6;1526.5kcal/day) was significantly higher than the BRA equations (1259.5, 1257.0;1262.0kcal/day). Mean EI/BMR ratio varied from 1.06 to 1.21 depending on age and sex when the SCHO equations were used and between 1.26 and 1.48 with the BRA equations. EI underreporting varied from 78 to 88% when using the SCHO equations and 59 to 74% when the BRA equations were used. Using the latter equations, underreporting was 64% and 69% in all men and women, respectively.

**Conclusions:** EI assessed by a 24hDR is underestimated by more than 60% of the Brazilian adult population. Caution is warranted when using 24hDR to estimate EI in adults in Brazil.

**Keywords:** Nutrition Assessment, Basal metabolism, Adults, Diet.

ger, satiety and binge eating scale scores on caloric estimation in healthy subjects.

**Methods:** This study was conducted with 46 healthy volunteers in Ankara, Turkey. Anthropometric measurements, body compositions were examined. Binge eating scale was evaluated on participants to identify the risk of binge eating disorder. Moreover, 24-hour recall food records were taken from subjects. To determine the effect of hunger and satiety situations on caloric estimations of some specific foods, a protocol was developed. Participants were asked to estimate the energy content of the foods in hunger and satiety status.

**Results:** The mean age of subjects was 22,9±4,4, and mean BMI was 22,5±2,6 kg/m2. According to Binge Eating Scale, 84,8% of participants' binge eating scores were low. Non-binging subjects estimated calorie content of CHO-based foods eg. green beans, chocolate, potato chips, and fried potatoes lower when they were hungry (p<0,05). Subjects who had moderate binge eating scores estimated calorie content of apple higher when they are satiated (p<0,05) when compared with hunger situation. According to data obtained from food records, 60,9% of subjects consumed higher energy from CHO. Estimations on calorie contents of CHO content foods apple, bread, and fried potatoes of these subjects were statistically different in hunger and satiety conditions (p<0,05).

**Conclusions:** This study shows that there is a significant association between hunger status and caloric estimations. Especially carbohydrate consumption affects predictions about foods that contain more carbohydrate. Further studies are required to investigate the relation between binge eating, carbohydrate consumption and caloric estimations.

**Keywords:** hunger, satiety, binge eating, caloric estimation

**Background and objectives:** Estimation of calories in foods is crucial in the maintenance of body weight and energy regulation. Binge eating is defined as eating an unusually large amount of food in a short period and experiencing a loss-of-control over eating. In this study, we aimed to investigate the effects of hun-

<footnote>(1) Ozdemir, Aslihan; (2) Madali, Berna; (3) Dikmen, Derya; (4) Inan-Eroglu, Elif; (5) Ellahi, Basma.</footnote>

<footnote>(1) MSc, Nutrition and Dietetics Department, Hacettepe University, Turkey; (2) MSc. Nutrition and Dietetics Department. Hacettepe University. Turkey; (3) PhD. Nutrition and Dietetics Department. Hacettepe University. Turkey; (4) PhD. Nutrition and Dietetics Department, Hacettepe University, Turkey; (5) PhD. Faculty of Health and Social Care. University of Chester. United Kingdom.</footnote>
# ACCURACY AND RELIABILITY OF A LOW-COST, HANDHELD 3D IMAGING SYSTEM FOR CHILD ANTHROPOMETRY

(1)Conkle, Joel; (2)Ramakrishnan, Usha; (2)Suchdev, Parminder S.;

(3)Alexander, Eugene; (2)Martorell, Reynaldo.

(1)MPH, Doctoral Program in Nutrition and Health Sciences. Laney Graduate School. Emory University, USA; (2)PhD. Hubert Department of Global Health. Rollins School of Public Health. Doctoral Program in Nutrition and Health Sciences. Laney Graduate School. Emory University. Atlanta, GA, USA; (3)Body Surface Translations, Inc.

**Background and objectives:** Body measurement, or anthropometry, is used to assess child growth and body composition. Anthropometry is used in clinical settings to identify and manage malnutrition, and in national surveys to guide nutrition programs. The usefulness of anthropometry however is undermined by poor measurement quality, which has led to calls for improved quality and/or new approaches. We evaluated the potential of a three-dimensional (3D) imaging system to replace the current gold standard of non-digital, manual measurements for child stature (length or height), head circumference (HC) and mid-upper arm circumference (MUAC).

**Methods:** Five trained anthropometrists measured 474 apparently healthy children 0-5 years of age in Atlanta, USA from September 2016 to February 2017. For manual measurements, we followed training and measurement techniques used to develop the 2006 WHO Growth Standards. Anthropometrists took 3D scans of children using an iPad Air® with Occipital Structure Sensor and custom software developed by Body Surface Translations. We analyzed the quality of manual measurements using the 2006 WHO Growth Standards to calculate z-scores and define biological plausibility. We evaluated the accuracy of scan-derived measurements against manual measurements using average bias and Bland-Altman Plots; for reliability, we calculated intra- and inter-observer Technical Error of Measurement (TEM) and Coefficient of Reliability.

**Results:** 99.8% of manual measurements were biologically plausible, and the z-score standard deviations (SD) were close to 1.0 for all anthropometric indices, ranging from 0.92 for weight-for-height to 1.07 for height-for-age. Z-score variances among children under 2 years did not differ from those 2 or more based on Levene's Test. Inter- and intra-observer TEM was below 0.35 cm for all manual measurements. We are still analyzing the accuracy and reliability of scan-derived measurements.

**Conclusions:** We collected high quality manual anthropometry. If accurate and reliable, 3D imaging could help to improve the efficiency, precision and accuracy of child anthropometry. Expensive 3D imaging systems are already used in the garment industry for adult anthropometry. The 3D scanner and associated software we used in this study are low-cost, mobile and can handle movement; possibly extending the use of 3D imaging for diagnostic purposes.

**Keywords:** anthropometry; 3D; imaging; accuracy; reliability

**Conflict of Interest Disclosure:** The Bill and Melinda Gates Foundation funded the study. Dr. Eugene Alexander is employed by BST, Inc. All other authors do not have affiliations with or financial involvement with any organization or entity with a financial interest in the subject matter or materials discussed in the manuscript.

# THE PILOT KOREAN KEY FOODS BASED ON DIET CONSUMPTION

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

(1)PhD. Department of Food and Nutrition. Kookmin University. Republic of Korea.; (2)PhD. Medical College. Yonsei University. Republic of Korea.; (3)PhD. Department of Food and Nutrition. Yongin University. Republic of Korea.; (4)PhD. Department of Food and Nutrition. Dongseo University. Republic of Korea.; (5)PhD. Department of Food and Nutrition. Daejeon University. Republic of Korea.

**Background and objectives:** This study was performed to develop the Key Foods approach to select foods for nutrient analysis of up-to-date National Food Nutrient Composition Database. The primary objective of nutrient composition database in Korea is to provide the information to represent the nutrients consumed by Korean population, especially the nutrient profile for each food identified as important in the food consumption. The Key Food approach assists database system to prioritize foods that contribute significant amounts of nutrients of public health interest to the diet.

