OBESITY ASSOCIATION OF OBJECTIVELY MEASURED PHYSICAL ...€¦ · 17 / #539 e-poster viewing obesity 08-27-2020 21:30 - 22:00 association of objectively measured physical activity

17 / #539

E-Poster Viewing OBESITY 08-27-2020 21:30 - 22:00

ASSOCIATION OF OBJECTIVELY MEASURED PHYSICAL ACTIVITY LEVELS AND BMI Z-SCORE AMONG CHILDREN AND ADOLESCENTS IN MOROCCO

I. Baddou1, I. El Harchaoui2, K. Benjeddou2, I. El Menchawi2, N. Saeid2, K. Elkari2, M. El Mzibri2, A. El Hamdouchi2, H. Aguenaou2 1Unité Mixte de Recherche Nutrition et Alimentation CNESTEN- Ibn Tofail University (URAC39). Regional Designated Center of Nutrition Associated with AFRA/IAEA. Morocco., Biology, Rabat, Morocco, 2Joint Research Unit in Nutrition and Food, URAC 39 (Ibn Tofaïl University-CNESTEN) Regional Designated Center of Nutrition (AFRA/IAEA), Department Of Biology, Kenitra, Morocco

Background and Aims:

Regular physical activity in childhood and adolescent plays an important role in reducing the risk of cardiovascular health diseases, diabetes and obesity in adulthood. The purpose of the study was to examine gender, type of day, and age grade differences in objectively PA and to examine the association between PA levels and BMI z-score among children and adolescents in Morocco.

Methods:

172 children/adolescents (mean age = 10.92 ± 1.55 years, mean BMI z-score = -0.16 ± 1.33, 19.2 % overweight) were recruited for this study and wore a tri-axial accelerometer (GT3X+) for 7 consecutive days. Time spent in sedentary, PA levels were measured and compared according to gender, age grade and to the type of day (weekdays/weekends).

Results:

In weekdays children/adolescents spent more time in sedentary than weekends (p < 0.001). Boys were eight time more likely to meet the recommendation for at least 60 min of moderate to vigorous physical activity per day than girls (OR: 8.569; 95% [CI]: 4.23–17.32), p < 0.001. Among adolescent, moderate to vigorous PA were inversely correlated with BMI z-score (r= -0,213; p= 0.04).

Conclusions:

These findings highlight the need for effective and sustainable strategies and programs aiming to promote physical activity and to reduce sedentary behavior among children and adolescents in Morocco.

18 / #471


ASSOCIATION OF FAT TASTE AND CD36 GENE VARIANT RS1761667 WITH OBESITY IN ADULT SUBJECTS (MOROCCO)

H. Bajit1, O. Ait Sidi Mohamed2, E. Bouaiti3, H. Belghiti4, M. Mrabet5, E. Elfahime6, A. Hichami7, N.A. Khan8, H. Benkirane9, H. Aguenaou10 1Joint Research Unit in Nutrition and Food. Faculty of Sciences. Ibn Tofaïl University., Department Of Biology, Kenitra, Morocco, 2Faculty of Medicine and Pharmacy. Mohammed 5th University, Research Team In Neurology And Neurogenetics, Genomics Center Of Human Pathologies, Rabat, Morocco, 3Faculty of Medicine. Mohammed 5th University, Laboratory Of Epidemiology And Clinical Research, Rabat, Morocco, 4Military Hospital of Instruction Mohammed 5th., Nutrition Unit Hygiene And Collectivity Medicine Ward, Rabat, Morocco, 5Faculty of Medicine Abulcasis (FMA). Abulcasis International University of Health Sciences, Fma, Rabat, Morocco, 6Centre National pour la Recherche Scientifique et Technique (CNRST), Unités D’appui Techniques à La Recherche Scientifique (uatrs), Plateforme Biologie Moléculaire Et Génomique Fonctionnelle, Rabat, Morocco, 7Université de Bourgogne-Franche Comte (UBFC), Physiologie De La Nutrition & Toxicologie Inserm Umr 1231, Dijon, France, 8Université de Bourgogne-Franche Comte (UBFC), Physiologie De La Nutrition & Toxicologie, Inserm Umr 1231, Dijon, France, 9Joint Research Unit in Nutrition and Food. Ibn Tofaïl University. Kenitra. National Center of Energy Sciences and Nuclear Techniques. Regional Designated Center of Nutrition (AFRA.IAEA).Rabat. Kenitra, Biology, Kenitra, Morocco, 10Joint Research Unit in Nutrition and Food. Ibn Tofaïl University. National Center of Energy Sciences and Nuclear Techniques. Rabat. Kenitra., Nutrition, Kenitra, Morocco


The association between oral fat sensitivity, polymorphism (SNP) in the CD36 gene, and obesity is polemic in humans. Since a reduced expression of CD36 in obese subjects was related to a high preference for dietary lipids. We aimed to evaluate whether an increase in BMI is associated with oro-sensory detection of a long-chain fatty acid, oleic acid (OA), and CD36 SNP in obese and control adult subjects.

Methods:

Obese (n=55, BMI= 33.87±4.01kg/m2) and control (n=55, BMI= 21.77±1.21kg/m2) age-matched participants were recruited. Their oral fat detection thresholds were determined using emulsions containing OA, by the 3-AFC method, and their genomic DNA was used to determine their genotype distribution of CD36 SNP rs1761667, by PCR reaction and sequencing analyzes.

Results:

Obese subjects showed a significant higher OA detection thresholds (3.045±3.35mmol/L) than did the controls (1.19±3.50mmol/L, p<0.01). A positive correlation was observed between OA taste sensitivity and BMI. There was a large distribution of rs1761667 in both groups, with a significantly higher frequency of the AA genotype in obese than in controls (p<0.05). OA detection thresholds significantly differed between obese and controls, which were higher for AA (p<0.01) and AG (p<0.05) genotypes in the first group compared to the second.

Conclusions:

Oro-sensory detection for fat taste and the CD36 SNP rs1761667 may be associated with promoting obesity in Adult Moroccan population.

19 / #563


MARITAL STATUS AND OVERWEIGHT: A STUDY OF PATTERNS AND CORRELATES AMONG WOMEN IN INDIA

K. Nigar1, M.Z. Siddiqui1, M. Dhakad1, S. Chakravorty2 1Jawaharlal Nehru University, Centre For The Study Of Regional Development, NEW DELHI, India, 2Jawaharlal Nehru University, Center For The Study Of Regional Development, NEW DELHI, India


Background- It has been found that being overweight disproportionately affects middle-aged adults (especially women) from wealthy and urban environments in developing and underdeveloped countries. Marital status has been highly associated with morbidity and mortality, with marriage seen as positively contributing towards an individual’s weight. The roles associated with married women, restricted mobility and also the burden of domestic work is considered as the main driver for increasing weight among them.

Objective- Overweight is an endemic that is most blatantly visible yet remains neglected in public health problems. Thus, the prime objective of this study is to explore the prevalence and correlates of overweight among women by their marital status in India.

Methods:

We have estimated the prevalence of overweight/obesity among Never Married, Currently Married and Divorced/Separated/Widowed women in India. Furthermore, binary logistic regression models are used for assessing the net effects of selected confounding factors w.r.t the prevalence of overweight.

Results:

Marriage was associated with a higher prevalence of overweight. Higher age and wealth quintile significantly increase the risk of overweight in women irrespective of their marital status. However, behavioral factors such as using tobacco and frequency of watching television are on one hand negatively associated with overweight among Never Married women and is positive in the case of Currently Married women.

Conclusions:

Ever Married women are at higher risk of overweight than their Never Married counterparts. Socio-economic factors are associated with a higher risk of overweight uniformly, whereas behavioral factors show an association with the risk of overweight only among ever-married women.

20 / #576


SECONDARY SCHOOL CHILDREN ARE AT THE GREATEST RISK OF THE NUTRITION RELATED WEIGHT GAIN

T. Chaychenko1, M. Gonchar1, T. Chumachenko2, V. Klymenko3, O. Rybka1, N. Buginskaya1, M. Kharkova1, D. Starik1, E. Petrenko1 1Kharkiv National Medical University, Pediatrics 1 And Neonatology, Kharkiv, Ukraine, 2Kharkiv National Medical university, Epidemiology, Kharkiv, Ukraine, 3Kharkiv National Medical University, Fundamentals Of Pediatrics No.2, Kharkiv, Ukraine


Educational programs were shown as an effective preventive strategy. Nutritional practices of school age children were assesed for developing effective national coaching campaign.

Methods:

392 school-age children were grouped by the age: primary school (aged 6–9, n=75), secondary school (aged 10–14, n=202) and high school (aged 15–18, n=115). Original questionnaire used for the survey and consist of both multiple choice questions and «open questions».

Results:

Awareness of obesity problem seriousness gradually increases with age (primary school – 58.67 %, secondary school – 70.51 %, high school – 91.67 %, p<0.05). Regardless of grade (p<0.05) children are aware of nutrition-related causes of the problem and able to name unhealthy food. Meanwhile, about 70 % of respondents spend their pocket money on meal and purchase their snacks at the nearest to the school groceries (63.66 %).

We found secondary-school children less worry of having obesity versus high-school ones (p<0.05). Number of those who experience lunch routinely is the highest (p<0.01) among them (66.1%). Simultaneously, 72.5% of them regularly purchase pastry, chips and crisps as well as sweet sparkling beverages (23.66 %) and processed juice (32.33 %). The family influence is still powerful at this age (more than 60 %), but just 36.3% of respondents informed about exact nutrition-related family practices. Meantime, lack of experience and circumstances such as busy timetable were named as a main barrier for the regular assorted nutrition.

Conclusions:

Secondary school age children are under the highest risk of nutrition-related weight gain.

Special education of children together with their parents must be started since the primary school for gaining proper nutrition-related skills.

21 / #292


EFFECT OF EARLY CATCH-UP IN WEIGHT ON BODY COMPOSITION TRAJECTORIES DURING THE FIRST TWO YEARS OF LIFE

K. De Fluiter1, I. Van Beijsterveldt1, D. Acton2, A. Hokken-Koelega1 1Erasmus University Medical Center - Sophia Childrens Hospital, Pediatric Endocrinology, Rotterdam, Netherlands, 2Danone Nutricia Research, Metabolism And Growth, Utrecht, Netherlands


Accelerated weight gain during the first three months of life, the critical window for adiposity programming, is associated with an increased risk for adiposity and cardiovascular diseases in adult life. We aimed to investigate whether first-year catch-up in weight is associated with unfavorable body composition trajectories until age 2 years and whether fast versus slow catch-up has different outcomes.

Methods:

Catch-up was defined as first-year gain in weight-for-age of >0.67 SDS. Fast catch-up was defined as >0.5 SDS in the first three months. In 401 infants, we measured fat mass (FM) until 6 months by PEAPOD, thereafter by DXA. Abdominal FM was measured by ultrasound.

Results:

24.2% of infants had first-year catch-up in weight of which 85.6% had fast catch-up. Infants with first-year catch-up had higher FM% and FM index (FMI) from 3 months until 2 years compared to infants without. Subcutaneous FM was also higher from 6 months, but visceral FM was similar.

Infants with fast catch-up had higher FM% and FMI during the first 3 months of age, but at age 1 and 2 years, FM% and FMI were similar to infants with slow catch-up. Visceral FM was similar from 3 months until 2 years of age.

Conclusions:

Infants with first-year catch-up have higher FM%, FMI and subcutaneous FM from 3-6 months until 2 years compared to infants without. Fast catch-up results in higher FM% and FMI at 3 months, but these were similar at age 1 and 2 years compared to slow catch-up.

22 / #574


DEVELOPMENT AND VALIDATION OF A CELL-PHONE APPLICATION TO REDUCE ATTENTIONAL BIAS FOR HIGH-CALORIE FOOD AMONG DIETERS

J.S. Fadardi1, M.M. Bazzaz1, H. Kareshki1, J. Parkinson2 1Ferdowsi University of Mashhad, Psychology, Mashhad, Iran, 2Bangor University, Psychology, Bangor, United Kingdom


Previous studies showed that psychological interventions could improve the effectiveness of weight reduction programs. Prior research shows that attentional bias for high-calorie food stimuli contributes to the continuation of high-calorie diets and failure to loose weight.

Methods:

First, successful and unsuccessful dieters were compared with each other on measures of food-attentional bias (FAB), working memory capacity, impulsivity, eating styles, and food preferences using a modified dot-probe task, IAT, N-back, Barrat Impulsiveness Scale (BIS), Dutch Eating Behaviour Questionnaire (DEBQ), and Food Choice Task, respectively. Second, we tested the effectiveness of a novel, cellphone application (Food-Attention Control Training Program (FACTP) on reducing attentional bias for high-calorie food stimuli, food craving, and BMI. Participants (n= 49) were female dieters randomly assigned to the FACTP intervention, sham-intervention, or no-intervention (control) groups.

Results:

First, unsuccessful dieters showed more attentional bias, external eating scores, and high-calorie food preference comparing to successful dieters. Second, a two-week training with FACTP was associated with a significant reduction in FAB, food craving for high-calorie foods, and BMI. Participants in the FACT group who scored higher on DEBQ external eating showed more weight reduction.

Conclusions:

Cellphone applications to reduce FAB can serve as an effective complimentary intervention to dieting programs.

24 / #589


EFFECT OF COMMON EGYPTIAN DRINKS OF CUMIN, CARAWAY AND HIBISCUS ON OBESITY; BIOCHEMICAL, GENETIC AND HISTOPATHOLOGICAL PERSPECTIVE

A. Gibriel The British University in Egypt, Biochemistry, cairo, Egypt


Obesity is a threatening metabolic disease which affects nearly 1.7 billion people worldwide with expectation for doubling by 2025. Obesity is characterized by elevated lipids, pressure and glucose with disorders such as diabetes, fatty liver and sleep apnea. The main aim of this study was to investigate effect of some common Egyptian drinks of Cumin, Caraway and Hibiscus on obesity using animal model.

Methods:

This study was conducted on 25 rats. Following adaptation, rats were randomly divided as follows; 5 rats fed a normal low-fat diet (-ve control) and 20 rats fed on a high fat diet for 8 weeks to induce obesity. The obese groups were then fed high fat diet and subdivided into 4 groups (5 rats each); +ve control and the remaining 3 groups were also fed aqueous extracts of either Cumin, Caraway or Hibiscus. Blood samples were collected for biochemical analyses of lipid profile, glucose, albumin, urea and AST. Histopathology for liver and adipose tissues was also examined for sacrificed animals. Genetic expression for FAS, PPAR-α and SREBP1-c was determined by qRT-PCR.

Results:

The increased weight and elevated biochemical parameters observed in the +ve obese group were almost recovered in the 3 groups treated with high fat diet and the herbal extracts. Those groups also showed remarkable decrease in expression of FAS, SREBP1 with significant increase in PPAR-α expression. Histopathological examination revealed high degree of recovery for affected tissues as well.

Conclusions:

Egyptian common drinks have promising effect against obesity.

25 / #338


ANTHROPOMETRIC MEASUREMENTS OF 7- AND 9-YEAR-OLD STUDENTS AND THEIR PARENTS' ASSESSMENT OF CHILD’S WEIGHT.

D. Grinberga, B. Velika, I. Pudule, I. Gavare The Centre for Disease Prevention and Control of Latvia, Department Of Research And Health Statistics, Riga, Latvia


Overweight and obesity is one of the most serious public health problems for children and adolescents in Europe. Children affected by it will be at much higher risk of suffering from a range of health conditions in adulthood. The aim of study was to monitor the prevalence of children’s overweight and obesity and their parent’s assessment of child’s weight.

Methods:

The study conducted in Latvia in 2018 used the framework of European Childhood Obesity Surveillance initiative study methodology developed by the WHO Europe. The design was a cross-sectional study. Anthropometric measurements were carried out for the cohorts of 7.0-7.9 (n=2766) and 9.0-9.9-year (n=2888) old children at schools. Parents of measured children were asked to fill in questionnaires.

Results:

The nutritional status of children was evaluated by WHO cut points. 12.7% of 7-year-old students were overweight and 10.1% obese, 15.1% of 9-year-old students were overweight and 10.0% obese.

10.2% of parents of 7-year-olds thought their child had overweight and 0.7% - obesity, as 14.5% of parents of 9-year-olds thought their child had overweight and 2.0% - obesity.

There was significant difference between parent’s estimations and results of the objective measurements regarding the prevalence of overweight and obesity among 7-year olds and 9-year-olds.

Conclusions:

Parents do not properly assume the overweight and obesity problem of their children.

26 / #243


PREVALENCE OF OVERWEIGHT AND OBESITY AND ASSOCIATED RISK FACTORS AMONG SCHOOL-AGE CHILDREN LIVING IN HIGH ALTITUDE REGIONS OF INDIA

A. Gupta1, U. Kapil2 1Lady Irwin College, Delhi University, Food And Nutrition, Delhi, India, 2All India Institute of Medical Sciences, New Delhi, Human Nutrition Unit, Delhi, India


The increasing prevalence of childhood obesity continues to be a major public health concern globally. There is limited data on risk factors associated with childhood overweight and obesity in school children living at high altitude regions of India. Therefore, the present study was conducted to fill the gap in the existing knowledge.

Methods:

A school-based cross-sectional study was conducted in District Shimla, Himachal Pradesh, India. A total of 2100 school-age children in the age group of 10–16 years were enrolled from 30 schools identified using population proportionate to size sampling methodology. BMI-for-age Z-scores were used to classify children as overweight and obesity. School-age children with a waist circumference of ≥90th percentile were considered as having abdominal obesity.

Results:

The prevalence of overweight, obesity and abdominal obesity among school-age children was found to be 12.8% (n=268), 6.0% (n=127) and 3.8% (n=81) respectively. Risk of overweight and obesity were significantly higher among children with: (i) high family monthly income (AOR for Rs. 36017 and above = 1.6; 95% CI: 1.2, 2.2, P = 0.002), (ii) sedentary lifestyle (AOR for PAL <1.5 = 13.0; 95% CI: 6.4,26.4, P < 0.001), (iii) consumption of evening snack (AOR = 0.6; 95% CI: 0.5,0.9, P = 0.010) and vi) motorized transportation for commuting to school AOR = 1.3; 95% CI: 1.0,1.7, P = 0.035)

Conclusions:

High prevalence of overweight and obesity amongst children suggests the need to formulate interventions to prevent and correct them for reducing early onset of metabolic diseases during adulthood.

27 / #436


DOES BREASTFEEDING DURATION AFFECTS CHILDREN’S BODY COMPOSITION AT SCHOOL-AGE?

P. Mamrot1, T. Hanć1, E. Bryl1, M. Dmitrzak-Weglarz2, A. Dutkiewicz3, A. Słopień3 1Adam Mickiewicz University, Biology Department, Poznań, Poland, 2Poznan University of Medical Sciences, Department Of Psychiatry, Poznan, Poland, 3Poznan University of Medical Science, Department Of Child And Adolescent Psychiatry, Poznan, Poland


Previous studies showed a significant impact of breastfeeding on minimalizing the risk of childhood obesity. However, there is less known about the relationship between breastfeeding and body composition (BC). The aim of the study was to assess if breastfeeding duration as an infant is related to children’s BC at age 6-12y.

Methods:

The sample included 282 boys and 261 girls aged 6-12 years. Underweight, overweight and obesity were diagnosed according to IOTF criteria. The electric bioimpendance method (TANITA MC-980) was applied to assess the children’s BC, including body fat (BF) and fat free mass (FFM). The body size and proportions were assessed by BMI, Fat Mass Index (FMI) and Lean Body Mass Index (LBMI). Mothers were asked the questions about the breastfeeding duration. ANOVA was used to compare the children’s BC according to breastfeeding duration: (i)up to 3 months, (ii)3-6 months, (iii)over 6 months.

Results:

The prevalence of underweight, overweight and obesity was approximately 10.5%, 15.7% and 5.2% in the sample. The most of children (89.7%) were breastfed. The breastfeeding length was related to children’s BF (p<0.0001), FMI (p=0.003) and BMI (p=0.032). Neither FFM (p=0.062) nor LBMI (p=0.647) was associated with breastfeeding.

Conclusions:

The longer breastfeeding duration, the greater chance for lower amount of BF and healthy weight at school age. Children who have been breastfed for more than 6 months had the greater chance for healthier BMI and FMI. There was no significant association of the breastfeeding and LBMI.

28 / #599


POSITIVE ASSOCIATION EXISTS BETWEEN ABDOMINAL OBESITY AND ASTHMA: EVIDENCE FROM A META-ANALYSIS OF REAL-WORLD DATA

M.S. Hussain1, A. Habib2 1Jamia Hamdard, Department Of Pharmaceutical Medicine, New Delhi, India, 2Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, Department Of Medicine, New Delhi, India


Asthma is the most common respiratory disease affecting more than 350 million people worldwide. Epidemiological studies found an association between asthma and abdominal obesity. However, the published evidence presented conflicting findings. So, this study is aimed to assess the association between abdominal obesity and asthma.

Methods:

An extensive literature search was performed in databases including PubMed, and Embase from inception to September 2019. Two investigators independently retrieved the literature, extracted the data and assess the study quality using Newcastle-Ottawa Scale. The primary outcome was to assess the association between abdominal obesity and asthma. Secondary outcomes include subgroup analysis based on gender. Review Manager version 5.3 was used for the statistical analysis.

Results:

This meta-analysis was based on five cohort studies with a total of 39533 patients. Included studies were of high quality. Abdominal obesity was assessed based on the waist circumference in all the included studies. The pooled analysis found a significant positive association between abdominal obesity and asthma with an odds ratio of 1.66 (95% CI: 1.30 – 2.15), p= <0.0001. Subgroup analysis based on the female population found a significant positive association between abdominal obesity and asthma with a pooled odds ratio of 1.30 (95% CI: 1.04 – 1.63), p= 0.02. Whereas, a non-significant association exists when the data were pooled for the male population with an odds ratio of 1.66 (95% CI: 0.78 – 3.52), p= 0.19.

Conclusions:

We found positive association between abdominal obesity and asthma. Future large epidemiological studies are warranted to make the evidence more robust.

29 / #364


METABOLIC AND HORMONAL MARKERS IN 4-MONTH-OLD INFANTS FED A MODIFIED LOW-PROTEIN INFANT FORMULA: RESULTS FROM A RANDOMIZED CONTROLLED TRIAL

S. Kouwenhoven1, N. Antl2, M. Finken1, J. Twisk3, E. Van Der Beek4,5, M. Abrahamse-Berkeveld4, B. Van De Heijning4, L. Holdt6, J. Van Goudoever1, B. Koletzko7 1Amsterdam UMC, Emma Children's Hospital, Amsterdam, Netherlands, 2LMU – Ludwig-Maximilians-Universität, Dr. Von Haunerschen Kinderspital, Munich, Germany, 3VU University Medical Center, Department Of Health Sciences, Department Of Epidemiology And Biostatistics, Amsterdam, Netherlands, 4Danone, Nutricia Research, Utrecht, Netherlands, 5University Medical Center Groningen, Department Of Pediatrics, Groningen, Netherlands, 6LMU – Ludwig-Maximilians-Universität Munich, Institute Of Laboratory Medicine, Munich, Germany, 7 Munich, Germany


High protein intake in early life is associated with increased childhood obesity risk. Dietary protein intake may affect endocrine and metabolic responses. We aimed to determine the effect of a modified low-protein (mLP) infant formula on growth factors at the age of 4 months.

Methods:

Term infants received mLP (1.7 g protein/100 kcal) or a specifically designed control formula (CTRL) (2.1 g protein/100 kcal) until 6 months of age in a double blinded RCT. A breast-fed (BF) group served as reference. Glucose, insulin, leptin, IGF-1, IGF-BP1, -BP2 and -BP3 levels were measured at the age of 4 months. Groups were compared using linear regression analysis.

Results:

No significant differences in plasma parameters were observed between the formula groups (n=53 mLP; n=44 CTRL) while protein intake was significantly different. Insulin and HOMA were higher in both formula groups compared to the BF group (n=36 BF) (P <0.001). IGF-BP1 was lower in both formula groups compared to the BF group (P <0.01). We found a lower IGF-BP2 level in the CTRL group compared to the BF group (P <0.01) and a higher IGF-BP3 level in the mLP group compared to the BF group (P 0.03). There were no significant differences found in glucose, leptin and IGF-1. Adjustment for sex did not change our results.

Conclusions:

At 4 months of age, there are no significant differences in growth factors between infants fed mLP formula and infants fed CTRL formula. In addition, there are distinct differences in fasting plasma parameters between formula-fed and breast-fed infants.

30 / #229


LOW CARBOHYDRATE WEIGHT LOSS INTERVENTION IN OBESE CHILDREN: 5 YEARS OF EXPERIENCE AND PREDICTORS FOR ATTRITION

H. Lev1, R. Lubetzky2 1Dana Dwek Children`s Hospital, Pediatric Gastroenterology, Tel Aviv, Israel, 2Dana Dwek Children`s Hospital, Pediatrics, Tel Aviv, Israel


Despite the dramatic increase in the incidence of obesity among youth, there is still no consensus on the preferred course of treatment.

The aim of the study was to evaluate the effects of an outpatient low carbohydrate multidisciplinary weight loss intervention in reducing body mass index (BMI) in obese children and to identify risk factors for attrition.

Methods:

This is a clinical database study of our low carbohydrate multidisciplinary clinic for obese children 2–18 years with. All patients seen between December 2014, and December 2019, were included. Characteristics of Active and Inactive families were compared. Longitudinal data on BMI percentile and Z score during follow up were assessed

Results:

248 patients (52% female, mean age 11.1 ±3.9) entered our intervention. In all, 37% dropped out of treatment. Inactive group children correlated with male gender, younger age, and low mother/ father education level, with no difference at baseline BMI Z score. More children in the active group were referred to the clinic by a physician or after hospitalization (p<0.05, table 1). Overall, 158 children (63%) maintained regular follow-up in our clinic, and the mean length of follow-up was 12 months. At the last attended follow-up visit, we observed a reduction in mean BMI Z score (from 2.3± 0.5 to 2.0±0.4). Most patients (80.8%) reduced their BMI z scores during follow-up.

Conclusions:

Low-carbohydrate multidisciplinary intervention is an effective method for long term weight loss among obese pediatric population. Age, gender, level of education among parents and type of referral for treatment can predict treatment success.

31 / #604


PREDICTORS FOR FIBROSIS IN OBESE PEDIATRIC FATTY LIVER PATIENTS AND THE EFFECT OF LOW CARBOHYDRATE DIET ON STEATOSIS AND FIBROSIS

H. Lev1, R. Lubetzky2, S. Cohen1 1Dana Dwek Children`s Hospital, Pediatric Gastroenterology, Tel Aviv, Israel, 2Dana Dwek Children`s Hospital, Pediatrics, Tel Aviv, Israel


Nonalcoholic fatty liver (NAFLD) is highly prevalent among obese children. While weight loss is the main treatment for pediatric NAFLD, little is known about the effects of dietary composition upon liver fat. The aim of the present study was to investigate predictors for fibrosis in obese pediatric patients and to assess the effect of low carbohydrate diet on steatosis and fibrosis.

Methods:

This is a cross-sectional study of obese pediatric children. Clinical data were collected. Liver fibrosis and steatosis were estimated by using shear wave elastography (Supersonic) and divided into 4 levels. All participants received nutrition instructions to reduce carbohydrate consumption and were followed regularly at our clinic. Blood tests and elastography were performed upon admission and repeated after 3 months. Between- and within-group differences in steatosis, fibrosis and metabolic parameters were determined.

Results:

Forty children were recruited (24 male/16 female, mean ages 14.1±2.6 years, mean BMI 39.1±9.9). Of these, 25 (60%) had liver fibrosis and 17 (42.5%) had significant fibrosis (F≥2). Higher BMI Z score, severe steatosis and lower LDL correlated with significant fibrosis. Twelve patients completed 3 months of follow up with repeated blood tests and elastography. After 3 months we found a significant decrease in the liver enzyme, level of steatosis and fibrosis (p<0.05, Figure 1).

Conclusions:

Patients with higher BMI, moderate or severe steatosis and lower LDL bear a greater risk for significant fibrosis. A low carbohydrate diet improves hepatic steatosis and fibrosis over 3 months. Additional research is needed to determine effectiveness over the long term.

32 / #197


THE ASSOCIATION BETWEEN BODY MASS INDEX TRAJECTORIES AND CARDIOMETABOLIC RISK IN YOUNG CHILDREN

X. Li1, C. Keown-Stoneman2, G. Lebovic2, J. Omand1, K. Adeli3, J. Hamilton4, A. Hanley5, M. Mamdani6, B. Mccrindle1, J. Sievenpiper5, M. Tremblay7, J. Maguire8, P. Parkin1, C. Birken1 1SickKids Research Institute, Child Health Evaluative Sciences, Toronto, Canada, 2St. Michael's Hospital, Applied Health Research Centre, Toronto, Canada, 3SickKids Research Institute, Molecular Medicine, Toronto, Canada, 4SickKids Research Institute, Translational Medicine, Toronto, Canada, 5University of Toronto, Nutritional Sciences, Toronto, Canada, 6St. Michael's Hospital, Li Ka Shing Centre For Healthcare Analytics Research And Training,, Toronto, Canada, 7University of Ottawa, Pediatrics, Ottawa, Canada, 8St. Michael's Hospital, Pediatrics, Toronto, Canada


To identify age and sex standardized body mass index (zBMI) trajectories in children 0-60 months. To examine the association between zBMI trajectories and CMR score in young children and to determine if sex, birthweight and breastfeeding duration modify the association.

Methods:

A longitudinal cohort study was conducted through The Applied Research Group for Kids (TARGet Kids!) in Toronto, Canada. zBMI trajectories were assessed using at least one zBMI measurements. CMR score was quantified as the sum of age- and sex- standardized waist circumference, systolic blood pressure, blood tests for glucose, log-triglycerides and negative high-density lipoprotein cholesterol, divided by √5. Latent class mixed modelling (LCMM) was used to identify distinct zBMI trajectories. Linear regressions were used to determine the associations between zBMI trajectories and CMR outcomes.

Results:

This study included 1166 children. Five trajectories were identified: early catch up, stable, rapidly accelerating, late catch up and decelerating. After adjusting for all the covariates, children in the rapidly accelerating trajectory had increased CMR scores compared to the stable group (β=0.82, 95% CI 0.05; 1.58, p=0.04), while children in the decelerating group had lower CMR scores (β=-0.40, 95% CI -0.58; -0.21, p<0.001). Sex, birthweight and breastfeeding duration did not modify the association between trajectories and CMR scores.

Conclusions:

Five patterns of growth trajectory were identified. Children in the rapidly accelerating trajectory were associated with higher CMR scores. Understanding early childhood growth may help develop interventions to prevent chronic cardiometabolic diseases later in life.

33 / #207


ASSOCIATIONS BETWEEN GROWTH IN INFANCY AND OBESITY RISK IN UK PRE-SCHOOL CHILDREN PARTICIPATING IN THE OPTIGROW INFANT FEEDING STUDY.

A. Mahmood, J. Lanigan, B. Marriage, A. Singhal Great Ormond Street Institute of Child Health, Population, Policy And Practice Research And Teaching Department, London, United Kingdom


Obesity is established early in life. In the UK, more than 1 in 5 children have overweight or obesity when they begin school. Associations between rapid weight gain and increased risk of later obesity have been widely reported. The identification of precise periods of rapid weight gain would inform when best to intervene to help prevent obesity. The aim of this study was to investigate associations between growth in infancy and obesity risk in pre-school age children (2-5 years).

Methods:

Participants were a subset of children who took part in the Optigrow randomised controlled trial that investigated effects of nutrition in infancy on growth and later body composition. Height and weight were measured and BMI z-scores calculated at pre-school age. Growth (change in weight z-score) was calculated during the first year (0-10 days, 0-2, 2-4, 0-4, 4-6, 0-6, 4-6 & 6-12 months). Linear regression models were used to investigate associations between growth and later obesity risk adjusted for infant feeding, sex, maternal education and birth weight.

Results:

188 were recruited as a convenience sample in the Optigrow study for follow up measurements [mean (SD) age 4.1±0.9 years]. Change in weight z-score at 2-4, 4-6 and 6-12 months was associated with higher BMI at pre-school age. There were no associations between growth in the first 10 days of life or at 0-2 and 0-4 months and later BMI z-score.

Conclusions:

The present study found evidence of associations between rapid early growth (2-12 months of age) and risk of obesity (higher BMI z-score) at pre-school age.

34 / #369


PREVALENCE AND KNOWLEDGE OF RISK FACTORS OF OVERWEIGHT AND OBESITY AMONG ADOLESCENT STUDENTS IN BAHRAIN

A. Mohamed, A. Abdelaziz Arabian Gulf University, Pediatrics, Manama, Bahrain


The prevalence of overweight and obesity in children and adolescents is increasing worldwide. The objective of this study was to determine prevalence and knowledge of risk factors of overweight and obesity among adolescent high secondary school students in Bahrain.

Methods:

This was a descriptive cross-sectional study among high secondary school adolescent students (n=612) selected using stratified random sampling method. Research instruments used were self-administered semi-structured questionnaires. The taken anthropometric measurements followed standard methods. Data were analyzed using the Statistical Package for Social Sciences (SPSS) software version 20.

Results:

The 24-hour dietary recall showed that food was essentially of high carbohydrate content in 391 (63.8%) of respondents, with regular consumption of sweets and soft drinks. Only 32 subjects (5.2%) were either overweight (2.9 0%) or obese (2.3%). 480 subjects (78.4%) had good knowledge score of risk factors for overweight and obesity. Predictors of good risk knowledge score were being older and being a female. However, predictors of being obese included being older and not regularly taking part in sporting activities.

Conclusions:

The adolescents studied were at risk of being obese, stressing the need for a sustained promotion of both primary and primordial prevention strategies targeted at this vulnerable age group.

35 / #274


SUSTAINABILITY OF A CULINARY NUTRITION EDUCATION PROGRAMME ‘KIDS IN KITCHEN’ (KIDCHEN) ON CHILDREN’S NUTRITIONAL OUTCOMES

S.K. Nachatar Singh1, C.M. Ng1, H.C. Koo2, R.W.K. Yap3, F. Mukhtar4, H.S. Yim1 1UCSI University, Food Science With Nutrition, Kuala Lumpur, Malaysia, 2Tunku Abdul Rahman University College, Faculty Of Applied Sciences, Kuala Lumpur, Malaysia, 3Taylor’s University, School Of Biosciences, Subang Jaya, Malaysia, 4Universiti Putra Malaysia, Faculty Of Medicine & Health Sciences, Serdang, Malaysia


KidChen Study was a hands-on healthy meal preparation intervention among school-aged children. This randomized controlled trial aimed to improve children’s psychosocial factors (knowledge, attitude, practice, self-efficacy) of healthy meal preparation and body composition (BMI-for-age, body fat percentage, waist circumference) through an experiential culinary nutrition education programme.

Methods:

Two schools in Kuala Lumpur, Malaysia were randomly selected and assigned to either intervention or control group. Eligible children aged 10-11 from the intervention group underwent 5 hands-on healthy meal preparation modules and 1 parent-child module, for 12 weeks.

Results:

Overall, 83 children completed the 3-month follow-up assessment. Mostly, children from the intervention group (71%) and control (57%) had normal weight. There were 22%(intervention) and 33% (control) of children were overweight/obese. After follow-up, intervention group had significant increase (p<0.05) in their knowledge [Δ=1.73(2.28) vs 0.02(2.39)], attitude [Δ=2.59(4.01) vs -0.05(2.75)], practice [Δ=2.02(4.34) vs -2.36(4.08)] and self-efficacy [Δ=3.61(4.04) vs -0.59(4.98)] of healthy meal preparation, as compared to control group respectively. As for, body composition, the control group had a higher increase in waist circumference when compared to the intervention group respectively [Δ=3.26(2.53) vs 1.03(2.84), p<0.001]. General linear model showed that there was a significant effect (p<0.001) between group and time on children’s knowledge (ES=0.09), attitude (ES=0.24), practice (ES=0.36), self-efficacy (ES=0.24) and waist circumference (ES=0.10). No significant difference observed in BMI z-score and body fat percentage.

Conclusions:

In short, KidChen Study made a positive impact on improving children’s nutritional outcomes and change was sustainable over a 3-months follow-up.

36 / #187


ARE WOMEN OF REPRODUCTIVE AGE AWARE OF IMPLICATIONS OF OVERWEIGHT ON PREGNANCY OUTCOMES IN A UNIVERSITY COMMUNITY NIGERIA?

M. Olumakaiye OBAFEMI AWOLOWO UNIVERSITY, Dept. Of Nutrition And Consumer Sciences, ILE-IFE, Nigeria


Overweight and obesity are life-threatening Public Health issues which pose a risk to health of both mother and child. This study was investigated if women of reproductive age know the effect of overweight on pregnancy outcomes.

Methods:

Three hundred women; disaggregated into science and non-science women were interviewed using self-administered questionnaires. Weight and Height were measured using bathroom scale and stadiometer respectively. Data were analysed using both descriptive and inferential statistics on SPSS version 22.

Results:

Mean age was 28.33±11.3years with 61.3% within 20-29 years age range. More of non-science women perceived their nutrition status lower than actual (P=0.001). None perceived herself as obese among both groups whereas 9.3% and 5.3% were obese among science and non-science women respectively. Likewise, 24.0% and 14.7% were overweight which were higher than self-reported. Only 22.7% of non-science women strongly agreed that there are risks associated with overweight and obesity in relation to pregnancy outcomes as compared to 42.7% among science women. Perception of overweight and obesity, in general, was significantly higher among science than non-science women (P=0.002). More of non-science women daily skipped breakfast, took carbonated drinks and ate less of fruits. Surprisingly, the nutritional knowledge on non-science women was slightly higher but practice of healthy diet was lower. Younger women in both groups were more likely to have better perception about self than older women (OR=2.79, 95%CI=2.41-3.24, OR-1.82, 95%CI=1.65-1.99) respectively.