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

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

**Conclusions:** This Key Foods list will be used for updating and revising the National Food Nutrient Composition Database from 2017 and concentrating resources for food composition analysis in Korea. We expect the updating database will give representative data for researchers, etc.
(This research was supported by a grant (16162MFDS087) from Ministry of Food and Drug Safety in 2016)

**Keywords:** Key Nutrients, Key Foods approach, KNHANES, Food Nutrient Composition database

**Keywords:** Brazilian Nut; Brazil nut; Body Composition; Obesity.
**Further collaborators:** Fundação de Amparo para Pesquisa do Estado de São Paulo (FAPESP)

144/2531

BRAZILIAN NUT INTAKE HAS NO INFLUENCE ON BODY COMPOSITION IN OBESE WOMEN

(1)Biude Silva Duarte, Graziela; (2)Zavarize Reis, Bruna; (3)Cercato, Cintia;

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

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

**Background and objectives:** Nuts are considered to have an optimal energy density and a good source of lipids, especially unsaturated fatty acids. One Brazilian nut provides approximately 35,3kcal and 3,24g of total lipids, mainly monounsaturated fatty acids. The daily consumption of this food has been associated with the improvement of lipid profile and risk reduction of cardiovascular diseases. However, there is a concern about the possible effects of the daily intake of nuts on weight gain. Thus, the aim of this study was to investigate the effects of Brazilian nuts (Bertholletia excelsa H.B.K.) intake on body composition of obese women.

**Methods:** We enrolled 72 obese women recruited in the outpatient clinic of endocrinology from Clinics Hospital of São Paulo, Brazil. They were randomly assigned to either ingestion of Brazil nuts (BN) group or control (CO) group and they were followed up for 2 months. Participants of the treatment group consumed one Brazilian nut daily and the control group avoided the intake of any food containing the nut for the same period of time. On baseline and after two months of follow-up were assessed weight and height for the calculation of body mass index (BMI), waist circumference (WC) and percentage of body fat (%BF). Repeated measures ANOVA analyses were performed using SPSS 18.0 software to evaluate the effect of supplementation time with Brazilian nuts on the variables mentioned above.

**Results:** Twenty-nine participants of the treated group (BN) and twenty-six of the control group (CO) completed the trial. The mean age of BN and CO group was 40,3±9,0 and 39,4±9,5 (P=0,714) respectively. For BN and CO groups, no significant differences were observed for weight (ΔAfter-Before= -0,50) (ΔAfter-Before= 0,20) (P=0,723), BMI (ΔAfter-Before= -0,10) (ΔAfter-Before=0,10) (P=0,784), WC (ΔAfter-Before= -1,10) (ΔAfter-Before= 2,50) (P=0,111) and %BF (ΔAfter-Before= 0,30) (ΔAfter-Before= -0,10) (P=0,587).

**Conclusions:** The data show that Brazilian nut consumption for two months has no effect on the body composition of obese women.

144/2539

A MODEL FOR DIGITALIZATION OF THE NUTRITION JOURNEY – CASE INSIGHTS FROM THE NUTRIDIA APP DEVELOPMENT FOR CANCER PATIENT COUNSELLING

(1)Mikkelsen, Bent Egberg; (1)Mikkelsen, Bent Egberg; (2)Clausen, Katja Serup; (3)Holst, Mette.

(1)PhD. Professor. Department of Clinical Medicine. Captive Foodscape Studies. Aalborg University. Copenhagen. Denmark.;
(2)MSc. Department of Civilengineering. Aalborg University. Denmark; (3)PhD. Center for Nutrition and Bowel Disease. Department of Gastroenterology. Aalborg University Hospital & Department of Clinical Medicine, Aalborg University. Denmark.

**Background and objectives:** Shared decision making is relevant to nutrition counselling for patients who have diminished food intake, and suffer from cancer and therapy related riskfactors. Shared decision making however requires the patient to be well informed, and the professional to have access to updated information on the patients foodintake and riskfactors as nausea, mouth-problems i.e. So far nutritional apps seem to have been inspired more by experience economy than by nutrition science. The objective of NutriDia was to digitalize the nutrition counselling in a transparent and beneficial manner for the client while at the same time making the most of the expert knowledge of nutritionists and app developers, in order to enhance shared decision making for the individualised nutrition plan.

**Methods:** Development was set in the University Hospital Nutrition Centre with a professional app developer as partner and with university scientific team as evaluators. Evaluation performed observation and interviews with patients and professionals in consecutive app intermezzo's. The "sprint" concept from Agile software development was adopted. It defines principles for software development under which user requirements are specified and solutions are returned through efforts of a multidisciplinary team. It is adaptive and aims at early delivery and continuous improvement to secure flexible and rapid response to user wishes. Two versions were developed – one for the counsellors and one for patients supporting the dialogue in the presence of both patient and counselor.

**Results:** Patients took high interest in the patient APP that ended up user friendly to a large group of cancer patients, regardless of age and diagnose. Professionals were in general in agreement that the professional future will be “app’tized” and patient focused. For both groups early and instructed introduction was viewed as important. For both groups the visual appearance and straightforwardness of the app was found essential to user loyalty. Professionals however found it difficult that the software under the development did not “speak” with other clinical software, and has to be opened separately.
**Conclusions:** The sprinted mode of working involving clients, practitioners and developers in an evidence based environment is a useful method for future nutrition app'tisation.

**Keywords:** Digitalization, Nutrition Counselling, Nutridia, Cancer Patients

**Further collaborators:**

Last author: Rasmussen. HH. PhD. Center for Nutrition and Bowel Disease. Department of Gastroenterology. Aalborg University Hospital & Department of Clinical Medicine, Aalborg University. Denmark.

The NutriDia program i supported by the National Board of Health Denmark

144/2540

MAN OR MACHINE - A REVIEW OF SMART ICT
ASSISTED REALTIME DIETARY ASSESSMENT
TECHNOLOGIES (RDAT) FOR AUTOMATED DIE-
TARY DATA ASSESSMENT

Mikkelsen, Bent Egberg.

PhD. Professor. Department of Clinical Medicine. Captive
Foodscape Studies. Aalborg University. Copenhagen. Denmark.

**Background and objectives:** Data collection in dietary intake studies using traditional methods is costly and time consuming. As a result ICT assisted measurement of dietary behavior has attracted interest from the nutrition research community and a number of groups across the world has through different trajectories tried to reduce the workload related to determining food intake. The aim of the study it to present an overview of smart ICT assisted devices for automated dietary data assessment - here referred to as Realtime Dietary Assessment Technologies (RDAT)

**Methods:** A literature search was conducted using the key words ICT assisted, app, devices, technology assisted automated, dietary data, food intake, assessment collection. In order to exclude ICT based solutions only replacing paper based methods with screen based ones, the study used as inclusion criteria was that methods should be based on < 1 hardware component. In addition, a network search was carried out based on snowballing technique in which known authors, research groups and technology acronyms was used as search terms. Only technologies that was reported scientifically was included. The search identified 8 technologies that was analyzed further

**Results:** The literature search identified the following Realtime Dietary Assessment Technologies (RDAT): eButton, Dietary intake Monitoring System (DIMS), Splendid, Smart Meal, Mandometer Technology and Technology Assisted Dietary Assesment (TADA). The review showed that the following specialized hardware based components was used in order to automatize the recognition of types and amounts of food: scales, jawbone motion, fork motion, imaging, picture recognition, spectrophotometry, Near InfraRed (NIR) technology and Near Field Communication (NFC).

**Conclusions:** The technologies identified all minimizes human involvement and involve novel combinations of various tech-

nology-solutions. All technologies are based on combinations of "intake signals" and uses a mix of different intake proxies. They include measuring jawbone and or fork movement as proxies, measuring chewing noise, measuring weight of plated food, math-based algorithms for automated or semi automated pictures recognition and artificial intelligence based recognition. The technologies are currently undergoing validation and feasibility studies. We conclude that more interdisciplinary research involving both nutritionists and digital media scientists is needed as well as more cooperation and knowledge sharing between involved research groups.

**Keywords:** Nutritional Assessment, Realtime Dietary Assessment Technologies, RDAT, automated dietary data assessment, ICT assisted food intake dietary data collection

**Further collaborators:** The author wish to acknowledge the dVices4food and the Richfields program

144/2543

NUTRITIONAL PROFILE OF JIU JITSU FIGHTERS
AND ANALYSIS OF ITS KNOWLEDGE REGARD-
ING DIET GRACIE

(1)Auler, Flavia; (2)Macedo, Ana Carolina Gonçalves de; (2)Meucci, Nayara Ramos.

(1)PhD. Nutricionist. Pontifical University Catholic of Paraná;
Argentina (2)Nutricionist. Pontifical University Catholic of
Paraná. Argentina.

**Background and objectives:** The Gracie Diet, created by Carlos Gracie (precursors of Brazilian jiu-jitsu), has as main objective to maintain a slightly alkaline blood pH through food combinations divided into groups in order to prevent chemical reactions harmful to the organism. Thus, the objective was to analyze body composition and diet under the principles of the Gracie Diet in jiu-jitsu fighters.

**Methods:** A cross-sectional field study with a descriptive analysis and a quantitative approach involving jiu-jitsu fighters, only men between 18 and 29 years of age, enrolled in a state competition, excluding those classified as obese by BMI (WHO, 1997). Data collection was based on individual interview about personal details, food and knowledge of the Gracie Diet. The anthropometric assessment was carried out by GC% arising from Guedes protocol (2010) with Fleck classification (1983) and Wilmore (1983) and BMI (WHO, 1997).

**Results:** Information of 69 fighters were collected, and 84% had excess body fat and 51% overweight and 80% did not conform to the recommendations of the Food Guide for the Brazilian Population (BRAZIL, 2005). As for the Gracie Diet, 67% claimed to know it, but only one fighter followed. Most followed principles as washing hands before meals (88%), at bedtime drink water (59%), not to consume alcohol (56%) and 10% non-mixed grains and / or starches together. The dietary maneuvers were used by 30% of the fighters, and supplements by 46%, of which, 44% under nutritionist prescription.
**Conclusions:** In view of these results, it was concluded that the majority of the study participants did not present a body composition comparable to the established standards for the sports modality and did not conform to the recommendations of the Brazilian Population Food Guide. A greater number of connoisseurs and followers of the Gracie Diet was expected, as this is widely known in the midst of martial arts. Therefore, it is believed that there is a disinterest of the fighters or lack of knowledge related to diet, and an urgent need to raise awareness about the role of nutritional guidance in sports performance, so that there is performance allied to health.

**Keywords:** Jiu jitsu, nutrition, body composition, anthropology, Gracie Diet.

the most balanced diets in terms of macronutrients. Vegetarians exhibited lower estimated prevalence of inadequacies for micronutrient such as antioxidant vitamins (e.g.: for vitamin E, 28.9% for vegetarian women <55y vs. 41.6 in meat eaters) while vegan exhibited higher estimated prevalence of inadequacies for some nutrients in particular vitamin B12 (69.9% in men and 83.4% in women <55y), compared to meat eaters.

**Conclusions:** Our study highlighted that vegetarian and vegan diets may overall allow reaching nutritional recommendations. Although such diets may be culturally difficult to accept, at least in some subgroups, well-planned vegetarian dietary patterns could be considered as sustainable diets including potential health benefits and a lower environmental impact.

**Keywords:** vegetarians, vegans, diet, sociodemographic characteristics, dietary nutrient inadequacy

144/2560

COMPARISON OF SOCIODEMOGRAPHIC AND NUTRITIONAL CHARACTERISTICS BETWEEN VEGETARIANS, VEGANS AND MEAT EATERS FROM THE NUTRINET-SANTÉ STUDY

(1)Allès, Benjamin; (2)Baudry, Julia; (2)Méjean, Caroline; (2)Touvier, Mathilde; (2)Péneau, Sandrine; (3)Hercberg, Serge; (2)Kesse-Guyot, Emmanuelle.

(1)Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, Université Paris 13, COMUE Sorbonne Paris Cité, Bobigny. France.; (2)PhD. Université Paris 13.Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche en Epidémiologie et Statistiques. Inserm (U1153), Inra (U1125), Cnam. France; (3)Prof. MD. Université Paris 13.Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche en Epidémiologie et Statistiques. Inserm (U1153), Inra (U1125), Cnam. France.

**Background and objectives:** Vegetarian and vegan diets are a growing trend in many western countries. Epidemiological evidence suggesting that such diets may help in maintaining a good health is rising. However, dietary and sociodemographic characteristics of vegetarian and vegan consumers are not well known. The aim of this cross-sectional study was to describe sociodemographic and nutritional characteristics of vegetarians and vegans adults, compared to meat-eaters, from the French NutriNet-Santé study.

**Methods:** Participants were classified into 3 diet groups based on self-reported information: 90,664 meat eaters, 2,370 vegetarians and 789 vegans. Dietary data were collected using repeated 24 h dietary records. Multivariable polytomic logistic regression models were perfomed to assess the association between the sociodemographic characteristics and type of diet. The prevalence of nutrient intake inadequacy was estimated, by sex, age and type of diet categories.

**Results:** Compared with meat eaters, vegetarians were more likely to be highly educated, and unlike vegans had lower education level. Vegetarians and vegans substituted animal protein dense products by higher consumption of plant protein dense products (e.g.: soy based products such as tofu or legumes). Vegans had

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VITAMIN D VALUES IN SERUM IN RELATION TO THE NUTRITIONAL STATUS AND LIFE HABITS IN A GROUP OF HEALTHY VOLUNTEERS FROM MEDELLÍN, COLOMBIA

(1)Giraldo Giraldo, Nubia; (2)Idárraga, Yelithza; (2)Ramirez, Carolina;

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

(1)MSc. Epidemiologist. Escuela de Nutrición y Dietética. Universidad de Antioquia. Medellín.; (2)Nutrition Student. Escuela de Nutrición y Dietética. Universidad de Antioquia. Colombia;

(3)PhD. Grupo de Micología médica y Experimental Corporacion para Investigaciones Biológicas (CIB). Colombia; (4)MsC. Grupo de Micología médica y Experimental Corporacion para Investigaciones Biológicas (CIB). Colombia.

**Background and objectives:** Vitamin D serum values depend mainly of its synthesis after solar light exposition and alternatively, from the ingestion of food rich in this vitamin. Factors such as age, skin pigmentation, use of anti sun-protecting agents, lenght of light exposition also influence its synthesis.