Conclusions:

It was concluded that perception of overnutrition was lower among non-science women and the risks associated.

38 / #266


NEONATAL OVERNUTRITION PRODUCES LONG-TERM ALTERATIONS ON FOOD INTAKE AND OBESITY MARKERS IN THE OFFSPRING RAT

G. Rivero-Salgado, L. Quevedo-Corona, S. Zamudio-Hernandez, L. Arellano-Trejo, T. Fregoso-Aguilar, L. Garduño-Siciliano Instituto Politecnico Nacional, Escuela Nacional de Ciencias Biologicas, Fisiologia, Mexico City, Mexico


In diverse studies, the use of foods to help fight obesity, such as chia, amaranth and curcumin has been reported. This study aims to evaluate neonatal overnutrition effects on rat obesity markers, and the anti-obesogenic power of these foods in infancy.

Methods:

Three groups of rats with different diets were used: standard diet (SD), hypercaloric diet and hypercaloric diet with functional food (amaranth (9%), chia (0.5%) and curcumin 0.5%)); provided from postnatal day 21 (P21). Each diet was evaluated in: small litters, which were adjusted to 4 pups on P5; and large litters, which were adjusted to 10 offspring on P2. Body weight and food intake were determined weekly; locomotion, memory and learning tests were assessed on week 7 of diet (W7); serum determinations of insulin, leptin, glucose, cholesterol and triglycerides, hepatic steatosis were performed, and epididymal and retroperitoneal adipose tissues were weighed after euthanasia (W8).

Results:

Small litter groups showed increased food intake and obesity markers compared to large litter groups. Large litter group with SD had the lowest obesity markers and food intake, followed by the small litter group with SD. Neonatal overnutrition induces an increase in food intake that is maintained throughout life, which in turn leads to the onset of obesity and its markers, which was not reverted by the functional food diet.

Conclusions:

This study shows that decreasing infant obesity is a challenging problem, probably due to long-term alterations in the functionality of brain structures that control food intake when overnutrition occurs in early life in rat.

39 / #40


IDENTIFICATION OF MODIFIABLE RISK FACTORS FOR OBESITY

G. Sinanaj1, R. Luçi2, D. Selfo3, B. Miftari4 1Faculty of Public Health, Research Center For Scientific Research, Vlore, Albania, 2Faculty of Public Health, Department Of Nursing,, Vlore, Albania, 3University "Ismail Qemali" Vlore, Department Of Nursing, Vlore, Albania, 4Faculty of Technical Medical Sciences,, Rheumatology Service, Tirana, Albania, Tirane, Albania


Background. In Albania, nearly 22% of the population is considered obese, according to data published by the World Health Organization (WHO).

Aim. Evaluation of knowledge of Vlora city population regarding modifiable risk factors for obesity.Objectives.Identify population knowledge about modifiable risk factors for obesity.

Methods:

The type of study is cross-sectional. The sample consists of 494 persons (284 females and 210 males). The data is stored and analyzed in SPSS 17.00, with summary measures, frequencies, chi2 and Anova.

Results:

It is noted that the overwhelming majority of the 31.4% of the population surveyed reported seeing sedentary life as a modifiable risk factor for obesity.

Conclusions:

Exercise greatly increases chance of long-term weight loss. Daily physical activity can help speed up metabolism, effectively reducing the "set point" — a sort of thermostat in the brain that makes resistant to either weight gain or loss — to a lower natural weight.

40 / #362


MEASURING BODY COMPOSITION IN YOUNG CHILDREN: A COMPARISON BETWEEN DUAL ENERGY X-RAY ABSORPTIOMETRY (DXA) AND AIR DISPLACEMENT PLETHYSMOGRAPHY (BODPOD)

I. Van Beijsterveldt, K. De Fluiter, A. Hokken-Koelega Erasmus University Medical Center, Pediatric Endocrinology, Rotterdam, Netherlands


Obesity is a growing problem worldwide. In childhood, different methods are used to measure body composition, in which DXA is used as golden standard. Nowadays air plethysmography by BODPOD is available to measure body composition in children. We investigated if measurements of fat mass percentage (FM%) from air displacement plethysmography and DXA have similar results.

Methods:

We investigated 26 healthy children at the age of 3 - 5 years. Anthropometry and body composition were measured. FM% was measured by both BODPOD (Cosmed) and DXA (Lunar Prodigy) within one hour. Correlations were calculated with Spearman’s. To determine if BODPOD and DXA measurements are similar, a Bland-Altman plot was made. This study is ongoing, the abstract presents preliminary data.

Results:

Median (IQ-range) FM% measured by BODPOD was 27.0% (21.0-30.6) and by DXA 25.9% (22.9-30.0). This difference was not significant and the correlation was 0.545 (p=0.006). The Bland-Altman plot showed a mean difference (SD) of -0.017 FM% (5.2). All measurements, except 1, fell inside the 95% confidence interval.

Conclusions:

In children aged 3 - 5 years FM% measurements by BODPOD and DXA are similar.

41 / #270


HOW DO OUR CHILDREN EAT – A RED FLAG FOR EARLY ONSET OBESITY

L. Brezeanu1, R. Vlad1,2, D. Pacurar1,2 1Grigore Alexandrescu Emergency Children's Hospital, Pediatrics, Bucharest, Romania, 2Carol Davila University of Medicine and Pharmacy, Pediatrics, Bucharest, Romania


Obesity is becoming a worldwide burden in children. Modern lifestyle is responsible for early development of excessive weight gain by promoting high caloric intake combined with lack of physical activity.

Methods:

We conducted a prospective study including overweight (BMI=85th-95th percentile) or obese (BMI≥95th percentile) 3-18 years old children. Patients admitted for unrelated pathology were enrolled in the Pediatrics Department, “Grigore Alexandrescu” Hospital. Parents filled in a questionnaire regarding eating habits and physical activity.

Results:

173 patients were included (75% obese). Average age was 11 years, sex ratio 1:1. Family history revealed obesity, early cardiovascular disease and type 2 diabetes in 58%, 47% and 35%. 54% had at least one obese parent. Half of patients engaged in bad eating habits (47% for families, 82% for children themselves). 77% consumed high carb diets, half skipped meals, 61% had frequent snacks in between, half drank sweet beverages daily (the average quantity-300 ml/day). 40% received fast food at least once a week. Mistakes in nutrition were associated with low physical activity and high exposure to screens. More than half of patients did not engage in any form of physical activity, average of sports hours-2.3/week. Average screen time was double the play time (4 vs.2 hours/day).

Conclusions:

Bad eating habits and sedentarism are learned in the family. These are the cornerstones of childhood obesity. Parents and teachers should be actively involved alongside pediatricians. Education and medical advice should target nutrition and a healthy lifestyle, so that the obesity pandemic will stop escalating.

42 / #285


POSTPARTUM WEIGHT RETENTION RELATED DIETARY PATTERN AND ITS ASSOCIATION WITH BREAST MILK SECRETION STATUS IN CHINESE LACTATING WOMEN

J. Zhang1, A. Zhao1, H. Lan2, W. Wu1, C. Yang1, Z. Ren1, I. Szeto2, Y. Zhang1 1Peking University, School Of Public Health, Beijing, China, 2Inner Mongolia Dairy Technology Research Institute Co. Ltd, Nutrition Research Center, Hohhot, China


To identify dietary patterns related to postpartum weight retention (PPWR) in Chinese lactating women and to study the association between PPWR and breast milk secretion status.

Methods:

This study was part of the YI Study. Data of 276 lactating women from three studied sites (Shenyang, Xuchang, and Ningbo) was used in our analysis. Information on sociodemographic characteristics, lifestyle behaviors, food consumption, and perinatal health was self-reported. Anthropometric measures were conducted by nurses. PPWR was defined as the difference between the current weight and weight in pre-pregnancy. Dietary patterns were derived by reduced rank regression with PPWR, waist circumference, and body fat mass percentage as dependent variables. Logistic regression models were conducted to explore the association between variables.

Results:

The median (25th,75th) of PPWR of participants was 4.1(1.0,7.5) kg. Two dietary patterns were identified. After adjustment of covariates, the pattern, which was characterized by high intakes of vegetables, fungi, processed meat, eggs, coffee and tea, and oil and low intakes of meat, poultry, aquatic products, dairy products, and pastry, was positively associated with PPWR (Q3 vs Q1: OR=3.3, P<0.001). Participants with higher PPWR were less likely to offer enough breast milk for their babies (Q3 vs Q1: OR=0.2, P=0.002) and were more likely to experience breast milk volume increase recently (Q3 vs Q1: OR=2.6, P=0.032).

Conclusions:

The dietary pattern with high intakes of vegetables, fungi, processed meat, eggs, coffee and tea, and oil contributed to the higher PPWR. Lactating women having a higher PPWR might not offer enough breast milk to their babies.

43 / #114


BROWN RICE IMPROVES OBESITY AND INCREASES SCFA CAECAL DIGESTA CONCENTRATIONS AND SERUM MAGNESIUM LEVELS IN RATS FED WITH HIGH FAT HIGH FRUCTOSE DIET (HFFD)

E. Sulisyowati1, D. Handayani1, S. Soeharto2, A. Rudijanto1 1Medicine Faculty Universitas Brawijaya, Nutrition, Malang, Indonesia, 2Medicine Faculty Universitas Brawijaya, Pharmacology, Malang, Indonesia


Obesity becomes a global health challenge. Thus, public awareness on functional food as therapy in obesity is increasing. The dietary guidelines recommend consuming whole grains,including rice. Of the variety, brown rice has higher dietary fiber and β-glucans, vitamins, and minerals content than white rice.

This study aimed to analyze brown rice intervention on abdominal circumference, Lee Index, Body Fat Index/BFI, SCFA concentrations, and serum Magnesium levels of rats given High Fat High Fructose Diet.

Methods:

This study used a post-test only control group design on 35 male Sprague Dawley strain rats. The rats were divided into five groups given dietary intervention Normal Diet (N), HFFD, and modified HFFD + brown rice dose 1 (112.5 g/day), 2 (225 g/day), and 3 (337.5 g/day) for 12 weeks. Data collected were intake, body weight, Lee index, abdominal circumference, BFI, SCFA caecum concentration, and serum magnesium level. The one-way ANOVA test was used to measure the differences.

Results:

The results showed no significant differences in the mean of daily calorie intake between HFFD and HFFD + brown rice groups. However, abdominal circumference, Lee index , and BFI of rats with brown rice intervention decreased significantly. Rats with brown rice dose 3 had the lower intake and the highest Lee Index reduction, the lowest BFI, and the highest SCFA concentration and serum Magnesium levels.

Conclusions:

Brown rice intervention can improve obesity parameters and increase SCFA concentration and serum Magnesium levels in rats given HFFD. Brown rice can substitute white rice to reduce obesity prevalence.

44 / #256


DIET AND METABOLIC SYNDROME IN OBESE EGYPTIAN CHILDREN: IS THERE A RELATION?

E. Abdel Hamid1, R. Helal1, N. Aboul Ella2, R. Abdelkader3, E. Hammad2, N. Salah4, S. Omar1 1NRC, Child Health, cairo, Egypt, 2National Nutrition Institute, Clinical Nutrition Department, cairo, Egypt, 3Institute of Postgraduate Childhood Studies, Ain Shams University, Medical Studies Department, cairo, Egypt, 4NRC, Clinical Pathology, cairo, Egypt


Childhood obesity is associated with substantial co-morbidity and late sequelae, it is a major risk factor for chronic diseases and plays a central role in the insulin resistance and metabolic syndrome which may be implicated in the development of many pathological states..

Aim:

To assess different indices of obesity, metabolic syndrome, as well as related dietary pattern and to study the level of serum vaspin as an indicator of insulin resistance in obese non diabetic children.

Methods:

A cross sectional study conducted on 45 obese children with BMI > 95th centile and 45 non obese children. Growth and nutrition were assessed. Fasting serum glucose, serum insulin, lipid profile, HBA1C, and Serum Vaspin were evaluated

Results:

93.3% of cases were exceeding the 90th percentile of waist circumference. 21 cases had high systolic and diastolic blood pressure. Metabolic syndrome was highly prevalent among obese children (53.3%). Thirty-one cases were on pre-diabetic level of HBA1c. Insulin resistance was detected in 47.7% of cases and acanthosis nigrican was found in 68.9% of obese children. High serum vaspin showed no statistical significant difference between cases and control. There was statistical significant difference as regard energy consumption between female group of cases and control and between male group of cases and control in fibers consumption.

Conclusions:

Prevalence of metabolic syndrome among Egyptian obese children is high, with presence of biomarkers of increased risk of cardiovascular and diabetic outcomes. Changing the dietary patter, development of effective programs to change life style is crucially needed for Egyptian children.

45 / #519


THE INFLUENCE OF THE NUTRITION IN INFANCY ON THE NUTRITIONAL STATUS OF CHILDREN AGED 7-10

V. Skvortsova1,2, T. Borovik2,3, M. Khodzhieva4, T. Bushueva2,5, E. Roslavtseva2, N. Zvonkova2,3, O. Lukoyanova2 1M.V.Vladimirsky Moscow Regional Research Clinical Institute, Neonatology Department, Moscow, Russian Federation, 2National Medical Research Center for Children's Health, Nutrition Department, Moscow, Russian Federation, 3I.M. Sechenov The First Moscow State, Pediatric Department, Moscow, Russian Federation, 4FSBU "Scientific and clinical center of otorhinolaryngology" FMBA of Russia, Pediatric Department, Moscow, Russian Federation, 5Research Centre for MedicalGenetics named after academician N.P.Bochov, Postgraduate Education Department, Moscow, Russian Federation


The number of overweight children is growing steadily worldwide. The purpose of study was to assess the effect of nutritional characteristics in infancy on the nutritional status of children at the age from 7 to 10 years.

Methods:

In 70 children aged 7-10 y.o. introduction of the complementary foods were evaluated retrospectively. 1st group -40 overweight children (BAZ = 2,29 [1,96;2,9]) and 2nd group -30 children with normal BMI (BAZ =0,30 [-0.43;0.72]). Anthropometric data was analyzed at birth and at age of 1 year (WHOAnthro 2006 program).

Results:

Anthropometric data of newborns did not differ between groups. At the age of 1 year, WAZ of the 1st group infants was significantly higher (p=0,038). Prescribing juice as a first complementary food had a positive correlation (r = 0,272, p = 0,03) and vegetables had an inverse correlation (r = -0,260, p = 0,04) with the overweight development in primary school age. A direct significant association between the consuming of 100 g cottage cheese (9 g protein) a day at the second half of the first year and the high values of BAZ (r = 0,245, p = 0,049) and WAZ (r = 0,375, p = 0,010) in primary school age was revealed.

Conclusions:

The complementary foods introduction may influence the development of overweight in later life.

46 / #528


HAVING BREAKFAST DURING CHILDHOOD AND BREASTFEED DURING INFANCY AS MODULATORY FACTORS FOR THE ASSOCIATION BETWEEN MOTOR COMPETENCE AND OBESITY PARAMETERS AT 8 YEARS OF AGE

A. Prats-Puig, R. Font-Lladó, B. Román-Viñas, J. Cazorla-González, J. Serrano-Ferrer EUSES. Escola Universitària de la Salut i l'Esport., Physiotherapy, Salt, Spain


Childhood obesity is linked to lower levels of motor competence (MC). The influence of dietary behaviours on MC is not well stablished. We sought to examine 1) the associations between MC and anthropometric variables 2) how those associations are modulated by dietary behaviours.

Methods:

MC (CAMSA), fat mass (TANITA), waist circumference and body mass index (BMI) SDS were assessed in 238 children (7.45±0.33 years). Breakfast consumption was assessed using the KIDMED questionnaire and information about breastfeeding was obtained by questionnaire. Associations between MC and anthropometric variables were assessed by Persons correlations following multiple regression analysis to adjust for confounding variables.

Results:

Higher MC values were associated with lower fat mass, BMISDS and waist circumference (β= -0.295, p<0.0001, β= -0.269, p<0.0001 and β= -0.252, p< 0.0001, respectively) explaining 33.7%, 28.7% and 39.8% of its variance after controlling for age, gender and maturity offset.

Interestingly, MC was 15% higher in those children who had breakfast every day, but no difference was seen according to the absence of breastfeeding during infancy. Moreover, the associations between MC and the abovementioned anthropometric variables were only significant in those children who had breakfast every day and were breastfeed during infancy (β= between -0.327 and -0.265, all p<0.0001; explaining more than 27.7% of its variance).

Conclusions:

Our results showed that higher MC levels are seen in leaner children and suggest that this association can be modulated by having breakfast every day during childhood and breastfeeding during infancy.

47 / #582


OBESITY AND VITAMIN D STATUS AMONG WOMEN OF THE REGION OF DRAA-TAFILALET, MOROCCO

S. Dadda1,2, B. Elhouate2, B. El Bouhali1 1Faculty of Science and Technique, University Moulay Ismail, Biology, Errachidia, Morocco, 2Higher Institute of Nursing and Health Professions, Nursing, Ouarzazate, Morocco


The prevalence of obesity is increasing all over the world and worsening at the same time the incidence of chronical diseases. This burden is especially high among women due to their physiology and genetics. In Morocco, socioeconomic and nutritional transitions can make women more exposed to obesity.

This study aimed at the evaluation of obesity and overweight and its relation with vitamin D status among women in the region of Draa-Tafilalet, Morocco.

Methods:

Clinical and sociodemographic characteristics were obtained from 210 women visiting local healthcare units from June 2019 to August 2019. The physical measurements included body height, weight and waist circumference (WC). The assessment of obesity was performed by BMI and abdominal obesity (WC and WC/height). The vitamin D was measured in plasma by immunofluorescence (25(OH)D2/D3). Univariate regression and khi-2 tests were performed to show correlations.

Results:

The prevalence of overweight was 35,2%, while that of obesity was 25.2%. The prevalence of abdominal obesity was 57.1% for WC and 55,7% for WC/height. Severe deficiency (<10ng/ml) in vitamin D concerns 55% of the population, while 38% suffers from deficiency (10 to 20ng/ml). Statistical analysis showed no correlation between vitamin D status and BMI or WC. At the same time, they showed a correlation with WC/height (p=0.04).

Conclusions:

The study showed a high prevalence of obesity and vitamin D deficiency among women in this region. More studies should evaluate the effects of obesity on general population.

Grant: UMI 2018

48 / #725


MEETING 2019 BEVERAGE RECOMMENDATIONS DURING THE COMPLEMENTARY FEEDING PERIOD AMONG INFANTS AND TODDLERS

K.L. Kong1, K. Morris1, R. Paluch2 1University at Buffalo, NY, Pediatrics, Buffalo, United States of America, 2University at Buffalo, Pediatrics, Amherst, United States of America


A professional panel of nutrition and pediatric experts recently updated the beverage recommendations (Healthy Drinks Healthy Kids) for children ages 0 to 5 years. The objective of the study is to examine beverage consumption of young children during the complementary feeding period and their weight status.

Methods:

Our sample consisted of 142 infants (45.1% males), ages 9 to <16 months old (mo). Parents were instructed that they would be contacted to collect three (2 weekdays and 1 weekend), 24-hour dietary recalls for their infants. We compared infants and toddlers’ beverage consumption to the updated recommendations. Beverages were divided into 3 groups: breastmilk or formula, other types of milks (i.e. whole milk, reduced fat milk, plant-based), and other types of beverages (i.e. 100% juices, sugar-sweetened beverages). We measured children’s weight and height during their laboratory visit.

Results:

Overall, 30.3% of children in our study did not meet the recommendations. For infants (9 - <12 mo), 22.1% consumed other types of milks, and 8.8% were introduced to 100% fruit juice or sugar-sweetened beverages. For toddlers (12 - <16 mo), 24.3% were given milks that were not whole milk, and 13.5% consumed more than ½ cup of 100% fruit juices or any sugar-sweetened beverages. Children with weight-for-length (WFL) ≥ 85th (18.6%) consumed significantly more sugar-sweetened beverages than those with WFL < 85th (7.1%) (p = 0.04).

Conclusions:

High consumption of sugar-sweetened beverages is associated with higher weight status. Parents of young children need to be educated with the updated beverage recommendations for their child’s optimal health.

49 / #192

E-Poster Viewing OTHER 08-27-2020 21:30 - 22:00

NUTRITION LITERACY STATUS OF YOUNG ADULT WOMEN LIVING IN NEW DELHI

A. Sharma, A. Adhikari UNICEF, Nutrition, Kathmandu, Nepal


Nutrition literacy (NL) is the degree to which individuals have capacity to obtain process and understand nutrition information as functional nutrition literacy (FNL), interactive nutrition literacy (INL) and critical nutrition literacy (CNL). Objective was to determine NL status of women (20-30 years) and its association with nutrition status.

Methods:

Study was conducted in Delhi among 100 adults. Questionnaire consist of socio-demographic information, lifestyle, health profile, dietary behaviour and attitude statements as FNL, INL and CNL.

Results:

Majority of them had satisfactory to good NL scores including FNL, INL, CNL and TNL (Total Nutrition Literacy). Working women had significantly (p<0.05) poorer scores in FNL and CNL and prevalence of overweight and obesity was higher among them. No significant association was found between NL, food and nutrient intakes. Trusted source was international organisations, health personnel, nutritionists and searched source for information was internet though it was least trusted.

Conclusions:

Women had basic skills to understand nutritional information and manage nutrition issues. About 1/3rd of them had satisfactory to good scores in CNL indicates that they had ability to analyse nutrition information, increase awareness, and participate in actions to address barriers independently. NL significantly negatively associated with obesity. Hence, NL is skill which needs to strengthen to reduce long-term negative health outcomes which if successfully addressed, help for better nutritional status, weight management and health,

50 / #493


NUTRITIONAL STATUS IN CHILDREN WITH MAPLE SYRUP URINE DISEASE ON ADMISSION OF A SPECIALIZED CENTER IN THE CITY OF SÃO PAULO, BRAZIL

C. Almeida, R. De Oliveira, B. Frangipani, C.S. Mendes, S. Kyosen, M. Rand, A.M. Martins, F. Oliveira EPM/UNIFESP, Pediatrics, São Paulo, Brazil


Management of Maple Syrup Urine Disease incurs in a restrictive diet that may represent risk for malnutrition in children, thereby monitoring nutritional status is an important step to promote adequate growth among this population. The aim of the study was to assess the nutritional status of children with MSUD on admission of a specialized center in inborn errors of metabolism in São Paulo, Brazil.

Methods:

In this cross-sectional retrospective study, 23-years medical records were evaluated, and were included 21 patients diagnosed with MSUD by amino acid chromatography. Height and weight at admission were collected, and body mass index (BMI) z-score and height z-score were calculated for each child. Classification of nutritional evaluation was determined by WHO growth curves (2006).

Results:

Of 21 children registered, 11 (52.4%) were female. Median age on admission was 4 months (IQ 25: 2 months; IQ 75: 32 months), and 14 (67%) were infants younger than 1 year. Median age at diagnosis was 27 days, while 8 (38.1%) were diagnosed older than 1 month of age (IQ 25: 20 days; IQ 75: 131 days). Results showed that 90.5% had inadequate height-for-age or BMI-for-age (14.3% height-for-age z-score between -2 and -3; 33.3% height-for-age z-score < -3; 33.3% BMI-for-age z-score < -2; 28.6% BMI-for-age z-score > +1). The only child diagnosed at 6 days of life was eutrophic with adequate length-for-age.

Conclusions:

Delay in diagnosis and inadequate nutritional therapy result in nutritional impairment of children with MSUD.

51 / #108


MATERNAL BMI AND INFLAMMATORY BIOMARKERS IN BREAST-MILK DURING 6 MONTHS POSTPARTUM: AN INDONESIAN STUDY

S. Bardosono Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Nutrition Science, Jakarta, Indonesia


As an important biological process, inflammation connects early life experiences with a range of health outcomes later in life. Breastfeeding is the earliest external exposure that rich in nutrient contents, but also has inflammatory bioactive compounds in which associated to maternal BMI. Therefore, this study aims to explore the correlation between maternal BMI and CRP in serum and breastmilk at 6 month postparum.

Methods:

This cross-sectional study was done in January to June 2019 among postpartum lactating mothers having infants aged 1–5 months in Jakarta-Indonesia. Maternal BMI at pre-pregnancy and during 6 months postpartum, and hs-CRP serum were measured. Post-feed mature breast-milk was withdrawn using manual milk pump to collect approximately 30 mL of breast-milk specimen, and analyzed accordingly for hs-CRP content. Correlations between maternal BMI, CRP serum and breast-milk CRP were analyzed using spearman-rank correlation test.

Results:

Among 96 subjects participated in the study, there are correlations between pre-pregnancy BMI to postpartum BMI (r=0.816; P<0.001), and serum hs-CRP (r=0.339; P=0.004). Accordingly, there are also significant correlations between postpartum BMI to serum hs-CRP (r=0.430; P<0.001) and breast-milk hs-CRP (r=0.316; P=0.007).

Conclusions:

It is still unclear on the consequences of infants receiving varying concentration of breast-milk CRP on its implication for the intergenerational transmission of disease risk. However, along with the strong recommendation that infants should be exclusively breastfed for the first 6 months, it is wise to prevent the elevation of inflammatory biomarkers both in mothers and in the breast-milk by starting and end the pregnancy with a healthy weight.

52 / #401


FACTORS ASSOCIATED WITH HEAD CIRCUMFERENCE AT BIRTH: A COMPARISON BETWEEN TWO BIRTH COHORTS BORN 30 YEARS APART

V. Cunha1, M. Barbieri1, P.R. Rocha1, M. Saraiva2, H. Bettiol1 1University of São Paulo, Department Of Puericulture And Pediatrics, Ribeirão Preto, Brazil, 2University of São Paulo, Department Of Pediatric Dentistry, Ribeirão Preto, Brazil


It is known that head circumference (HC) is related to environmental and maternal health conditions, and its evaluation has acquired great importance after the epidemic of Zika virus infection in Brazil. Aims: To evaluate the association of newborn HC with sociodemographic characteristics and maternal habits in two birth cohorts before the Zika virus epidemic.

Methods:

Two birth cohorts were studied in Ribeirão Preto, Brazil, in 1978/79 and 2010. The data were collected in a similar way in both moments. The variables used in the analysis were newborn’s sex, intrauterine growth restriction (IUGR), gestational age, maternal age and schooling, smoking during pregnancy, parity and type of delivery. Unadjusted and multiple linear regression analyzes were performed to test the association of the HC with the independent variables in each year

Results:

In the 1978/79 cohort, 2941 newborns participated and 7353 participated in 2010. The general average of the HC in 1978/79 was 34.10cm and, 34.29cm in 2010. Maternal smoking in pregnancy decreased (28.3% to 11.8%) and cesarean section more than doubled (27.5% to 58.6%). At the two moments, the variables that were the predictors of higher HC were male sex and cesarean delivery, and for lower values of HC were smoking in pregnancy and IUGR. The IUGR was the factor that most impacted, HC reduced by 1.30cm (95%CI -1.43;-1.18) in 1978/79 and 1.74 cm (95%CI -1.87;-1.61) in 2010

Conclusions:

Maternal characteristics during gestation, although they have improved over the years, still need attention given that they were associated with HC.

53 / #410


FOOD INTAKE AND DIETARY ADEQUACY AMONG INFANTS FROM RIBEIRÃO PRETO, SP, BRAZIL

R. Oliveira1, M. Barbieri1, M. Saraiva2, P.R. Rocha1, D. Sartorelli3, H. Bettiol1 1University of São Paulo, Department Of Puericulture And Pediatrics, Ribeirão Preto, Brazil, 2University of São Paulo, Department Of Pediatric Dentistry, Ribeirão Preto, Brazil, 3University of São Paulo, Department Of Nutrition, School Of Public Health, Ribeirão Preto, Brazil


Infant complementary feeding may influence health and food preferences throughout life. Dietary adequacy regarding the intake of portions of food groups and macro/micronutrients was assessed in a convenience sample of 491 12-to-32-month-old children in Ribeirão Preto, Brazil.

Methods:

Foods and preparations were evaluated by means of the 24-hour food recall. Proportions of children with nutrient intake below or above the Brazilian recommendations were described. Chi-square test was used for analysis.

Results:

Children aged 18-23 months (52%), preterm (22%), with normal weight (92.9%), girls (52.5%), and whose mothers had 9-11 years of schooling (57.4%), were predominant. There was insufficient carbohydrate and fat intake (38.5%, 29.5%), and excessive protein intake (79.8%). Adequacy of iron, vitamin C and Vitamin B12 was high (98.6%, 97.0%, 94.9%), whereas it was low for calcium and vitamin E (27.3%, 37.7%). Intake above recommendations was observed for vitamin A (43.6%) and zinc (33.6%). Infants up to 23 months showed insufficient food portion intake regarding meat, eggs (42.7%), milk group (47.7%), and excessive regarding cereal group, fat group and fruits. Children ≥24 months showed insufficient intake regarding cereal group (56.1%) and fruits (75.8%). All children showed a markedly insufficient intake of vegetables and excessive intake of sugars and sweets

Conclusions:

Children’s diet showed inadequate nutrient intake, insufficient vegetable intake and excessive intake of sugars and sweets. Low rates of inadequate intake were observed for iron and vitamin A, the more deficient micronutrients in Brazil.

54 / #418


THE ENERGY AND MACRONUTRIENTS CONTENT IN HUMAN MILK IS RELATED TO THEIR HABITUAL BUT NOT CURRENT INTAKE

A. Bzikowska-Jura1, A. Czerwonogrodzka-Senczyna1, A. Wesołowska2, D. Szostak-Węgierek1 1Medical University of Warsaw, Faculty of Health Sciences, Department Of Clinical Dietetics, Warsaw, Poland, 2Medical University of Warsaw, Faculty of Health Sciences, Laboratory Of Human Milk, Department Of Neonatology And Lactation Research At Regional Human Milk Bank In Holy Family Hospital, Warsaw, Poland


The composition of human milk is dynamic and may vary according to many maternal, infant and physiological factors. The aim of this study was to investigate the association between energy and macronutrients content in human milk and their maternal dietary intake.

Methods:

A convenience sample of exclusively breastfeeding women (n=40) was recruited from the Holy Family Hospital in Warsaw. Participants were enrolled during their first month of lactation. Human milk samples were analyzed using the MIRIS human milk analyzer (HMA) and the assessment of women’s nutrition was evaluated with two methods: dietary intake based on the three-day dietary record (current intake) and intake frequency of food products (habitual intake).

Results:

The correlation coefficient (Pearson’s; r) did not show any significant statistical relationship between human milk composition and current intake of energy and nutrients. However, we observed that the habitual intake of eggs, poultry and margarine affected true protein concentration in human milk. Kendall’s rank correlation coefficients were 0.21 (p=0.047), 0.26 (p=0.018) and 0.22 (p=0.041), respectively. Olive oil consumption was negatively correlated with total lipid concentration in human milk (r=0.028; p= -0.24).

Conclusions:

These findings suggest that the nutritional needs of the child are first met and that current energy and macronutrients intake does not translate directly into their concentration in human milk. On the contrary, habitual intake seems to markedly influence their milk concentration.

55 / #626


AFLATOXIN B1 AND OCHRATOXIN A LEVEL IN INFANT FORMULAE AND BABY FOODS MARKETED IN POLAND.

K. Mruczyk, A. Cisek-Wozniak, R. Wójciak, M. Mizgier Poznan University of Physical Education, Dietetic Division, Poznan, Poland


Aflatoxin B1 (AFB1) and ochratoxin A (OTA) may lead to severe problems in children’s health, especially if they occur in foods especially intended for young children.

Methods:

In the presented study 149 samples (149 samples AFB1 and 149 samples OTA) of various commercial complementary foodstuffs including processed cereal products and other foods for infants and young children (rice, corn and wheat products) were collected from pharmacies and supermarkets in the Lubuskie Province, Poland. Samples were investigated for the presence of AFB1 and OTA, using a high performance liquid chromatography (HPLC) system equipped with post-column photochemical derivatization and a fluorescence detector.

Results:

In this study, 2 out of 198 samples (1%) were contaminated with AFB1 and OTA – respectively one contaminated sample (corn-rice milk porridge 3 fruits) of AFB1 (0,5%) and one contaminated sample (gluten-free cereal product) of OTA (0,5%). Result value of: AFB1 – 0,032 above the detection limit LOD 0,004 and OTA – 0,09 above the detection limit LOD 0,006.

Conclusions:

Considering the results obtained, it can be stated that the tested products for young children were safe in terms of their contamination AFB1 and OTA

56 / #286


LONG-TERM EFFECTS OF UNDERNOURISHMENT IN UTERO DURING WWII ON FINAL HEIGHT AND WEIGHT STATUS OF YOUNG ADULT WOMEN.

Z. Czapla1, G. Liczbińska2, J. Piontek3, R. Malina4 1Institute of Anthropology, Faculty of Biology, Adam Mickiewicz University, Department Of Human Biological Development, Poznań, Poland, 2Institute of Anthropology, Faculty of Biology, Adam Mickiewicz University, Department Of Human Evolutionary Ecology, Poznań, Poland, 3Institute of Anthropology, Faculty of Biology, Adam Mickiewicz University, Department Of Human Evolutionary Biology, Poznań, Poland, 4University of Texas, Department Of Kinesiology And Health Education, Austin, United States of America


Growth in utero under marginal nutritional conditions is related to later growth and final height. The aim of this research is to compare the young adult body size of women grouped by estimated duration of pregnancy relative to World War II.

Methods:

Subjects were 620 university students 18-25 years, for whom archival data: date of birth, age, height and weight were available; BMI was calculated. Based on estimated time of pregnancy and birth relative to WWII, the women were grouped as follows: (1) pregnancy and birth before the war (n=203); (2) pregnancy before the war, birth during the war (n=54); (3) pregnancy and birth during the war (n=173); (4) pregnancy during the war, birth after the war (n=16); and (5) pregnancy and birth after the war (n=174).

Results:

Heights of women born before and after WWII were significantly taller than heights of women born during the war. Though not significant, the height of women conceived before but born during the war was intermediate between heights of women born before and during the war. The height of women conceived during the war but born after the war was similar to that of women conceived and born during the war. In contrast, heights and BMIs, and the distributions of women by weight status did not differ among the five pregnancy groups.

Conclusions:

The results suggested that heights of young adult women exposed in utero to the conditions of WWII (maternal stress, marginal nutrition) were shorter than women who not exposed in utero to wartime conditions.

57 / #249


A RARE CASE OF CAUDAL REGRESSION SYNDROME WITH SEVERE FAILURE TO THRIVE

R. Darie1, I. Oprescu1,2, L. Carasava1,2, R. Stanciu1 1“Grigore Alexandrescu”Emergency Children’s Hospital, Paediatrics Department, Bucharest, Romania, 2“Carol Davila” University of Medicine and Pharmacy, Paediatrics Department, Bucharest, Romania


Caudal Regression Syndrome is a rare congenital disorder consisting in closed spinal dysraphism with a variety of malformations. It's most frequently diagnosed in the offspring of insulin-dependent diabetic mothers.

The case presented points out the challenges faced while treating a child with this pathology.

Methods:

We report the case of a 1 year old boy admitted in the Paediatrics Department of “Grigore Alexandrescu” Hospital, Bucharest for failure to thrive and recurrent UTI. The patient had an intricate medical history: lumbar myelomeningocele partially closed through in utero surgery, ventriculoperitoneal shunt set up at one month, sacrococcygeal defect and nephrocalcinosis. Amniocentesis established regular male karyotype. Clinical examination found seriously altered auxological parameters and global muscle weakness. Laboratory tests showed normal liver and renal functions, proper levels of vitamin D, thyroid hormones mildly elevated. Upper GI tract barium X-ray encountered massive gastroesophageal reflux. Abdominal ultrasound described bilateral nephrocalcinosis. MRI confirmed sacrococcygeal agenesis. Genetic advice set the diagnosis of caudal dysplasia based on severe form of spina bifida and sacrum malformation, but reported a possible MPZ IV association (enzymatic testing was negative). Due to severe failure to thrive in a child with rare disorder and massive gastroesophageal reflux, continuous enteral nutrition was the next logical step. On grounds of no improved weight balance, enteral nutrition via percutaneous gastrostomy combined with Nissen fundoplication was recommended.

Results:

CASE REPORT

Conclusions:

Caudal dysplasia is a rare condition with severe implications and it takes combined efforts from the medical team and family to establish the best therapeutic approach.

58 / #452


VEGETABLE REJECTION IN CHILDREN: NEOPHOBIC AND PICKY EATER

L. Dridi, H. Oulamara, A. Agli LNTA/INATAA, Mentouri Brothers University, Constantine , Algeria


Some children have a limited food intake especially vegetables. Picky eating and food neophobia are two components of eating behavior that may explain rejection in children. To help parents guide their children's feeding, it is interesting to identify the vegetables rejected by child picky eating and child food neophobia.

Methods:

A study concerned 1202 children aged 6 to 10. A 3-item questionnaire was sent to mothers to study the child picky eating. The answers were rated on a 5-point scale from strongly disagree to strongly agree. Child food neophobia is measured by the Child food neophobia scale. It consists of six questions on a 7-point and respondents are asked to indicate the extent of their agreement with each item (endpoints: strongly disagree, strongly agree). Children were divided into neophobic (or picky eater) vs. non-neophobic (or non-picky eater) groups, based on median score. We have listed the names of 17 vegetables, for each vegetable, the mother was asked to indicate if her child likes or rejects the vegetable.

Results:

Positive correlations were observed between refusal food behaviors and rejection of vegetables.

Compared to non-neophobic, 64% of the vegetables studied are significantly more rejected by neophobic children. Compared to non-picky eater, one-third of the vegetables studied are rejected by child picky eater. Cabbage and Eggplant are the most rejected vegetables respectively by the child neophobic and the child picky eater.

Conclusions:

To overcome the rejection of vegetables, it is interesting to study several factors to increase the appreciation and consumption of this category of food

59 / #595


FLEXIBLE, RIGID AND STRONG NEOPHOBIA: STUDY OF AGE AND GENDER DIFFERENCES

L. Dridi, H. Oulamara, A. Agli LNTA/INATAA, Mentouri Brothers University, Constantine, Algeria


Food neophobia is a rejection and/or reluctance to taste unfamiliar food (Loewen & Pliner, 2000). There are four types, flexible neophobia, children accepted to taste a new kind of food after tasting a tiny piece of it. Rigid neophobia, children tried new food under pressure (Hanse, 1994), and strong neophobia, children refuse categorically to try novel food (Rubio et al. 2008). The aim was to study food neophobia types, age and gender differences.

Methods:

The survey involved 1033 children (524 girls) aged 6- to 10- year- old and their mothers. The child food neophobia scale was used to assess the level of food neophobia. This 6-item questionnaire has 7-point rating scale, a possible scale range of 6 to 42. A score of 42 indicates high food neophobia. In order to identify the type of neophobia, we asked the mother to clarify her child’s reaction to the proposed novel foods.

Results:

In total, 71 % of children were neophobic. The majority (61 %) has a flexible neophobia behavior. Rigid and strong neophobia behavior represented, respectively, 5.5 % and 4.5 %. No gender and age differences were observed between neophobia score for all types of neophobia. For girls and boys, neophilic children had a lower neophobia score (p<0.0001). The neophobia score varied according the neophobia type for children aged 6, 7, 8, and 9 years (p<0.0006), however, in 10-year-old, no differences were observed (p=0.35).

Conclusions:

Knowing the type of food neophobia helps parents to improve their children’s eating behavior.

60 / #516


EATING HABITS OF LACTATING WOMEN IN HEALTH CENTERS IN THE PROVINCE OF LAAYOUNE, SOUTH OF MOROCCO

N. El Barnoussi Faculty of Science and Technique, Moulay Ismail University, Errachidia. Morocco., Departement Of Biology, ERRACHIDIA, Morocco


Breastfeeding is the normative standards for infant feeding and nutrition. Nutritional status in lactation is one of the most important determinants of women’s health, and the health and well-being of the infant.

The aims of this study were to describe the eating habits and determine the macronutrient intakes of breastfeeding women, at Laayoune province and to compare these to recommended intakes.

Methods:

63 breastfeeding women were screened for this study, between March and May 2019. Participants’ information regarding their: demographic, anthropometric and socio-cultural as well as a 24-hour dietary recall (24HR) associated with the frequency of food consumption, were collected through a questionnaire.

Results:

Results showed that 87% of participants aged 20-40, 30% are obese, 47.6% had a secondary school level and 44.4% are exclusively breastfed.

The 24H recall showed an average of 2245.5kcal/day energy intake, the mean protein intake was 123g/day, 297g/day for carbohydrate and 67.8g/day for lipid. In term of frequency, only 30.16% of participants consumed protein daily. 51% did not consume milk and its derivatives every day, 26% consume fruits daily, and only 20,64% consumed complete cereal products.

Conclusions:

the participants in this study have an unbalanced diet with lower fruit and milk consumption. energy, protein and carbohydrate intake higher than the recommendations. Hence, there is a need to improve the feeding practice for lactating mothers to ensure the ongoing health of their babies.

61 / #601


ANEMIA AMONG PREGNANT SAUDIS IN SELECTED PRIMARY HEALTH CENTERS

B. Elbashir Ministry of Health, General Directorate Of Nutrition, Riyadh, Saudi Arabia


Anemia is a global public health problem with major consequences for human health as well as social and economic development. It occurs at all stages of the life cycle, but is more prevalent in pregnant women and young children. (World Health Organization, 2014, Weinshet et al., 2017).

Saudi Food and Drug Authority (SFDA) issued specification of wheat flour, one of its items is to fortify with iron, folic acid and other nutrients

The aim of the study:

To determine the prevalence of anemia among pregnant Saudis

Methods:

This data is part of the nutritional surveillance in selected primary health centers in health directorate different regions from KSA

Results:

The mean (±SD) hemoglobin level according to the trimester of the pregnancy (in the year 2016 - 1437)

Hemoglobin level Standard Deviation (SD)

Ist trimester 11.7 1.45

Second trimester 11.3 1.51 NG*

Third trimester 11.2 1.48 NG*

Total

NG = the differences were not significant

The percentage of anaemia according to the trimester of the pregnancy (in the year 2016 1437)

≥ 11 g/100

Less than 11 g/100

(anemic subjects)

Ist trimester (up to 13 weeks) 73.4 % 26.6%

Second trimester (14- 27 weeks) 64.0% 36.0%

Third trimester (≥ 28 weeks) 62.6% 37.4%

Total 66.3% 33.7%

Conclusions:

Anaemia among pregnant Saudis is high, due to different reasons, such as unhealthy dietary habits, fortfication of wheat and not rice, Saudis consume rice more that wheat products

62 / #531


PROTEINO-ENERGY DENUTRITION IN THE ELDERLY IN THE OASIS REGIONS DARAA-TAFILALET

F. Sebbari, B. Elbouhali Faculty of Science and Techniques, Moulay Ismail University, Errachidia, Morocco., Biology, Errachidia, Morocco


The Malnutrition of the elderly is one of the public health problems studied under the National Nutrition and Health Program (PNHP). The prevalence of malnutrition is high among people living at home, in institutions or in hospitals, and its harmful health consequences are now well recognized.

The objective of our study was to determine the prevalence of Proteino-Energy Malnutrition (PEM) in patients over 60 years, and to study the associated factors.

Methods:

The main judgment criterion was an MNA<17/30. The Mini Nutritional Assessment (MNA), allows the screening of patients at risk of (PEM) even before the decrease in BMI (body mass index) or albumin.

Results:

The prevalence of (PEM) was calculated with one (MNA <17/30) in 520 elderly subjects. Given the reduced prevalence of patients without (PEM) (MNA> 23.5/30). The most represented nutritional category was the 50.6% risk of (PEM). The goods fed were in the minority 37.1%. Patients who are not denutris had better cognitive status with a higher Mini Mental State (MMS) score (p=0.000). The analysis of the qualitative variables highlighted the statistically significant link between MMS and severe cognitive impairment, the MMS scores <10/30 was a risk factor for (PEM). MNA was positively correlated with BMI so that 15.5% are BMI-deficient (p=0.001).

Conclusions:

Protein-energy malnutrition is gradually appearing in the elderly. It was linked to reduced dietary intake for many reasons. (PEM) promotes falls, infections and loss of autonomy.

Financial support: UMI-2018 project

63 / #602


NUTRITIONAL EVALUATION OF CHILDREN WITH CEREBRAL PALSY WITH HOME ENTERAL SUPPORT

A. Fernandez1, V. Garrido1, H. Gonzalez2, G. Merlo1, J. Hernandez1, J. Sachun1,2, E. Contrera1 1Nutri Home, Pediatrics, La Plata, Argentina, 2IDIP - Hospital de Niños de La Plata - Min Sal/IDIP CIC-PBA, Nutrition, La Plata, Argentina


Background and aim: cerebral palsy patients (CP) have a high incidence of eating problems, and high risk of malnutrition. Motor oral dysfunction determines the need for Home Enteral Support (HES). Our aim is to describe the nutritional evolution of CP pediatric patients on HES.

Methods:

Method: Cohort study, retrospective, data obtained from clinical records of CP patients assisted for an interdisciplinary team. Those with genetic syndromes and / or refractory epilepsy were excluded. Follow-up analyzed was from August 2018 to September 2019. Variables were sex, age, nutritional status through of z score weight, z score height and z BMI (WHO), feeding route, complications, estimation of total energy expenditure (GET) (Schonfield, WHO) and caloric intake (Kcal/d).

Data analysis: statistical package SPSS version 20 was used.

Results:

Results: 75 CP patients were analyzed, 46 (61%) male, x age 9.66 (r 2-16 years); 61 patients (81%) had a gastrostomy, the rest have nasogastric tube feeding.

In 2018 z height was x -2.67 SD ± 2.02 and z weight x -2,42 SD± 1.42.

In 2019, z height was x -1,98 SD± 1.89 and z weight x -1,98 SD± 1.54

The mean GET was 1422 Kcal/d and the x intake was 1356 Kcal/d, with an hypercaloric formula (1Kcal/ml) which covered the 95% of GET.

Complications: 29% constipation, 0.7% diarrhea, 2.5% accidental exit of gastrostomy tube, 4% vomit.

Conclusions:

Conclusion: The implementation of HES improved nutritional status of patients with CP without correcting the deficiency despite the high caloric intake received and no major complications presented.

64 / #344


DETERMINANT OF WEIGHT LOSS OF POSTPARTUM MOTHER IN CIPAYUNG DEPOK

S. Fikawati, A. Syafiq Faculty of Public Health Universitas Indonesia, Center For Nutrition And Health Studies, Depok, Indonesia


Maternal postpartum body weight changes particularly in form of retention of excess weight clould cause obesity, then could lead to degenerative diseases. This study aims to determine the determinants of postpartum maternal weight loss.

Methods:

This research is a quantitative research with cross sectional design. This study uses secondary data from research on breastfeeding intervention and complementary foods of breast milk in the implementation of first 1000 days of life program. The primary research was conducted in Puskesmas Cipayung Puskesmas on 2017. The sample size was 169 breastfeeding mothers.

Results:

Mean age of the mothers was 29.8 years (95% CI: 29-31 years). Majority of the mother had senior high school, not in employment, multiparous, vaginal delivery, high knowledge, not doing early breastfeeding initiation, and practice exclusive breastfeeding. Mean maternal energy intake was 1962 kcal/d (1907 – 2016 kcal/d), mean maternal weight loss in 6 months postpartum was 2.76 kg. There was a significant relationship between education (p = 0,019), exclusive breastfeeding in the 1st month (p = 0.021), exclusive breastfeeding in the 2nd month (p = 0.018) with postpartum weight loss. Exclusive breastfeeding in the 2nd month is the dominant factor in postpartum weight loss.

Conclusions:

Mothers who still give exclusive breastfeeding in the second month are more likely to experience postpartum weight loss. This implies the importance of exclusive breastfeeding not only for the infant’s health but also for the mother.

66 / #208


STEP COUNTS ASSOCIATIONS BETWEEN ADULTS AT RISK OF DEVELOPING DIABETES AND THEIR CHILDREN: THE FEEL4DIABETES STUDY – PRELIMINARY RESULTS

P. Flores Barrantes1, G. Cardon2, I. Altaba3, L. Moreno4, O. Androutsos5, Y. Manios5, J. Kivelä6, M. De Craemer2 1University of Zaragoza, Health Sciences Faculty, Zaragoza, Spain, 2University of Ghent, Faculty Of Medicine And Health Sciences, Ghent, Belgium, 3Instituto de Investigación Sanitaria, Red Samid, Zaragoza, Spain, 4University of Zaragoza, Genud Research Group, Zaragoza, Spain, 5University of Harokopio, Nutrition And Dietetics, Kallithea, Greece, 6National Institute for Health and Welfare (THL), Research, Helsinki, Finland


Aim: To determine the association of objectively measured daily step counts between parents at risk of developing type 2 diabetes mellitus (T2DM) and their 6-9-year-old children.

Methods:

Methods: 648 dyads of children and one of their parents classified at risk of developing T2DM according to the FINDRISC questionnaire (53.9% girls and 69.8% mothers) belonging to the Feel4Diabetes-study from Belgium, Finland, Greece and Spain, were included. FINDRISC uses age, body mass index, physical activity, vegetable & fruit intake, medical treatment of hypertension, own and family history of hyperglycemia to determine risk of T2DM. Step counts measured using pedometers and accelerometers during 4 consecutive days (2 weekdays and 2 weekend-days) were considered in the analyses. Spearman correlations and linear regression analyses were performed to observe the associations between all possible sex-specific dyads.

Results:

Results: Positive correlations between parents’ and children’s steps/day were found (weekdays (r=0.07; p=0.05), weekend days (r=0.16, p<0.01). Correlations between mothers’ and sons’ step counts were the strongest on weekend days (r=0.19, p<0.01), while with daughters´ was r=0.17, p<0.01. In weekdays, the only significant correlation was found between the mother-daughter dyad (r=0.15, p=0.02). Maternal step-counts were associated with daughters´ step-counts in weekdays (β=0.16, p=0.02) and in weekend-days (β=0.27, p<0.01).

Conclusions:

Conclusion: Maternal steps are associated with their daughters´, especially on weekends. Public health interventions trying to increase physical activity levels of families with high risk of T2DM, may have to consider the weekends as an ideal time for children and their parents for being physically active together.

67 / #203


PRESERVED RENAL FUNCTION IN CHILDREN WITH INTESTINAL FAILURE ON LONG-TERM PARENTERAL NUTRITION

A. Guz Mark1,2, S. Levi2,3, M. Davidovits2,3, R. Shamir1,2 1Schneider Children's Medical Center, Institute Of Gastroenterology, Nutrition And Liver Diseases, Petach-Tikva, Israel, 2Tel Aviv University, Sackler Faculty Of Medicine, Tel Aviv, Israel, 3Schneider Children's Medical Center, Institute Of Pediatric Nephrology, Petach Tikva, Israel


Long-term treatment with parenteral nutrition (PN) has been associated with renal complications, including hypercalciuria, nephrocalcinosis, proteinuria and reduced glomerular filtration rate (GFR). High prevalence of proteinuria and renal complications has been reported in children on home-PN, but evidence is scarce and mostly short-termed. We aimed to evaluate renal complications in children with intestinal failure, receiving long-term treatment with PN.

Methods:

A cross-sectional retrospective study was performed between 5.2017 and 12.2018, using electronic medical records of patients treated in our pediatric intestinal failure clinic for more than 1 year. Data was collected regarding medical background, anthropometry, blood and urine tests and abdominal sonography.

Results:

Complete data was available for 15 children, median age of 6 years (ranged 1.5 to 15 years). Median duration of PN treatment was 4 years (IQR 1.5-6 years). All patients had normal blood pressure. Low grade proteinuria was identified in 61% and mild albuminuria in 30% of the cohort. Hypercalciuria was present in 50% and hyperoxaluria in 46% of the patients. Only one patient had nephrocalcinosis noted on renal sonography. Estimated glomerular filtration rate (eGFR) was normal in all but one patient, who had preexisting renal disease.

Conclusions:

Pediatric patients with intestinal failure can present with preserved kidney function after years of PN treatment. Among this age group, eGFR is normal in the absence of preexisting kidney disease. Despite high prevalence of hypercalciuria, nephrocalcinosis is rare. Tight monitoring of all aspects of renal function is essential. Long-term follow-up into adulthood is needed to evaluate renal funtion in pediatric-onset intestinal failure.

68 / #121


THE RELATIONSHIP BETWEEN BODY MASS INDEX AND BODY FAT PERCENTAGE IN DIFFERENT MIGRANT GROUPS IN PERU: THE CRONICAS COHORT STUDY

S. Hardy1, W. Checkley2, J.J. Miranda3 1London School fo Hygiene and Tropical Medicine, Nutrition For Global Health, London, United Kingdom, 2Johns Hopkins University, Public Health, Baltimore, United States of America, 3Universidad Peruana Cayetano Heredia, Cronicas Centre For Disease Excellence, San Martín de Porres, Peru


Body Mass Index (BMI) is often used as a proxy to assess body fat percentage (BFP), but does not directly measure body composition. The aim of this study was to use the CRONICAS Cohort Study to examine the association between BMI and BFP, and how this varies with different confounders and behavioural factors, based on migration status amongst Peruvians, to assess how migration might affect weight accumulation and body composition.

Methods:

Multivariable linear regression models, stratified by migrant group, were created associating BFP with BMI, sex, age and years spent in education, with facilities index score added in the urban group.

Results:

The association between BFP and BMI alone was strongest in the rural group at 67.51%, followed by the rural-to-urban migrant group at 58.86%, and weakest in the urban group at 55.99%. When sex was added to the regression BFP explained 85.69%, 81.32% and 84.19% of the variability in BMI, in the respective groups. The contributions of the other independent variables were small, and once added explained 84.95% of the variability in the urban group, 81.72% in the migrant group and 86.27% in the rural group.

Conclusions:

The results suggest that additional factors play a larger role in explaining the association between BFP and BMI in the migrant group than in the urban or rural group. However, there were no associations found between BFP and behavioural factors related to diet and physical activity, meaning it is still not clear which factors are influencing this difference and suggesting the need for further research.

69 / #441


VALIDATION OF MYRAREDIET® A CLINICAL AND RESEARCH NUTRITION APPLICATION SYSTEM

D. Hook1, C. Lemons2, D. Yang3 1University of California, Davis, Graduate Group In Nutritional Biology, FONTANA, United States of America, 2National Urea Cycle Disorders Foundation, None, Pasadena, United States of America, 3Brightoutcome, Owner, Buffalo Grove, United States of America


The extensive availability and increasing use of mobile apps and software applications for nutrition-based health interventions and research makes evaluation and validation crucial for integration of apps and programs into nutritional counseling, dietary assessment, and use within research.

MyRareDiet® is a nutrition software and mobile application that can be used in research and clinical management. MyRareDiet® has a Patient, Researcher, and Clinician Portal.

To insure that MyRareDiet® would meet the rigors of research we validated both our unique food database as well as the nutrition application system itself.

Methods:

Sources of data were obtained from the Minnesota University NCC, USDA, and from manufacturers.. 150 commonly used foods pluse 50 specialty foods were chosen for validation . We manually compared the information on macronutrients and three amino acids between our database and sources. Manufacturer information was initially validated prior to uploading.

15 paper diet diaries were completed and collected and are in the process of being analyzed using MyRareDiet®, USDA FoodCenteral and two profession nutrition applications.

Results:

Preliminary data shows consistency between our database and sources. Diet analysis validation is being finshed.

Conclusions:

We designed, developed and are in the process of finishing validation of MyRareDiet® to meet the rigors of research in addition to reducing the burden of diet monitoring in clinical research.

70 / #488


EARLY AND EXCLUSIVE BREASTFEEDING IN NIGER : IMPLICATIONS OF PARTICIPATORY ACTION RESEARCH ON COMMUNITY BASED CHILD HEALTHCARE PROMOTION

N. Horii Independent consultant, Social And Behavior Change Communication, Mch&nutrition, Issy les Moulineaux, France


Action research is a methodology enabling local people to take part in conceptualizing, planning and executing specific types of actions in project management. A program of social and behavior change communication led by UNICEF has been dedicated to child healthcare and infant feeding promotion since 2008 in Niger. The program piloted plausible ways to reducing child mortality by adopting participatory action research. This research seeks to understand the impact of participatory action research methods on early and exclusive breastfeeding promotion.

Methods:

Participatory monitoring and evaluation, a project based mechanism to track progress and change made by community actors was established. Participatory rural appraisal were exploited to facilitate group discussions involving mothers and other key informants to diagnose causes of and seek together possible solutions to uncommon early and exclusive breastfeeding. The previous research findings of a retrospective cross-sectional study were exploited to evaluate the program impact on early and exclusive breastfeeding promotion.

Results:

Local people in program pilot sites were no longer subjects of trials nor target of interventions undertaken by outside specialists. They became actors playing key roles, awoken to ownership of change, able to analyze and understand what information gathered from their community tells what changed their newborn and infant care and feeding practices.

Conclusions:

Field observation and statistical findings clearly indicated significant impact of participatory approaches on optimal breastfeeding promotion. The participatory Monitoring and Evaluation generates highly valuable information to explore what needs to be done.

71 / #267


LIVING WITH DIABETES AND CELIAC DISEASE- A CASE STUDY

J. Jaho, K. Jaupaj University of Vlora, Albania, Research Center Of Public Health, VLORA, Albania


Type I Diabetes Mellitus and Celiac disease are two illnesses that we often find in the same patient, especially those of pediatric age. Both of these diseases last a lifetime since being diagnosed and it is important that the patient is properly informed about them to have the most optimal quality of life. With a careful monitoring and patient education, the timely complications of these two diseases can be avoided.

Methods:

This study presents the case of a 10 years old girl who was diagnosed with diabetes mellitus type I and celiac disease at the age of 5.5 years old. Based on the observation of the medical file, near of the health center where shereceives insulin therapy, we obtained data on the state of health since the diagnosis of these tyo diseases to date.

Results:

Based on the data from the medical file of the child, it is found that there is a significant change in the overall health status because the analysis results show significant improvement values. For 6 years the girl is treated with insulin and adhres to a regular gluten free diet. The child's weight gain is at the appropriate age and psycho-motor development.

Conclusions:

It is very valuable for children with this co-morbidity to be under regular monitoring. Undoubtedly, a complete education about the child's illnesses requires the family. Such pediatric patients need extra education and intervention in their diet and lifestyle, as these are two key elements that provide these sick children with a good health condition.

72 / #327


EATING PATTERNS AND ADHERENCE TO THE MEDITERRANEAN DIET: A CROSS-SECTIONAL STUDY.

K. Jaupaj1, B. Subashi1, J. Çelaj1, I. Zotaj2 1Universiteti "Ismail Qemali" Vlore, Research Center In Public Health, Vlore, Albania, 2University ''Ismail Qemali'', Department Of Nursing, Vlore, Albania


The term “Mediterranean Diet” has been widely used to describe the traditional dietary habits of people living around the Mediterranean sea.It is a concept that goes beyond food,it is a lifestyle that focuses on social activity,the use of traditional and local ingredients,exposure in the sun and most of all "by measure".Studies have shown that MD prevents the development of cardiovascular disease,breast cancer,depression and Alzheimer’s,colorectal cancer,diabetes,obesity,asthma and dementia.The aim of this study was to evaluate the prevalence of healthy and unhealthy eating patterns and level of adherence to the Mediterranean Diet.

Methods:

This is a cross-sectional study carried out during July 2019 in Vlora and Fieri cities, Albania.Participation in the study was voluntary and we analyzed data from 180 participants using a validated questionnaire.

Results:

Most of the participants in the study were female(82.7%) and the majority of them were in the age group 20-35 years old(84.8%).About 51.27% of the population consumed 1-3 portions of fruits/day,39.9% consumed more than 2 portions of vegetables /day,78.8% used olive oil as the main condiment,only 11.04% consumed fish more than three times/week,36.4% consumed nuts more than twice/week and 76% of them consumed cakes / sweets more than 2 times/week. Women consumed more vegetables than men (p =0.037),while men went to fast food restaurants more often (p=0.01).

Conclusions:

The results of this study indicate that eating patterns and lifestyle habits in the population have to be improved. We recommend that there is a strong need for effective strategies to promote healthy behaviour and to implement MD by more individuals.

73 / #496


EFFICACY AND SAFETY OF ORAL AND INHALATION COMMERCIAL BETA-GLUCAN PRODUCTS: SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS

A. Jelicic Kadic1, N. Markovina2, L. Puljak3, I. Banjari4, V. Bucevic Popovic5 1University hospital Split, Department Of Pediatrics, Split, Croatia, 2Pharmacy Prima Pharme,, Prima, Split, Croatia, 3Center for Evidence-Based Medicine and Health Care, Catholic University of Croatia,, Evidence Based Medicine Center, Zagreb, Croatia, 4Faculty of Food Technology,, Department Of Food And Nutrition Research, Osijek, Croatia, 5University of Split, Faculty of Science, Department Of Chemistry, Split, Croatia


Beta-glucans are advertised as biologically active compounds, with various health claims. We summarize results about efficacy and safety of commercial oral and inhalation beta-glucan products on human health from randomized controlled trials (RCTs).

Methods:

We conducted systematic review of RCTs. We searched MEDLINE, CENTRAL and ClinicalTrials.gov. Any commercial product, any types of participants and any health-related outcomes were eligible. Two authors screened studies and extracted data. Cochrane risk of bias tool was used. This review did not have any extramural funding. Registration: PROSPERO record no. 42016043539.

Results:

We included 30 RCTs that were conducted on healthy or ill participants. Most of the trials reported beneficial effect of beta-glucan, but among the 105 different outcome domains and measures that were used, only three could be considered clinically relevant, while others were various biomarkers and surrogate outcomes such as complete blood count. Included studies on average had 33 participants per study arm, high or unclear risk of bias of at least one domain, and only half of them reported data for safety. More than half of trials that reported source of funding indicated commercial sponsorship from producers of beta-glucan. Only five RCTs reported trial registration.

Conclusions:

Commercial beta-glucan products were studied in a number of RCTs whose results can be considered only as preliminary, as they used small number of participants and surrogate outcomes. The quality of many studies was poor and further research and trials on bigger population should be performed before a final conclusion can be made.

74 / #278


ANALYSIS OF HUMAN MILK MICROBIOTA OF HEALTHY MOTHERS IN KOREA

S.Y. Kim1, I.S. Lim1, D.Y. Yi1, D.Y. Shin1, Y.-J. Kim2 1Chung-ang University Hospital, Pediatrics, Seoul, Korea, Republic of, 2Jeju National University School of Medicine, Pediatrics, Jeju, Korea, Republic of


Understanding the influence of human milk on early gut colonization is important as modulating a dysbiosis and protecting the disease development. Bacteria-derived extracellular vesicles (EV) can be detected in body fluids and imply that the microbiota are metabolically active. The aim of this study was to characterize the bacterial communities in human milk of healthy Korean mothers by analyzing both the microbiota and bacteria-derived EV using culture independent technique.

Methods:

A total of 22 human milk samples were collected from healthy mothers. The DNA from bacteria and bacteria-derived EV were extracted in each sample. Gene analysis was performed by MiSeq (Illumina, USA) sequencing.

Results:

Firmicutes accounted for the largest portion with 56.4% (SD 19.4) among the phyla, followed by Proteobacteria, Bacteroides, and Actinobacteria. At the genus level, Streptococcus and Staphylococcus accounted for high portion at 25.1% (SD 20.9) and 10.7% (SD 12.3). In EV samples, phyla firmicutes also accounted for the largest portion with 35.8%. However, at the genus level, Bacteroides, Acinetobacter and Lactobacillaceae(f) accounted for high portion of EV samples. Acinetobacter, Ruminococcaceae(f), Bifidobacterium, Comamonadaceae(f), Rothia, and Clostridiaceae(f) showed significant positive correlation between bacteria and EV samples (p<0.05).

Conclusions:

Human milk microbiota showed complex communities, with Firmicutes as the predominant phyla. Analysis at the genus level showed significant proportional differences between bacteria and EV samples. Several genera showed significant positive correlation between two samples. Our data can be used as a basis for future studies to assess the metabolically active bacteria influencing infants’ gut colonization.

75 / #368


PREGNANCY, BIRTH, NEONATAL AND POSTPARTUM OUTCOMES OF DIETARY PATTERNS OF NULLIPAROUS WOMEN IN IRELAND

J. Marchi1, J. Kearney2, C. Begley3, D. Daly3 1Trinity College Dublin, Nursing And Midwifery, Dublin, Ireland, 2Dublin Institute of Technology, School Of Biological Sciences, Dublin , Ireland, 3Trinity College Dublin, School Of Nursing And Midwifery, Dublin, Ireland


There is a growing body of literature around maternal peri-conceptional dietary patterns and outcomes. Research needs to continue as there is much more to be learned. The aim was to explore the outcomes of maternal diet during pregnancy.

Methods:

Site hospital and university ethical approval were granted. Data on maternal diet during pregnancy were collected using a validated Food Frequency Questionnaire and assessed using four different methods: the Alternate Healthy Eating Index for pregnancy in Ireland (AHEI-P(I)), cluster analysis, adequacy of all macronutrients and Protein:Non-protein ratio. Pregnancy/birth/neonatal and postnatal outcomes were explored.

Results:

Participants whose Protein:Non-protein ratio were below the median were statistically less likely to birth spontaneously (OR 0.7, CI 95% 0.4-0.9, p=0.037). Women more likely to be breastfeeding at 3 months postpartum were sometimes satisfied with their body image (AOR 5.2, 95% CI 1.9-14.5, p=0.002) (AHEI-P (Ireland)) and (AOR 5.0, 95% CI 1.8-14.0, p=0.002) (cluster analysis). Women less likely to be breastfeeding at 3 months postpartum were aged ≥35 years (AOR 0.5, 95% CI 0.2-0.9, p=0.015) (AHEI-P(I)) and (AOR 0.5, 95% CI 0.3-0.9, p=0.043) (cluster analysis), educated to leaving certificate/vocational level(AOR 0.4, 95% CI 0.2-0.8, p=0.004) (AHEI-P(I)) and (AOR 0.5, 95% CI 0.3-0.9, p=0.019) (cluster analysis), or had a diet during pregnancy that needed improvement (AOR 0.6, 95% CI 0.4-0.9, p=0.039) (AHEI-P(I)) and (AOR 0.4, 95% CI 0.3-0.7, p=0.000) (cluster analysis).

Conclusions:

Understanding the outcomes of diet during pregnancy better is essential to decreasing and avoiding the deleterious effects for the mother and baby.

76 / #529


UNLOCKING THE HUMAN MICROBIOME WITH STRAIN-LEVEL METAGENOMICS

A. Materna CosmosID, Product Development, WD EU, United Kingdom


We present an overview of the CosmosID-optimized metagenomics workflow, designed to deliver high-quality sequencing data and easy-to-access strain-level bioinformatics.

Methods:

CosmosID’s CLIA certified laboratory cover the entire workflow from study design to sample collection, extraction, library preparation, NGS, bioinformatics and publication support.

Results:

CosmosID’s cloud-based metagenomics application offers user-friendly access to the largest databases for microbial genomics, antimicrobial resistance (AMR) and virulence (VIR) data and has been independently validated to return metagenomic analyses at strain level resolution with industry leading sensitivity and precision.

Conclusions:

CosmosID has achieved global recognition and success for its platform in high-resolution microbiome analysis.

77 / #523


WHAT FACTORS DETERMINE PRE-PREGNANCY MATERNAL NUTRITIONAL STATUS? A PROSPECTIVE STUDY IN THE TIGRAI REGION, NORTHERN ETHIOPIA

K. Misgina1, H. Boezen1, E. Van Der Beek1,2, H. Groen1, A.M. Bezabih3 1University Medical Center Groningen, Epidemiology, Groningen, Netherlands, 2Danone, Nutricia Research, Utrecht, Netherlands, 3Mekelle University, School Of Public Health, College Of Health Sciences, Mekelle, Ethiopia


Low maternal pre-pregnancy nutritional status is highly prevalent in low-income countries. Improving maternal nutrition in the pre-pregnancy period may be an opportunity to break the vicious cycle of transgenerational malnutrition. However, little is known about the factors that determine pre-pregnancy nutritional status. Therefore, this study was aimed to assess a broad range of determinants of pre-pregnancy nutritional status in Ethiopia.

Methods:

The data are collected as part of an ongoing prospective study in Kilite-Awlaelo Health and Demographic Surveillance Site, North Ethiopia. First, the weight of 17,500 women of reproductive age was measured between August and October 2017. Subsequently, women who became pregnant were included between February and September 2018. Most data were collected using pretested forms and standard anthropometric instruments at inclusion while some were extracted from the surveillance database. Body mass index (BMI) and Mid upper arm circumference (MUAC) were used as proxies for pre-pregnancy nutritional status. Linear regression was used for the analyses.

Results:

A total of 991 women were included. The mean gestational age at enrollment was 14.76 (±1.92) weeks. The mean BMI and MUAC were 19.71 kg/m2 (±1.96) and 22.6 ± 1.93 cm, respectively. Not being from a model household, low women empowerment, intimate partner violence, food insecurity, low dietary diversity, higher coffee intake and low agrobiodiversity associated with both low BMI and MUAC.

Conclusions:

The prevalence of pre-pregnancy undernutrition in our study was very high. Pre-pregnancy nutritional status could be improved by advancing community awareness, empowering females, raising agricultural productivity as well as diversity and strengthening health extension.

78 / #622


OCCURRENCE AND SAFETY EVALUATION OF DIETARY INTAKE OF DEOXYNIVALENOL IN CEREAL-BASED BABY FOODS COLLECTED FROM POLISH RETAIL MARKET

K. Mruczyk, M. Mizgier, A. Cisek-Wozniak, R. Wójciak Poznan University of Physical Education, Dietetic Division, Poznan, Poland


Contamination of agricultural commodities with deoxynivalenol (DON) is a worldwide concern in recent decades. Consumption of DON-contaminated baby foods exerts health implications especially in children as the most vulnerable subpopulations. DON can accumulate in human and animal bodies and has teratogenic, neurotoxic, embryotoxic, immunosuppressive.

Methods:

In the current study, for the first time in Poland, 110 baby foods (rice, wheat, corn and multigrain) samples available in the Polish market were analyzed to determine DON level, using a HPLC with fluorescence detector.

Results:

Overall, DON was observed in 10 % of analyzed samples with a mean and maximum level of 107,8± 30 and 148 μg/kg, respectively. All samples were lower than the permissible limit recommended by European Commission (permissible limit: 200 µg/kg).

The highest OTA contamination was observed in baby food: corn-based (mean 100± 37,96; 35,30%) wheat-based (mean 121± 7,07; 4,8%), multigrain (mean 118± 5,65; 4,25%), rice-based products (0). DON intake in infants (9 months old) was low than established a Provisional Maximum Tolerable Daily Intake (PMTDI) of DON at 1 μg/kg body weight (b.w.)/day. The estimated daily intakes for DON through the consumption of the infant cereals at 9 months were 0,14 μg/kg bw/day. These intakes were respectively 14,4 % of the TDI (Tolerable Daily Intake) established by EFSA.

Conclusions:

In this study there was not a high level of DON in products for children, products were safe, but mycotoxin contamination should be routinely monitored in foods for babies in order to reduce food-borne hazards in infants and young children.

79 / #466


THE FOOD TECHNOLOGY NEOPHOBIA SCALE AND THE ACCEPTABILITY OF CHICKEN EGGSHELL POWDER FOR HUMAN CONSUMPTION

S. Nabukenya Kampala Capital City Authority, Department Of Gender, Community Services And Production, Kampala, Uganda


The success of new food technologies largely depends on consumers’ behavioral responses to the innovation. In Eastern Africa, Uganda in particular, a technology to process chicken eggshell into flour would provide an excellent calcium source to all age groups to curb down calcium deficiencies. This study applied the Food Technology Neophobia Scale (FTNS) to investigate the potential use of chicken eggshell powder for human consumption.

Methods:

A pretested, structured questionnaire was administered to a representative household sample of 160 respondents in face-to-face interviews in Ssabagabo Makindye sub-county; Wakiso district. The questionnaire collected information on consumer’s demographic characteristics, food technology neophobia levels of potential eggshell powder consumers, familiarity and people’s willingness to try chicken eggshell powder

Results:

In general, respondents are relatively neophobic towards new food technology, with an average FTNS score of 61.20. Those who are willing to consume chicken eggshell powder have slightly low levels of FTNS scores. This poses a threat to the success of chicken eggshell powder adoption. Besides Food Technology Neophobia levels, socio-demographic indicators such as ‘age,’ ‘education’ and familiarity were key factors that influenced consumer’s willingness to consume chicken eggshell powder

Conclusions:

In conclusion, a relatively high proportion of the sample surveyed expressed willingness to consume chicken eggshell powder if presented to them. This is irrespective of the high level of food technology neophobia scores of respondents as well as their low familiarity with the product. The results of this study lend support to awareness creation and consumer education to improve acceptability of chicken eggshell powder.

80 / #298


INTRODUCING A NUTRITIONAL RISK SCREENING TOOL IN A SOUTH AFRICAN HOSPITAL

L. Ndhlovu, T. De Maayer Rahima Moosa Mother and Child Hospital, Paediatrics And Child Health, Johannesburg, South Africa


Background: Nutritional screening facilitates the early identification of hospitalised children at risk of malnutrition. Screening tools have scarcely been evaluated in the developing world where the burden of malnutrition is greatest.

Objectives: To introduce nutritional risk screening using a modified Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and comparing this score against the World Health Organisation (WHO) definition of acute malnutrition using anthropometry in hospitalised children.

Methods:

This was a retrospective study of 113 patients admitted to general paediatric wards at Rahima Moosa Mother and Child Hospital in Johannesburg, South Africa (SA). Children 6 months – 14 years old were screened for malnutrition using anthropometry and correlating WHO z-scores, and retrospectively screened for nutritional risk using the modified STAMP (mSTAMP). Risk scores were compared to anthropometric assessments, and outcomes compared.

Results:

The mSTAMP identified more patients at nutritional risk than anthropometry alone. The majority (82%) of children with normal anthropometry scored as medium and high risk using the mSTAMP. Weight loss and length of hospital stay were higher in medium and high risk groups (p= 0.028 and p= 0.0008 respectively).

Conclusions:

The mSTAMP identified more children than anthropometry at risk of malnutrition. Pitfalls in measurement and interpretation of anthropometry may result in some children not receiving necessary nutritional rehabilitation. There is a place for nutritional risk screening in developing world settings, but screening tools may need modification locally. Further studies and validation of these tools in Sub-Saharan Africa seem prudent and may result in improved nutrition and outcomes of hospitalised children.

81 / #419


EFFECT OF MUNG BEAN (VIGNA RADIATA L.) YOGURT ON LIPID PROFILE IN HIGH FATS HIGH FRUCTOSE DIET INDUCED MALE SPRAGUE DAWLEY RATS

F. Nisa Gadjah Mada University, Nutrition And Health, Yogyakarta, Indonesia


Metabolic syndrome is a cluster of cardiovascular risk factors. One of the risk factors of cardiovascular disease is dyslipidemia. Dyslipidemia is an abnormal condition where triglyseride, cholesterol, and LDL level is higher than normal meanwhile HDL level is lower. Food that have hypolipidemic effect like fiber and isoflavone can prevent dyslipidemia. One of the food that has hypolipidemic effect is mung bean. Fermentation processing of mung bean become yogurt is expected to increase that hypolipidemic effect. The aim of this study is to observe the effect of mung bean yogurt on lipid profile in high fat high fructose diet induced male Sprague Dawley rats.