To determine Vitamin D serum values and explore their relation with the nutritional status and life habits in a group of healthy volunteers from the city of Medellín, Colombia

**Methods:** A cross sectional study was carried out in a group of 53 healthy volunteers. Data pertaining sociodemographic, anthropometric and life habits were collected. Vitamin D serum values were determined by means of the High Efficiency Liquid Chromatography (HPLC) technique with ultraviolet detection. To quantify Vitamin D intake we used frequency of ingesta, evaluated the nutritional status, took anthropometric mesasurements and determined the skin prototype by means of the Fitzpatrick and Von Luschan scales. In order to explore the relationship among the nutritional status, the life habits and certain socio-demographic conditions such as vitamin D serum classification, the Chi square test was used. Correlations among vitamin D serum values and certain quantitative variables were measured by the Spearman r test.

**Results:** Women predominated in this study, 79,2%, with 41,5% of them belonging to social strata 3. Median age was 32
years, the predominating skin phenotype was IV (49,1%), the most subjects (72,2%) used sun blockers once a day. The mean vitamin D ingesta was 191,7±142,0 UI day and mean lenght of light exposition was 36±28 minutes/day. According to the Body Mass Index (BMI), 39,6% were either overweight or obese. Deficient or insufficient vitamin D serum values were found in 67,9%. Age was found to be the only variable that showed an inverse correlation with Vitamin D deficient or insufficient values (r=-0,279; p=0,43).

**Conclusions:** The proportion of healthy volunteers that showed deficient or insufficient vitamin D values was very high. Vitamin D intake was lower than recommended. No relationship was found among the nutritional status and life habits with these values. Age was found to be the only factor that showed a negative correlation.

**Keywords:** Vitamin D, serum values, nutritional status, intake

144/2598

## INTRA-INDIVIDUAL DIFFERENCES IN PLASMA FERRITIN CONCENTRATION IN RELATION TO INFLAMMATION OBSERVED DURING A SHORT-TERM LONGITUDINAL STUDY ARE SIMILAR TO CROSS-SECTIONAL INTER-INDIVIDUAL DIFFERENCES

(1)Wessells, K. Ryan; (2)Peerson, Janet M.; (3)Hess, Sonja; (4)Rouamba, Noel; (5)Ouédraogo, Jean Bosco; (6)Brown, Ken.

(1)PhD. Assistant Project Scientist. Program in International and Community Nutrition. Department of Nutrition. University of California, Davis. USA; (2)MSc. Statistician. Program in International and Community Nutrition. Department of Nutrition. University of California, Davis. USA; (3)PhD. Associate Research Nutritionist. Program in International and Community Nutrition. Department of Nutrition. University of California, Davis. USA; (4)MD. Researcher. Regional directorate for the West, National Research Institute in Health Sciences, Bobo-Dioulasso, Burkina Faso.; (5)MD. PhD. Director of Research. Regional directorate for the West, National Research Institute in Health Sciences, Bobo-Dioulasso, Burkina Faso.; (6)MD. Senior Program Officer. Bill & Melinda Gates Foundation. USA. Distinguished Professor. Program in International and Community Nutrition. Department of Nutrition. University of California, Davis. USA.

**Background and objectives:** Cross-sectional (CS) surveys indicate that individuals with acute inflammation have higher plasma ferritin (pF) concentrations than those without, possibly due to either inflammation-induced increases in pF or a heightened risk of inflammation among individuals with higher iron status. To determine the validity of adjusting pF for inflammation using CS data, we assessed the effects of short-term changes in inflammation status on pF, based on the assumption that body iron stores were unlikely to change during the study period.

**Methods:** Two blood samples were obtained 21d apart from 451 asymptomatic 6-23mo Burkinabé children; plasma was analyzed

for ferritin, C-reactive protein (CRP) and alpha-1-acid glycoprotein (AGP). Inflammation was defined as CRP>5mg/L and/or AGP>1g/L. Additionally, a regression correction (RC) approach was used to adjust pF to a presumably healthy reference point within the study population (10th percentile CRP/AGP concentrations). Cross-sectional RCs were estimated from a naïve regression model which treated observations from the same children as independent. Longitudinal RCs, to estimate effects of intra-individual changes in CRP/AGP were estimated from structural equation models, accounting for repeated measures.

**Results:** pF was significantly greater in children with inflammation (44.9±2.9µg/L) than those without (13.6±1.0µg/L; P<0.0001). Similarly, pF differed intra-individually in longitudinal models, based on changes in inflammation status (with inflammation: 37.0±3.2µg/L vs. without: 15.3±1.2µg/L; P<0.0001). The RC approach from CS models over-adjusted slightly for the effects of inflammation on pF compared to longitudinal models (P<0.001); adjusted pF were 9.5±0.3µg/L and 10.5±0.4µg/L, respectively, vs. unadjusted 25.0±1.0µg/L. The estimated prevalence of iron deficiency (pF<12µg/L) was comparable between CS and longitudinal models (61.0% and 56.5%, respectively vs. unadjusted, 27.7%).

**Conclusions:** In this population, pF changed intra-individually in relation to inflammation. Cross-sectional RC models tended to over-adjust for the effects of inflammation on pF compared to longitudinal models, suggesting that pre-illness iron status was slightly higher in those with inflammation than those without, or that adjustments did not capture the full effect of inflammation. However, estimated mean pF and prevalence of iron deficiency were similar, especially when compared to unadjusted values, suggesting that CS adjustments are valid for survey data collection and programmatic decisions in comparable populations.

**Keywords:** ferritin, regression correction, iron deficiency, inflammation

144/2609

## IRON AND VITAMIN C INTAKE IN SCHOOL-AGE CHILDREN IN POLAND

Stos, Katarzyna; Oltarzewski, Maciej; Glowala, Aneta; Ziolkowska, Izabela; Jarosz, Mirosław; Krygier, Bogumiła.

National Food and Nutrition Institute, Warsaw, Poland.

**Background and objectives:** Iron is required for oxygen transport, electron transfer, oxidase activities and energy metabolism. The main components of the body that contain iron are erythrocyte haemoglobin and muscle myoglobin, liver ferritin, and haem and non-haem enzymes.

One of the main factors that increase the absorption of non-heme iron is vitamin C. Vitamin C has also a number of biochemical and physiological functions in the body. There is still ongoing problem of not sufficient iron and vitamin C intake in Poland. The aim of the study was to assess the iron and vitamin C content in daily diets of Polish school-age children.

**Methods:** The study was carried out between 2006 and 2011 among 981 girls and boys aged 9-13 years with the use of one-day
dietary recall method. The data on iron and vitamin C content in food products were based on the National Food Composition Database. The results of iron and vitamin C intake were compared to the Estimated Average Requirements (EAR).

**Results:** The median total daily iron intake in the group of pupils was 7.7 mg and ranged from 7.3 mg (girls) to 7.9 mg (boys). The comparison of individual iron intake to EAR values showed that 38.6% diets were below EAR. The main sources of iron in pupils' diets were cereal products (31.4%), vegetables and fruits (21.1%) and meat and meat products (11.1%). The median total daily vitamin C intake in the group of studied pupils was 46.0 mg and ranged from 43.7 mg (boys) to 48.8 mg (girls). In comparison to EAR, the 46.9% of diets were below EAR. The main sources of vitamin C in pupils' diets were juices (27.1%), vegetables and pulses (25.6%) and potatoes and their products (23.3%).