Methods:

This research is a true experimental study with pre-post test. The subject is 28 male Sprague Dawley rats that adapted for 7 days. A total of 21 rats induced with high fat high fructose diet for 14 days. Rats divided into 4 groups, negative control group, positive control group, 2,5 ml/200gr bw yogurt diet group, and 5 ml/200gr bw yogurt diet group. Intervension given for 28 days and the lipid profile was analyzed before and after intervention.

Results:

The adiministrasion of 2.5 ml/200gr mung bean yogurt was significantly decrease (p<0,05) total cholesterol (29.62%), triglyseride (21.36%), LDL (31.25%) and significantly increase (p<0.05) HDL (11,29%). While the administration of 5 ml/200gr mung bean yogurt was significantly decrease (p<0,05) total cholesterol (65.15%), triglyseride (46.79%), LDL (55,86%) and significantly increase (p<0,05) HDL (42,93%).

Conclusions:

Mung bean yogurt can improve the plasma lipid profile by decrease total cholesterol, triglyseride, LDL, and increase HDL.

83 / #426


INITIATION, DURATION OF BREASTFEEDING AND SPECIFICATION FACTORS THAT INFLUENCE IT.

C. Papachristou, E. Sakellari, G. Vlachou, G. Della General hospital of Trikala, Pediatrics, trikala, Greece


Breast milk is the best food for the baby, especially during the first months of life. Exclusive breastfeeding is difficult to achieve.

The purpose of this retrospective study is to record the frequency of breastfeeding for the first 6 months of life and the factors that contribute to the establishment and continuation of this.

Methods:

We performed a retrospective study using a telephone questionnaire to all mothers who gave birth at the obstetrics clinic of General Hospital of Trikala from January 2015 to December 2016.

Results:

Data were collected from 303 mothers. About 76,5% begun to nurse after birth, 33% of mothers continued with exclusive or partial breastfeeding up to 6 months, while 30% continued with exclusive breastfeeding up to the sixth postpartum month. Mothers who adopted lactation exclusively rather partial breastfeeding declared very well informed about the process, especially from the obstetric and medical staff of the hospital (p<0.001). Home help did seem to play a role in the choice of exclusive comparing with partial breastfeeding (p=0,016).

Conclusions:

It appears that on the part of mothers there is strong interest in the initiation and establishment of breastfeeding. Almost all of the mothers who breastfeed up to sixth postpartum months continue with exclusive breastfeeding. The overall breastfeeding rates declines. The approach of obstetric and pediatric care is not enough and the health care system should focus on the support of breastfeeding at the community too, apart from the hospital services, for better breastfeeding rates to be achieved.

84 / #312


ASSOCIATION BETWEEN DURATION OF BREASTFEEDING AND BMI AMONG INDIVIDUAL AGED 4-49 MONTHS IN POLAND.

P. Pruszkowska-Przybylska, E. Żądzińska University of Lodz, Faculty of Biology and Environmental Protection, Department Of Anthropology, Lodz, Poland


Breastfeeding seems to be an important factor affecting the body mass, height and proportion at the later stages of the human ontogenesis. The aim of this study was to evaluate if duration of breastfeeding affects BMI in later life.

Methods:

In the analysis were included 493 children born in time, aged 4-49 months. The data were collected in years 1993-1997 and came from the nurseries in Lodz (central Poland) where children's parents filled the questionnaires. In the analysis were included information about: duration of breastfeeding, parental educational level, birth body mass, birth body length. The BMI was standardised on sex and age of the children. The ANOVA test and the regression models were used to evaluate the hypothesis. The obtained in regression model residues for BMI were used to verify only breastfeeding impact.

Results:

The ANOVA test showed that children who were not breastfed or breastfed not longer than 1 month had higher BMI than these breastfed more than 3 months (F=3.00;p=0.05). The regression model included parental education level and birth parameters that were used to adjust BMI and revealed that low educated mothers had children with higher BMI (Beta=0.198; p<0.021). Additionally, heavier newborns had higher BMI at the later stages of the ontogenesis (Beta=0.217; p<0.005). The breastfeeding duration was statistically significantly associated with BMI (Beta=-0.098; p<0.030) and explained 0.7% of the BMI variability.

Conclusions:

Breastfeeding importantly differentiates the BMI among Polish children aged 4-49 months and seems to reduce BMI in the further life.

87 / #232


A PRACTICAL TABLE FOR THE NUTRITIONAL MANAGEMENT OF INFANTS DIAGNOSED WITH COW’S MILK ALLERGY BASED ON A COMPARATIVE REVIEW OF DRACMA, ESPGHAN, AAP.

E. Lopez1, C. Ramirez2, B. Marriage2 1Abbott Nutrition, Abbott Research Park, Champaign, United States of America, 2Abbott Nutrition, Medical & Scientific Affairs, Columbus, United States of America


Cow’s milk allergy (CMA) is a common food allergy managed by allergists, gastroenterologist, pediatricians and primary care physicians. Decisions about the most appropriate feeding method if breastfeeding is not an option, vary among health care professionals worldwide.

Aims:

Hence, the objective of this project was to build a practical decision-making tool/table for the nutritional management of CMA by comparing and contrasting the three most relevant international guidelines/recommendations.

Methods:

Evidence Review:

The three guidelines reviewed were:

(1) The Diagnosis and Rationale for Action against Cow’s Milk Allergy (DRACMA) -2010 (And 2016 Update)

(2) European Society for Pediatrics Gastroenterology, Hepatology and Nutrition (ESPGHAN) Diagnostic approach and management of cow’s milk protein allergy in infants and children -2012

(3) Statement on Hypoallergenic Formula of the Nutrition Committee of the American Academy of Pediatrics (AAP) -2000

Results:

A comparative decision-making table was built depicting the most utilized infant-feeding methods. Although there is general agreement on the use of hypoallergenic formulas for the nutritional management of CMA, our findings show that there are some differences across guidelines when recommending other infant-feeding options depending on symptoms, age, availability and affordability.

Conclusions:

Conclusions and relevance:

This table can help health care professionals to assess in a practical way which type of infant formula to recommend depending on the patients’ age, severity of CMA symptoms, and formula availability and affordability.

88 / #566


EFFECT OF MATERNAL CHARACTERISTICS ON FOETAL GROWTH IN RURAL ETHIOPIA: A LONGITUDINAL STUDY

M. Roro1,2, W. Deressa1, T. Gari3, E. Loha3, B. Lindtjørn2 1Addis Ababa University, School Of Public Health, Addis Ababa, Ethiopia, 2University of Bergen, Centre For International Health, Bergen, Norway, 3Hawassa University, School Of Public Health, Hawassa, Ethiopia


Main indicators of foetal health include foetal size and foetal growth curves. Evidence regarding factors that affect intrauterine growth is scarce. The objective of our study was to examine the effect of maternal characteristics on intrauterine foetal growth using serial ultrasound measurements in a drought affected rural community in the Rift Valley of South-central Ethiopia.

Methods:

We conducted a longitudinal community-based study of IUG pattern using serial ultrasound measurements. Data collection period was from July 2016 to November 2017. We included 675 singleton pregnant foetuses >24 weeks based on ultrasound-derived estimation of gestational age. The study included 1699 observations in the analysis. We applied panel regression fixed effects model.

Results:

We observed a significant association of maternal weight with the mean Z-score of estimated foetal weight (EFW), head circumference (HC), biparietal diameter (BPD), abdominal circumference (AC) and femoral length (FL). We found that a one Kg increase in maternal weight resulted in a mean Z-score increase of 0.086 EFW, 0.025 HC, 0.059 BPD, 0.079 AC, and 0.144 FL. Maternal depression had a significant association with EFW Z-score only. A maternal depression symptom increase by one unit resulted in 0.024 increase in mean EFW Z-score. Mid-upper arm circumference (MUAC) of the mother had a negative correlation with EFW Z-score that was significant. A one cm increase in MUAC resulted in 0.045 decrease in the mean EFW Z-score.

Conclusions:

We conclude that maternal weight during pregnancy and presence of maternal depression symptoms had an effect on foetal weight.

89 / #353


PROBING THE NUTRITIONAL & ANTI-ANEMIC ACTIVITY OF BARLEY AND WHEAT GRASSES

F. Saeed Government College University Faisalabad Pakistan, Human Nutrition, Faisalabad, Pakistan


Pakistan is quiet away from its objective in controlling ID (iron deficiency) and IDA (iron deficiency anemia) among susceptible groups of people and there is need of remedial work to overcome malnutrition

Methods:

In 1st phase, nutritional characterization i.e. nutritional, minerals, antioxidative profile, and phenolic acids of wheat and barley grasses were explored. In 2nd phase, functional drinks i.e. wheat and barley grass juices were prepared with different concentrations and were subjected for sensorial characteristics. Moreover, in 3rd phase, efficacy trials were conducted to determine the effect of wheat and barley grass juice against anemia.

Results:

Functional drinks were prepared with different concentrations and were subjected for sensory attributes. Physicochemical analysis of selected treatments were performed and explored that total soluble solids and pH of juices were 1.321, 2.8900, 3.100 & 6.225, 6.032, 6.491 for T0, T1 and T2, respectively whereas a slight decreasing trend in acidity was observed during storage. Furthermore, serum biochemistry values were within normal range revealing safety of use. The parameters for anemic study including red blood cell (RBC), hemoglobin (Hb), hematocrit level (Ht), mean carposule volume (MCV), serum iron and serum ferritin showed an increasing trend for these parameters in anemic and non-anemic rats study during both trials.

Conclusions:

From the present investigation, it is deduced that cereal grass juice specifically barley grass juices are effective against anemia therefore, should be a part of diet based therapy for attenuation of lifestyle-related disorders.

90 / #552


KNOWLEDGE, ATTITUDE AND PRACTICE OF MATERNAL NUTRITION ACTIONS AMONG PREGNANT WOMEN UTILIZING ANTENATAL CARE SERVICES IN SELECTED HEALTH FACILITIES IN IBADAN

T. Osunkentan1,2, F. Samuel2 1United Nations Children’s Fund (UNICEF) Country Office, Nigeria, Nutrition Section, Abuja, Nigeria, 2University of Ibadan, Department Of Human Nutrition, Ibadan, Nigeria


Maternal nutrition during the first 1,000 days has important influences on children’s nutrition outcomes. In Nigeria, prevailing poor national indices on maternal nutritional outcomes brings questions on the adequacy of knowledge and practice of maternal nutrition actions. This study therefore assessed knowledge, attitude and practice (KAP) of maternal nutrition actions among pregnant women utilizing antenatal care services in Ibadan municipality, Nigeria.

Methods:

A descriptive cross sectional study was conducted among pregnant women (15-49 years) receiving antenatal care (ANC) services across selected Primary, Secondary and Tertiary health facilities as well as Private maternity hospitals and Mission homes. Questionnaire was used to collect data on maternal nutrition actions (optimal dietary intake, prevention and control of anaemia and promotion of supportive lifestyle and care), according to Essential Nutrition Actions Framework.

Results:

Age of respondents (n=247) was 29.85±4.89 years, mean gestational age of pregnancy at respondents’ booking was 18.33±6.12 months, while mean number of ANC visits was 4.43±2.77. About one-third (33.6%) of the respondents had poor knowledge scores (overall score 5.70±1.50 out of 10), with no significant difference across type of health facility. Mean attitude score was 13.76±2.44 out of 20, while practice was generally poor (overall score 4.80±1.34 out of 10). Mean practice score was significantly higher in Private hospitals than Primary Health Care and Mission homes. Respondents’ number of ANC visits had positive correlation with their knowledge and practice.

Conclusions:

Knowledge and practice of maternal nutrition actions was inadequate among pregnant women and this varied across type of health facilities offering antenatal care.

91 / #321


EXCLUSIVE ENTERAL NUTRITION INDUCES EARLY CLINICAL AND ULTRASOUND TRANSMURAL REMISSION IN PEDIATRIC CROHN’S DISEASE.

M. Zeferino Feltrin, M. Tolín Hernani, C. Sánchez Sánchez, C. Miranda Cid, G. Alvarez Calatayud Hospital Universitario Gregorio Marañon, Pedia, Madrid, Spain


The goals of treatment in pediatric Crohn’s disease (CD) are to induce and maintain remission and optimize growth, while minimizing side effects. Exclusive enteral nutrition (EEN) therapy induces clinical and mucosal healing with fewer adverse events than corticosteroids.  

Our aim was to describe early clinical and ultrasound effect in pediatric CD patients during treatment with EEN.

Methods:

An observational descriptive study, reviewing medical records of patients CD debut in a reference pediatric hospital in 2019. EEN was polymeric formula administered orally for 8 weeks. All patients underwent clinical (wPCDAI), biochemical and ultrasound control at fourth, eighth and twelfth weeks.

Results:

Patient 1: a 4-year-old boy, with abdominal pain, diarrhea, 2 kg loss and moderate clinical activity (47.5 wPCDAI). Abdominal ultrasound showed cecum mural thickening, with hyperemia and adjacent adenopathies. After 4, 8 and 12 weeks, he was asymptomatic, in clinical remission (wPCDAI 0), with weight catch-up and ultrasound inflammation resolution.

Patient 2: a 9-year-old girl diagnosed of pediatric CD (diarrhea, abdominal pain, 1.5 kg loss, and a moderate clinical activity [30 wPCDAI]). Abdominal ultrasound showed 15 mm ileal involvement with 7 mm wall thickening, increased mesenteric fat density, hyperemia and superficial mucous ulcerations. After 4, 8 and 12 weeks, she was asymptomatic, wPCDAI 0, gain of 3 kg and improved ileal inflammation without mesenteric inflammatory signs or mucosal ulceration by ultrasound.

Conclusions:

EEN is an effective treatment for early clinical, mucosal and ultrasound transmural remission in pediatric CD. Early ultrasound control may predict late clinical response at the end of EEN.

93 / #125


NUTRITIONAL STATUS AND EATING ABILITY OF CHILDREN WITH CEREBRAL PALSY

A. Shaitarova, O. Perfilova, E. Khramova Tyumen State Medical University of the Ministry of Healthcare of the Russian Federation, Pediatric Postgraduate Depatment, Tyumen, Russian Federation


The aim of this study is to assess food intake patterns and nutritional status of children with cerebral palsy.

Methods:

A cross-sectional study with 73 children from 6 to 17 years with cerebral palsy in the following forms: hemiplegia, diplegia, and tetraplegia. The participants were assessed for functional motor impairment by the Gross Motor Function Classification System (GMFCS). The assessment of eating and drinking ability was based on the Eating and Drinking Ability Classification System (EDACS). The nutritional status was estimated by weight, height, and age data. The food intake was verified by a 24-hour recall and food frequency questionnaire.

Results:

In 75% of children with hemiplegia and tetraplegia the energy intake was below the recommended limits. All children presented a low intake of carbohydrates and proteins, and a high intake of lipids. The tetraplegia group had a higher prevalence of chewing (55.7%) and swallowing (30%) difficulties compared to 25% and 11% of children with hemiplegia, respectively. 66.7% of children from the tetraplegia group had a significantly lower height/age Z score than those with hemiplegia (49%).

Conclusions:

The children with cerebral palsy proved to have inadequate dietary patterns and impaired nutritional status while mostly tetraplegia imposes more difficulties in chewing and swallowing with a major impact on height.

94 / #605


CLINICAL AND MOLECULAR FINDINGS IN TEN NEW CASES OF TETRASOMY 18P SYNDROME: FISH AND ARRAY CGH CHARACTERIZATION

W. Slimani, H. Ben Khalifa, S. Dimassi, A. Jelloul, M. Kamoun, A. Saad, S. Mougou-Zerelli Farhat hached university teaching hospital, Human Cytogenetics And Reproductive Biology, Sousse, Tunisia


Small Supernumerary Marker Chromosomes (sSMC) are rare chromosomal abnormalities, which have abnormal banding arrangement and take many shapes. Several disorders have been correlated with sSMC presence. The aim of this study is to characterize the sSMC derived from chromosome 18.

Methods:

TEn children were investigated by Fluorescence in situ hybridization (FISH) and Array Comparative Genomic Hybridization (aCGH).

Results:

Ten children with dysmorphic features have been investigated. They have these features in common: a triangular face, low-set ears, a large mouth with a thin upper lip, and a horizontal palpebral fissure. Epicanthus and strabismus were present in two patients. In addition, we have noticed microcephaly and mental and/or developmental delay with low birth weight. However, two patients had standard birth weight; one patient had hypospadias; two had skin problems; and three showed different congenital heart defects. One patient had corpus callosum hypoplasia. Systematic karyotype analysis revealed a de novo supernumerary chromosome. Array CGH showed a gain in copy number on the short arm of chromosome 18 in the nine cases. In one case, the sSMC seemed to be in mosaic. The breakpoints of the marker were identified using aCGH and FISH. Thus, the sSMC led to 18p tetrasomy with approximately 14 Mb lengths, between 364 344 and 14 763 575 based on the human genome version 18.

Conclusions:

These results have been completed by FISH in order to ascertain the shape of the sSMC. Our results confirm the uniqueness and particularity of the iso18p syndrome on the phenotypic as well as on the genetic level

95 / #624


ASCORBIC ACID EFFECT ON HUVEC PROLIFERATION AND NECROSIS

M.C.E. Smahi1, S. Dahou2, Z. Dahmani2, S. Benmansour1, W. Nouari2, M. Aribi2 1University of Tlemcen, Faculty of medecine, Pediatrics, Tlemcen, Algeria, 2Laboratory of Applied Molecular Biology and Immunology, Biology, Tlemcen, Algeria


Endothelial cells are unique multifunctional paracrine and endocrine organ, which fulfill a variety of vital basal and inducible, metabolic and synthetic functions. Ascorbic acid (AA) is an essential micronutrient that plays a preventing role in cardiovascular diseases and sepsis by reversing endothelial dysfunction. In this context, we examined the exvivo effect of AA on the proliferation of human umbilical cord venous endothelial cells (HUVECs) and cell necrosis.

Methods:

HUVECs were isolated from Umbilical Cord Vein by collagenase digestion, cultivated until reaching confluency, and passaged with trypsin-EDTA to the fourth passage. HUVECs proliferation was evaluated using BRDU incorporation assay (Abcam’s BrdU Cell Proliferation colorimetric ELISA Kit). Cell necrosis was determined by measuring the release of the Lactate dehydrogenase (LDH) activity using LDH colorimetric assay Kit (Sigma Aldrich Co., St. Louis, USA).

Results:

Ascorbate treatment has significantly reduced the LDH release levels and cell necrosis of cultured HUVECs compared to that of not treated HUVECs. Additionally, ascorbate supplementation has significantly increased the proliferation of cultured HUVECs treated compared to that of not treated cells with an optimum at 4mM (p value < 0.00001 and < 0.01 by Kruskal-Wallis test and Mann-Whitney U test, respectively).

Conclusions:

Ascorbic acid has stimulated the proliferation of cultured confluent HUVECS and decreased the cell Necrosis.

96 / #630


ASCORBIC ACID EFFECT ON PHAGOCYTOSIS AND BACTERIAL KILLING BY HUVEC AGAINST S.AUREUS

M.C.E. Smahi, S. Dahou, Z. Dahmani, W. Nouari, S. Benmansour, L. Ysmail-Dahlouk, M. Aribi Laboratory of Applied Molecular Biology and Immunology, Biology, Tlemcen, Algeria


Endothelial cells may serve as a vehicule for pathogens invasion and dissemination into organ tissues, leading to persistent chronic infections. Furthermore, ascorbic acid (AA) plays pleiotropic roles in immune defense including antibacterial effects. The aim of our study was to evaluate the ex vivo effect of AA on phagocytosis and bacterial killing capacities of HUVECs against S. aureus.

Methods:

HUVECs were isolated from Umbilical Cord Vein by collagenase digestion, cultivated until reaching confluency, and passaged with trypsin-EDTA to the fourth passage. Bacterial growth, phagocytosis and bacterial killing assays were performed on a mixture of HUVECs, Staphylococcus aureus ATCC 25923 at MOI 50 and different doses of vitamin C (0, 1, 4, 7,10 mM) for 24h.

Results:

Compared to control (HUVECs untreated), the AA treatment at 1, 4, 7 mM significantly reduced the percentage of phagocytosis of S.aureus by HUVECs treated. At MOI 50, the AA treatment gradually increased the phagocytosis activity of HUVECs vs control, and this phagocytic activity reached an optimal level at 4mM. Inversely, AA progressively increased the activity of bacterial lysis from a dose of 1 to 4mM as compared to control (HUVEC infected not treated). Similarly to the phagocytic activity, this bacterial lysis reached an optimal level with a dose of ascorbate corresponding to 4mM than significantly decreased at doses ranging from7 to 10mM (p- value < 0.05).

Conclusions:

AA treatment has significantly increased the phagocytosis activity and killing capacity of HUVECs against S.aureus, opening perhaps a new therapeutic strategy to control S. aureus infection at early stage.

97 / #181


ASSOCIATION BETWEEN DIETARY INFLAMMATORY INDEX SCORE WITH OXIDATIVE STRESS AND BREASTMILK LEVEL OF SUPER OXIDE DISMUTASE AMONG INDONESIAN LACTATING MOTHERS

D. Sunardi Faculty of Medicine, Universitas Indonesia, Nutrition Sciences, Jakarta, Indonesia


Dietary inflammatory index (DII) is currently receiving great attention, because of its effects on individual low grade inflammation. Breastmilk is the best food for infant, yet many substance are transferring from lactating mothers to their infant via breastmilk, including inflammatory and stress oxidative substances. The aim of the study was to see the association between lactating mothers DII with their oxidative stress level by measuring malondialdehyde (MDA) and level of super oxide dismutase (SOD).

Methods:

A cross sectional study was done in two primary health care in Jakarta, Indonesia. All of lactating mothers were asked for their willingness to join the study. Food intake were taken with semi-quantitative food frequency questionnaire, and then scored into DII. Super oxide dismutase and MDA data were retrieved from breastmilk and blood sample, respectively.

Results:

Data collection was done in February–March 2019. Fifty five lactating mothers were agreed to take part in the study, but serum and breastmilk SOD data were only obtained from 33 subjects. Lactating mothers breastmilk MDA significantly associated with their SOD serum level (p<0.001), and SOD level in mothers serum significantly associated with breastmilk SOD. Lactating mothers DII score significantly associated with mothers breastmilk MDA level (p=0.001) and serum SOD level (p<0.001), as well as breastmilk SOD (p<0.001).

Conclusions:

This study proves that lactating mothers should pay more attention not only to the nutritional content of their intake but also to their DII score, because the oxidative stress that occurs can affect their babies health in the future life.

98 / #205


RELATIONSHIP BETWEEN BREAKFAST INTAKE AND EATING HABITS FOR MOTHERS AND CHILDREN LIVING IN URBAN AREAS IN JAPAN

K. Tomina1, N. Tsushima1, Y. Sakaida1,2, Y. Tsujimoto1,3, A. Iwahashi1,4, T. Fukumura1, K. Yoshita1 1Osaka City University, Graduate School of Human Life Science, Department Of Food And Human Health Science, --, Sugimoto, Sumiyoshi-ku, Osaka, Japan, 2University of Nagasaki, Department Of Nutrition Science, --, Manabino, Nagayo-machi, Nagasaki, Japan, 3Hiroshima International University, Faculty Of Clinical Nutrition, --, Hirokoshingai, Kure, Hiroshima, Japan, 4Tezukayama University, Department Of Food And Nutrition, --, Gakuenminami, Nara, Japan


We examined the breakfast and eating habits of mothers and their children.

Methods:

A self-administered questionnaire was distributed to the parents of children who underwent their 18-month health checkup from July 2016 to 2017. Of those who responded (79%), 895 subjects were included in the analysis. The contents of the survey included the eating habits of the mothers and children and the developmental status of the children. We focused on the breakfast intake and eating habits of the mothers and children.

Results:

The mother's age, height, weight, the child's height, and average weight (S.D.) were 33.0 (5.4) years, 158.2 (5.3) cm, 2.6 (8.4) kg, 49.0 (2.6) cm, and 2,990.6 (405.6) g, respectively. There were 747 mothers (83.5%) who ate breakfast daily, and 148 other mothers (16.5%). There were 725 (97.1%) mothers who ate breakfast every day and 22 (2.9%) other children. Mothers who did not eat breakfast daily had 113 breakfasts (76.4%) and 35 other children (23.6%). The children of mothers who ate breakfast daily had a higher breakfast rate than other children. Mothers who ate breakfast daily were more likely to consume vegetables, fruits, milk and dairy products than other mothers.

Conclusions:

We confirmed that the mothers’ eating habits affected their children. Desirable eating habits are important after giving birth, and it is necessary to promote appropriate support and guidance to improve the eating environment throughout the family.

99 / #224


NUTRITIONAL STATUS AND RISK FACTORS OF OVERWEIGHT AND OBESITY FOR PRIMARY SCHOOL CHILDREN

T. Triyanti, J. Harland Faculty of Public Health, University of Indonesia, Public Health Nutrition, Depok, Indonesia


Overweight and obesity is a seroiusly public health problem in the world, included Indonesia as a developing country. In Indonesia, there is increasing prevalence of overweight and obesity among children. Many factors are associated with obesity, such as energy and macro nutrient intake, physical activity, fast food eating habit, consume sweet beverage habit, and sex. The purpose of the study was determine dominant factor that associated with overweight and obesity in children.

Methods:

. The design study was cross sectional and used primary data of 114 student as samples. Data was collected by interview the children using quesionaire. Measurement anthropometry such as weght and height also were collected. Nutrient intake data was collected by food recall 2x24 hours used food model to predicted quantity of food cunsumme. Analysis data used chi-square test and multiple logistic regression.

Results:

The result showed that 27,2% children was overweight and 21,9% was obesity. Bivariate analysis showed there was association between physical activity, fat intake, fast food eating habit, consume sweet beverage habit. Psysical activity was a dominant factor of averweight and obesity (OR = 5,474; CI: 2.188 – 13.826). It means that children who have low phisical activity, increase 5,4 times more overweight and obesity controlled variables, for example, protein intake, consumme sweet beverage habitand fast food eating habit.

Conclusions:

The high prevalence of overweight and obesity among children. Physical activity as a dominat factor of overweight and obesity among children

100 / #220


THE RELATIONSHIPS BETWEEN BODY IMAGE TYPE BEFORE PREGNANCY, WEIGHT LOSS EXPERIENCE AND BIRTH WEIGHT IN JAPANESE WOMEN

N. Tsushima1, K. Tomina1, Y. Sakaida1,2, Y. Tsujimoto1,3, A. Iwahashi1,4, T. Fukumura1, K. Yoshita1 1Osaka City University, Graduate School of Human Life Science, Department Of Food And Human Health Science, --, Sugimoto, Sumiyoshi-ku, Osaka, Japan, 2University of Nagasaki, Department Of Nutrition Science, --, Manabino, Nagayo-machi, Nagasaki, Japan, 3Hiroshima International University, Faculty Of Clinical Nutrition, --, Hirokoshingai, Kure, Hiroshima, Japan, 4Tezukayama University, Department Of Food And Nutrition, --, Gakuenminami, Nara, Japan


In this study, we investigated the relationships between maternal body image type before pregnancy, weight loss experience, and birth weight of the infant.

Methods:

A self-administered questionnaire was conducted to the mothers of children undergoing their 18-month medical checkup in a ward in Osaka City, Japan from July 2016 to July 2017. The questionnaire was comprised of 38 questions, including the physical condition of mothers and children, lifestyle, and eating habits. Among those who responded (response rate: 79%), 858 subjects, excluding those who had multiple fetuses and those with missing data, were included in the analysis.

Results:

Comparing maternal body image type before pregnancy and the current average BMI, the mothers who recognized obesity (221) were 23.8 kg/m2, the mothers who recognized a normal body image (444) were 20.5 kg/m2 and the mothers who recognized an underweight body image (193) were 18.8 kg/m2. In addition, when we examined the relationship between body type recognition before pregnancy and the current BMI. We found that mothers with a BMI that was classified in the normal range or underweight tended to overestimate their body type. There was no relationship between body image type and the birth weight of the infant.

Conclusions:

We confirmed that some mothers overestimated their body shape despite being underweight or an appropriate weight. This misrecognition can affect inappropriate weight loss, poor nutritional status, and decrease in the birth weight of the infant. It will be necessary to establish accurate knowledge about the body shape from the school age.

101 / #222


EFFECTS OF PHYSICAL CONDITION, LIFESTYLE, AND DIETARY HABITS OF PREGNANT JAPANESE WOMEN ON DURATION OF GESTATION AND INFANT BIRTH WEIGHT

K. Yoshita1, K. Tomina1, N. Tsushima1, Y. Sakaida1,2, Y. Tsujimoto1,3, A. Iwahashi1,4, T. Fukumura1 1Osaka City University, Graduate School of Human Life Science, Department Of Food And Human Health Science, --, Sugimoto, Sumiyoshi-ku, Osaka, Japan, 2University of Nagasaki, Department Of Nutrition Science, --, Manabino, Nagayo-machi, Nagasaki, Japan, 3Hiroshima International University, Faculty Of Clinical Nutrition, --, Hirokoshingai, Kure, Hiroshima, Japan, 4Tezukayama University, Department Of Food And Nutrition, --, Gakuenminami, Nara, Japan


We examined the mother's physical condition, lifestyle, and dietary habits related to gestational age and birth weight of infants among Japanese pregnant women.

Methods:

We administered a questionnaire survey to mothers who brought their 3-month old infants to a health examination in Sumiyoshi-ku, Osaka City from April 2015 to April 2016.

Results:

We administered the survey to 543 mothers. The subjects included 493 mothers with full-term birth, normal weight infants (NBW) (Group FN) and 28 mothers with full-term, Low birth weight infants (LBW) (Group FL). Those mothers with premature birth babies included 10 with NBW infants (Group PN) and 12 with LBW infants (Group PL). The FN mothers were taller, weighed more before pregnancy and immediately before delivery, and had a greater BMI, compared with that of the FL group. The FN group weighed more immediately before delivery and had a greater BMI than that of the PN Group, while the FL group mothers were shorter and weighed less before pregnancy than those of the PL group. Regarding lifestyle, the FN group was higher than Group FL, and Group PN had a higher percentage of those who took breakfast every day before pregnancy and those who did not smoke.

Conclusions:

The reduction in gestational weeks and birthweight were strongly affected by the smoking habit of the mothers. In addition, it was suggested that improvement in the number of gestational weeks and birthweight of the infants was also related to regular breakfasts and weight reduction before pregnancy.

102 / #329


POSSIBLE EPIGENETIC ORIGIN OF HYPERCHOLESTEROLEMIA

R. Zorzo1, R. Liberatore1, V. Suen2, A. Honorato1, V. Suazo1 1Universidade de Sao Paulo, Pediatrics, Ribeirao Preto, Brazil, 2Universidade de Sao Paulo, Internal Medicine, Ribeirao Preto, Brazil


Familial Hypercholesterolemia is a genetic disease which may provocate severe outcomes in cardiovascular system, even in pediatric patients. The disease is manifested when at least one of three genes do not work properly. The objective of this study was to identify the methylation patterns of promoter regions of LDLR, APOB and PCSK9 genes in patients with FH phenotype without mutation.

Methods:

The inclusion criteria was the presence of serum LDL levels above 230mg / dL and a negative result for genetic mutations in LDLR, APOB and PCSK9 genes. We tested the methylation status of these genes using MS-HRM technique, resulting in cathegoric results "methylated" or "not methylated". We found 2 CpG islands in LDLR gene, 1 CpG island in APOB gene and 1 CpG island in PCSK9 gene The 3 islands were submitted to methylation analysis. The number of samples was: 199 for island 1 of LDLR gene, 141 for island 2 of LDLR gene, 198 for APOB gene and 185 for PCSK9 gene.

Results:

The results were: Island 1 of the LDLR gene: 74.8% of the samples were methylated; island 2 of the LDLR gene: 100% of the samples were methylated; single island of the APOB gene: no sample (0%) was methylated; single island of the PCSK9 gene: no sample (0%) was methylated.

Conclusions:

The methylation pattern found on genes LDLR and PCSK9 point to a possible epigenetic mechanism involved in the genesis of FH in patients without mutation in related genes. We still intend to do the methylation study on control group to compare the patterns.

103 / #480


THE INFLUENCE OF DIFFERENT INTRAUTERINE ENVIRONMENTS ON THE TELOMERE LENGTH IN NEWBORNS

M. Zubaran Goldani Universidade Federal do Rio Grande do Sul, Pediatric, Porto Alegre, Brazil


Backgrounds and Aims: Telomere length is influenced by genetic and environmental determinants. Objetive The objective was to evaluate the impact of exposure to different intrauterine environments on the telomere length of newborns.

Methods:

Methods: This is a longitudinal observational study using a convenience sample of 223 mothers and their term newborns (>37 weeks of gestational age) from hospitals in Porto Alegre, Rio Grande do Sul (Brazil), from September 2011 to January 2016. Sample were divided into four groups: pregnant women with Gestational Diabetes Mellitus (DM)(n=39), Smokers (TOBACCO)(n=52), mothers with small-for-gestational age (SGA) children due to idiopathic intrauterine growth restriction (n=33) and a control group (n=99). Maternal and newborn genomic DNA were obtained from epithelial mucosal cells. Telomere length was assessed by qPCR, with the calculation of the T/S ratio.

Results:

Results: There was no significant difference in telomere length among groups. We observed a significant correlation between the length of maternal telomeres and length of newborn telomeres (r=0·229; p<0·001). There was no influence of pre-gestational BMI, physical activity and parity on maternal telomeres length, also between birth weight and telomere length of newborns (p>0·05).

Conclusions:

Conclusion: for healthy term newborns the adverse intrauterine environment did not influence telomere length at birth.

104 / #241


THE EFFECTS OF FREQUENCY OF EATING BREAKFAST AND EXERCISING ON PHYSIQUE AND BEDTIME/WAKE UP TIME FOR FEMALE STUDENTS

M. Niinuma Yasuda Women Unversity, Child Education, Hiroshima, Japan


We adopted ,BMI as an indicator of physique, frequency of eating breakfast and exercising to represent diet and exercise, and daily rhythms set by bedtime and wake up time to represent how subjects spend their days and examined the relationships between these variables in order to understand challenges in managing health for female students.

Methods:

We carried out a questionnaire survey on “current and ideal height and weight,” “current health status,” “weekly frequency of eating breakfast and exercising,” and “bedtime and wake up time and hours of sleep” with female students who consented to participation.

Results:

The mean ± SD values for current height and weight were 157.0±4.7 cm and 50.2±6.1 kg respectively. Meanwhile, the ideal values were 159.7±4.2 cm and 48.0±5.1 kg respectively.

Subjects who stated that they were currently healthy tended to have both earlier bedtimes and wake up times.

Those who “do not eat” breakfast had a lower ideal BMI and both later bedtimes and wake up times .

As frequency of exercise increased, BMI increased, wake up time was earlier, and hours of sleep tended to be shorter.

Conclusions:

Going to sleep and waking up early promoted health while eating breakfast maintained a higher BMI, thus it is best to be active in the morning. Further, exercise should be incorporated into daily activities for self-management of health and weight

The importance of attention (awareness) to diet, exercise, and sleep in one’s daily activities was suggested for managing health as indicated by individual weight compared to height

106 / #429


COMPARATIVE STUDY ABOUT WASTE MANAGEMENT AND THE USE OF BIOSECURITY MEASURES OVER THE YEARS

D. Selfo Univesity Of Vlora, Nursing Department, Vlore, Albania


Health care waste is every waste that is gained during the diagnose, treatment or immunization of people or animals, whether it is dangerous or not. WHO has evaluated that 75% of the produced waste is not dangerous and only 25% is considered as dangerous. WHO has also classified the hospital waste into: infective, sharp, pathological, radioactive, chemical, pharmaceutical and general waste.There are 6 kinds of containers for management: black, green, yellow, red, brown and blue containers. Aim of the study: this study is recognizing the way of managing the hospital waste and the relationship evaluation between medical staff’s knowledge, which is related to the safe execution of the work procedures and the number of biological risk accidents.Also make comparison with previous years.

Methods:

Comparative study

Results:

In this study there was noticed more awareness from the health staff about managing the hospital waste and use of bio-security measures. In 2013, 56% managed hospital waste and used bio-security measures regularly. In 2015, 65-75% applied this procedures regularly.In 2017, 87% managed hospital waste and used bio-security measures regularly.The most endangered pavilions have been surgery and pediatrics. About 50% of the accidents have happened because of drillings. In 2017 the number of the accidents has been low around 20%.The least endangered pavilion has been ORL.Waste management and use of bio-security measures affect significantly at health staff welfare.Working in turns trainings and education level also affect.

Conclusions:

Waste division is a key step to the reduction infections spreading .Use bio-security measures is essential during hospital waste management.

107 / #442


COMPLEMENTARY FEEDING KNOWLEDGE, ATTITUDES AND PRACTICES OF PEDIATRIC RESIDENTS: DO WE NEED TO CHANGE THE CURICULLUM?

T. Prawitasari, S. Yullyana Faculty of Medicine, Universitas Indonesia, Department Of Child Health, Jakarta, Indonesia


Background: Despite known as main competency for medical doctor, infant feeding practice continuous to challenge many physicians in-training, especially residents of pediatric. In a continuing attempt to improve the curriculum, we set the study to explore complementary feeding knowledge, atittude and practice among pediatric residents and their needs to meet the gap.

Methods:

A self-administered survey and focus group discussion were conducted. Eighty two participants response to the questionnaires survey and twenty of them participated in focus group discussion.

Results:

Participants were primarily female (71%), married (57%), has no child (61%), first or second year of residency (63%). Most of them know about the appropriate time to introduce solid food (89%), and safety issues (88%), but have minimal knowledge of nutrient adequacy (74%) and properly fed method (68%). Female residents tend to have higher knowledge about feeding practice (p=0.049; CI 95% 1.002-9.173), and stage of their residency affects the practices (p=0.010; CI 95% 1.428-13.382). Most of participants know about the reason for early initiation of complementary feeding, as well as the consequences of delayed it. There are inadequacy of practice and feedback during junior residency phase, lack of self-confident to counsel the parents due to limited knowledge about nutrient contents and adequacy, along with feeding process and interaction.

Conclusions:

This study indicate the need of more focused and applied module about optimal feeding practices, especially during first year of residency on topics related to complementary feeding.

109 / #606


GROWTH IN PRIMARY IMMUNE DEFICIENCIES: ARAB DATA

N. Boutrid1,2, H. Rahmoune1,2, A.A. Bousfiha3 1University Hospital of Setif, University of Setif-1, Pediatrics, Setif, Algeria, 2Genetic, Cardiovascular & Nutritional Diseases Laboratory, Setif-1 University, Medecine, Setif, Algeria, 3University Hassan II, Medecine, Casablanca, Morocco


In Primary immunodeficiencies (PIDs), growth delay is frequent and ranges from 11.2% to 28%

We cite different data from some Arab countries and compare it to international reports

Methods:

We report the high frequency of stunting/growth delay in Algeria, Egypt and Tunisia according to various reports of recent years

Results:

- By analytic descriptive retrospective study (2002–2016) for PID and short stature, the algerian cohort encompassing all patients with PID diagnosed up to december 2016 (519 patients, mainly children) depicted failure to thrive in 38% of patients ( the second most important clinical finding)

- Pr.Bejaoui’s team at Tunis, also by retrospective study (1987–2015), estimated at 27% the total PID children exhibiting a growth delay: PID with height < –2 standard deviation (518 PID patients, 123 with short stature )

-Dr Reda, in Egypt, reported 40% of PID patients that present a failure to thrive

Conclusions:

During PID, several causes may lead to children’s short stature/stunting:

-Classical symptoms of severe and/or recurrent infections with related increase in energy requirements, hypercatabolism and deficient growth.

-Digestive involvement and malabsorption due to protracted diarrhea

-Syndromic association of PID and growth delay/short stature (Stat 5b deficiency)

Monitoring anthropometric and nutritional parameters (along to an accurate diagnosis) would ameliorate such complications.

110 / #612


PECULIAR CHRONIC DIARRHEA: KABUKI SYNDROME

N. Boutrid1,2, H. Rahmoune1,2, N. Djerrad3 1Setif-1 University, Paediatrics, Setif, Algeria, 2Genetic, Cardiovascular & Nutritional Diseases Laboratory, Setif-1 University, Pediatrics, Setif, Algeria, 3University of Algiers -1, Medecine, Algiers, Algeria


Peculiar conditions that can mimick celiac disease are frequent, but some rare genetic disorders deserve a particular attention.

We present a very rare Kabuki Syndrome case report

Methods:

A 12-year-old child diagnosed since age 5 as celiac , presents a particular facial dysmorphism, mental retardation and a pronounced visual impairment. . Neurological functional and imaging investigations did not find a specific stigma, but ophthalmology visit reveals a severe bilateral optic atrophy. The syndromic features lead to the diagnosis of the extremely scarce Kabuki Syndrome.

Results:

According to the last 2018 Kabuki syndrome international consensus diagnostic criteria , our patient fulfill the definite diagnosis items: developmental and intellectual disability along with typical dysmorphic features . Short stature is also present and probably multifactorial

Conclusions:

If the causative pathogenic is identified, prenatal testing and preimplantation genetic diagnosis for KS are possible.

Fortunately, targeted treatments for this KS are currently being developed

111 / #660


ANTHROPOMETRIC INDICATORS AND BODY COMPONENT COMPOSITION IN THE DIAGNOSIS OF NUTRITIONAL STATUS DISORDERS IN CHILDREN WITH CEREBRAL PALSY.

R. Rakhmaeva, V. Aupova, E. Ahmadullina, A. Kamalova Kazan State Medical University, Hospital Paediatric, KAZAN, Russian Federation


Children with cerebral palsy (CP) are at high risk of nutritional disorder development. The aim of our study is to identify nutritional disorders in children with CP according to anthropometry and bioelectrical impedance analysis.

Methods:

The study included 97 patients (57% boys and 43% girls) with spastic forms of CP aged 2 to 17 years. We assessed weight, height, BMI of all patients and body composition according to bioelectric impedance (BIA) in 78 children. The patients were classified according to the form of CP and the results of GMFCS scale.

Results:

In our study population 30/97 subjects (31%) had GMFCS-I, 27/97 subjects (28%) had GMFCS-II, 9/97 subjects had GMFCS-III (9%), 20/97 subjects had GMFCS-IV (21%), 11 subjects had GMFCS-V (11%). The mean age of children was 8,5 years. The results of anthropometry revealed 20 children (20.6%) with mild malnutrition, 14 children (14.4%) with moderate malnutrition, 10 children (5.6%) with severe malnutrition and 10 children (10%) with 1st degree obesity. 36/43 children with good anthropometric parameters had alterations in the component composition of the body, namely an increase in fat mass, a decrease in active cell mass and muscle mass.

Conclusions:

Thus, nutritional status disorders were detected in 93% of children with cerebral palsy. All these children need competent nutritional correction. Dates of bioelectrical impedance analysis have a high informative value, the results of which allow to identify 40% of nutritional status disorders in children with cerebral palsy.

112 / #673


NUTRITIONAL PROFILE IN HOSPITALIZED CHILDREN IN WEST NUSA TENGGARA PROVINCIAL GENERAL HOSPITAL, LOMBOK, INDONESIA

J. Febrila1, J. Tengkawan1, T. Karuniawaty2,3, A. Septisari1, Z. Ihyauddin1 1Capella Project, Pediatric, Jakarta, Indonesia, 2West Nusa Tenggara Provincial Hospital, Pediatrics, Mataram, Indonesia, 3Mataram University, Faculty of Medicine, Pediatrics, Mataram, Indonesia


Malnutrition has short and long term consequences in growth, developmental and global health of children. However, nutritional status in hospitalized children is often ignored. The aim of this study was to describe nutritional profile in hospitalized children and its association with chronicity of diseases in West Nusa Tenggara Provincial General Hospital.

Methods:

This was a retrospective study and the data collected from 220 children hospitalized during January – April 2018 in Pediatric Ward in West Nusa Tenggara Provincial General Hospital. Anthropometric measurement was collected at hospital admission and at discharge. Nutritional status of weight-for-height, height-for-age, and weight-for-age, were calculated using nutrisurvey application from World Health Organization (WHO).

Results:

Most of the patients were male (60%), underweight (45.4%), stunted (61.4%), and almost one third had poor nutritional status (weight for height) (27.2%). Length of stay varied between 1 to 23 days. Using chi square, we found nutritional status (weight for age and weight for height) was associated with presence of underlying chronic disease (p=0.000 and p=0.000) and longer length of stay (p=0.018 and p=0.021).

Conclusions:

Poor nutritional status among hospitalized children is still very prevalent. It is associated with chronicity of the diseases and longer length of stay. Anthropometric measurement and nutritional screening upon admission, at discharge and follow up in outpatient department are crucial. Nutrition management for preventing hospitalized children to fall into malnutrition is also as important as treating their underlying diseases.

113 / #674


AN ASSESSMENT REGARDING THE INCIDENCE OF MALNUTRITION RELATED TO DIGESTIVE DISEASES IN A TERTIARY PEDIATRIC ROMANIAN CENTER

B. Rotaru1, S. Strat1, G. Paduraru1,2, L. Bozomitu1, G. Ghiga2, N. Gimiga1,2, S. Diaconescu1,2 1"Sf. Maria" Children's Hospital, Pediatric Gastroenterology, Iasi, Romania, 2Grigore T Popa University of Medicine and Pharmacy, Pediatrics, Iasi, Romania


Romania experiences a malnutrition burden, especially among its pediatric population. According to the latest data, the national prevalence of under-five stunting is 12.8 %, which is less than the global average but is still a significant percentage. North Eastern Romania gathers a population of 3302217 people, a quarter of whom being children.

Methods:

We analyzed registered data regarding malnutrition due to digestive diseases admitted in a in a tertiary pediatric center in a period of three years (2016-2018).

Results:

Our hospital serves an average of 27,000 children per year. An average of 2643children/year were reffered to the gastroenterology department. Between 2016 and 2018 we registered a number of 6619 ( 2817 in 2016, 1833 in 2017 and 1969 in 2018 ) cases of malnutrition, which represents 8.16% of all hospitalised cases.

Conclusions:

In our region we found an incidence of malnutrition lower than the incidence reported in the pediatric population of Romania. However, considering the fact that the poverty rate in North Eastern Romania is estimated at about 33.4% with 55% of the population living in rural areas and that in our country one third of children from rural areas suffer from malnutrition, we presume that the real incidence is higher.

Severe and acute malnutrition rates on geographic coverage are still unreported in Romania, especially in the North Eastern Region, which is considered the poorest region in the country. Data reporting remain mandatory in order to implement efficient social and medical strategies.

114 / #682


ASSOCIATION OF NUTRITIONAL STATUS AND DIARRHEA AMONG FILIPINO CHILDREN AGES 0-5 YEARS OLD

K. Abanes Dr. Jose N. Rodriguez Memorial Hospital and Sanitarium, Paediatrics, Caloocan City, Philippines


Background: Nutrition and diarrhoea are one of the factors that affect child’s health. A child’s nutrition may have significant influence in diarrheal episodes or vice versa. Other factors may also influence likelihood of more diarrheal episodes and moderate to severe wasting in children.

Objective: Determine the association of nutritional status and diarrheal episodes among Filipino children ages 0-5 years old

Methods:

Method: Cross-sectional study

Main Outcome Measures: Growth indicator status, diarrheal episodes, 24-hour food recall.

Results:

Out of the 180 children age 0-5 years old, majority of the participants are moderate to severely underweight and stunted (mostly 1-2 and 3-5 years age group), 18.3% has minimal wasting and only 4% has chronic malnutrition. After adjusting for age, occurrence of diarrheal episodes are significantly influenced by age (highest among <1 year old, 65%), severe wasting (increased by 3.55 times), and early complimentary food (<6 months, increased by 3 fold). Protective factors include updated immunization and breastfeeding duration of >6 months. Likewise breastfeeding decrease the odds of moderate to severe wasting by 4.55 times (AOR=–4.55, p=0.023) and 5.56 times (AOR=–5.56, p=0.010).

It is notable that there were no diarrheal episode among those with normal WFA, mild underweight, and normal HFA. However, 100% of those who are moderately underweight and 34.27% of those who are severely underweight suffered from diarrhea within the last 6 months.

Conclusions:

Conclusion: This provided pertinent information on current nutritional status and diarrheal episodes in the population. A nutritional program must include repeat assessment in the population after a suitable program.

115 / #688


MATERNAL FAT-SOLUBLE VITAMIN LEVELS DURING PREGNANCY AND THEIR ASSOCIATION WITH INFANT BIRTH WEIGHT: A RETROSPECTIVE COHORT STUDY IN CHINA

W. Yang, Q. Zhou Peking University, School of Public Health, Department Of Maternal And Child Health, Beijing, China


Fat-soluble vitamins during pregnancy are of vital importance for fetal growth and development. The present study was the first, and a large-scale retrospective cohort, conducted in Beijing, China to explore the association between vitamin A, E and D status during pregnancy and infant’s birth weight.

Methods:

Data were derived from the electronic information system in the Tongzhou Maternal and Child Health Hospital of Beijing, China. A total number of 19,640 women with live-born singleton deliveries were included in the study. Maternal serum vitamin A, E and D levels were measured during pregnancy. Logistic regression was performed to estimate the association between the vitamins status and low birth

weight (LBW) and macrosomia after adjusting for potential confounders.

Results:

Within the adequate concentration range, there was a positive association between vitamin E levels and macrosomia in 2nd (OR: 1.228, 95% CI: 1.059~1.425, per SD increase) and 3rd (OR: 1.299, 95% CI: 1.038~1.626, per SD increase) trimester. Vitamin A level was positively associated with LBW in women classified as adequate in 2nd (OR: 1.369, 95% CI: 1.082~1.731, per SD increase) and 3rd (OR: 1.851, 95% CI: 1.335~2.568, per SD increase) trimester, and negatively associated with macrosomia in 2nd (OR: 0.827, 95% CI: 0.733~0.933) and 3rd (OR: 0.724, 95% CI: 0.581~0.901) trimesters. There was no significant association between vitamin D level in each trimester and LBW or macrosomia.

Conclusions:

High vitamin E levels during pregnancy might lead to macrosomia. Maintaining a moderate level of vitamin A during pregnancy might be beneficial to achieve optimal infant birth weight.

116 / #689


NUTRITIONAL SUPPORT FOR LACTATING WOMEN WITH OR WITHOUT AZITHROMYCIN FOR INFANTS COMPARED TO IMPROVE SIX-MONTH GROWTH OUTCOMES AMONG INFANTS OF SLUMS AT KARACHI,PAKISTAN-RANDOMIZED CONTROLLED TRIAL

A. Muhammad1, N. Yazdani1, M.I. Nisar2, F. Jehan2, Y. Shafiq1 1VITAL Pakistan Trust, Mnch, Karachi, Pakistan, 2Aga Khan University, Pediatrics And Child Health, Karachi, Pakistan


Globally, about 45% of under-five deaths are attributable to childhood malnutrition mainly in LMICs. Early 6 months of infants life are crucial for growth - period affected by maternal undernutrition and resultant poor quality of breastfeeding. This trial aim to assess the efficacy of balanced energy-protein (BEP) diet in a proposed dose to undernourished lactating women for at least 6 months of lactation, alone or in combination of single dose of Azithromycin, on lenght velocity as primary, and weight velocity as secondary outcome.

Methods:

Factorial, randomized controlled, open-label, community based trial (blinded at outcome assessment), with arms detail as: 'Arm A'-control arm where LW randomized to standard counseling only; 'Arm B'-LW randomized to receive 2 sachets per day of diet named as Afzaaish (locally produced) which is 75 gm per sachet until 180 days of infant age, and 'Arm C'-LW randomized to receive same BEP plus infant to receive a single stat dose (20mg/kg orally) at 42 day (sample size =319 per arm). Sub-sample on maternal and infant stool, blood, and breast milk of LW are collected to aassess biomarkers of nutrition and other markers of significance.

Results:

Until October 30, 2019, N=1552 LW approached at birth outcome and screened for Mid-Upper Arm Circumference (MUAC), n=1069 had MUAC less than 23.0 cm and n=604 consented and enrolled after eligibility assessments (rest had exclusion/s). So far 36% of enrolled participants completed 6 months following (8.7% lost-to-follow-ups).

Conclusions:

The findings of trial may have significant public health implications to address stunting and wasting in LMICs.

117 / #703


NUTRITIONAL SUPPORT AND PROPHYLAXIS OF AZITHROMYCIN FOR PREGNANT WOMEN TO IMPROVE BIRTH OUTCOMES IN THE PERI-URBAN SLUMS OF KARACHI, PAKISTAN – A RANDOMIZED CONTROLLED TRIAL

A. Muhammad1, A. Khan2, F. Jehan2, M.I. Nisar2, Y. Shafiq1 1VITAL Pakistan Trust, Mnch, Karachi, Pakistan, 2Aga Khan University, Pediatrics And Child Health, Karachi, Pakistan


Maternal under nutrition plays a critical role in the etiology of poor perinatal outcomes such as low birth weight. Aim of this trial is to address the impact of nutritional supplementation on pregnant women by using fortified balanced energy, protein supplement alone or in combination with prophylactic use of Azithromycin OR Chloine and Nicotinamide, on birth weight as primary outcome, and birth lenght as secondary outcome, to be assessed within 72 hours of birth outcome.

Methods:

Factorial, open labeled, community based randomized controlled trial in a peri-urban area of Karachi Pakistan is underway (blinded aylt outcome assessment). Arms details are: 'Arm A'- where pregnant women (PW) randomized to routine ANC care only; 'Arm B' -PW randomized to balanced energy-protein diet (BEP) 2 sachet of 75gm/day until birth outcome; 'Arm C'-PW randomized to same BEP plus 2 doses of oral Azithromycin (2gm each) at 20 and 28 weeka od gestation; and 'Arm D'-PW randomized to same BEP plus daily oral supplement of Choline (450mg) and Nicotinamide (100mg) (sample size=367 per arm). Further, we will be collecting maternal blood sample to assess different biomarkers, and at later stage the infant will be assessed for neurodevelopment at 6 and 12 montha of age - using HINE and Mullen toola of neurodevelopment and MRI imaging).

Results:

Until October 30, 2019, n=221pregnant women were identified within gestational age of 8 to less than 19 week, and 123 women were consented and enrolled in the trial.

Conclusions:

Findings has potentially great implications to address maternal and resutant child malnutrition

118 / #706


PREVALENCE OF IODINE DEFICIENCY DISORDERS AMONG SCHOOL CHILDREN AGED 8-10 YEARS OLD IN SAUDI ARABIA MINISTRY OF HEALTH KINGDOM OF SAUDI ARABIA

B. Elbashir, M. Aldakheel Ministry of Health, Nutrition Department, Riyadh, Saudi Arabia


Iodine is essential for healthy brain development in the fetus and young child. Iodine deficiency negatively affects the health of women, economic productivity and quality of life. It is cause of preventable mental impairment throughout the world [1].

Objective

This study was conducted to assess prevalence of IDD Among School Children Aged 8-10 years and determine the household coverage with iodized salt , and to determine adequacy of salt iodization.

Methods:

Study population and sampling

School children aged 8–10 years was the target population of this survey. Three stage random sampling was employed. A school-based cross-sectional study using WHO 30-cluster survey methodology. Every cluster represented a pair of schools; a male school and its neighbor female one, since schools in Saudi Arabia are unisex. Children were clinically examined for goitre, urine and household salt samples were collected to estimate urinary iodine concenteration (UIC) and iodine content in salt.

The data were collected and analyzed using Statistical Package for Social Sciences (SPSS).

Results:

The overall goitre prevalence at the national level among 4 016 children was 4.2%. The median UIC of samples was 133 μg/L. Analysis of 4242 salt samples using qualitative rapid test kit revealed that 68.7% were iodized with significant regional differences (p < 0.001). iodine content of ≥15 ppm was found in 95.2% of samples.

Conclusions:

The overall goitre prevalence at the national level among 4 016 children was 4.2%. A well-functioning monitoring system at factory level and surveillance system are crucially needed to ensure proper salt iodization and intake.

119 / #718


ACHIEVING EQUALITY IN CHILD GROWTH IN AUSTRALIAN ABORIGINAL CHILDREN

S. Hanieh, G. Gurruwiwi, R. Dhurrkay, V. Gondarra, B.-A. Biggs University of Melbourne, Peter Doherty Institute For Immunity And Infection, Melbourne, Australia


Chronic undernutrition remains endemic for young children living in remote Aboriginal communities in Australia, and is a major impediment to human and economic development. To accelerate achieving growth equality in young Aboriginal children, a major shift in public health strategies is required that is informed by a better understanding of the biological, cultural and social underpinnings of impaired child growth; and recognition of community voices that promote an Aboriginal worldview.

Methods:

In a remote community in Australia we conducted a survey of all young children (0-2 years) and their carers. This community driven project used the power of community voices to address prevailing challenges to optimal child growth using quantitative and qualitative methods.

Results:

There was a high prevalence of stunting (18.6%). Food insecurity and enteric pathogen infection were common. Infection with two or more pathogens was negatively associated with growth. Other less tangible factors included the effects of family’s experience of adversity over previous generations. Ownership over health, recognition of Aboriginal learning; and embedding connection to culture, land, and community was identified as a fundamental step in the road back to health.

Conclusions:

Using a participatory-action research framework (focusing on locally defined priorities and perspectives) in conjunction with community members and key stakeholders, we have used findings from the project to open a dialogue about optimal nutrition in the first 1000 days of life. This will be a stepping stone to developing a coordinated and sustainable multidisciplinary program to address undernutrition in children that maybe generalizable to other First Nations communities.

120 / #713


FACTORS ASSOCIATED WITH POOR WEIGHT AND HEIGHT GAIN IN CHILDREN WITH CONGENITAL HEART DISEASES FOLLOWED UP BY AN INTERDISCIPLINARY TEAM

B. Talassi, T. Konstantyner, H. Leite EPM/UNIFESP, Pediatrics, São Paulo, Brazil


Knowing the clinical and epidemiological factors associated with insufficient weight and height gain is essential for optimizing nutritional support in children with chronic diseases. We aimed to identify the variables associated with the poor weight and height gain in children with congenital heart disease (CHD).

Methods:

This is a historical cohort study of 131 children with CHD who were followed up at an interdisciplinary outpatient unit. The outcome was ‘insufficient weight and height gain’, defined as an increase of ≤0.5 in the z-scores of weight for age (WAZ), height for age (HAZ), and body mass index for age (BMIZ) at 12 months of follow-up, according to the WHO standards. To identify factors associated with insufficient gain of the anthropometric indices, multivariable logistic regression models were applied.

Results:

After follow-up, 55.7% of patients did not achieve a greater than 0.5 increase in WAZ, 77.1% in HAZ and 45.8% in BMIZ. Attending less than five visits during the follow-up was associated with insufficient gain of WAZ (OR=7.78, p<0.001), HAZ (OR=10.79, p<0.001), and BMIZ (OR=2.54, p=0.025). Failure to undergo cardiac surgery and age ≥12 months were associated with insufficient gain of WAZ (OR=3.95, p=0.010 & OR=3.60, p=0.011) and BMIZ (OR=2.81, p=0.034 & OR=3.39, p=0.010), and low income was associated with an insufficient gain of HAZ (OR=4.11, p=0.020).

Conclusions:

These four charactheristics should be in focus to ensure the nutritional recovery of children with CHD followed up by an interdisciplinary team, independently of the initial nutritional status, sex, and type of heart defect.

121 / #404

E-Poster Viewing CHILDHOOD & ADOLESCENCE 08-27-2020 21:30 - 22:00

CONTRIBUTION OF HOME-GROWN SCHOOL FEEDING PROGRAMME TO DIETRY DIVERSITY AND ITS RELATIONSHIP WITH NUTRITION STATUS OF PRIMARY SCHOOL PUPILS IN ILE-IFE, SW, NIGERIA

A. Adegbenro, M. Olodu, M. Maitanmi Obafemi Awolowo University, Community Health, Ile-Ife, Nigeria


The study assessed the contribution of home-grown school feeding to the dietary diversity among primary school pupils in Ile-Ife. The relationship between dietary diversity and nutritional status of the pupils was also determined.

Methods:

The respondents were 411 volunteered pupils randomly selected from the study population using multistage sampling technique and pretested, interviewer-administered questionnaire was used to elicit response from them. A 24- hour dietary recall was used to determine the dietary diversity using 14 food groups. Nutritional status was determined using both anthropometric measurement and World Health Organisation (WHO) anthroplus. Univariate and bivariate analysis were carried out and the level of significance was set at P< 0.05.

Results:

The results showed that the mean dietary diversity score (DDS) in this study was 4.58 ± 1.07. Majority (67.2%) of the pupils had medium dietary diversity score. Organ meat and vitamin-A rich fruits were not consumed by the respondents. Additionally, DDS of the children in the high DDS group increased from 1 (0.2%) to 64 (15.8%) with a percentage increase of 15.6% when the Home Grown school feeding (HGSF) meal was added to it especially, as regards egg and fleshy meat food groups. There was a significant relationship between dietary diversity score (DDS) and stunting (x2 = 9.611, p= 0.002).

Conclusions:

The respondents had medium dietary diversity score and that the HGSF provides one meal per day for the primary school pupils but does not meet the recommended adequate nutrients (30% of DRI) of the pupils.

122 / #406


CONTRIBUTION OF HOME-GROWN SCHOOL FEEDING PROGRAMME TO DIETARY DIVERSITY AND ITS RELATIONSHIP WITH NUTRITIONAL STATUS OF PRIMARY SCHOOL PUPILS IN ILE-IFE, SW,NIGERIA

A. Adegbenro, M. Maitanmi, M. Olodu Obafemi Awolowo University, Community Health, Ile-Ife, Nigeria


The study assessed the contribution of home-grown school feeding to the dietary diversity among primary school pupils in Ile-Ife. The relationship between dietary diversity and nutritional status of the pupils was also determined.

Methods:

The respondents were 411 volunteered pupils randomly selected from the study population using multistage sampling technique and pretested, interviewer-administered semi-structured questionnaire was used to elicit response from them. A 24- hour dietary recall was used to determine the dietary diversity using 14 food groups. Nutritional status was determined using both anthropometric measurement and World Health Organization (WHO) anthroplus. Univariate and bivariate analysis were carried out and the level of significance was set at P< 0.05.

Results:

The results showed that the mean dietary diversity score (DDS) in this study was 4.58 ± 1.07. Majority (67.2%) of the pupils had medium dietary diversity score. Organ meat and vitamin-A rich fruits were not consumed by the respondents. Additionally, DDS of the children in the high DDS group increased from 1 (0.2%) to 64 (15.8%) with a percentage increase of 15.6% when the Home Grown school feeding (HGSF) meal was added to it especially, as regards egg and fleshy meat food groups. There was a significant relationship between dietary diversity score (DDS) and stunting (x2 = 9.611, p= 0.002).

Conclusions:

The respondents had medium dietary diversity score and that the HGSF provides one meal per day for the primary school pupils but does not meet the recommended adequate nutrients (30% of DRI) of the pupils.

123 / #343


A CROSS-SECTIONAL STUDY ON THE NUTRITIONAL STATUS OF SCHOOL GOING CHILDREN FROM URBAN AND RURAL POPULATIONS OF PAKISTAN

A. Ahmed Government College University, Faisalabad, Institute Of Home And Food Sciences, Faisalabad, Pakistan


Malnutrition is a globally increasing public health concern among children, and Pakistan is no exception. Malnutrition affects number of school children influencing their health, growth, development and academic performance.

Methods:

The tenet of the current cohort study was to assess the nutritional biomarkers of school going children of age 12-15 years resulting in stunting, underweight, overweight, bone deformities and other health disparities in nutritionally deprived urban and rural populations of Pakistan. A sample size comprising of 180 school going children was stipulated from the targeted urban and rural populations. The experimental subjects were evaluated by hematological assessment through laboratory standard procedures.

Results:

The fallouts of investigation unveiled that both rural and urban populations were experiencing nutritional challenges however; on account of awareness paucity the rustic population was nutritionally more compromised. Hematological tests elucidated 16.7% and 7.8% cases for high glucose level, 35.6% and 27.8% cases for low hemoglobin levels, 87.8% and 97.8% cases for normal erythrocyte sedimentation rate (ESR), 14.4% and 15.6% cases for low calcium indices, 12.2% and 4.4% high white blood cell count (WBC), 20% and 14.4% low red blood cell count, 71.1% and 72.2% normal mean corpuscular volume (MCV), 76.7% and 74.4% low hematocrit (HCT) values, 68.9% and 75.6% mean corpuscular hemoglobin concentration (MCHC) among the rural and urban populations respectively.

Conclusions:

The above mentioned outcomes can serve as a way forward for policy and law maker institutions to curtail or curb the possible barricades in the way of healthy nutritional status in these areas.

124 / #573


IMPROVEMENT OF NUTRITION OF CHILDREN OF EARLY AGE IN THE REPUBLIC OF KARAKALPAKSTAN

D. Akhmedova1, N. Zakirova2, N. Ishniyazova2, N. Akhmedova2 1Republican Specialized Scientific and Practical Medical Center of Pediatrics, Director, Tashkent, Uzbekistan, 2Tashkent Pediatric Medical Institute, Department Of Pediatrics, Tashkent, Uzbekistan


Background. Efficient nutrition is the most important condition for preserving the health of children and their optimal state and neuropsychic development, especially in conditions of ecological distress.

Aim: to improve nutrition and the prevention of micronutrient insufficiency in young children in the Republic of Karakalpakstan.

Methods:

The study involved 600 children aged 6 to 24 months living in the Republic of Karakalpakstan. Among children, anemia was screened. In order to prevent and treat micronutrient deficiency among the examined children, Sprinkles multivitamin supplement is used, which is a mixture of micronutrients in the form of visible ones intended for enriching home-made products.

Results:

The results of the studies revealed the presence of mild and moderate anemia in 105 (17.5%) children. These children underwent home fortification supplemented within 2 months. A second study after taking the supplement revealed a 40% reduction in the number of children with iron deficiency anemia. The level of hemoglobin in children 6-12 months increased by 28%, in children 12-24 months - by 35%. Use of micronutrient goodness 12.5% of girls and 18% of boys aged 6-12 months, 18.5% of girls and 14% of boys aged 12-24 months showed an increase in body weight gain. Body length indicators also improved in 6.8% and 8% of girls, 15.5% and 8% of boys, respectively. Parents note an improvement in appetite and a decrease in the incidence of children.

Conclusions:

Home fortification with Sprinkles multivitamin supplement allows reaching indicators indicating the development and nutritional status of young children.

125 / #629


OMEGA 3 IS A PROMISING TREATMENT FOR CHILDREN WITH AUTISM: PRESENTATION OF CASE SERIES OF OMANI CHILDREN WITH AUTISM

Z. Al Mukhaini Diwan of Royal Court Medical Services, Curative Services, Al Rusayl, Oman


Background: Omega-3 fatty acid is known to have positive effect on cognitive function and brain development. Its recommended to give children enough amount of it for their brain development and their general health. Autism is a type of neurodevelopmental disorder that affects person’s communication and functionality including different brain function.

Aim: The idea of this study is to offer children with Autism a supplementation of omega-3 in a routine recommended dose for children for its known benefit for neurocognitive function and hence possible benefit to improve Autism symptoms.

Methods:

Method: Eight children (aged 3 -9 years, 5 boys and one girl) with autism attending single centre were offered omega-3. Six children started to take the recommended dose, while two refused. Parents advised to continue the rehabilitation sessions and the special educational support their children receive.

Results:

Results: All six children improved in their eye contact, communication, language development, learning ability in both language and simple calculation, and in their concentration and memory. Their hyperactivity and temper tantrum disappeared. The younger to start the intervention with omega-3 the better the outcome. One of these children is on Omega-3 for six years since age 2.8 years and now his Autistic symptoms disappeared. He is functioning normally and doing well at school.

Conclusions:

Omega-3 has great potential in treating children with Autism. Omega-3 should be used in addition the behavioural therapy.

126 / #280


PREVALENCE OF THINNESS AND ITS IMPACT ON HEIGHT VELOCITY IN SCHOOLCHILDREN

H. Narchi1, A. Alblooshi1, M. Altunaiji2, N. Fares2, L. Alshehhi2, H. Alshehhi2, A. Almazrouei2, A. Alsuwaidi1, A.-K. Souid1 1United Arab Emirates University, Department Of Pediatrics, Al Ain, United Arab Emirates, 2Ministry of Health, School Health Team, Ras Al-Khaimah, United Arab Emirates


Contrary to childhood obesity, studies involving thin children are much fewer, especially in modernized societies. In addition, most reports do not address the impact of childhood malnutrition on height velocity.

This study aims to ascertain the prevalence of thinness and its influence on height velocity in a cohort of schoolchildren in United Arab Emirates (UAE).

Methods:

Weight and height were measured in 29,410 (50.5% females) schoolchildren in UAE, as part of the annual health assessment in academic year (2014–2015). Body-mass index (BMI) was calculated using the standard formula, and was classified as normal, thinness, overweight or obese using cutoffs established by International Obesity Task Force (IOTF), World Health Organization (WHO), and Centers for Disease Control (CDC).

Results:

Ninety-two percent of the children were UAE citizens living in urban areas; median age was 10.2 y (range, 3-19). Using IOTF scale, one-quarter of female and male children 4-6 y and one-third of children 7-9 y were thin (BMI ≤18.5 kg/m2). Thereafter, thinness was less prevalent, reaching 8-10% in the adolescents. Group peak height velocity (calculated after the age of 10 years) was delayed by one to three years in thin children, regardless of their gender, and was higher in children with excess body fat than that in those with low body fat.

Conclusions:

The prevalence of thinness was the highest (25 to 33%) in children between 4 and 9 years of age and their peak height velocity after the age of 10 years was delayed by one to three years when compared to the other children.

127 / #434


COMPARING THE EFFICACY OF NUTRITIONAL SUPPLEMENTATION ON LINEAR GROWTH AND WEIGHT GAIN IN LATE CHILDHOOD, A LONGITUDINAL STUDY.

N. Alaaraj, M. Itani, C. Jour, F. Alyafei, A. Soliman Hamad General Hosiptal, Pediatric, DOHA, Qatar


Background:There is a lack no longitudinal studies on the efficacy of liquid nutritional supplement (NS) for undernourished children (5: 12 years).

Aim:

We evaluated growth of 30 underweight children without systemic illness who were put on formula supplements (1cal/1 ml) versus 1.5 cal/1ml) for one year.

Methods:

Underweight children (BMISDS < -1.5, age = 9 ±4 years), were divided into two groups according to the type of NS and advised to take 500 cal/d. Group 1 (N=10) received (1cal/1 ml) formula and Group 2 (N=20) received 1.5 cal/1ml formula. We recorded their WT, HT, BMI, weight gain /day (WGD), HSDS, GV & IGF-1 for a year.

Results:

Age

(yr)

WGD1 HtSDS1

BMI

SDS1

GVSD1 HtSDS2 BMISDS2 WGD2 GVSD2 HtSDS3

BMI

SDS3

WGD 3

GVSD3

Group 1

8.9 5.6 -2.3 -1.1 -1.1 -2 -1.2 8.7 0.4 -1.7** -1.2 9.8 1.2**

Group 2

10.1 5.7 -2.1 -1.3 0.4* -2.1 -1 14.1* 0.1 -1.9** -1.2 11.6 1.3**

1 = first , 2= 6 months, 3 = 1 y on NS. * p<0.05 after vs before NS, ** P<0.05 among groups.

WGD, GV and HSDS increased significantly during the year of NS in both groups. The WGD and BMISDS increased more in the 1.5cal/1ml group. A significant increase in the BMISDS was observed in group2. IGF-I increased significantly in both groups

Conclusions:

NS improved growth of underweight children without systemic illness. There was a significantly better WGD in the group on (1.5 cal/ 1ml formula) compared to those on 1cal/ml formula.

128 / #484


IMPACT OF ORAL NUTRITIONAL SUPPLEMENTS ON GROWTH OUTCOMES IN UNDERWEIGHT OLD CHILDREN (5: 12 YEARS) WITH NO SYSTEMIC DISEASE.

A. Soliman, M. Itani, C. Jour, S. Elsiddig, F. Alyafei, N. Alaaraj Hamad General Hosiptal, Pediatric, DOHA, Qatar


Liquid nutritional supplements (ONS) are used successfully in the management of underweight infants and young children with undernutrition. However, their use in healthy old children and adolescents with underweight and/or poor weight gain has not been reported. This study describes the effect of OSN on nutritional outcomes in healthy underweight children and adolescents with no systemic illness.

Methods:

20 underweight children (BMISDS < -1), aged 10.1 ±3.8 years, received ONS (1.5 cal/1ml, 500 kcal/day) in addition to their habitual diet for one year. We recorded their anthropometric measurements including weight, height, BMI, weight gain /day (WGD), height growth velocity (GV), height SDS (HtSDS) for a year.

Results:

WGD and linear GV markedly improved during the year of ONS. After 6 months of ONR, there was a significant increase in the BMISDS and GVSDS. After a year of OSN, GVSDS continued to increase and there was a significant increase in the HtSDS. After OSN, there was a significant decrease in the difference between the HtSDS and their mid parental HtSDS (MPHtSDS).

At presentation After 6 months After 1yr

Age

(yr)

N. WGD1 HtSDS1

BMI

SDS1

GVSD1 HtSDS2 BMISDS2 WGD2 GVSD2 HtSDS3

BMI

SDS3

WGD3 GVSD3

10.1

3.8

20 5.7

-2.1

0.7

-1.3

0.3

-.4*

1.8

-2.1

0.6

-1

0.9

14.1*

10.8

0.08

1.4

-1.8**

0.7

-1.2

1.1

11.6

6.6

1.3**

2.0

Conclusions:

ONS are effective in improving nutritional/growth outcomes in underweight older children and adolescents with slow weight gain and poor appetite who had no systemic illness.

129 / #417


ASSOCIATED FACTORS IN NUTRITIONAL AND DEVELOPMENTAL STATUS OF CHILDREN WITH SEVERELY UNDERWEIGHT HISTORY AFTER FOOD SUPLEMENTATION IN SENTANI, PAPUA.

E. Ameliana1, Y. Devaera2 1Hermina Bekasi Hospital, Pediatric And Neonatal Intensive Care, Bekasi, Indonesia, 2Faculty of Medicine Universitas Indonesia, Child Health, Jakarta, Indonesia


Malnutrition is the major health problem in developing country. It correlated with socio-economic status and educational status of parents. Long term effects of malnutrition are low ability to study and education performance. Sentani is a district of Jayapura Regency in Papua, where as 13.01% of the population classified as poor in 2017. Food suplementation is a program of Primary Health Care (PHC) in Sentani for severely underweight (SU) children. This study aim to see the success of food suplementation in SU children and factors that associated with nutritional and developmental status.

Methods:

This study conducted in Sentani PHC in Papua, between January-August 2018. Samples are children with SU history and had an improvement nutritional status (INS) in 2017. Samples were analyzed for nutritional status (Z-score), developmental score (DDTK), and socio-economic status.

Results:

From 72 SU there were 41 INS children, and only 28 children eligible to be included in this study, most didn’t obtained their normal daily intake (71.4%) and exclusive breastmilk (67.9%). The frequencies of nutrition problem were 21.4% severely underweight, 71.4% severely stunted, 25% wasted and 21.4% had developmental delay. There were statistical significant difference in educational status of mother (ρ = 0.043) and mother’s job with DDTK score (ρ = 0.049), also between economical and nutritional status ( ρ = 0.017 in Weight for Age and ρ = 0.001 in Weight for Height).