**Conclusions:** The study showed that many diets of school children aged 9-13 years in Poland were low in iron and vitamin C in relation to the requirements.

**Keywords:** iron, vitamin C, intake, girls, boys

cholesterol, HDL-cholesterol level, albumin and hemoglobin significantly lower (all p less than 0.05). Forns index value, aspartataminotransferase, alaninaminotransferase, and gamma-glutamyl transpeptidase were statistically significantly higher in patients with denutrition (all p less than 0.05). The average concentrations of pro-inflammatory cytokines (TNF-α, IL-6) were higher in patients with denutrition. Multivariate analysis identified two independent risk factors for denutrition: mean duration of CHC (odds ratio [OR] = 1.3; 95% confidence interval [CI] = 1.03-2.4), and Forns index (OR = 1.2; 95% CI = 1.02-2.5).

**Conclusions:** The results of this study demonstrated that patients with chronic hepatitis C associated denutrition in a high percentage. Nutritional screening using both clinical and especially biochemical methods is necessary in this population.

**Keywords:** chronic hepatitis C, denutrition, nutritional risk index, instant nutritional assessment score

**Conflict of Interest Disclosure:** This study was supported by the Romanian National Authority for Scientific Research as a part of the PNCDI 2 program DIADIPOHEP 41-008/2007.

## NUTRITIONAL STATUS IN PATIENTS WITH CHRONIC HEPATITIS C

(1)Rusu, Emilia; (2)e, Georgiana; (3)Dragut, Ramona Maria; (2)Cursaru, Raluca; (4)Rusu, Florin; (5)Ateia, Simona; (6)Popescu Valceanu, Horatiu Cristian; (3)Jinga, Mariana; (2)Dragomir, Andreea Diana; (3)Radulian, Gabriela.

(1)MD. PhD. Carol Davila University of Medicine and Farmacy. Bucharest. Romania; (2)MD. PhD student. University of Medicine and Farmacy "Carol Davila". Bucharest. Romania.; (3)MD. PhD. University of Medicine and Farmacy "Carol Davila". Bucharest. Romania.; (4)MD. PhD. Emergency Military Hospital "Carol Davila". Bucharest, Romania.; (5)MD. PhD. Medas. Bucharest. Romania.; (6)MD. PhD. Bucharest. Romania.

**Background and objectives:** The objective of the study was to assess nutritional status in patients with chronic hepatitis C (CHC) by different methods and to evaluate the risk factors for denutrition in this population.

**Methods:** This observational study, held in three medical centers from Bucharest, Romania, included 173 patients. We followed anthropometric indices and biochemical parameters for each patient. Clinical and biological assessment of nutritional status was performed using body mass index (BMI), nutritional risk index (NRI) and instant nutritional assessment score (INA). Each patient completed Mini Nutritional Assessment (MNA). We also recorded a denutrition combined score. We considered patients to be malnourished according to the combined score if any score indicated denutrition. Hepatic fibrosis was assessed using Forns index.

**Results:** The mean average age was 54.14±9.1 years. The mean duration of CHC was 7.21±3.23 years. Using the combined score, denutrition was present in 17 patients (9.8%). Patients with denutrition had weight, body mass index, waist circumference, total

## PREVALENCE OF MALNUTRITION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

(1)Canicoba, Marisa; (2)Colon, Carolina; (2)Spiazzì, Renata; (2)Milano, Claudia.

(1)Nutritionist. Department of Nutrition and Division of Gastroenterology. Hospital Nacional "Prof. A. Posadas". El Palomar. Provincia de Buenos Aires. Argentina; (2)MD. Department of Nutrition and Division of Gastroenterology. Hospital Nacional "Prof. A. Posadas". El Palomar. Provincia de Buenos Aires. Argentina.

**Background and objectives:** Inflammatory bowel disease (IBD) including ulcerative colitis (UC), Crohn's disease (CD) and inclasificable colitis(IC). Patients with IBD are at risk of malnutrition (MN), the nutritional assessment plays a crucial role in the practice of care of patients with IBD. The aim was to determine prevalence of MN in patients with IBD

**Methods:** Analyzed data from a cohort of patients with clinical and histopathological diagnosis of IBD treated at the Division of Gastroenterology, with a multidisciplinary care model, from January 2013 to March 2017. Nutritional assessment were calculated in each, consisted of anthropometric measurements of body mass index (BMI) and Subjective Global Assessment (SGA) as a systematic method of integrating nutritional history data, gastrointestinal symptoms and physical examination, 3 diagnoses were obtained: A. eunutrids, B. at risk or moderate malnutrition and C. severe malnutrition. To determine the clinical activity of CD, the Harvey-Bradshaw index was used and for the UC the modified Truelove-Witts index

**Results:** 151 patients with IBD were included: median age was 44, 32 (±16, 9) year, 56, 4% female, 30.2% had CD, 66, 9% UC and 2, 9% IC, year diagnosis median 6 year (1- 43).
Treuth, Pate, Puyau, Mattocks), while Evenson equation was add-
ed for prediction of activity intensity, making 6 equations in total.
The accuracy of accelerometer energy prediction was assessed by
comparing measured and predicted values, using the paired t-test.
Based on their METs, activities were classified as sedentary, light,
moderate or vigorous. The intensity classification accuracy was
evaluated with k statistics and ROC-Curve.

**Results:** For activities of lying down, watching TV and reading, Freedson / Trost and Treuth equations were accurate in predicting energy expenditure. Regarding Pate equation, it was accurate for vacuuming and slow treadmill walking energy prediction. Puyau predictive equation was inaccurate in all activities, while Mattocks' equation was accurate in all treadmill walking activities. Concerning activity intensity classification accuracy, Pate equation had the best performance across the 4 intensities (κ = 0.72), while the remaining equations had low accuracy (κ = 0.14~0.37). In case of the sedentary activities, all equations had a good prediction accuracy (ROC-AUC = 0.83-0.89), while in light activities, Pate equation had an excellent accuracy (ROC-AUC = 0.91). For moderate activities, all equations showed a poor performance whereas in vigorous activities, Pate equation had an excellent prediction accuracy (ROC-AUC = 0.94).

**Conclusions:** In conclusion, no equation was accurate in predicting energy expenditure across all assessed activities in children athletes. For activity intensity classification, Pate equation had the best prediction accuracy.

**Keywords:** Energy expenditure, accelerometer, Children, Athlete.

nathic surgery (December 2013 to March 2016). Data collection was performed a week before surgery and 10, 40, and 90 days post operatory (PO). BMI (kg/m2) was estimated with the equation: weight (kg)/height (m)2, and classified in: < 18.5, underweight; 18.5-24.9, eutrophic; 25.0-29.9, overweight; and >30.0, obesity. Statistical analysis was performed with Chi-Square test and Student t-test for independent samples, with a confidence interval of 95%.