Conclusions:

Low socio-economic status of a family will affect the parenting ability of a family and nutritional choice that related with nutritional and developmental status in children.

130 / #194


NUTRITIONAL STATUS IN VEGETARIAN CHILDREN

D. Yasakov1, S. Makarova1, A. Fisenko2, T. Chumbadze1, I. Gordeeva1, O. Ereshko1 1National Medical Research Center of Children's Health, Department Of Preventive Paediatrics, MOSCOW, Russian Federation, 2National Medical Research Center of Children's Health, Directorate, MOSCOW, Russian Federation


The popularity of vegetarian diets has increased in Russia over the past decade. However, the exclusion of different types of animal origin food and inadequate composition of the diet can lead to nutrition deficiency and then can affect physical growth.

Aim of the study – to assess the nutritional status in Russian vegetarian children.

Methods:

We examined 158 children on different types of vegetarian diet. The assessment of anthropometric measurements in vegetarian children was performed using Z-score indexes (Anthro+). The component body composition was studied using bioimpedance analysis.

Results:

Anthropometric indexes were within normal limits in 68.3% vegetarian children. 11 children (6.3%) had low body weight, 17 vegetarian children (10.7%) - overweight. 3 children (1.9%) had low height (HAZ <-2). 24% of vegetarian children had high height. 21 children (13.3%) had mild malnutrition (BAZ > -2 / <-1), 2 children (1.3%) - moderate malnutrition (BAZ > -3 / <-2), 1 child (0.6%) – severely malnutrition (BAZ <-3). There were no children with obesity. Bioimpedance analysis revealed a decrease in phase angle in 49% vegetarian children and reduced percentage of active cell mass - in 49%.

Conclusions:

The study showed the necessity to gain knowledge about planning an adequate diet in vegetarian families. Anthropometric measurements and the component body composition of vegetarian children should be closely monitored by pediatricians.

132 / #317


MACRO AND MICRONUTRIMENTS INTAKES IN ADOLESCENT ATHLETES

R. Sahnoune, M. Bouchenak Université Oran1 -Laboratoire de Nutrition Clinique et Métabolique, Biology, Oran, Algeria


Adolescent athletes are faced with the complex challenge of consuming adequate nutrition to fuel sport performance, as well as growth and development. To evaluate the daily food consumption of adolescents athletes, and its adequacy in macro and micronutrients intakes.

Methods:

A study was conducted on 175 adolescents, (males/females 106/69), aged 11-17 years, attending school in Oran city, and trained from 6 to 10 hours/week. Athletes were categorized into two groups: GI : 11–13 years (n=58), and GII : 14–17 years (n=117), because of different age-specific nutritional recommendations. Food consumption was evaluated by 24h recall, and 3 days records,.

Results:

Mean energy intake represented 2194 vs 2339 Kcal/day, in GI and GII. Carbohydrates and proteins intakes (g/kg BW)) were significantly higher, in the both groups (p=0.01). Athletes consuming < 6-10 g/kg BW of carbohydrates represented 20.6 and 42.8%, and those feeding <1.2-1.7 g/kg BW of proteins were 25.5 and 32.5%, in GI and GII, respectively. Fiber intake (g/d) was lower than adequate intake (AI) (20 in GI vs 26-31, and 24 in GII vs 26-38). Calcium consumption (g/d) was lower than AI (1300mg/d) (693 in GI, and 655 in GII), and vitamin D was bolow AI (5µg/d) (1.14 and 1.27, in GI, and GII). The both groups did not meet Recommended Dietary Allowances (RDA) for iron (19 and 53%), magnesium (36 and 87%), and folate (79 and 91%).

Conclusions:

A large proportion of adolescent athletes doesn’t follow recommended intakes for carbohydrate, protein and micronutrient , especially adolescents aged 14-17 years. It’s necessary to improve health nutrition practices.

133 / #413


NUTRITIONAL STATUS OF A PEDIATRIC POPULATION WITH CELIAC DISEASE

F. Kaddour1, N. Mahdad1, C. Latroch2, K. Nedjadi Bouziane2, M. Bouchenak1 1Université Oran1 -Laboratoire de Nutrition Clinique et Métabolique, Biology, Oran, Algeria, 2Clinique Amilcar Cabral. CHU-Oran., Service Pédiatrie, Oran, Algeria


Celiac disease (CD) is an enteropathy autoimmune disease caused by gluten in genetically predisposed individuals. Gluten free diet (GFD) is the only treatment. To evaluate nutritional status of CD pediatric population.

Methods:

Subjects (n=61, Girls/Boys 37/27), aged 1 to 16 years, were recruited in Oran Pediatric Clinic, and divided in infants (1-<5ans) (n=24, 14/10), young children (≥5ans-<10ans) (n=17, 12/5), and adolescents (≥10ans) (n=23, 17/6). Nutritional habits, GFD quality and fractional energy expenditure were determined. Food consumption was estimated using 24 hours recall, followed by 3-days record.

Results:

Eight % of population were underweight, and 9% overweight/obesity. Irregular or non-existent breakfast was found, respectively in 6 and 23% of children, and 13 and 22%, of adolescents. Sugary drinks were noted in 38% of infants, and snacking in 79% of children and adolescents. GFD adherence was satisfactory, but voluntary diet transgression was observed in 26% of adolescents. Energy balance, which was difference between total energy intake, and daily energy expenditure, was positive in children (+117Kcal/d), and negative for teenagers (-255Kcal/d). Breakfast percentage was lower than recommendations, and high energy intake was noted for morning snack, in all population. Qualitatively, simple carbohydrates, and saturated fatty acids intake, were higher, compared to recommendations. Iron and vitamin D deficiency was noted, in population, and low calcium and zinc intake was observed, in adolescents, compared to recommendations.

Conclusions:

The celiac young patients are characterized by a nutritional and behavioral imbalance, the RSG can be difficult to implement. Dietary and psychological support for patients and their parents could be beneficial

134 / #460


CYSTIC FIBROSIS & DIGESTIVE SIGNS

N. Boutrid1, H. Rahmoune1, K. Radoui2 1University Hospital of Setif, University of Setif-1, Paediatrics, Setif, Algeria, 2EHS Canastel, Oran University, Pediatrics, Oran, Algeria


Despite the frequency and specificity of digestive signs in cystic fibrosis (CF) in children, they remain neglected as a "primer" for diagnosis In our study, gastrointestinal tract involvment during CF has been investigated in an Algerian cohort of CF children.

Methods:

This is a retrospective study at EHS Canastel Pediatric Pulmonology Unit, Oran, Algeria Inclusion criteria: all patients diagnosed with CF between 2000 and 2019 ( two positive sweat tests: Cl > 60 mEq / l) and / or the presence of a homozygous mutation or 2 heterozygous mutations in the CFTR gene. Data is collected and analyzed by Microsoft® Excel and IBM® SPSS 20 softwares

Results:

51 cases of children with cystic fibrosis were studied At admission, the most frequently encountered signs were bronchopneumonia (98%) and chronic diarrhea with steatorrhea (82.4%)

11.8% presented with dehydration and 36% with undernutrition; while 10% of children had clinical hepatomegaly and 14% had enlarged liver on ultrasounds.

These results are close to those of other international reports: the main gastrointestinal manifestations are pancreatic insufficiency (steatorrhea), meconium ileus, acute intestinal obstruction syndrome and hepatobiliary complications (leading to cirrhosis and liver failure). Frequent symptoms are steatorrhea, abdominal distention, constipation, abdominal pain, with dehydration, undernourrishment and stunting.

Conclusions:

Cystic fibrosis is a serious genetic ubiquitous condition with high morbidity and mortality

Delayed diagnosis and management of children ( due to unavailable neonatal screening) is of high concern, correlated to severe gastrointestinal impacts, dehydration and undernutrition.

135 / #561


24-HOUR URINARY CALCIUM EXCRETION IN MOROCCAN CHILDREN AND ADOLESCENTS

A. Bouziani1, N. Saeid1, M. Idrissi1, S. Benaich1, H. Bajit2, M. El Mzibri2, K. Benjeddou2, H. Benkirane3, H. Aguenaou4 1Joint Research Unit in Nutrition and Food, URAC 39 (Ibn Tofaïl University-CNESTEN) Regional Designated Center of Nutrition (AFRA/IAEA), Department Of Biology, Kenitra, Morocco, 2Joint Research Unit in Nutrition and Food. Faculty of Sciences. Ibn Tofaïl University., Department Of Biology, Kenitra, Morocco, 3Joint Research Unit in Nutrition and Food. Ibn Tofaïl University. Kenitra. National Center of Energy Sciences and Nuclear Techniques. Regional Designated Center of Nutrition (AFRA.IAEA).Rabat. Kenitra, Biology, Kenitra, Morocco, 4Joint Research Unit in Nutrition and Food. Ibn Tofaïl University. National Center of Energy Sciences and Nuclear Techniques. Rabat. Kenitra., Nutrition, Kenitra, Morocco


As nutritional deficiencies, calcium deficiency is one of the most common deficiencies in the world. The assessment of 24-hour urinary excretion has been widely used, as long as studies on calcium in Morocco, are limited, this study was conducted to assess calcium status in Moroccan children and adolescents using 24-urinary excretion.

Methods:

Form three public schools in Rabat-Salé-Kénitra region, a sample of 240 children and adolescents (6-18 years) were recruited. Just 131 participants provide an adequate 24-hour urinary collection and a valid anthropometric and socioeconomic questionnaire. Completeness of 24-hour urinary collection was validated by measuring urinary creatinine.

Results:

The mean of 24-hour urinary calcium excretion was 73.58±37.1 mg/day, and 73% of participants had calcium deficiency with a low Ca/Cr ratio (0.095±0.05). According to sex and nutritional status, no significant differences were observed.

Conclusions:

The low Calcium status in Moroccan children and adolescents indicate that they may be in risk of many health disorders. Thus, implementation of strategies presents an urgent need to improve calcium status in children and adolescents.

136 / #588


ADOLESCENT PREGNANCY AND LINEAR GROWTH OF INFANTS: A BIRTH COHORT STUDY IN RURAL ETHIOPIA

A. Bushra1, T. Belachew2, A. Argaw2, S. Ghosh3, M. Kershaw3, P. Kolsteren4, C. Lachat4 1Tufts University, Friedman School Of Nutrition Science And Policy, Addis Ababa, Ethiopia, Ethiopia, 2jimma university, Population And Family Health, jimma, Ethiopia, 3Tufts University, Friedman School Of Nutrition Science And Policy, boston, United States of America, 4Gent University, Department Of Food Technology, Safety And Health, Ghent, Belgium


Evidences indicate that the risk of linear growth faltering is higher among children born from young mothers. This study aimed to assess the association between young maternal age and linear growth of infants using data from a birth cohort study in Ethiopia.

Methods:

Evidences indicate that the risk of linear growth faltering is higher among children born from young mothers. Although such findings have been documented in various studies, they mainly originate from cross-sectional data and demographic and health surveys which are not designed to capture the growth trajectories of the same group of children. This study aimed to assess the association between young maternal age and linear growth of infants using data from a birth cohort study in Ethiopia.

Results:

Overall, 27.2% of the mothers were adolescents (15–19 years) and the mean ± SD age of the mothers was 20 ± 2 years. Infant Length for Age Z score (LAZ) at birth was negatively associated with maternal age of 15–19 years (β = − 0.24, P = 0.032). However, young maternal age had no significant association with linear growth of the infants over the follow-up time (P = 0.105). Linear growth of infants was associated positively with improved maternal education and iron-folate intake during pregnancy and negatively with infant illness (P < 0.05).

Conclusions:

The fact that wide spread socio economic and environmental inequalities exist among mothers of all ages may have contributed to the non-significant association between young maternal age and linear growth faltering of infants. This leaves an opportunity to develop comprehensive interventions targeting for the infants to attain optimal catch-up growth.

137 / #228


EMPOWERING FAMILIES AND PROFESSIONALS ACROSS THE SYSTEM TO REDUCE ENTERAL FEEDING

S. Aubrey1, K.Y. Chan2, R. Araujo3 1Barts Health Nhs Trust, Childrens Therapy ,7 Th Floor , Clinic 3, london, United Kingdom, 2Barts Health NHS Trust, Childrens Therapy, London, United Kingdom, 3NHS Tower Hamlets CCG, Comissioning Group, London, United Kingdom


In 2005, Tower Hamlets had 65 tube-fed children, by 2018 there were 172 tube-fed children costing the NHS £522,000 in feeds alone.

The project aimed to prove:

• Dietetics working in partnership across health, education and social care would result in children to have tube-feeds stopped and in feeds being changed into cheaper products safely;

• Significant impact on the quality of life of local families;

• Cost savings would pay for additional dietetic resource required.

Methods:

During 10 months the team:

• Developed a database of tube-fed children, feed costs, new referrals and feeds stopped;

• Targeted 30 children to have their tube-feeds stopped with dietetic support;

• Focused in safely targeting children who could have feeds changed into less expensive products;

• Collected improvments in quality of life data via a structured questionnaire on 25 families;

• Offered telephone advice 5 days/week for professionals across the system;

• Collected feedback from professionals.

Results:

For the first time in 14 years the 8% yearly increase of nasogastric tube-fed children locally was stopped. 34 feeds were stopped and 53 feeds were changed into cheaper but effective, safe products.

Total net savings of £106,486 were realised and the service is safer as patients are reviewed more frequently.

Families/children reported improvements in: eating, drinking, sleeping, extracurricular activities, anxiety, social interactions and body image.

Professionals reported improvement in communication, educational opportunities and clarity of pathways.

Conclusions:

Working collaboratively across the system with minimal investment improved quality, safety, user experience and professional collaboration whilst reducing costs.

138 / #247


FRUIT AND VEGETABLE INTAKE IN RELATION TO DEPRESSIVE AND ANXIETY SYMPTOMS AMONG ADOLESCENT IN 25 LOW- AND MIDDLE-INCOME COUNTRIES

Q. Chen, M.-W. Liu, Q.-Q. He Wuhan University, Health Sciences, Wuhan, Hubei, China


Fruit and vegetable intake (FVI) has been inversely associated with the risk of depression. However, there is a gap in evidence from low- and middle-income countries (LMICs) and among adolescents. Further, little is known about FVI in relation to the risk of anxiety. Therefore, we examined these associations among adolescents in 25 LMICs.

Methods:

Data from the Global School-based Student Health Survey were analyzed in 65267 adolescents aged 12-15 years (mostly nationally representative). Depressive and anxiety symptoms during the past 12 months were self-reported. Frequencies of FVI during the past 30 days were collected. Multivariable logistic regression and meta-analyses of country-wise estimates were undertaken.

Results:

The prevalence of depressive and anxiety symptoms were 30.3% and 9.8%, respectively. A meta-analysis indicated that FVI of <5 times/d (vs. higher) was associated with an increased risk of depressive symptoms (OR = 1.10; 95% CI = 1.02-1.18). The pooled estimate for anxiety symptoms was insignificant. When examined separately, fruit intake was significantly associated with both lower risks of depressive and anxiety symptoms; vegetable intake was significantly associated with a lower risk of depressive symptoms, but not with anxiety.

Conclusions:

Our study provides multi-national evidence of the protective effect of FVI against depressive and anxiety symptoms among adolescents in LMICs, enabling key stakeholders to address mental health issues among adolescents globally. However, outcomes were not measured against the gold-standard diagnostic criteria, thus inspiring further research.

139 / #335


PARENTAL BELIEFS ABOUT CHILD FEEDING PRACTICES AND GROWING UP MILK IN CHINA: A QUALITATIVE STUDY

Z. Cheng1, B. Yu1, H. Li1, Y. Chen2, E. Jaquier3, J. Dong4, F. Scheidegger-Balmer5, E. Weishaupt5, K. Van Der Horst5 1Peking University, Institute Of Reproductive And Child Health, Beijing, China, 2Nestlé Product Technology Center-Nutrition, Clinical Research, Vevey, Switzerland, 3Nestlé Research, Dietary Intake & Modelling, Lausanne, Switzerland, 4Wyeth Nutrition, Medical Affairs, Shanghai, China, 5Bern University of Applied Sciences, Applied Research & Development In Nutrition And Dietetics, Bern, Switzerland


Growing-up milks (GUM) play a prominent role in the diet of Chinese children. Between 53-75% of Chinese toddlers consume GUMs on a daily basis. This study explored parental beliefs about feeding practice and GUMs.

Methods:

Healthy toddlers (n=387) aged 12-36 months from metropolitan Beijing were enrolled in a randomized trial in a real-world setting. A qualitative study, using a semi-structured interview guide, was conducted with a subsample of 24 parents. Interview transcripts underwent content analysis and key themes were developed from the data.

Results:

There is strong consensus among parents that habitual diet alone cannot meet all nutritional requirements for healthy growth, and the primary reason for providing GUMs is to help their children achieve balanced nutrition. Parents have common notion that GUMs are easy-to-digest compared to standard cow’s milk products, because they can improve constipation, regulate bowel movements and improve stool odor. When selecting GUMs, parents would cater to their children’s tolerance and preferences. Majority of parents reported smooth transition to new A2 GUM. Based on Milk Satisfaction Questionnaire, parents consistently rated, on average, “quite good” to “very good” in overall appearance, mouthfeel or texture, and nutritional quality of A2 GUM. Overall, A2 GUM was well liked by 99.2% of the toddlers.

Conclusions:

The nutritional value of GUMs is a main reason for parents to provide to their child. However, in the product choice, child’s liking and acceptance of the GUMs play a key role. Almost all children in the study enjoyed drinking A2 GUM, and this reinforced the parent’s product choice.

140 / #185


ASSOCIATION BETWEEN NUTRITION-SENSITIVE AGRICULTURE AND THE NUTRITION STATUS OF CHILDREN AGED 6-59 MONTHS IN RURAL ZAMBIA.

G. Chipili1, J. Msuya2 1Mukuba University, Nutritional Sciences, Kitwe, Zambia, 2Sokoine University of Agriculture, Food Science, Nutrition And Consumer Science, Morogoro, Tanzania


Background: Low nutritional value food is associated with poor growth in children below the age of five. Low-income household may improve the nutrition status of children by growing nutrient dense crops. To date no study Zambia has focused on nutrition-sensitive agriculture and the nutrition status of children below the age of five.

Aim: The aim of this study was to access the association between nutrition-sensitive agriculture and the nutrition status of children aged 6-59 months in rural Zambia.

Methods:

Methods: We examined associations between crops grown in households and height-for-age (HAZ), Weight-for-age (WAZ) and weight-for-height (WHZ) Z- scores in children age 6-59 months of Kapiri-Mposhi district in the Central Province of Zambia. T-test was performed to compare means values of various indicators of nutrition status (Z-scores) for different categories of test variables. The test variables considered here were crops grown by households.

Results:

Results: The prevalence of Stunting, underweight and wasting was 21%, 9% and 2% respectively. There was an association between household who grew mangoes (P=0.001 and orange-fleshed sweet potatoes (P=0.003) and improved HAZ. Growing groundnuts was also associated with improved WAZ.

Conclusions:

Conclusion: We concluded that nutrition-sensitive agriculture is likely to improve growth in children aged 6 -59 months in low-income rural communities.

141 / #437


RISK FACTORS OF EATING DISORDERS IN ADOLESCENTS WITH TYPE 1 DIABETES

T. Chisnoiu, C. Mihai County Emergency Hospital of Constanta, Pediatrics, Constanta, Romania


People with type 1 diabetes, especially adolescents may develop eating disorders. Treatment with insulin cause weight gain and so adolescents with type 1 diabetes to prevent weight gain a compensatory behavior, namely intentional insulin omission. The aim of this study is to highlight risk factors for developing eating disorders.

Methods:

This study consisted in evaluation of 145 patients between 10 and 18 years with type 1 diabetes, during December 2018- October 2019. All patients were evaluated based on several parameters, including a questionnaire designed to collect information directly from them, that contains questions for parents and for children.

Results:

According to these study eating disorders in adolescents with type 1 diabetes are present in 45 patients, with a higher incidence in girls (90%). Low self-esteem and trend to depression was met in 65% of adolescence girls. The prevalence of intentional insulin omission has been shown to increase with age from 27% among girls aged 10-12 years, 73% among girls aged 13-18 years. The average value of glycated haemoglobin was 10.5%, that show a poor glycemic control. Recurrent episodes of diabetic ketoacidosis was met in 22 case of children that need hospitalized. In 21 cases the children experienced hypoglycemia, 10 of them need hospitalized. The prevalence of families in which a parent have anorexia or bulimia nervosa was 8%.

Conclusions:

Diagnosis of eating disorders in adolescents with type 1 diabetes may be difficult. Early diagnosis is essential, because the coexisting of eating disorders and diabetes increased appearance of short or long-term complications.

142 / #590


LIPID PANEL IN PAEDIATRIC PATIENTS – A RETROSPECTIVE STUDY

A. Constantin1,2, C. Delia3,4, M. Covacescu1,2, L. Gaman5, I. Rosca6,7, I. Gherghina1,2 1National Institute for the Mother and Child Health Alessandrescu Rusescu, Paediatrics, Bucharest, Romania, 2"Carol Davila" University of Medicine and Pharmacy, Paediatrics, Bucharest, Romania, 3University of Bucharest, Faculty Of Biology, Bucharest, Romania, 4National Institute for the Mother and Child Health Alessandrescu Rusescu, Paediatrics, Medical Laboratory, Bucharest, Romania, 5"Carol Davila" University of Medicine and Pharmacy, Biochemistry, Bucharest, Romania, 6Panait Sarbu Clinical Hospital for Obstetrics and Gynecology, Neonatology, Bucharest, Romania, 7"Carol Davila" University of Medicine and Pharmacy, Paediatrics, Neonatology And Qualified Care, Bucharest, Romania


Dyslipidemias are disorders that affect the lipoprotein metabolism. In adult patients these lipid panel abnormalities are considered a risk factor for cardiovascular disease. Since dyslipidemia often begins in childhood, identifying paediatric patients and improving their lipid profile by healthy lifestyle choices may reduce the risk of cardiovascular disease at young age.

Methods:

We conducted a retrospective study in our paediatric department. The team evaluated the lipid panel of consecutive children for whom the clinician decided to request it, on a 2 years period (2013-2015). In our laboratory all lipid panel components, except total lipid values, were directly determined from the serum. We considered criteria for dyslipidemia to be: total cholesterol levels ≥ 200 mg/dL, LDL-cholesterol ≥ 140 mg/dL, triglycerides ≥ 130 mg/dL and HDL-cholesterol ≤ 35 mg/dL.

Results:

There were 502 lipid profile evaluations from paediatric patients with a mean age of 6,6 years ± 4,9. 53,7% were female. 16,8% had high total cholesterol levels, 16% had high LDL-cholesterol levels, 17,43% had low HDL-cholesterol levels and 21,2% high triglycerides levels. There was no statistical significance for elevated lipid panel levels when stratified by gender.

Conclusions:

During the two-year period of our study there was a higher rate of high lipid profile levels than expected, compared with data from literature (studies in Europe report a prevalence of 6,4% for dyslipidemia compared to 16,8% in our study). Patients in our clinic were tested mainly during minor respiratory or digestive intercurrences but there were also some patients with genetic disorders.

143 / #389


BODY COMPOSITION AND BONE MINERAL DENSITY IN FEMALE ADOLESCENT PATIENTS WITH ANOREXIA NERVOSA

A. Moreira1, C. Correia2, A. João2, E. Carolino1,2, L. Mendes2 1H&TRC- Health &Technology Research Center, Nutrition, Lisbon, Portugal, 2Nutrition - Hospital Dona Estefania, Nutrition, Lisbon, Portugal


Introduction: Anorexia nervosa (AN) is characterized by a severe restriction of energy intake with low body weight reflecting depletion in body compartments.1 As a consequence some associated complications arise, particularly at the bone - low bone mineral density.

Objective: analyze association of body composition and factors associated with anorexia nervosa affect with bone strength.

Methods:

Methods: Descriptive cross-sectional study in female patients with anorexia nervosa followed at pediatric hospital. Body composition was measured by Air Displacement Plethysmography (Bod Pod®), and bone mineral density was accessed by quantitative ultrasound (Sunlight omnisence®). Clinical data was collect from electronic health records.

Statistical analysis was performed using SPSS program v.22. A p value less than .05 was considered significant.

Results:

Results: A total of 29 female patients aged 11 to 17 years were evaluated. The mean Fat Mass was 19.5±7.1Kg, wile Fat Mass Index (FMI) was 3.6kg/m2 was and Fat Free Mass Index (FFMI) was 14.7kg/m2. After classification according to age and gender patients had FMI z-score between -1.33 and -0.67; FFMI z-score between -0.67 and 0, and a BMI z-score between -1 and 0. Regarding bone strength, z-score was 0.7±1.1 in the tibia and 0.2±0.8 in the radius. In radio only 2 patients had z-score under -1 where in tibia were 9, and from those 3 had z-score lower than -2.

There was a correlation between amenorrhea duration and disease duration. No significant associations were found between with bone density.

Conclusions:

Conclusions: Longer time on amenorrhea has an negative impact on bone density.

144 / #768


CLINICAL STUDY TO MEASURE THE IMPACT OF FORTIFIED MALT BASED FOOD ON IMMUNITY OUTCOMES IN SCHOOL CHILDREN

A. Khadilkar1, V. Rawat2, P. Kalita3, P. Verma4, V. Garg4 1Jehangir Clinical Development Centre, Sassoon Road, Pune, , Maharashtra, India, 2GlaxoSmithKline Consumer Healthcare Ltd, Clinical Research, Gurugram, Haryana, India, 3GlaxoSmithKline Consumer Healthcare, , , Singapore, 4GlaxoSmithKline Consumer Healthcare, , Gurugram, India

Background and Aims: The illnesses due to nutritional deficiencies in children are well known and are a threat to their growth and development. This clinical study was conducted to test the improvement in immunity outcomes by a micronutrient fortified malt-based food in children on regular diet.

Methods:This was a matched pair, cluster randomized, open-label, parallel group, controlled study (fortified malt-based food plus dietary counselling vs dietary counselling alone) in 7-10 years age group in India, conducted by single center (multiple sites), and stratified by gender. Immunity outcome-measures (illness duration, frequency, severity, and school absenteeism) over the 9-month intervention, attributed to gastrointestinal (GI) and/or respiratory illnesses were considered excluding the symptoms arising from non-infectious causes.

Results: Of the 924 enrolled participants, 907 completed the study. Participants in test group fell ill 6 days less (Primary analysis, p=0.0690, 95%CI (-12.7, 0.8); ~5 days less (additional analysis: log(.+1)-transformed data, p=0.0390), at 9 months vs control group. Participants in test group had 0.18 less illness episodes/month (p=0.0330, 95%CI (-0.32, -0.03), had overall less severity episodes for GI and respiratory illnesses and were ~0.5 days less absent from school (p=0.044, 95%CI (-0.9, -0.0) at 9 months versus control group. The test product was generally well tolerated. Conclusions: Study demonstrates that test product is highly effective compared to control in reducing number of ill days and has a positive impact on reducing frequency & severity of GI and respiratory illnesses and the resultant school absenteeism, suggesting improved immunity against common infections in school going children.

The study was sponsored by GlaxoSmithKline Consumer Healthcare

145 / #591


BODY HEIGHTS, MENARCHE, SWEET DREAM CHILDRENS FROM MALNOURISHED PREGNANT WITH ZINC AND FOOD SUPPLEMENTATION HISTORY

N. Daud Universitas Hasanuddin, Nutrition, Makassar, Indonesia


Malnourished pregnant women had Inadequate food intake, zinc as a micronutrient has important role for foetus, especially for growth and foetus development.1,5% mortality children in the world due to zinc deficiencies. The aims of study to identify the beneficial of zinc to growth velocity children.

Methods:

Cohort retrospectives Sample is a children 11 y,o and divided by three categories based on intervention in their mothers (malnourished pregnant women) 6 years ago.

Group A (58) have zinc and food supplementation, group B (25) have food supplementation and group C as a control (60) without zinc and food supplementation. Child Growth status is calculated by Marshall & Schwan formula and data analysis using t-test and U Manwitney.

Results:

Study showed increasing body height during six years period for group A, B and C are 60.35±4.73, 53.01±5.71 and 49.39±5.74 cm respectively and significantly different between group A and C and group B and C (p <0,000 and <0,013). Children with zinc and food supplementation has higher IGF-1, and good growth velocity, low morbidity risk to disease and early Menarchedan wet dream after eleven yaears compared to control group.

Conclusions:

Zinc and food supplemen should be givimg to malnourished pregnant women to prevent stunting.

146 / #31


QUALITATIVE STUDY OF FACTORS CONTRIBUTING TO IRON DEFICIENCY AMONG CHILDREN IN ARMENIA

A. Demirchyan American University of Armenia, Turpanjian School Of Public Health, Yerevan, Armenia


Globally, 43% of children are anemic and iron deficiency is responsible for roughly half of all anemia cases. According to different estimates, the prevalence of anemia among under-five children in Armenia varies from 16% to 32%. This study aimed to identify the factors contributing to iron deficiency among under-five children in Armenia.

Methods:

Thirteen focus group discussions and eight in-depth interviews were conducted with policymakers, providers, and mothers of young children. Participants were recruited from Yerevan city and Lori and Shirak provinces. The study was conducted during 2015 and included 99 participants. Qualitative content analysis was applied utilizing deductive approach.

Results:

We identified two main groups of factors contributing to iron deficiency among children: (1) inadequate consumption of iron through diet, and (2) lack of systemic preventive measures. The main themes within the first group were: inadequate maternal knowledge about iron-rich foods; low affordability of meat, diverse diet, and iron-fortified infant food; and use of cow’s milk as breastmilk replacement. The main themes within the second group were: unfavorable perinatal practices (no preventive iron supplementation during pregnancy, immediate umbilical cord clumping, and insufficient support for exclusive breastfeeding) and failure of initiation of iron fortification program because of strong resistance among population mainly based on fear of iron overdose.

Conclusions:

We identified several modifiable factors that contribute to iron deficiency during childhood, thus creating a basis for policymakers to develop effective strategies for reducing iron-deficiency anemia rates among children in Armenia. Our findings might be applicable to other countries with similar socioeconomic background.

147 / #497


CLINICAL CHARACTERISTIC OF INFLAMMATORY BOWEL DISEASE IN CHILDREN

A. Jelicic Kadic1, R. Despot1, E. Runjić2, V. Zitko1 1University hospital Split, Department Of Pediatrics, Split, Croatia, 2General Hospital Dubrovnik, Department Of Pediatrics, Dubrovnik, Croatia


In approximately 25% of cases inflammatory bowel disease (IBD) are diagnosed before the age of 20. The IBD has a large impact on nutritional state and growth. The aim of our study is to present the clinical features of patients with IBD treated in the Department of Pediatric, Univesity Hospital Split.

Methods:

Retrospective study of children with IBD was conducted at the University Hospital Split, Croatia

Results:

We included 65 patients; 29 with ulcerative colitis (UC) and 36 with Crohn's disease (CD). Patients were average age 13 years and 5 months. The incidence of UC was the same in both gender, while CD was diagnosed mostly in boys (2:1). Ten patients has BMI < 5 centile. The level of C- reactive protein was higher than 5 mg/ in 70% children in time of diagnosis. Serum levels of 25(OH)D was analysed and vitamin D insufficiency (25(OH)D < 51 nmol/L) was found in 84 %. Mean levels of 25(OH)D in children with CD was 38.8 nmol/L and in children with UC 22. 8 nmol/L. Fecal calprotectin level was analysed in 26 children; 10 with CD and 16 with UC (aged 1-18 years). All patients had calprotectin level more than 50 µg/g. Fecal calprotectin more than 1500 µg/g was found in 50 % children with CD and in 69 % children with UC.

Conclusions:

Our results suggest that concentrations of 25(OH)D < 51 nmol/L are common in children with IBD and that fecal calprotectin level is more often higher in children with UC than CD.

148 / #217


GROWTH HORMONE STIMULATION TESTS IN SHORT CHILDREN: THE DIAGNOSTIC ACCURACY OF GLUCAGON-FIRST TEST AS COMPARED TO CLONIDINE-FIRST TEST

R. Diamant1, T. Oron1, L. Lazar1,2, M. Yackobovitch Gavan1,3 1Schneider Children’s Medical Center of Israel, The Jesse Z And Lea Shafer Institute For Endocrinology And Diabetes- National Center For Childhood Diabetes, Petah Tikva, Israel, 2Tel Aviv University, Sackler Faculty Of Medicine, Tel Aviv, Israel, 3Tel Aviv University, Dept. Of Epidemiology And Preventive Medicine, School Of Public Health, Sackler Faculty Of Medicine, Tel Aviv, Israel


The diagnosis of childhood growth hormone deficiency (GHD) requires a failure to respond to two provocative tests performed with different stimuli. The most widely used GH stimulation tests (GHSTs) are glucagon, clonidine and arginine. Our aim was to assess the diagnostic value of glucagon stimulation test (GST)-first as compared to clonidine test (CT)-first.

Methods:

Retrospective, single-center, observational study from 2016 to 2018, conducted in a tertiary endocrine center. The study population included 512 short children and adolescents, median age 9.3 years (IQR 6.2, 12.1), 61% boys and 83% prepubertal, who underwent GHST with GST-first or CT-first and confirmatory test with the opposite stimulus in cases with initial GH peak < 7.5 ng/ml.

Results:

Subnormal GH response in the initial test was recorded in 204 (39.8%) children: in GST-first -148 (45.5%) and in CT-first -56 (30%), P < .001. Confirmatory test verified GHD in 75/512 (14.6%) patients. False positive (FP) rate was more prevalent in GST-first than CT-first [103/148 (69.6%) vs. 26/56 (46.4%), P < .001]. The accuracy of CT-first (86.1%) was better than the accuracy of GST-first 68.3%. The only significant predictive variable for a FP result was the type of the stimulation test [OR=0.349 (95% CI 0.217, 0.562), P < .001].

Conclusions:

The higher rate of FP results in GST-first suggests that CT-first would be beneficial. Thereby, in children with a peak GH ≥7.5 ng/mL, GHD can be ruled out by performing only a single stimulation test.

149 / #272


INTERGENERATIONAL EFFECTS OF MALNUTRITION: A CASE-CONTROL STUDY TO DESCRIBE NUTRITIONAL STATUS OF CHILDREN BORN FROM MOTHERS TREATED FOR SEVERE MALNUTRITION IN CHILDHOOD IN D.R. CONGO.

G. Bisimwa Balaluka1, C. Chimanuka Murhimalika1, G. Amani Ngaboyeka1, P. Mwene-Batu Lyabayungu1, S. Balolebwami Zigabe1, J. Macq2, P. Donnen3 1Université Catholique de Bukavu, Ecole De Santé Publique, BUKAVU, Congo, Republic of, 2Université Catholique de Louvain, Ecole De Santé Publique, BRUXELLES, Belgium, 3Université Libre de Bruxelles, Ecole De Santé Publique, Bruxelles, Belgium


Intergenerational effects of malnutrition have been described by many authors. Our aim is to describe nutritional status of children born from mothers who have been treated for severe malnutrition in childhood.

Methods:

Case-control study conducted in Miti-Murhesa health Zone (DRC) from february to May 2019 bearing children born from mothers who were treated for severe malnutrition in childhood in Lwiro hospital between 1988-2002. This cohort was matched with controls whose mothers were never severely malnourished, selected according to age, sex and villages. We collected weight, height, MUAC for mothers and children. We use WHO curve reference 2006 to define WHZ (wasting:<-2), HAZ (stunting:<-2) and WAZ (underweight:<-2). Capillary blood was obtained for hemoglobin measurement by Hemocue®. Anemia was defined as Hb<11g/dL. We applied chi2-test for comparisons.

Results:

We recorded 192 children aged 6-59 months (52,6% boys) and 135 control (45,9% boys). Mean (SD) birth weight (Kg) was 3,223(0,609) case group and 3,248 (0,596) in control group (p=0,721). Proportion of stunting was 53,7% case group and 42,5% control group (p=0,05). Proportion of wasting was 16,1% case group and 5,2% control group (p=0,005). Proportion of oedema was 1,7% in two group. Prevalence of anemia was 36,5% case group and 32,6% control group (p=0,56). For mothers (120 cases and 101 control), mean (SD) BMI (Kg/km2) was 23,4 (3,4) in case group and 23,3 (2,9) in control group (p=0,683).

Conclusions:

Children born of mothers with severe acute malnutrition in their childhood have a high prevalence of wasting. In-depth studies are needed to describe the health status of such children.

150 / #518


DIETARY IRON INTAKE IN SCHOLAR CHILDREN, MOROCCO

K. Azekour, B. El Bouhali Faculty of Science and Techniques, Moulay Ismail University, Department Of Biology, Errachidia, Morocco


Iron deficiency remains the most common nutritional deficiency all over the world. In particular, Children are at risk because they are in total growth, which increases iron requirements.The purpose of the current study was the assessment of dietary iron intake in scholar children.

Methods:

825 children (47.25% girls and 25.75% boys) were randomly selected from primary public schools to participate to this study. The mean age was 9.08±2.12 years. Socio-economic characteristics were obtained. Dietary intake datawere assessed via 24-h recall.

Results:

The mean intake of iron was 14.26 (12.57) for girls and 15.11 (14.67) for boys.The prevalence of inadequate intake of iron was noticed in 6.7%. In the totality of the sample, girls had a tendency to develop iron deficiency. Children aged between 10 to 12 years old had the highest rates of inadequate intake.For the place of residence, urban children were identified as apparently at risk of inadequate dietary intake (p = 0.000). Concerning parents’ educational level,we did not find any significant differences.

Conclusions:

Further studies such as blood nutritional indicators and intestinal absorption of iron are needed to beestablished in order to complete iron profile in the studied region.

Financial support : UMI-2018 project

155 / #427


IATROGENIC HYPOGLYCEMIA INDUCED BY PARENTERAL OVERNUTRITION

J. Ferenczova, V. Vargova, E. Banoova Medical Faculty PJ Safarik University, Paediatrics, Kosice, Slovak Republic


Hyperinsulinemic hypoglycemia due to overproduction of insulin can be congenital or acquired, apparent in the newborn period, or many years later. Leucin stimulates the secretion of insulin by acting indirectly as a positive allosteric activator of glutamate dehydrogenase. It results in hypoglycemia after protein (leucine) rich meal. The same observation is seen when intravenous mixture of amino acids is administered to healthy subjects.

Methods:

Case report

Results:

Patient was diagnosed with autoimunne hepatitis at the age 2. When he was 6 years old, systemic lupus erythematosus, keratoconjuctivitis and autoimmune intestine dysfunction appeared. Genetic analysis confirmed combined imunodeficiency with autoimunne symptoms, pacient is heterozygot in RELB gene (p.V216I and p.D294N). To improve caloric intake home parenteral nutrition was implemented with daily amino acid intake 1,6 g/kg. At age 6,5 years he was admitted to hospital propter pneumonia. We continued with nocturnal parenteral nutrition, during which were observed hypoglycemia. We took blood with glycemia 1,3 mmol/l with finding of adequate cortisol (>2000 nmol/l N 220-875) and growth hormone (11,2 ng/ml N 0,09-3,83) response, but elevated C peptide (4270 pmol/l N 206-934) and insulin (222 uIU/ml N 2-25) level. Upon questioning, the mother admitted giving parenteral nutrition during the day and night for the past two weeks (total amino acid load was 3,2 g/kg). We immediately started with diazoxide treatment (5 mg/kg/day). After discharge we decreased dose, and after 6 months the treatement was terminated.

Conclusions:

Authors document unusual cause of severe hyperinsulinemic hypoglycemia due to parenteral overnutrition with enormously increased protein intake.

156 / #587


INFLUENCE OF ADHERENCE TO THE MEDITERRANEAN DIET ON BODY COMPOSITION OF CHILDREN AND ADOLESCENTS

D. Filipe, A. Faria, M. Loureiro Coimbra Health School, Dietetics And Nutrition, Coimbra, Portugal


Childhood obesity is considered one of the most worrying helth problems today and the change in eating and lyfestyle habits are cause for its development. The adoption of the Mediterranean Diet could have an important impact on this type of pathology.

The aim of this review is to understand if there is a relationship between aherence to this diet and the body composition, the educational level of children and adolescents and the educational level of the parents.

Methods:

This was an observational cross-sectional cohort study focusing on the analysis of body composition and the KIDMED questionnaire of students from the Escola Básica e Secundária Quinta das Flores aged 10 to 18 years.

Results:

The results suggest that there is no relationship between adherence to the Mediterranean diet, BMI and education of the parent. However children of more educated parents have a lower FM% (-5.7%) (p <0.01, d = 0.64) which suggests that education may have an influence on diet. Age was the only variable where a significant and negative association with adherence was established (r = -0.166, p <0.05).

Conclusions:

Given the hypotheses formulated at the beginning of the study, only one has been proven, and it may be interesting to conduct further studies with more representative samples, compared to national values, to try to understand if the other variables are not really related.

157 / #549


CONTRIBUTIONS OF BODY COMPOSITION, PHYSICAL ACTIVITY, MACRONUTRIENTS INTAKE AND MATURITY ON ENERGY INTAKE AND ENERGY EXPENDITURE DURING ADOLESCENCE

I. Fragoso1, A.L. Silva2, J. Teles2 1Faculdade de Motricidade Humana, Sports And Health, Cruz Quebrada, Portugal, 2Faculdade de Motricidade Humana, Mathematics Unit, Cruz Quebrada, Portugal


Background and aim: The relationship between energy intake (EI) and energy expenditure (EE) with body composition (BC) and physical activity (PA) is not well understood. The purpose of this study was to examine the relationships between EI and EE with BC, PA and macronutrients intake and to understand whether an accurate measure of maturation can clarify these relations.

Methods:

Methods: Energy intake were self-reported in a valid Food Frequency Questionnaire. Energy expenditure was estimated according to rest energy expenditure multiplied by the self-reported level of PA. Anthropometric and BC measures included weight, height, sitting height, fat mass (FM), fat free mass (FFM) and body mass index (BMI). Biologic maturity was objectively measured. Energy intake and EE were categorised into four groups of EI/EE.

Results:

Results: Males were significantly more active, engaged more time in moderate and vigorous PA and were less sedentary (p<0.05). They also had significantly higher EI and EE than the females’. Weight, height, body composition (FM and FFM), BMI, maturity (BA and maturity offset), PA and protein intake were negative associated with EI/EE and showed significant differences between EI/EE groups. Multiple linear regression analysis showed that FFM, FM, PA and protein intake were predictors of EI/EE.

Conclusions:

Conclusion: Results showed that FFM and PA were inversely associated with EI/EE suggesting that adolescents might have more constrictions in balance their energy requirements when great amounts of EE is required. Also, adolescents with higher FM might adjust their energy needs by reducing EI throughout an augment in protein intake.

158 / #214


THE LONGITUDINAL DYNAMIC OF GROWTH CHILDREN’S OF MONGOLIA

O. Galsanjav MNUMS, School Of Bio Medicine, Physiology, -, Mongolia


Background: Normal growth is the progression of changes in body height, weight. Normal growth of children changed in long live time.

Aim: The aim our studying is compare the body height of children’s, living in capital city of Mongolia, Ulaanbaatar, in 1961 -2011 years .

Methods:

Methods: We studied children aged in 8-17 years in 2006 and 2011 years. Body height measured by common anthropological methods. We used arithmetical mean of height children’s, measured at last year’s: 1961, 1981, 1994.

Statistical data analyses was made on SPSS-17, software. Arithmetical mean and standard deviation for each group (M±SD), standard error of the mean was calculated.

Results:

Results: Last 50 years height of boys increased 3.4-8.6 cm at 11-17 years, 6.8-8.5 cm, height of girls 4.2-8 cm, in particularly 6.5-9.5 cm at 12-17 years(p≤0.01). Arithmetical mean of height boys and girls in 1961-1981 years was statistically significant increase(p≤0.05), that shows process of intensive acceleration. Its looked on teenagers in 1981-1994 years. Slowly increase of height in this time. In 1994-2005 years decreased the height. In 2011 year average of mean of height of boys increased very low. Height of girls decreased.

Conclusions:

Conclusion: The our study has show tendence longitudinal dynamics of the growth children’s city Ulaanbaatar. In last year’s looked deceleration process of child growth.

161 / #363


THE LONG-TERM EFFECTS OF SEVERE CHILDHOOD MALNUTRITION ON NON-COMMUNICABLE DISEASE RISK: A SYSTEMATIC REVIEW

K. Grey1, A. Abdissa2, M. Abera3, M. Berhane3, T. Girma3, G. Gonzales4, N. Lelijveld5, D. Thompson6, M. Kerac1 1London School of Hygiene and Tropical Medicine, Population Health, London, United Kingdom, 2Armauer Hansen Research Institute, Deputy Director, Addis Ababa, Ethiopia, 3Jimma University, Pediatrics And Child Health, Jimma, Ethiopia, 4Ghent University, Department Of Internal Medicine, Ghent, Belgium, 5University of Southampton, Faculty Of Medicine, Southampton, United Kingdom, 6University of the West Indies, Tropical Metabolism Research Unit, Kingston, Jamaica


While convincing evidence links prenatal undernutrition with increased risk of non-communicable diseases (NCDs) later in life, less is known about the long-term sequelae of severe malnutrition in other periods of developmental plasticity such as childhood and adolescence. This systematic review brings together evidence from studies of documented severe childhood malnutrition in low- and middle-income countries (LMICs) and famine survivors to examine associations between postnatal undernutrition and adult NCDs.

Methods:

A search strategy built around the concepts of ‘severe childhood malnutrition’, ‘NCDs’, and ‘LMICs and famines’ was used to identify relevant studies in EMBASE, MEDLINE, Global Health, and CINAHL databases. The results were synthesised narratively, and the main sources of bias were summarized qualitatively across studies.

Results:

Among 57 included studies, 14 examined NCD-related outcomes after documented severe childhood malnutrition in LMICs and 43 studied famine survivors. Severe malnutrition and famine exposure in childhood were consistently associated with cardiovascular disease, impaired glucose metabolism, and metabolic syndrome. Evidence for effects on lipid metabolism, obesity, and other outcomes was less consistent.

Conclusions:

Overall, the evidence suggests that severe malnutrition or famine exposure in childhood is associated with increased long-term NCD risk. Building on the developmental origins of health and disease hypothesis, this suggests that windows of developmental plasticity extend beyond prenatal life, and that severe childhood malnutrition has serious implications not only for acute morbidity and mortality but also

for survivors’ long-term health. However, there is little direct evidence on mechanisms underlying this association.

162 / #614


SCREENING FOR ACUTE MALNUTRITION AMONG CHILDREN AGED BETWEEN 6 AND 59 MONTHS USING THE MID UPPER ARM CIRCUMFERENCE IN A RURAL COMMUNITY NORTH-WESTERN NIGERIA

K.L. Hamza1, B. Nwankwo2, E. Ajumuka1, B. Usman1, A. Suleiman1, U. Umar1, M.F. Isah1, M. Sufiyan1 1Ahmadu Bello University Zaria, Community Medicine, Zaria, Nigeria, 2Kaduna State University, Community Medicine, Kaduna, Nigeria


In several sub-Saharan countries of Africa, children aged under five years suffer chronic inadequate dietary intake which increases their risk of death. The community management of acute malnutrition (CMAM) approach treats children with severe acute malnutrition (SAM) and aims to reduce mortality rates amongst them. The use of Mid Upper Arm Circumference (MUAC) for SAM diagnosis provides an acceptable and low-cost indicator that is measured in the field.

This study screened for acute malnutrition by use of the MUAC measurements of children in Mahuta, Nigeria.

Methods:

Children aged between 6 and 59 months were included in the assessment following a multi-staged sampling technique. Data was collected from each caregiver after an informed verbal consent was obtained, the study tool was a pretested, semi-structured interviewer administered questionnaire. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 25.

Results:

There were a total of 141 children, 78 (55.3 %) males and 63 (44.7%) females. The moderate acute malnutrition prevalence by MUAC (MUAC>=115 and <125 mm) for children 6-59 months was 3.5% and severe acute malnutrition (MUAC<115 mm/oedema) had a rate of 1.4%. The overall global acute malnutrition rate by MUAC was 4.9%.

Conclusions:

The results of this study indicate poor nutrition situation, SAM which is closely associated with increased mortality. There is need for nutrition intervention in this community so as to reduce morbidity and mortality.

163 / #107


VITAMIN D PLASMA LEVELS IN CHILDREN AND ADOLESCENTS WITH TYPE 1 DM ARE ASSOCIATED TO SUN EXPOSURE DURATION BUT NOT NUTRITIONAL STATUS

D. Handayani1, I. Kusumastuty1, E. Sari1, H. Cahyono2 1Brawijaya University, Nutrition, Malang, Indonesia, 2Brawijaya University, Pediatric, Malang, Indonesia


Type 1 DM is often linked to vitamin D plasma level insufficiency influenced by sun exposure duration, inadequate vitamin D intake, and nutritional status. Whether children and adolescents with type 1 DM in Indonesia also suffer vitamin D plasma insufficiency has not been widely reported.

This study aimed to observe sun exposure (using the Sun Exposure Questionnaire), BMI/U nutritional status (WHO-Anthro), and the relationship of the two parameters to vitamin D plasma level (Enzyme-linked immuno assay) among 31 respondents ranging from children to adolescents.

Methods:

The relationship analysis was done using the Pearson test.

Results:

The results showed 64.5% of respondents were at the median of 14 (minimum and maximum scores of 7 and 34, respectively) or lack of sun exposure. All respondents had an average plasma vitamin D level of <20 ng/ml (deficiency category). The nutritional status of 74% of respondents was normal weight, 13% were underweight, 6% were overweight, and 6% were obese. There was a significant relationship between sun exposure duration and vitamin D plasma level (P <0.001; r = 0.267), but no relationship between BMI/U and vitamin D plasma level (p = 0.049; r = -0.154).

Conclusions:

This research shows although Indonesia has year-round sunshine, vitamin D plasma deficiency in type 1 DM patients is still found. There is no relationship between nutritional status and vitamin D plasma because most respondents were in the normal nutritional status category.

165 / #571


ABILITY OF BMI FOR AGE TO DEFINE EXCESSIVE BODY FATNESS IN KUWAITI ADOLESCENT GIRLS

H. Hasan University of Strathclyde, Physical Activity For Health, kuwait city, Kuwait


: Adolescent obesity, as defined by BMI-for-age, is amongst the highest in the world in Kuwait. This study aimed to determine the extent to which BMI might underestimate obesity (over fatness) in Kuwaiti female adolescents and young adults

Methods:

400 healthy Kuwaiti female university students (mean age 18.0 SD 0.6) were recruited. Over-fatness was defined as body fat % ≥30 in the Kuwaiti adolescent females using the Tanita model TBF-310 Bio-impedance system. Obesity was defined conventionally as a BMI >30 kg/m2 for those age >19.1y, and as WHO BMI-for-age for those aged between 17.0-19.0 years old. The accuracy of BMI-defined obesity to identify over-fat individuals was determined by calculating standard diagnostic accuracy statistics: sensitivity, specificity, and predictive values.

Results:

Prevalence of over-fatness was 62 % (247/400 individuals were overfat) while the prevalence of obesity according to BMI was 42% (169/400 individuals were obese according to their BMI). The sensitivity of BMI was moderate (66%) but specificity was high (96 %).

Conclusions:

BMI-based measures substantially underestimate the prevalence of obesity (over-fatness) in Kuwaiti females. Further studies are required to ascertain the extent to which obesity prevalence in Kuwait is being underestimated by use of BMI.

166 / #212


NUTRITIONAL STATUS AND ANAEMIA AMONG PRIMARY SCHOOL CHILDREN OF MYMENSINGH DISTRICT.

M.M. Hasan Chest Diseases Clinic, Paediatrics, Mymensingh, Bangladesh


The school age is a dynamic period of growth and development.During this period physical ,mental and social development takes place.

Purpose of the study is to observe the nutritonal status and anaemia among primary school children and to compare the rural and urban children as well as to see the relationship between anaemia and malnutrition.

Methods:

It is a descriptive cross sectional study.Data were collected from 600 primary school children of mymensingh district for a period of one year.

Results:

Among the primary school children in mymensingh 15.1% were wasted ,22.1% were stunted 2.3% were both stunted and wasted, 60.4% children within normal limit.

Malnutrition were more among rural children.In rural area severly underweight, moderately underweight children were 62.1%,65.6% and corresponing result in urban area were 37.9%, 34.4% respectivly.

In rural area severly stunted, moderately stunted children were 100%, 58.6% and in urban area they were 0%,41.4% respectively.

Again severly wasted ,moderately wasted children were 62.5% ,59.4% in rural and 37.5% , 40.5% in urban area respectively . Malnutrition among girls were more than the boys.

Seventy one percent of our primary school children were anaemic.Again rural children were more sufferer in anaemia.

Amaemia was more in low income group and illiterate mothers child.Some anaemic children were malnourished and some were not but there is significant relationship between anaemia and malnutrition.

Conclusions:

A large portion of our primary school children suffured from malnutrition as well as anaemia and both the conditions were more prevalent in rural area.

167 / #310


ENVIRONMENTAL STIMULATIONS OF HEIGHT DEPEND ON SEX AND AGE: THE INDONESIAN EXAMPLE

A. Pulungan1, C. Scheffler2, M. Hermanussen3 1University of Indonesia, Pediatrician, Jakarta, Indonesia, 2University of Potsdam, Instituite Of Biochemistry And Biology/human Biology, Potsdam, Germany, 3University of Kiel, Pedriatric, Kiel, Germany


Boys appear to be more sensitive than girls to environmental stress and stimuli. Sexual dimorphism in sensitivity to adverse environmental conditions has been evident already in the pediatric literature since the 19th century. We decided to study height of “transmigrant” school children who originated from Java and other parts of Indonesia and had migrated to Papua, and putative effects of this migration on the sexual dimorphism of body height.

Methods:

Cross-sectional data on height were obtained in 186 children (59 native Papuan girls, 38 transmigrant girls; 56 native Papuan boys, and 33 transmigrant boys, aged 7.0 to 7.99 years, from three primary schools in Nabire, Papua, Indonesia. Height data were obtained from Indonesian 2013 National Basic Health Survey, and have been used to construct National Indonesian Growth Charts. Three environmental conditions of each of the 33 provincial capitals to address the ethnic and cultural diversity of the Indonesian populations. We first calculated correlation matrices (figure 1) and linear mixed models (LMM) using the programming language “R”. Thereafter we made use of St. Nicolas House Analysis. This novel statistical enables visualizing chains of associations between parameters that are multiply correlated.

Results:

Transmigrant 7-year old boys were almost 3 cm taller their native age matched peers. They do not adjust in height towards their shorter peers. Female data were less obvious, yet suggested sexual dimorphism in the biological response to migration in girls appear less affected than boys.

Conclusions:

Environment more influences transmigrant boys height than girls.

168 / #482


PERCEPTION AND ATTITUDE TOWARD CHILDREN EATING BEHAVIOR AMONG PARENTS AND PHYSICIANS IN PEDIATRIC AMBULATORY CLINICS, QATAR

M. Hassan1,2, A. Alhammadi1, H. Abdelrhman1 1SIDRA medicine, Pediatric, Doha, Qatar, 2hamad medical corporation (HMC), Pediatric, doha, Qatar


Eating behavior in children is considered part pf their growth and development, one those behavior is picky eater.There is no single widely accepted definition of picky eating.Our aim from this study is to explore the perception of picky eater concept in the community among parents and physicians.

Methods:

A cross sectional single institution retrospective study was done at Hamad Medical Corporation in outpatients clinics.Survey include details of demographic,several questions to explore the perception of picky eater among parents and physicians.

Results:

Analysis of 136 survey from both side parents and physicians had show sharing of same concern about children growth but family concern was higher(58%) compering to physicians concern (43%) p value (0.05).family concern was matching low body mass index for their kids where the BMI was <15 (72%) p value (0.016).Doctors concern was less compering to BMI of the children (50%) p value (0.17).also family showed superiority on the physicians in the point of considering their children as picky eater as about (57%) from parents they agreed on that while only (40%) from physicians they agreed on that p value (0.006). Both sides had shared almost similarity in concern regarding picky eater behaviors importantly,refusal to eat at meal time parents (44%) and physicians (21%) p (0.001).

Conclusions:

Family concern should be taking in consideration all the time in evaluation of eating behavior in children, understanding of children eating behaviors will represent a great area to work on as it will open new doors for communication and collaboration between community and physicians.

169 / #103


THE ASSOCIATION BETWEEN DIETARY ANTIOXIDANT QUALITY SCORE AND ANTHROPOMETRIC MEASUREMENTS IN CHILDREN AND ADOLESCENTS

M. Heidari-Beni1, M. Khoshhali2, R. Kelishadi2 1Isfahan University of Medical Sciences, Isfahan, Iran, Department Of Nutrition, Child Growth And Development Research Center, Research Institute For Primordial Prevention Of Non-communicable Disease, Isfahan, Iran, 2Isfahan University of Medical Sciences, Isfahan, Iran, Department Of Pediatrics, Child Growth And Development Research Center, Research Institute For Primordial Prevention Of Non-communicable Disease, Isfahan, Iran


Limited experience exists in the relationship between anthropometric measures and dietary antioxidant intake in the pediatric age group. We aimed to investigate the association of dietary antioxidants intake and anthropometric measurement in children and adolescents.

Methods:

This nationwide study was conducted in 4270 Iranian children and adolescents, aged 6-18 years. Demographic and anthropometric were assessed. Children were classified as underweight, healthy weight or overweight/obese based on body mass index (BMI) percentiles. Dietary intake was obtained by a 168-item semi-quantitative validated food frequency questionnaire. Energy and nutrients intake was estimated using the Nutritionist IV software. Dietary antioxidant quality score (DAQS) was calculated based on daily dietary intake of selenium, zinc, vitamin A, vitamin C and vitamin E compared to daily recommended intake (DRI).

Results:

After adjustment for age, gender, living area (rural or urban), energy intake and physical activity level, DAQS was positively associated with waist circumference (WC), hip circumference (HC) and waist- to- height ratio (WHtR) in under-weight children and adolescents (B= 1.614, 1.634, and 0.01, respectively; all Ps<0.05). Increased DAQS was significantly associated with higher WC and WHtR in normal–weight children (B = 0.536 and 0.003, respectively; all Ps <0.05).

Conclusions:

Dietary intakes of some antioxidants were higher in children and adolescents with excess weight. The positive relationship between central obesity and DAQS in underweight and normal-weight children underlines the adverse effects of lower intake of antioxidants on childhood obesity.

170 / #105


ASSESSMENT OF LIFESTYLE AND EATING HABITS AMONG ADOLESCENT GIRLS

M. Heidari-Beni1, R. Shayan-Moghadam2, R. Riahi2, R. Kelishadi3 1Isfahan University of Medical Sciences, Isfahan, Iran, Department Of Nutrition, Child Growth And Development Research Center, Research Institute For Primordial Prevention Of Non-communicable Disease, Isfahan, Iran, 2Isfahan University of Medical Sciences, Isfahan, Iran, Child Growth And Development Research Center, Research Institute For Primordial Prevention Of Non-communicable Disease, Isfahan, Iran, 3Isfahan University of Medical Sciences, Isfahan, Iran, Department Of Pediatrics, Child Growth And Development Research Center, Research Institute For Primordial Prevention Of Non-communicable Disease, Isfahan, Iran


Lifestyle and eating habits affect mental and physical health throughout life, with adolescence as one of its critical periods. The aim of this study was to describe some lifestyle and eating habits among Iranian adolescent girls, as future mothers.

Methods:

This nationwide study was conducted within the framework of the fifth survey of a national surveillance program known as the Childhood and Adolescence Surveillance and PreventIon of Adult Non-communicable disease study (CASPIAN-V). Lifestyle and eating habits of 3207 adolescent girls, aged 12-18 years, living in 30 provinces of Iran were assessed.

Results:

The prevalence of overweight and obesity was 11.3% and 10.2%, respectively. The frequency of daily intake of fruits was 60.9%, followed by dairy products (45.6 %) and vegetables (33.5%). Skipping breakfast was reported by 15.8% of participants. It was more common than skipping lunch and dinner. Overall, 55.2% of Iranian adolescent girls watched television for at least 2 hours a day; 27.1% of them slept less than 8 hours a day. Moreover, 10.6 % consumed fast food daily and 16.2% consumed fast food weekly. 61.1% of them had physical activity of more 30 minutes per day. 16.3% of them have less than 5 minutes of sun exposure per day and 60.2% received sunlight less than 30 minutes per day.

Conclusions:

Improper lifestyle habits should be considered in public health programs to help health promotion of adolescent girls and the future generation. Primary prevention of diseases by promoting healthy lifestyle should be a national public health priority.

172 / #120


FAMILY INCOME AFFECTED ON DIETARY PATTERN AND NUTRITIONAL STATUS OF IRANIAN SCHOOL CHILDREN

S. Hooshmand Freelancer, Food And Nutrition, Leidschendam, Netherlands


Abstract: Many the parameters of nutritional status of school children influenced by diet. In Iran according to economic crisis and lower purchasing power, dietary pattern of this age group gets gradually worse. The present study aimed to assess the pattern in food consumption and dietary diversity of 2600 school children in both genders based on total family income.

Methods:

The cross- sectional study was conducted in Tehran during 2015-16 school year. Nutritional status was determined by using World Health Organization (WHO) anthropometric indices of weight-for-age (WA) and height-for-age (HA) and weight-for-height. Family income and consumption of 118 food items in 11 food groups was recorded by using questionnaire and personal interview.

Results:

The results showed that mean dietary diversity scores increased by increasing family income because of greater variety makes the diet more palatable and pleasant. Mean score for cereals, vegetables, fruits, dairy products and non-vegetarian foods increased by increasing family income. Children who were moderately or severely wasted were from families in the lowest income category and overweight was highest in family with highest income. (χ2=30.953, p=0.002) There was a significant relation between child stunting and family income. (χ2=41.674 p=0.000)

Conclusions:

The association between dietary diversity , child nutritional status and family income needs to be studied in depth,to prevent childhood under nutrition as well as stunting. A need for further study needs to determine whether among fruit and vegetables, cereals preparations and mixed dishes; the type and method of preparation and consequently the energy density affect body weight and nutritional status.

173 / #332


THE MACRO NUTRITION INTAKE AND LEARNING ACHIEVEMENT IN ADOLESCENTS AGES 16-18 YEARS

R. Indriawati Universitas Muhammadiyah Yogyakarta, Physiology, Yogyakarta, Indonesia


The adolescents who are 16 until 18 years old have a specific nutritional need because they are in the young adulthood period. The balanced nutrient that suits with the adolescent needs will help them in their growth and their optimal development. The menu contains the nutrient requires to grow and develop. Consuming a good regular food will make the body healthy, having a good achievement in the study, the fit body, and a quality human resource. This research contained the information of the macronutrients such as carbohydrates, proteins, and fats toward the adolescents that influenced their learning achievement.

Methods:

We used the observational analytic research design with the Cross-Sectional approach. The nutrient recall questionnaire of food recall used to collect data for 3 days. The sample of this research were 71 adolescent ages 16-18 years.

Results:

The result showed that 63.32% of the subject had a moderate protein intake also a good achievement, 36.62% of subject had a moderate fat intake also a good learning achievement and 64.79% of subject had a good carbohydrate intake also a good learning achievement. The Pearson product-moment test showed that there was a positive correlation of the protein and carbohydrate intake toward the learning achievement (p=0.0001, r=0.752; p=0.0001; r=0.433). There was a negative correlation between the lipid intake toward the learning achievement (p=0.038; r=-0.118).

Conclusions:

The macro nutrition affects the learning achievement of adolescents aged 16-18 years. The protein and carbohydrate intake increases the learning achievement but the lipid intake decreases the learning achievement.

174 / #388


A 4 YEAR-OLD SMALL FOR GESTATIONAL AGE BORN GIRL WITH HYPOCHONDROPLASIA AND GROWTH HORMONE DEFICIENCY

A. Janchevska, V. Tasic, O. Jordanova, Z. Gucev University Children's Hospital;, Medical Faculty, Skopje, North Macedonia


Hypochondroplasia is skeletal dysplasia expressed with short-limb dwarfism, lumbar lordosis, short and broad hands and feet and macrocephaly. Mutations in exon 12 of a FGFR3 gene are detected in approximately 70 percent of affected patients with hypochondroplasia, inherited from one or two affected parents.

Methods:

A 4 year-old girl was born at term (40th gestation week), but small for gestational age (SGA), with birth weight (-2.35 SDS) and birth length (-2.76 SDS). She has short stature (-4.45 SDS) and weight (0.22 SDS), with short limbs, lumbar lordosis, broad and short hands and mild frontal bossing. The both parents have the same clinical features and short stature, mother's height (-5.45 SDS) and father's height (-6.66 SDS). Diagnostic assessment of our patient was achieved by analysis of clinical features, auxology parameters, biochemical and molecular analyses.

Results:

Hormonal analyses revealed low serum values of IGF-1 (49.1 ng/ml) and growth hormone (GH) with peak of 4.58 ng/ml in both provocation tests. Molecular analyses (PCR amplification and DNA sequencing) confirmed a presence of c.1620C>G (p.Asn540Lys) mutation in exon 12 of FGFR3 gene. The same mutation was detected in her father, but not in her mother. A GH treatment is planned to be commenced.

Conclusions:

Herein we present three members of one family with short stature and typical clinical features for hypochondroplasia. Our SGA born patient and her father are carriers of the same mutation in the exon 12 of FGFR3 gene.

175 / #390


EFFECT OF MATERNAL CALCIUM SUPPLEMENTATION ON OFFSPRING BLOOD PRESSURE IN A POPULATION WITH A LOW CALCIUM INTAKE: A SERIAL FOLLOW-UP STUDY IN CHILDHOOD

L. Jarjou1, G. Goldberg2, A. Prentice2 1Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Nutrition, Banjul, Gambia, 2Medical Research Council, Nutrition And Bone Health Group, Cambridge, United Kingdom


Studies suggest that increasing calcium intake in pregnancy may lower offspring blood pressure. The aim was to investigate if calcium supplementation of pregnant rural Gambian women with a low calcium intake (300-400mgCa/d) lowers offspring blood pressure.

Methods:

Of 525 children born to women who completed an RCT of calcium carbonate supplementation (1500mgCa/d) in pregnancy (ISRCTN96502494), 491 children (94%)had blood pressure (systolic SBP; diastolic DBP, Dinamap 8100), height and weight measured at age 3y and every 2y until 11y.

Generalised linear models, with interactions, were constructed to investigate maternal supplement effects by sex and age.

Results:

Girls had higher SBP and DBP than boys (p≤0.001) and greater increases in SBP with age (p<0.0001). In girls, the maternal supplemented group had lower SBP than placebo (S-P=-1.99±0.85mmHg, p=0.02) but not in boys, although the SBP increase with age was greater in the maternal supplemented group (p=0.01). No supplement effects were seen on DBP. Overall, there were no significant sex differences in height and weight, but girls grew faster than boys in height (0.37 cm/y) and weight (0.22 kg/y) (p<0.0001). In girls, the maternal supplement group grew less rapidly than placebo (0.15 cm/y (p=0.02); 0.09 kg/y (p=0.03)). No supplement effects were seen in the boys. The sex differences in the supplement effects on SBP, height and weight with age were significant (p<0.0001).

Conclusions:

Calcium carbonate supplementation in pregnancy resulted in sex-specific effects on childhood blood pressure and growth, with girls experiencing lower SBP and slower growth but not boys.

176 / #275


ASSOCIATION BETWEEN NUTRITIONAL STATUS ,BODY IMAGE AND OTHER FACTORS OF GYMERS IN JAKARTA

K. Kusharisupeni, D. Sinta Faculty of Public Health, Universitas Indonesia, Public Health Nutrition, Depok, West Java, Indonesia


Body image is a concept related to the body appearance, including size, body shape and weight which describes someone based on their shape and weight. This study aims to show factors that significanly associated between nutritional status, body image, and other factors among the gymmer community.

Methods:

This cross-sectional study was conducted in April 20I5 with a total of I43 respondents

Results:

The result, obtained by questioner, showed that 74,1 % men and women respondents were unsatisfied with their body image. Variables that significantly associated with body image are nutritional status (p-value 0,00l), energy and isotonic drink frequencies (p-value 0,003), impact by peer group (p-value 0.00 I ), and body image perception based on opposite gender counterparts (p-value 0,009).

Conclusions:

The results of this study suggest that there is a need for gymmers to increase knowledge on eating habits, physical activity and the right body image

177 / #113


BREAKFAST HABIT, FE INTAKE ADEQUACY, AND LOW FREE SUGAR INTAKE ARE ASSOCIATED WITH THE COGNITIVE DEVELOPMENT OF CHILDREN AGED 54-66 MONTHS

I. Kusumastuty, Y. Kurniawati, Y. Fadhilah, E. Pratiwi, S. Astutik, L. Harti Universitas Brawijaya, Nutrition, Malang-East Java, Indonesia


Cognitive development is vital in the critical period of children and will influence the quality of life in the future. Cognitive development is influencedby many factors, including breastfeeding history, breakfast habit, and nutritional intake adequacy. This study aimed to determine the relationship of breastfeeding history, breakfast habit, and nutrient intake on the cognitive development of children.

Methods:

This research was a cross-sectionalstudy on 53 kindergarten-aged children (54 - 66 months). Data collection on nutrition was done by interviewing the respondent's parents using food record forms, SQ-FFQ, and breastfeeding history questionnaires. Cognitive development was measured through direct observation and interviews with respondents using instruments developed by the Indonesian Ministry of National Education year 2004.

Results:

The statistical analysis results showed that breakfast habit (p = 0.001, r = 0.420), Fe intake (p = 0.001, r = 0.444), and sugar intake (p = 0.001, r = -0.352) were associated with the cognitive development of children; whereas, carbohydrate intake (p = 0.221), protein intake (p = 0.149), vitamin C intake (p = 0.179), and breastfeeding history (exclusive breastfeeding,p = 0.964; colostrum administration, p = 0.657; breastfeeding duration, p = 0.770) were not related to the cognitive development of children.

Conclusions:

This study concludes that the cognitive development of children is associated with Fe intake, breakfast habit, and sugar intake. A better Fe intake adequacy will result in higher cognitive development score. A more routine breakfast habit will result in higher cognitive development score. A lower free sugar intake will result in higher cognitive development score

178 / #593


NUTRITIONAL STATUS, PSYCHOSOCIAL STIMULATION AND COGNITIVE FUNCTION: IMPLICATIONS FOR NEURODEVELOPMENT OF PERINATALLY HIV-POSITIVE CHILDREN IN RESOURCE-CONSTRAINED SETTINGS

A.G. Lentoor Sefako Makgatho Health Sciences University, Clinical Psychology Department, School Of Medicine, Pretoria, South Africa


Due to improved early treatment, most children with perinatally acquired HIV (PHIV) in resource-constrained settings are surviving into adolescence, yet they face increased neurodevelopmental risks. The purpose of this study was, therefore, to examine the relationship between nutritional status, psychosocial stimulation, and cognitive function of children living with HIV in South Africa.

Methods:

Nutritional status was assessed in a 152 purposively recruited hospital-based sample of HIV-positive children aged 3-7½ years, using the WHO anthropometric method. Cognitive function were evaluated on the Wechsler Preschool and Primary Scale of Intelligence (WPPSI), while the caregivers completed the Home Screening Questionnaire (HSQ) as a measure of psychosocial stimulation in the home. Correlation and multiple regression analysis were performed.

Results:

The result showed that children with PHIV were at risk for undernutrition, with 36.2% of children presenting with stunting. Cognitive function was associated with both stunting and underweight. PHIV children who presented with stunting (X[n=152] = 14.79, p= 0.05) were also more likely to live in a home-environment lacking in psychosocial stimulation; evidenced by, limited child-caregiver interaction, limited play activities exposure, reading material and overcrowding.

Conclusions:

The findings has implications for the psychosocial needs of families living with HIV. The provision of support that that integrates medical with nutritional and psychosocial stimulation interventions is expected contribute to optimal neurodevelopment outcomes of HIV-positive children.

179 / #359


IDENTIFY LIFESTYLE PATTERNS IN RELATION WITH CARDIORESPIRATORY FITNESS AMONG CHINESE CHILDREN: A LATENT CLASS ANALYSIS

M.-W. Liu1, R. Tang1, J. Zhang1, Q. Chen2, Q.-Q. He1 1Wuhan University, School Of Health Sciences, Wuhan, China, 2Wuhan University, Health Sciences, Wuhan, Hubei, China


Cardiorespiratory fitness (CRF) plays an important role in cardiovascular risk and subsequent diseases among children. Diet, physical activity and sleep are modifiable determinants of CRF. However, a clustering of lifestyle behaviors has seldom been conducted to predict CRF worldwide and in China.

Methods:

The study subjects comprised 778 schoolchildren (424 boys and 354 girls, aged 9.1±0.6 years) in Wuhan, China. CRF was assessed by the 20-meter multistage fitness test, and the predicted maximum oxygen uptake (VO2max) was derived accordingly. Sleep duration (SD), physical activity (PA), screen time, fruit and vegetable intake (FVI), beverage intake, snack intake, and fast food intake were self-reported. A latent class analysis (LCA) was conducted among these factors to identify lifestyle patterns. Age, gender, household income, and body mass index were adjusted in all models.

Results:

The final LCA yield a three-class solution: (1) Healthy lifestyle: proper SD, high PA, low screen time, high FVI, and low junk food; (2) Unhealthy lifestyle: low SD, low PA, low screen time, low FVI, and high junk food; (3)Mixed lifestyle: proper SD, medium PA, high screen time, medium FVI, and high junk food. Multivariate linear regression showed that children with a healthy lifestyle have higher CRF than those with an unhealthy lifestyle (β=0.57, 95% CI=0.20-0.94, P=0.003) and those with mixed lifestyle (β=0.68, 95% CI=0.33-1.03, P<0.0001). However, there is no significant difference between mixed and unhealthy lifestyles (P=0.56).

Conclusions:

Among three major lifestyle patterns found among Chinese schoolchildren, the healthy pattern is associated with higher CRF than the mixed pattern and unhealthy pattern.

180 / #569


BONE MINERAL DENSITY IN CHILDREN SUBMITTED TO DAIRY RESTRICTION

T. Lopes, M. Monteiro, A. Faria, M. Pocinho, H. Loureiro Coimbra Health School, Dietetics And Nutrition, Coimbra, Portugal


Calcium is one of the responsible nutrients for bone health and can only be obtained exogenously through food. Dairy is the richest source of calcium in our diet. The aim is to determine whether children who do not consume dairy products regularly show adequate bone mineral density.

Methods:

Anthropometry (weight and height) and body composition (DEXA) children aged 3 to 11 years regularly restricting milk intake were evaluated. A questionnaire of habits and feeding frequency was also applied. This is an observational descriptive study.

Results:

Seventeen children were included (3 to 11 years old), with a mean age of 6.7 years old. None were taking calcium. All children showed adequate height Z-score (-2 to +1). Thirteen subjects do never consume dairy or do it less than once a month. The remainder consumed it 1 to 3 times a month. Just two children reported drinking fortified vegetable beverages on a daily basis. About the consumption of dark green vegetables, 2 kids consume 4 to 5 servings per day, 7 consume 2 to 3 servings per day and 3 one per day. Average BMD Z-score was -1.05, with 6 children presenting BMD Z-score adequate ( -1 to +1). The remaining 6 showed values lower than -1.