**Results:** Mean age was 29.42±8.72 years, 56.5% (n=39) of the patients were women, and 56.5% (n=39) were monomaxillary surgeries. In the preoperative period, 51.30% (n=20) and 43.30% (n=13) of the patients submitted to mono and bimaxillary, respectively, were eutrophics, and 90 days PO 61.50% (n=24) and 46.70% (n=14) of the patients submitted to mono or bimaxillary, respectively, were eutrophics. There were no difference between BMI classification in mono and bimaxillary before (p=0.551) and after surgery (p>0.05). BMI before monomaxillary was similar to bimaxillary surgery (24.84±4.23 and 26.11±4.52, respectively, p=0.237,). At 10, 40 and 90 days PO, BMI were also similar to mono and bimaxillary surgery (PO10: 23.94±4.16 and 24.97±4.41, respectively; PO40: 23.86±3.96 and 24.65±4.37, respectively; PO90: 24.34±4.00 and 24.85±4.19, respectively; p>0.05).

**Conclusions:** BMI are similar to mono and bimaxillar in pre and postoperative periods. BMI alone is not enough to predict body composition, and BMI classification is unable to verify fast and small weight variations.

**Keywords:** Orthognathic surgery. Nutritional status. Nutrition assessment. Body Mass Index.

144/2681

BODY MASS INDEX OF PATIENTS WITH DENTOFACIAL DEFORMITIES BEFORE AND AFTER MONO AND BIMAXILLARY ORTHOGNATHIC SURGERY

(1)Thieme, Rubia Daniela; (2)Silva Benato, Leonardo; (3)Oliveira Carlos, Ligia; (4)Madalozzo Schieferdecker, Maria Eliana; (5)Rebellato, Nelson.

(1)MSc. Nutritionist. Nutrition Department. Universidade Positivo. Brazil.; (2)Master of Science student. Oral and Maxillofacial Maxillofacial Surgeon. Odontology Department. Universidade Federal do Paraná. Brazil.; (3)MSc. Nutritionist. Nutrition Department. Universidade Federal do Paraná. Brazil.; (4)PhD. Nutritionist. Nutrition Department. Universidade Federal do Paraná. Brazil.; (5)PhD. Oral and Maxillofacial surgeon. Odontology Department. Universidade Federal do Paraná. Brazil.

**Background and objectives:** Orthognathic surgery is a treatment for patients with dentofacial deformity. After surgical procedure, diet restriction is recommended and, consequently, weight loss is common. The objective was to compare Body Mass Index (BMI) of patients with dentofacial deformities before and after mono and bimaxillary orthognathic surgery.

**Methods:** Prospective clinical study with 69 adults with dentofacial deformity submitted to mono or bimaxillary orthog-

144/2693

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

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

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

**Background and objectives:** Added sugar (AS) intake is highly associated with the epidemic of overweight and obesity. This study aimed to identify the dietary intake and sources of AS among Brazilian population.
**Methods:** Latin American Health and Nutrition Study (ELANS) is a multicenter study developed in urban areas of 8 Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. Data were obtained from 2,000 Brazilians (15-65 y.o) participating in EBANS (Brazilian Health and Nutrition Study). Two 24-hour recall were used to identify the intake of AS and the major food items accounting for AS, using the weighed-proportions formula developed by Block (1985) in which the relative contribution (RC) of a given food item/food group is defined as: $RC=[(Total AS grams from a food item x 100)/Total AS grams from all food items]$. Median intake and sources of AS were performed by age group, gender, socioeconomic level (SES) and nutritional status.

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

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

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

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

**Further collaborators:** On behalf of ELANS Study Group

(1)Piedra, Fiorela; (2)Chinnock, Anne; (3)Gómez Salas, Georgina.

(1)Bch. Nutritionist. School of Nutrition. University of Costa Rica.;

(2)PhD. Nutritionists. School of Nutrition. University of Costa Rica; (3)MSc. Nutritionist. Department of Biochemistry. School of Medicine. University of Costa Rica.

**Background and objectives:** Several cross-sectional studies have shown an inverse relationship between dietary calcium intake and both body mass index (BMI) and waist circumference. Possible mechanisms for such associations include increased fcal fat excretion, changes in adipocyte metabolism and increased thermogenesis. The aim of this study was to investigate the asso ciation between total dietary calcium, body mass index and waist circumference in Costa Rican population living in urban areas during the period between 2014-2015 as part of the Latin Ameri can Study of Nutrition and Heath (ELANS).

**Methods:** Data were obtained from 798 subjects from urban Costa Rican population, between the ages of 15 and 65 partici pating in ELANS, a multicentric study developed in urban areas of Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. Food intake assessment included two 24-hour recall (Multiple Pass Method), from non-consecutives days and processed by the software Nutritional Data System for Research (NDS-R). Calcium usual intake was estimated with the Multiple Source Method (MSM) statistic package (https://nugo.dife.de/ msm). Anthropometric measurements were obtained and BMI and BMI-for-age percentiles were calculated. Population was di vided into tertiles according to dietary calcium consumption, and association with nutritional status were analyzed. Logistic regres sion was use to calculate the probability of having excess weight or waist circumference above recommendation.

**Results:** The probability of having excess weight (≥24.9 kg/ m2) was 39% less for those in the second tertile of calcium intake, and 55% less for those in the highest tertile of calcium intake. The risk of having a waist circumference above the recommendation (men ≥102 cm; woman ≥ 88 cm) was 34% less for the second ter tile and 42% less for the higher tertile of calcium intake.

**Conclusions:** Evidence suggests that a low dietary calcium in- take increase the probability to have excess weight and waist cir cumference above recommendations in urban Costa Rican pop ulation.

**Keywords:** calcium intake; excess weight; waist circumfer- ence; Costa Rica

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

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

**Background and objectives:** Evaluation of energy and nutri-
ent consumption allows identifying possible nutritional deficien-
cies and/or excesses. The aim of this study is to assess the adequacy
of energy and nutrients intake by sex in Peruvian population.

**Methods:** The ELANS (Latin American Health and Nutrition Study) is a transversal study conducted in 8 Latin America countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela), in adolescents and adults (1113 peruvians, 15 to 65 years old). We obtained usual intake (Multiple Source Method) of energy, macro and micronutrients through two 24 hour dietary recall in non-consecutive days. Estimated average requirement (EAR) were used to determine the percentage of adequacy to recommendations. For energy adequacy, basal energy expenditure-BEE was calculated according to age, sex and physical activity level-PAL proposed by Gerrior et al (2006), using results from the long IPAQ. We used mean difference test for continuous variables and chi2 Fisher's exact to assess difference by sex at 95% confidence level.

**Results:** The energy adequacy was 95% for men vs 105% for women (p<=0.000). The percentages of energy coming from macronutrients by sex were: protein 15% vs 15% (p=0.159), fat 22% vs 23% (p<=0.000) and carbohydrates 64% vs 62% (p<=0.000), for men and women respectively. Adequacy for micronutrient intake: calcium was 57% vs 52% (p<=0.000), iron was 136% vs 72% (p<0.000), vitamin A was 109% vs 131% (p<0.000) and vitamin C was 151% vs 168% (p=0.002). Percentages of population that showed insufficient macronutrients intake were: 28% for fat (men: 35% vs women: 23%, p<0.000), in contrast to the 35% that consumed more carbohydrates than recommended (men: 41%, women 29%, p<0.000). Micronutrients with the highest percentages of insufficient intake were: calcium (97%, men: 97% vs women 98%, p=0.083) and iron (97%, men: 15% vs women 83%, p<0.000).

**Conclusions:** While energy consumption does not appear to be a problem in the Peruvian population, the adequacy of fats were low while carbohydrates high, the micronutrients with greater inadequacy were calcium and iron. Given the nutritional problems in the country: micronutrient deficiencies and high carbohydrate

intake, strategies that cover both problems at the same time are
required.

**Keywords:** Energy, macronutrient, micronutrient, adequacy

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

**Further collaborators:**

Instituto Pensi/Hospital Infantil Sabara, International Life Sci-
ence Institute of Argentina, Universidad de Costa Rica, Pontificia
Universidad Católica de Chile, Pontificia Universidad Javeriana,
Universidad Central de Venezuela (CENDES-UCV)/Fundación
Bengoa, Universidad San Francisco de Quito, and Instituto de In-
vestigación Nutricional de Peru.

**Background and objectives:** Most of elderly who requires nursing care has chronic disease, and due to a diminished food intake and physical activity, they tend to show decreased skeletal muscle mass. As a result, there is a great increase in the risk of fall and malnutrition in the elderly. Malnutrition is known to worsen the prognosis after infection and delay healing of disease in the elderly due to decreased immune function.

**Methods:** We have examined the associations between nutri-
tion status and blood biochemical parameters, the degree of inde-
pendence in dementia elderly's activity of daily living, the nursing
care levels, and the form of food in 1,823 elderly persons aged 61-
106 y (average 86.7 y) who lives in nursing care facilities were ana-
lyzed using Spearman's rank correlation coefficient analysis and
steel-dwass test.

**Results:** The percentages of the elderly at risk of malnutri-
tion according to GNRI (Geriatric Nutritional Risk Index) were
67.0% for men and 66.2% for women. The GNRI scores tended
to be lower according to an increase in the nursing care level. In
elderly men, the GNRI scores were remarkably lower in the groups
categorized as nursing care levels 4 and higher than those in nursing
care level 3 or lower. In elderly women, the GNRI scores were

<footnote>(1)Liria Domínguez, María Reyna; (2)Pareja, Rossina Pareja.</footnote>

<footnote>(1)PhD Nutritionist. Instituto de Investigación Nutricional. Peru.;</footnote>

<footnote>(2)MSc Nutritionist. Instituto de Investigación Nutricional. Peru.</footnote>

<footnote>(1)Yukiko, Oe; (2)Toshinao, Goda.</footnote>

<footnote>(1)phD. Institute of Health Longevity Science and Nutrition, Watami Corporation, Ltd, Japan; (2)phD. School of Food and Nutritional Sciences, University of Shizuoka, Japan.</footnote>
greatly decreased in the groups categorized as nursing care levels 2 and higher. The lower the degree of independence in dementia elderly's activity of daily living was, the lower the GNRI, and the GNRI scores of the groups categorized IIIa and over were significantly lower than those categorized as of IIb or under. The GNRI scores were associated with the provided form of food, according to the transition from regular to liquid form.

**Conclusions:** The results of this study suggest that the nutrition status of elderly who requires nursing care in nursing homes was associated with the degree of independence in dementia elderly's activity of daily living, the nursing care level, and the form of food, and it may be attributable to a decrease in physical function required for activity of daily living.

**Keywords:** Geriatric Nutritional Risk Index, elderly, malnutrition, Nursing care Facilities

144/2753

COMPARISON OF NUTRITIONAL STATUS Y PERINATAL OUTCOMES BETWEEN IMMIGRANT AND CHILEAN PREGNANT WOMEN WHO ATTENDED THEIR DELIVERY AT SAN BORJA ARRIARAN HOSPITAL IN THE YEAR 2015

**Background and objectives:** The migration in Chile increased by 28% between the years 2012 and 2015. As there are no studies in the country that describe the pre-pregnancy nutritional status (NS) and perinatal outcomes of immigrant (GI) versus Chilean (GI) pregnant women, the objective of this study was to compare the NS and to analyze its association with maternal and newborn pathologies in GNI versus GI who attended their delivery at the Hospital Clínico San Borja Arriarán (2015).

**Methods:** A comparative study carried out at 1,078 GI and 1,520 GNI. The data were obtained from: 1. the clinical records 2. The health agenda and a survey made to the pregnant woman. The variables studied were NS (underweight, normal, obesity and overweight) determined by Atalah standard; Gestational diabetes (GD), preeclampsia (PE), intrauterine growth retardation (IUGR) and preterm birth (PTB). Data were presented as prevalences and compared with CHI2 test. Crude and adjusted (by sociodemographic, obstetric and of maternal diseases variables) logistic

regression models were performed to evaluate the association between NS and maternal and newborn pathologies.

**Results:** The GNI had significantly more likely to have obesity 3.0 [2.4 - 3.8] and overweight 1.7 [1.4 - 2.1] at the beginning of gestation than GI, in relation to have a normal nutritional status (50% GI and 34% In GNI, p <0.001), with no differences in the risk of underweight 1.1 [0.8 -1.5]. GI had a higher prevalence of anemia than GNI (12.6% vs 7.7, p <0.001). On the other hand, the GNI had higher prevalences of GD (8.7% vs 4.4%, p <0.001) and preeclampsia (8.3% vs 4.9%, p <0.05) than GI, while their children had a higher prevalence of PTB (14.0% vs. 6.6%, p <0.001) and IUGR (6.9% vs. 3.7%, p <0.001) than GI. Crude and adjusted logistic regression models showed that GD was associated with maternal obesity and overweight; PE was associated with obesity; while maternal underweight was associated with IUGR.

**Conclusions:** The GNI presented higher prevalences of obesity, DG, PE, IUGR and PTB than GI. Obesity was associated with DG and PE and the latter with PTB.

**Keywords:** Migration, Immigrant, Pregnant women, Nutritional status, Obesity.

144/2757

SERUM VITAMIN B12 LEVELS IN PATIENTS WITH TYPE 2 DIABETES TREATED WITH METFORMIN

**Background and objectives:** According to all guidelines, metformin is the frontline treatment and the most prescribed drug for type 2 diabetic patients, that can be associated with other oral medication or insulin. Treatment with metformin may lead to a decreased absorption of vitamin B12. The purpose of this study is to evaluate serum vitamin B12 levels in patients with type 2 diabetes, treated chronically with metformin.

**Methods:** We evaluated 119 patients with type 2 diabetes, aged 33-86 years, who underwent annual periodic evaluation at our center. Patients provided their socio-professional and medical history, their history of diabetes treatment and supplements taking. We obtained anthropometric data: weight, height, abdom-

<footnote>(1)Ortiz, Jovita; (2)Díaz, Marcela; (3)Quiroz, Jael; (3)Pavez, Joselyn;</footnote>

<footnote>(3)Carroza, Begoña; (4)Binfa, Lorena; (4)Araya B, Marcela.</footnote>

<footnote>(1)MsC. Midwifery. Department of Women's and Newborn Health Promotion. School of Midwifery. Faculty of Medicine. University of Chile. Santiago. Chile; (2)MsC. Midwifery. Department of Women's and Newborn Health Promotion. School of Midwifery. Faculty of Medicine. University of Chile. Santiago. Chile;</footnote>

<footnote>(3)Midwifery. Department of Women's and Newborn Health Promotion. School of Midwifery. Faculty of Medicine. University of Chile. Santiago. Chile; (4)PhD,MPH. Midwifery. Department of Women's and Newborn Health Promotion. School of Midwifery. Faculty of Medicine. University of Chile. Santiago. Chile.</footnote>

<footnote>(1)Gherasim, Andreea; (2)Mihalache, Laura; (3)Nita, Otilia; (4)Oprescu, Andrei Catalin; (5)Gavril, Radu Sebastian; (5)Mitu, Ovidiu; (6)Burlui, Alexandra Maria; (3)Arhire, Lidia Iuliana.</footnote>

<footnote>(1)MD. PhD student. I Medical Department.; (2)MD, PhD. II Medical Department. "Grigore T Popa" University of Medicine and Pharmacy. "St. Spiridon" Clinical Emergency Hospital. Iasi. Romania; (3)MD.PhD. II Medical Department. "Grigore T Popa" University of Medicine and Pharmacy. "St. Spiridon" Clinical Emergency Hospital. Iasi. Romania; (4)MD.PhD student. "Grigore T Popa" University of Medicine and Pharmacy. "St. Spiridon" Clinical Emergency Hospital. Iasi. Romania; (5)MD.PhD. I Medical Department. "Grigore T Popa" University of Medicine and Pharmacy. "St. Spiridon" Clinical Emergency Hospital. Iasi. Romania; (6)MD.PhD student. II Medical Department. "Grigore T Popa" University of Medicine and Pharmacy. Clinical Rehabilitation Hospital. Iasi. Romania.</footnote>
inal circumference (AC), body mass index (BMI), blood pressure, measured vitamin B12 serum levels and performed biochemical analyses regarding the metabolic control of diabetes. B12 vitamin deficiency was defined at serum levels below 193 pg/ml. Descriptive statistics provided frequencies, means, standard deviations and medians. Anova and Mann-Whitney U tests were used to analyze the differences between the variables.

**Results:** Of the 119 enrolled patients, the 87 treated with metformin for at least six months had a higher mean BMI (32.9 kg/m2 vs. 29.2 kg/m2, *p* = .001), a higher mean AC (99 cm vs 108 cm, *p* = .001) and a lower mean vitamin B12 serum level (352.28 pg/ml vs 450.09 pg/ml, *p* = .016). 12 patients (13.8%) on metformin had values below the lower limit of vitamin B12, compared to 3.1% from those on other treatments. No statistically significant differences were found regarding treatment duration and control, nor the dose of metformin. No evidence was found to support the diagnosis of anemia. In the metformin patients, taking supplements containing B12 was associated with a reduction in the prevalence of B12 deficit, however, those taking supplements had an average of the B12 levels of 472.50 pg/ml vs 329.22 pg/ml, *p* = .05.

**Conclusions:** Our results found 13.8% of the patients treated with metformin had a vitamin B12 deficit. We recommend periodic evaluation of the level of vitamin B12 for patients receiving chronic metformin treatment. B12 supplementation may be protective against B12 deficiency.

**Keywords:** B12 vitamin, type 2 diabetes, metformin

144/2775

ASSESSMENT OF FOOD CONSUMPTION AND NUTRIENT INTAKE OF OUTPATIENTS WITH CHRONIC DISEASES AT A UNIVERSITY FEDERAL HOSPITAL IN RIO DE JANEIRO

(1)Duas, Juliana Furtado; (2)Leão, Leila Sicupira Carneiro de Souza;

(3)Silva, Renata de Souza; (4)Pereira, Alessandra Pereira; (2)de Aquino, Luana Azevedo; (2)Santos, Claudia Roberta Bocca.

(1)PhD, Professor, Departamento of Aplicated Nutrition, Nutrition School, Rio de Janeiro Federal State University, Brazil; (2)PhD, Professor, Departamento of Nutrition and Public Health, Nutrition School, Rio de Janeiro Federal State University, Brazil;

(3)Nutrition Student, Departamento of Nutrition and Public Health, Nutrition School, Rio de Janeiro Federal State University, Brazil; (4)Professor, UNIRIO, Rio de Janeiro, Brazil.

**Background and objectives:** The assessment of food consumption is often carried out to develop and implement nutritional advice. Due to the high prevalence of chronic diseases and its relation with nutrient intake, the objective of this study was to assess food consumption and nutrient intake of patients with chronic diseases.

**Methods:** During the consultation, two nutritional questionnaires were applied (non-consecutive two days 24 hour and food frequency) in 45 outpatients from February 2016 to April 2017. Daily food consumption, and quantity of energy, macro and mi-

ronutrients related to chronic diseases were estimated. Socio-economic and anthropometric information were also collected.

**Results:** Most respondents (85%) were female, 67% were 50 years or older (58,8 ± 12,1 years), 40% were white, 36% had 4 to 7 years of study, and 82% presented more than one chronic disease. Obesity was observed in 45%, Hypertension in 62%, and Diabetes in 54%. Soft drinks (11%) and sweets (20%) daily consumption were significant; fruits (60%), vegetables (37%), beans (47%) and milk (64%) consumption were considered insufficient. Elevated salt consumption was observed in 13% of individuals. Average energy intake was 1400±420,2 kcal, protein 20,2±6,6%, carbohydrate 52,3±13,8%, lipids 27,5±10,6%. It was observed high prevalence of inadequate nutrient intake for vitamin D (72,2%) and calcium (95,5%) and expressive prevalence for vitamin C (42,8%) and zinc (18,4%).

**Conclusions:** Food consumption and nutrient intake in this group of outpatients with chronic diseases was considered not healthy and preoccupant due to expressive presence of simple sugars and salt as well as insufficient amount of fiber and micronutrients such as calcium and zinc, and vitamins C and D.

**Keywords:** food frequency; anthropometry; vitamin D; Calcium; vitamin C;

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IS NECK CIRCUMFERENCE A GOOD INDICATOR TO IDENTIFY MUSCLE WASTING IN CHILDREN AND ADOLESCENTS WITH MALIGNANT NEOPLASMS?

(1)Lucena Ferretti, Roberta; (2)Santos Maia-Lemos, Priscila; (3)Jaloretto Teixeira Guedes, Karen; (4)Maria Monteiro Caran, Eliana.

(1)PhD Student, MSc. Nutritionist. Federal University of Sao Paulo. University of Taubate. Sao Paulo. Brazil.; (2)PhD. MSc. Nutritionist. Federal University of Sao Paulo. Sao Paulo. Brazil.; (3)Nutritionist. Federal University of Sao Paulo. Sao Paulo. Brazil.; (4)PhD. MSc. Doctor. Federal University of Sao Paulo. Sao Paulo. Brazil.

**Background and objectives:** Children and adolescents with malignant neoplasms may present muscle wasting early, and this finding may be underestimated when only the Body Mass Index is considered, due to the various metabolic changes, and the side effects caused by antineoplastic therapy. It has been considered in the literature that even Arm Muscle Area (AMA) or Calf Circumference (CC) present strong correlation with muscle mass stores. Neck circumference (NC) is a measure of easy gauging and applicability in clinical practice. The main objective of this study was to verify if there is a correlation between NC with AMA and CC.

**Methods:** A cross-sectional study that assessed children and adolescents from 0 to 20 years old with malignant neoplasms at a Pediatric Oncology Specialized Institute between October 2015 and March 2017. Measurements of NC and CC were evaluated, all performed by trained evaluators, following anthropometric techniques standardized by the literature, besides middle upper arm