Conclusions:

Children submitted to dairy restriction do not seem to accomplish calcium requirements. This may justify that half of the sample present low bone mineral density. It is suggested to consume 2 servings of calcium-fortified vegetable drinks per day and increase the intake of dark green vegetables.

181 / #354


NUTRITIONAL STATUS OF SCHOOL CHILDREN (6-12 YEARS) IN IGBOEZE SOUTH LOCAL GOVERNMENT AREA ENUGU STATE NIGERIA

A. Maduforo1, V. Esogibe1, C. Okoro2 1University of Nigeria Nsukka, Department Of Nutrition And Dietetics, Nsukka, Nigeria, 2Nutrition Section, Federal Capital Territory Primary Health Care Board, Abuja, Nigeria, Nutrition, Abuja, Nigeria


Physical growth of a child is a reflection of its state of nutrition. In some developing countries such as Nigeria with changing economy and rapidly growing population, the nutritional status of the children is a reflection of the general well-being of the society. The nutritional status of school-aged children contributes significantly to the health status of the community in which they reside. One of the major global health problems faced by developing countries today is malnutrition. The study assessed the nutritional status of school-aged children (6-12 years) in Igbo-eze south local government area, Enugu State, Nigeria.

Methods:

Cross sectional survey design and multistage sampling technique was used to select 353 primary school pupils (respondents). Well-structured and validated questionnaire was used to elicit information of socio-demographic characteristics, health history and dietary pattern. Anthropometric data collected with appropriate tools and was compared with World Health Organization standards. Frequencies, percentages, mean and standard deviation was used to describe the data. The variables were compared using chi square, Pearson correlation, and student T-test. Significance level was accepted as p<0.05.

Results:

Out of 353 respondents, 30.9% were males and 69.1% were female. Results showed that 60.9% of the respondents skipped meals, 5.4 % had been diagnose with goitre, 23.2% of the respondent was underweight, 9.3% were overweight, 2.0% were obese, 27.7% was stunted and 52.3 % of the respondents had low dietary diversity score Significant negative correlation exist between mothers’ parity and dietary diversity score (r=-0.108; p=0.043).

Conclusions:

There is double burden of malnutrition in the communities.

182 / #350


THE ASSOCIATION OF SCHOOL EXAMINATION ON STRESS AND EATING BEHAVIOR AMONG MULTI-ETHNIC MALAYSIAN ADOLESCENTS: AN ANALYSIS OF PERCEIVED STRESS AND MEASURED SALIVA CORTISOL

H. Majid1, M. Jalaludin2, N. Shah3, N. Aghamohammadi3 1University of Malaya, Department Of Social & Preventive Medicine, Kuala Lumpur, Malaysia, 2University of Malaya, Pediatrics, Kuala Lumpur, Malaysia, 3University of Malaya, Dept Social And Preventive Medicine, Kuala Lumpur, Malaysia


The concurrent increasing prevalence of mental health and obesity among adolescents worldwide has been attributed to urbanization and changes in lifestyle. This study aims to explore the level of stress experienced by Malaysian adolescents and its impact on their eating behaviour.

Methods:

A cohort study was conducted among 797 multi-ethnic Malaysian adolescents from both urban and rural areas. Baseline data were collected during the 2 weeks prior to the final-year national school examination. The stress level was assessed subjectively by using a validated Cohen Perceived Stress Scale questionnaire and objectively by using the saliva cortisol level of a subsample of 261 participants. Eating behaviours were explored by using a validated self-reported Child Eating Behaviour questionnaire.

Results:

The prevalence of high stress among the adolescents was 29.1%; highest among Chinese (34.4%), female (34.4%), urban (32.6%) and obese and overweight (33.8%) adolescents. The mean saliva cortisol was 3.8 nmol/L (95% CI: 3.4, 4.3); highest among Indian [5.7 nmol/L (95% CI: 3.4, 8.0); p < 0.05]; male [4.3 nmol/L (95% CI: 3.5, 5.1)], urban [3.9 nmol/L (95% CI: 3.3, 4.4)] and underweight [4.5 nmol/L (95% CI: 3.4, 5.6)] adolescents. The strongest significant positive correlation was observed between perceived stress and emotional overeating; stronger among urban (r = 0.28), female (r = 0.29), underweight (r = 0.31) and moderately stressed adolescents (r = 0.20).

Conclusions:

Stress and obesity are significant problems among adolescents. The perceived stress level affects the emotional eating and external eating patterns of adolescents and therefore obesity prevention programmes should be designed taking these issues into account.

183 / #383


NUTRIENT ADEQUACY OF MEXICAN TODDLERS BY MILK CONSUMPTION TYPE.

T.N. Mak1, A. Prieto Patron2, E. Offord1, S. Villalpando-Carrión3 1Nestlé Research, Nestlé Institute Of Health Science, Vers-Chez-Les-Blancs, Switzerland, 2Nestlé Research, Health Economics, Vers-Chez-Les-Blancs,, Switzerland, 3Hospital Infantil de México Federico Gómez, Departamento De Gastroenterología Y Nutrición, Mexico City, Mexico


Only 1 in 3 Mexican toddlers consume age-appropriate beverages such as milk and water. A recent national survey revealed preschool children had inadequate intakes of vitamin D, iron, polyunsaturated fat and fibre. This study aims to determine the nutritional adequacy among Mexican children aged 1 to 3 years by type of milk consumption.

Methods:

Dietary intake data from the Mexico National Nutrition Survey (ENSANUT) 2012 were analysed. Children aged 1 to 3 years (n=489) were stratified by milk consumption type: Young child milk beverages (YCMB), milk, and no/low milk. Mean daily intakes of nutrients and percentage of children with inadequate intakes (below EAR) were compared between groups.

Results:

Fifty percent of children were milk consumers, 32% had no/low milk, 18% had YCMB consumers. Mean consumption of YCMB was 584g/d and of milk 514g/d. YCMB consumers had the highest adequacy of calcium, vitamin D, iron, folate, vitamin E compare to milk or no/low milk consumers. No/low milk consumers had the lowest daily intakes of calcium, vitamin D, iron, folate, zinc, vitamins B1, B2, B6 and B12 compare to other groups (all p< 0.001). YCMB consumers had higher daily intakes of folate (339µg/d vs. 225µg/d), iron (13.2mg vs. 8.2mg), vitamin D (5.9µg/d vs. 3.9 µg/d), vitamin E (9.3mg/d vs. 4.3mg/d), and lower saturated fats (15.3g vs. 18.4g) compare to milk consumers (all p<0.01).

Conclusions:

No/low milk consumers had the lowest nutrient intakes. YCMB consumers had higher micronutrient and lower saturated fats intakes than milk consumers. YCMB could help to fulfil the micronutrient gaps among Mexican toddlers.

184 / #328


GROWTH PATTERNS IDENTIFICATION IS AFFECTED BY THE METHODOLOGY APPLIED: AN EXPLORATORY STUDY

P. Massara1,2, L. Erdman3, C. Keown-Stoneman4,5, E. Ohuma6,7, J. Maguire1,8,9,10, C. Bourdon2, E. Comelli1,11, R. Bandsma1,2, C. Birken1,12 1University of Toronto, Nutritional Sciences, Toronto, Canada, 2The Hospital for Sick Children, Translational Medicine, Toronto, Canada, 3University of Toronto, Computer Science, Toronto, Canada, 4St. Michael's Hospital, Applied Health Research Centre, Toronto, Canada, 5University of Toronto, Dalla Lana School Of Public Health, Toronto, Canada, 6The Hospital for Sick Children, Centre For Global Child Health & Child Health Evaluative Sciences, Toronto, Canada, 7University of Oxford, Centre For Tropical Medicine And Global Health, Oxford, United Kingdom, 8St. Michael's Hospital, Pediatrics, Toronto, Canada, 9Unity Health Toronto, Li Ka Shing Knowledge Institute, Toronto, Canada, 10The Hospital for Sick Children, Pediatric Outcomes Research Team, Toronto, Canada, 11University of Toronto, Joannah And Brian Lawson Centre For Child Nutrition, Toronto, Canada, 12The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, Canada


Growth patterns detection is commonly used to better understand factors that contribute to different growth trajectories. However, the substantial variability that has been observed in identified growth patterns, even within the same populations, renders data synthesis challenging. This study compared different clustering approaches and how well they agree/disagree in their classification of the same population of children.

Methods:

We included 1134 children from The Applied Research Group for Kids (TARGet Kids!) cohort with data available from birth until 12 years. We conducted 72 clustering configurations using various growth measures (weight and height/length, BMI for age z-scores), clustering algorithms and distance metrics. For comparison purposes, we also implemented a latent class mixed models (LCMM) analysis.

Results:

For BMI z-scores (zBMI), we identified 3 distinct growth patterns by both time series clustering (TSC) and LCMM. The LCMM group trajectories were labeled as 1) normal increasing, 2) early high-decreasing, 3) rapidly developing overweight and the TSC as 1) lower normal, 2) higher normal, 3) developing obesity. The clustering agreement was 51% between LCMM and TS clusters, and between 31%-93% within the TSC configurations. These results were consistent for all growth measures.

Conclusions:

Our study demonstrates that the analysis algorithm can affect pattern detection results and participants' distribution across clusters. Further analysis is required to identify the most precise clustering configuration according to clinical markers.

186 / #494


DETERMINATION OF EATING BEHAVIOUR, FOOD HABITS AND ANTHROPOMETRIC MEASUREMENTS OF HIGH SCHOOL STUDENTS AGED 14-18 ACCORDING TO THEIR GENDER.

M. Milani1, N. Yousefirad2, I. Ozdemir2 1YEDITEPE UNIVERSITY, Nutrition And Dietetics, ISTANBUL, Turkey, 2Health Sciences/Istanbul Medipol University, Nutrition And Dietetics, Istanbul, Turkey


Researches has shown that well nourished students can have better performance at school and good nutrition is an important part of leading a healthy lifestyle. Because of these crucial roles it is important to determine students fodd habits in order to find the ways to improve their nutrition at school and home. This research include 197 boys and 201 girls, total 398 students selected by random sampling method to determine the food habits and anthropometric measurments of 14-18 years old high school students according to their gender.

Methods:

The personal information and food habits of students were determined by questionnaire, which prepared in 25 questionnaires.

Body mass index was calculated by measuring height and weight of each students.

Revalent data was calculated by SPSS 18 program.

Results:

49.5% of students consume 3 meals per day. 63.6% of them have irregular meal times and the most skipped meal is determined as breakfast and the major reason is they are in rush in the mornings to get ready for school. 72% of the students eat sandwiches , bagels, toasts from conteen in school. 88.7% of students have unhealthy snacks between meals. 73.4% of the students read labels information on attention to the expiration date. 78.9% of students eat fast food because they think it's more delicoius. Also, they had insufficient consumption of fruits and vegtables.

Conclusions:

As a result, high school students had insuffcient nutrition and this condition can be improved by replacing adequate and balanced nutrition, and giving students more education about the importance of healthy eating.

187 / #30


PROPOSAL FOR EDUCATIONAL MATERIAL DEVELOPMENT BASED ON THE JAPANESE SCHOOL MEAL MENU PLAN

K. Miyahara, Y. Ichinei, Y. Saito KIRYU UNIVERSITY, Faculty Of Health Care,department Of Nutrition, Midori-City Gunma, Japan


The purpose of this study is to propose school lunch as educational material in which pressing health issues as required through school lunch can be resolved, by developing the theory that the school lunch menu is educational material.

Methods:

Using "school lunch" and "dietary education" as keywords, the researcher (National Registered Dietitian), who is familiar with school lunch, plans the following five steps. 1. Information on health issues in Japanese children is collected, from which health issues are then abstracted. 2. The school dietary education model is set according to the assessment results. 3, Subjects for guidance in order to achieve the monthly dietary education goals are set. 4. A menu plan for dietary education is prepared. 5. A learning guidance plan and educational materials are prepared.

Results:

Main items in the menu plan proposal were guidance subjects, aim of the menu, reasons for creating the menu, elements of menu creation as educational material, etc. For example, the dietary education goal in September was functions of foods, and four subjects were set as guidance material: The benefit of rice, Elements in creating the menu as educational material included○Rice is a dietary staple. ○The proper amount of rice for one meal. ○A menu that combines the main dish and a side dish.

Conclusions:

School lunch in Japan are said to be carried out as part of education. Therfore, ernlightenment of the importance of a menu plan, as an element in education material which is an evaluation index, is needed to handle school lunch educationally.

188 / #499


DIETARY AND LIFESTYLE MODIFICATIONS AS A TREATMENT OF PREMENSTUAL SYDROME IN ADOLESCENT GIRLS.

M. Mizgier1, G. Jarząbek-Bielecka2, K. Mruczyk1, A. Cisek-Wozniak1 1Poznan University of Physical Education, Faculty of Physical Culture in Gorzow Wielkopolski, Dietetic Division, Poznan, Poland, 2Poznan University of Medical Sciences, Department Of Perinatology And Gynecology, Poznan, Poland


PMS and painful menstruation are frequent problems in adolescent gynecology. In the prevention and treatment of both, it is very important to include diet therapy as a minimally invasive method, which is very important in developmental age.

Methods:

Review of medical literature available at Pub Med.

Results:

In view of the diverse positions in the literature regarding the supplementation and dosage of vitamins and microelements, it is safest to use a balanced diet. In this way, overdosing is avoided and side effect are less probable. Preparing the correct, balanced diet is a task for the dietitian. Obtaining plenty of calcium, magnesium, vitamin D and possibly iron, zinc, vitamin B1, B2 and B6 from food appears to be beneficial.

Risk factors for the occurrence of PMS symptoms may be vitamin and mineral deficiencies. To synthesize neurotransmitters potentially involved in the pathogenesis of this syndrome, B vitamins incloaded folic acid are necessary, among other factors. Increased amounts of thiamine (vitamin B1), riboflavin (vitamin B2) and pyridoxine (vitamin B6) have a beneficial effect on relieving PMS symptoms. Researchers emphasize the importance of vitamin D, magnesium and calcium.

There is insufficient evidence for the use of supplements in PMS, except possibly fish oil supplements.

Conclusions:

Diet and lifestyle factors, including weight loss in case of being overweight or obese, and following a low GI/GL diet have been shown to limit PMS symptoms. Physical exertion, e.g. aerobics, but also relaxation or relaxation exercises, may also be beneficial in treating Premenstrual Syndrome in adolescent girls.

189 / #511


FOOD INSECURITY AND NUTRITIONAL STATUS OF GIRLS AGES 6 TO 12 YEARS IN SAUDI ARABIA

W. Mumena1, H. Kutbi2 1Taibah University, Clinical Nutrition, Madinah, Saudi Arabia, 2King Abdulaziz University, Clinical Nutrition, Jeddah, Saudi Arabia


Food insecurity is a global concern that has been linked to poor dietary quality and health. Thus, this study aims to estimate the prevalence of household food insecurity and to determine the association between food insecurity, dietary intake, and children’s growth in Madinah, Saudi Arabia.

Methods:

This cross-sectional study was conducted among 120 female students ages between 6-12 years. Girls and caregivers were recruited from 4 elementary public schools, 2 schools from wealthy neighborhoods and 2 schools low-income neighborhoods. Children’s weight and height were measured to calculate HFA z-score and BMI-for- age z-score, based on the WHO criteria. Children’s dietary intake (24-hour dietary recall) and household food security data (FAO food security questionnaire) were collected during phone interview.

Results:

A total of 28.6% caregivers reported experiencing food insecurity at the household level. Eleven percent of girls were stunted (HFA z-score < -2). Intakes of vitamin D, calcium, potassium, fiber, and zinc were lower than the EAR in both food security groups. The dietary intake of most nutrients were similar among girls from food secure and food insecure households. Only vitamin D intake was higher among girls living in food secure households, while sodium intake was higher among girls living in food insecure households. The frequency of purchasing dairy products as well as fruit and vegetables was higher among food secure households.

Conclusions:

Food insecurity may affect the dietary quality and growth of children living in Saudi Arabia. Further research is needed to investigate the causes of the health issues among Saudis living in food insecure households.

190 / #38


IMPACT OF NUTRITION SUPPORT TEAM IN PAEDIATRIC ICU OF AGHA KHAN UNIVERSITY HOSPITAL .

Q. Naim Agha Khan University hospital, Paediatrics And Child Health, karachi, Pakistan


The aim of this study is to implement enteral nutrition protocols by NST in our PICU that will increase delivery of nutrition ,which may help in achieving enteral nutrition goals in critically ill childrens.The objective is to asses the impact of (NST) on nutritional management of critically ill childrens on the adequacy of energy intake and to be compared with historical control

Methods:

All patients who fulfilled the inclusion criteria and admitted in PICU AKUH were included. After ethical approval ,volume and calorie intake will be checked for 3 days and assess the outcome i-e % of actual target, length of stay ,multiorgan dysfunction, hospital acquired infections.Causi Experimental Study .

Results:

200 patients were included from PICU .100 after 100 before the NST era.In Pre era 61 (61%) were females and 39 (39%) were males with mean age of < 5 years .In Post group 60 (60%) were females and 40 (40%) were males with the mean age of < 5 years. 45 (45%) childrens were below 2 Z score in both the groups ,17(17%) and 15 (15%) were above 2-Z score respectively .46 (46%) were received adequate caloric intake with the mean LOS in ICU is 7.61 + 4.36 in pre group. 83 (83%) were received adequate caloric intake with the mean LOS is 4.17 + 1.76 in post group. No difference in developing multiorgan dysfunction and hospital acquired infections in both groups.

Conclusions:

Conclusion: In conclusion majority of PICU children had adequate energy intake with a decrease in mean length of stay .

192 / #508


INEQUALITY IN STUNTING: A COMPARISON BETWEEN WEALTH QUINTILES IN THE POOREST PROVINCE (PROVINCE 2) OF NEPAL

S. Nepali ADRA Nepal, Health, uygttiy, Nepal


Stunting has declined at national level; however the prevalence of stunting in Province 2 is unequal when disaggregated into economic subgroups. According to Nepal Multidimensional Poverty Index 2018, more than 2.5 million people are multidimensionally poor in Province 2, which is 1 million more people than other provinces. This study assesed the trend of stunting among different wealth quintiles living in Province 2 of Nepal in 15 years.

Methods:

Data from Nepal Demographic and Health Surveys from 2001 to 2016 were used for this study. The study population was children under five years.

Results:

The reduction in the prevalence of stunting among the economic subgroups is not uniform. Among those belonging to poorest group, it decreased by 5.3 percent, whereas among those in richest and richer group, the prevalence decreased by 20 and 12.4 percent respectively. Similarly, there was gap of 25.8 percent in prevalence between poorest and richest economic subgroup in 2001; however, it worsened to 49.4 percent in 2016, which is twice more than the gap in prevalence of 2001. Province 2 had the highest percentage (33%) of households without water, soap or other cleaning agent at hand washing facility and held the second highest position in prevalence of diarrhoea.

Conclusions:

Given the associations between stunting and sanitation in previous studies, these high percentages indicate that, government and non-government organizations and their programs have excluded poor people in Province 2 and is one of the main reasons behind increased inequality in stunting.

193 / #184


STUDYING THE ASSOCIATION BETWEEN BREASTFEEDING AND ADHD IN CHILDREN

F. Norouzi Tehran university of medical science, Psychiatry, Tehran, Iran


ADHD is the most common psychiatric disorder diagnosed in outpatient psychiatric clinics in children. Given the role of breast feeding in the development of the nervous system, we decided to investigate the role of breast milk and other factors in the development of ADHD.ADHD is the most common psychiatric disorder diagnosed in outpatient psychiatric clinics in children. Given the role of breast feeding in the development of the nervous system, we decided to investigate the role of breast milk and other factors in the development of ADHD.

Methods:

This case-control study was performed in 1998 on children referred to psychiatric clinics of hospitals affiliated to Tehran University of Medical Sciences. Demographic information (gender, age, past medical history) and specifically breastfeeding were assessed by telephone from the child's parents. This information was recorded and analyzed.

Results:

This study was a case-control study on 400 children. The results showed that the incidence of ADHD in children was 49%. The prevalence of this disorder was 69% in infants who were not breastfed. Correlation analysis also showed that the incidence of this complication was related to factors such as neonatal jaundice, surgical history, maternal literacy level, maternal age and duration of breast feeding.

Conclusions:

This study showed that the prevalence of ADHD in Iranian children is increasing. This study showed that increased breastfeeding time as well as breastfeeding is a major factor in the future incidence of ADHD in children. A history of surgery and jaundice can also be a risk factor for the disease.

194 / #42


FACTORS ASSOCIATED WITH GROWTH STATUS AMONG TODDLERS WITH MEDICAL CONDITIONS AT PEDIATRIC OUTPATIENTS CLINIC

N. Nurliyana1, M.-Y. Barakatun-Nisak1, M.S. Zalilah1, M.N. Noor-Safiza2 1Universiti Putra Malaysia, Department Of Nutrition & Dietetics, Selangor, Malaysia, 2Ministry of Health Malaysia, Allied Health Sciences Division, Putrajaya, Malaysia


Toddlers with medical conditions had a higher risk of developing undernutrition. Therefore this study aimed to identify the factors associated with growth status of toddlers with medical conditions in selected outpatient’s clinic.

Methods:

A cross-sectional study was conducted at a outpatient clinic among a total of 152 toddlers. A questionnaire consisted of socio-demographic, medical-background and parental-feeding-practices were assessed. Weight and height of the respondents were measured and the growth status was compared with WHO growth chart. The cut-off values for underweight, stunting and wasting were <-2SD

Results:

The prevalence of underweight, stunting, and wasting was 25%, 30.3%, and 17.8% respectively. The logistic regression model showed that in underweight; higher birth weight, frequent use of monitoring practices and higher energy intake were the factors that appeared to be protective against underweight. In stunting, age group of 25-36 months old were 7.56 times more likely to be stunted than the 12-24 months old respondents, higher number of siblings were 2.76 times and frequent use of pressured-to-eat practices were 8.55 times more likely to be stunted. Meanwhile, higher birth weight, frequent use of monitoring practices and higher energy intake appeared to be protective against stunting. In wasting; higher number of siblings were 1.94 times to be wasted and frequent use of monitoring appeared to be protective against wasting.

Conclusions:

The findings suggest that the factors that associated with growth status were different for each indicators of growth status. However, parental feeding practice of monitoring was consistently associated with all the indicators of undernutrition among toddlers with medical conditions.

195 / #334


BODY COMPOSITION AND EFFICACY OF PHYSICAL ACTIVITY EVALUATION USING AN ACCELEROMETER IN ELEMENTARY SCHOOLCHILDREN

S. Ozawa1, N. Omi2 1University of Tsukuba, Graduate School Of Comprehensive Human Sciences, Tsukuba, Japan, 2University of Tsukuba, Faculty Of Health And Sport Sciences, Tsukuba, Japan


Few studies have examined the relationship between physical activity and other indicators such as obesity level and of regional differences body composition in Japanese children. This study aimed to investigate the body composition and the efficacy of physical activity evaluation using a triaxial accelerometer, and examine sex and regional differences among children from rural and urban elementary schools.

Methods:

The participants were 262 fifth or sixth graders (124 boys and 138 girls) from 5 schools in 2 rural areas and 1 urban area who had parent consent for participation. Height, weight, body composition (TANITA DC-217A), and physical activity were measured using a triaxial accelerometer (TANITA AM-161). The children wore the accelerometer during two consecutive weeks, and the data for the last week were analyzed. For the analysis, children whose step counts were <1000 were excluded, and 231 children (99 boys and 132 girls) were finally included.

Results:

The urban school girl had significantly lower body fat than the rural schoolchildren. The girls had significantly lower values for all the parameters than the boys. The urban schoolboys had significantly higher living activity expenditure/weight than the rural schoolchildren.

Conclusions:

Differences in school region could be evaluated in girls. Differences in sex and school region could be evaluated with a triaxial accelerometer. Our results suggest the efficacy of physical activity evaluation using a tri-axial accelerometer.

196 / #319


THE CORRELATION OF ENERGY AND MACRONUTRIENTS INTAKE FROM SCHOOL LUNCH WITH NUTRITIONAL STATUS OF PRESCHOOL CHILDREN

I.R. Palupi1, S. Setyowati2, H.D. Sadida1 1Universitas Gadjah Mada, Health Nutrition Department, Yogyakarta, Indonesia, 2Health Polytechnic Ministry of Health Yogyakarta, Nutrition Department, Yogyakarta, Indonesia


School lunch contributes to one-third of the daily energy intake, so it may affect the fulfillment of nutrient requirements as well as nutritional status of children. This study aims to determine the correlation of energy and macronutrients intake from school lunch with nutritional status of preschool children.

Methods:

This was a cross-sectional study conducted in a full day school which provided lunch for all of its students. A total of 90 preschool children of a kindergarten in Jogjakarta, Indonesia, participated in this study. Intake of school lunch were observed for 7 days using a visual estimation method with the 6-point Comstock scale. Anthropometric data (body weight and height) were measured to assess the nutritional status. Spearman Correlation test was employed for data analysis.

Results:

School lunch intake fulfilled 85%-110% of the nutrient needs of the subjects in terms of energy, protein, fat and carbohydrate. The proportion of subjects with normal nutritional status based on BMI for age was 81.1%, overweight was 16.7%, and 2.2% of the remaining was underweight. There was a significant correlation between intake of energy and macronutrients from school lunch with subjects’ nutritional status (p<0.05), except for carbohydrate (p=0.816).

Conclusions:

Energy and macronutrients (protein and fat) intake from school lunch has a correlation with nutritional status of preschool children. Further studies are suggested to assess the contribution of nutrient intake from school meals to nutritional status of preschool children by taking into account food consumption outside of the school.

197 / #416


ASSESSMENT OF NUTRITIONAL STATUS OF CHILDREN WITH NEUROLOGICAL IMPAIRMENT

R. Pancheva1, A. Toneva1, S. Nikolova1, L. Rangelova2, A. Morfova3 1Medical University of Varna, Hygiene, Varna, Bulgaria, 2National Center of Public Health and Analyses, Nutrition, Sofia, Bulgaria, 3Karin dom foundation, Early Intervention, Varna, Bulgaria


Children with neurological impairment (NI) are a risk population group in terms of nutrition. Their nutritional status has a significant impact on their overall health, development, physical activity and survival.

The aim of this study is to assess the nutritional status of children with NI based on anthropometric indicators according to the WHO and American Society for Parenteral and Enteral Nutrition (ASPEN) standards.

Methods:

A cross-sectional survey was conducted in the period of April 2017 to April 2018, which included 109 children with NI. Questionnaires on socio-demographic data, gross motor skills, nutrition specifics and quality of life were applied. The height, weight, head, mid-upper circumferences and skin fold thickness of studied children were measured. Children’s nutritional status was assessed by WHO and ASPEN standards.

Results:

According to WHO standards, the rate of children with underweight was 42,3% (weight-for-age <–2Z), stunted–43.3% (length/height-for-age <–2Z) and wasted 32% (BMI-for-age<–2Z). According to ASPEN standards, the prevalence of NI children with underweight was 61.9%, where wasted were 46,9% (BMI-for-age<–2Z) and 13% were children with mild malnutrition (BMI-for-age < –2Z ÷ –1Z). There was a high percentage of likely protein deficiency – 34%, measured by mid-upper arm circumference (MUAC-for-age <–1Z) index.

Conclusions:

Nutritional problems in NI children are critical to achieve optimal growth and development but, they are often underestimated on account of the primary concern for the main disease. The use of more sensitive standards and criteria enables a more accurate and timely assessment of the nutritional status of NI children - a basis for early and targeted intervention.

198 / #295


EVALUATION OF DAIRY PRODUCTS CONSUMPTION FREQUENCIES AND THE RELATIONSHIP BETWEEN CALCIUM INTAKE AND ANTHROPOMETRIC MEASUREMENTS OF CHILDREN AGED 10-14 YEARS

M. Pehlivan1, F.E. Sezer2, R. Yilmaz3 1ISTANBUL MEDIPOL UNIVERSITY, Nutrition And Dietetic, Istanbul, Turkey, 2Istanbul Medipol University, Department Of Nutrition And Dietetics, Istanbul, Turkey, 3ISTANBUL MEDIPOL UNIVERSITY, Nutrition And Dietetic, ?STANBUL, Turkey


The aim of this research is to determine dairy products consumption frequencies and the relationship between calcium intake and anthropometric measurements of the secondary school students in a private school.

Methods:

The study was conducted with 146 children aged 10-14 years (50.7% male and 49.3% female) in a private school in Çanakkale. The data were obtained by a questionnaire including questions about demographic features, anthropometric measurement, dietary habits, dairy products consumption frequency and a 24-hour dietary recall. All statistical analysis were performed using SPSS v.18.0.

Results:

The mean body weight and height of males and females were 47.4 ± 11.2 kg, 154.5 ± 10.3 cm; 46.5 ± 10.6 kg, 156.4 ± 9.1 cm respectively. While the daily consumption of milk, yogurt and white cheese were 48.6%, 39.2% and 33.8% for males respectively and 51.4%, 52.8% and 47.2% for females respectively. The mean calcium intake was 579.9 ± 260 mg for male and 600.9 ± 327.1 mg for female. Calcium intakes of both sexes were found to be insufficient compared to RDA. The effect of calcium intake on body weight, height and BMI was examined but no significant relationship was found (p> 0.05).

Conclusions:

Calcium intake of dairy products plays an important role for adolescents in growth and development, especially for bone health. Therefore, it is recommended that calcium intake of children and adolescents should always be within RDA.

199 / #399


EOSINOPHILIC ESOPHAGITIS IN THE PEDIATRIC POPULATION - OUR EXPERIENCES

B. Perse1, O. Zaja1, M. Mihajević2 1Sestre milosrdnice University Hospital Center, Department Of Pediatrics, Zagreb, Croatia, 2University Hospital Center Zagreb, Department Of Pediatrics, Zagreb, Croatia


Eosinophilic esophagitis (EoE) represents chronic esophageal inflammation, which if untreated leads to esophageal damage. The etiology has not been clarified, an immune-mediated process has been assumed, with nutritional allergens as triggers. We wanted to demonstrate the clinical features and the effectiveness of the diagnostic-therapeutic approach in a child with EoE.

Methods:

We did retrospective review of the documentation, identified patients, analyzed age, sex, symptoms, length of illness until diagnosis, presence of atopic diseases, blood eosinophil level, total IgE, endoscopic and histological findings, therapeutic response and compliance.

Results:

11 children met criteria for EoE (9 male), aged 10-17 years (mean age 13.45). Only one did not have sensitization to nutritional allergens and all have high total IgE. Five of those patients had other atopic diseases. After the introduction of targeted or empiric elimination diet, four patients were in remission. In one of those patients, we subsequently introduced milk protein, but because of the relapse, we decided to recommend topical corticosteroid therapy, which again led to great response. Two patients had clinical response and control endoscopy had yet to be done. Three did not respond to therapy, but in one of them we needed to excluded more food allergens, which than led to great clinical response. Two patients were non-cooperative. The duration of symptoms ranged from 2 - 60 months.

Conclusions:

The path to diagnosis as well as therapy are complicated, however with early diagnosis and treatment, it is possible to establish good control, prevent consequences of the disease and ensure normal growth and development.

200 / #381


THE IMPACT OF STUNTING AND HIV EXPOSURE (HEU) ON THE QUALITY OF CHILD GROWTH IN RURAL ZIMBABWE

J. Piper1,2, R. Ntozini1, I. Mapurisa1, T. Mashedze1, F. Majo1, B. Chasekwa1, J. Humphrey1,3, J. Wells4, K. Michaelsen5, A. Prendergast2 1Zvitambo Institute of Child Health, Child Health, Harare, Zimbabwe, 2Queen Mary University of London, Genomics And Child Health, London, United Kingdom, 3Johns Hopkins, School Of Public Health, Baltimore, United States of America, 4UCL institute of child health, Population, Policy & Practice Dept, London, United Kingdom, 5University of Copenhagen, Department Of Nutrition, Exercise And Sports, Copenhagen, Denmark


Globally, 150 million children fail to grow properly and become stunted in response to both nutritional and socio-economic factors. Beyond simply measuring linear growth, body composition provides important insights into function and emerging metabolic disease. Food insecurity makes the body prioritise fat mass for short-term survival, but increases the long-term risk of cardiovascular disease. However, inflammation such as HIV exposure may decrease prioritised fat mass. By contrast, increased lean mass (ie muscle, tissues and organs) ultimately provides better health, physical and cognitive function. The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial tested the effects of improved nutrition and water, sanitation and hygiene (WASH) on stunting at age 18 months in rural Zimbabwe.

Methods:

Research nurses travelled by motorbike to measure children's growth at their homestead. Bio-impedance analysis was performed which measured fat and lean mass. The subcutaneous fat layer was assessed using the skinfold thicknesses and tibial growth recorded using knee to heel length.

Results:

230 children were measured at age 2 years, of whom 69 were stunted and 36 had a history of HIV exposure in-utero. Children with stunting had reduced lean mass. Children with HIV-exposure had both reduced lean mass and subcutaneous fat.

Conclusions:

Advanced body composition measurement techniques, which provide important determinants of population health, can be successfully adapted for use in rural areas only accessible by motorbike. They have also provided insight into the adverse effects of stunting and HIV exposure. Future work aims to assess the SHINE trial public health interventions’ effect on body composition.

202 / #314


AGE MODIFIES THE ASSOCIATION BETWEEN GENDER AND HYPERCHOLESTEROLEMIA AMONG ADOLESCENTS IN MALAYSIA: (MYHEART) STUDY

R. Ramakrishnan, S. Rampal, H. Majid, Y. Jalaludin University of Malaya, Department Of Social & Preventive Medicine, Kuala Lumpur, Malaysia


Hypercholesterolemia is a major modifiable risk factor for cardiovascular disease (CVD). Many existing studies have shown evidence that atherosclerosis begins in adolescents which later progresses into CVD manifestations at early adulthood. The objective of this study is to report the risk of hypercholesterolemia according to age by gender among adolescents in Malaysia.

Methods:

This is a longitudinal analysis of the MyHeART cohort (2012 - 2016). MyHeART study used a multi-staged cluster sampling method to select participants among adolescents attending public secondary schools in Malaysia. A self-administered questionnaire was used to collect socio-demographic and lifestyle information. Fasting blood samples were taken to measure serum lipid profile. Acceptable serum lipid percentiles for children and adolescent was defined according to the US National Heart, Lung, and Blood Institute (NHLBI) Guidelines 2012. The multivariate model was adjusted for confounders including race, location of school, diet intake and physical activity.

Results:

For the analysis, we included all 1,118 participants who were followed up at least once. Compared to males, the adjusted Odds Ratio (OR) for Hypercholesterolemia among female adolescents was 2.80 (95%CI 1.73, 4.52) at 13 years, 9.11 (95%CI 5.39, 15.40) at 15 years and 9.25 (95%CI 5.25, 16.29) at 17 years respectively with a significant p-interaction value of <0.001.

Conclusions:

Female adolescents have higher risk of hypercholesterolemia with increasing age as compared to male adolescents which potentially predisposes them for development of CVD in adulthood. Hence, appropriate prevention and intervention health programs should be tailored accordingly by gender and age among adolescents.

203 / #345


AN ASSOCIATION BETWEEN ELECTRODERMAL ACTIVITY PROFILE, GROWTH RATE AND NUTRITIONAL STATUS.

J. Ratajczak, T. Hanć Adam Mickiewicz University, Biology Department, Poznań, Poland


Electrodermal activity (EDA) has been used as an indicator of emotional state and linked with many disorders, which may potentially affect the course of individual development. The aim of the study was to examine the link between EDA profile, growth rate and nutritional status in childhood.

Methods:

Children aged 5-6 were assigned to highly reactive (HR, n=32) and low reactive (LR, n=32) group based on the upper and lower quartile of the average value of the skin resistance from the EDA measurement. The body height, weight, waist and hips circumferences were measured and BMI and WHR were calculated. All measurements were performed twice (M1, M2) at a three-month interval. Height, weight, and BMI z –scores were established on the basis of WHO growth charts. WHR z-scores were calculated using the means and standard deviations of the study sample. International Obesity Task Force recommendations were used for an identification of individuals with underweight, normal weight, and overweight/ obesity.

Results:

HR had significantly lower height and weight in both measurements but weight and height gain between M1 and M2 were similar in both groups. WHR was higher in LR and the rate of underweight was significantly increased in HR but only in M1.

Conclusions:

Although the growth rate in highly and low reactive children was similar, the significant differences in height, weight, and nutritional status were observed. The mechanism of this association needs to be explored in future research.

204 / #396


ANTHROPOMETRY AND NUTRITIONAL ASSESSMENT IN PEDIATRIC PATIENTS WITH OSTEOGENESIS IMPERFECTA (OI)

C. Rodríguez Jimenez1, L. Grande Herrero1, A. Sanchez Suárez1, S. Marquina Cintora1, B. Sagastizabal Cardelus2, A. Alcaraz Romero1, N. Alonso Perez1 1Hospital Universitario de Getafe, Pediatría, Getafe, Spain, 2Hospital Universitario de Getafe, Pediatria, Getafe, Spain


OI is a genetic disease that affects the formation of type I collagen. Its clinical spectrum includes bone fragility and short stature. Nutritional status may influence the course of the disease.

To describe the anthropometry and nutritional parameters in children with OI, and its variability between different types of disease.

Methods:

Descriptive retrospective study. Clinical histories of 46 patients with OI were reviewed, classified in three groups of severity according to the Silence Clinical Scale: mild, moderate and severe. Anthropometric and nutritional parameters were evaluated.

Results:

Of the 46 patients, 21 were mild, 18 moderate and 7 severe.

With regard to ED height, we found statistically significant differences between mild vs. moderate and severe forms (-1.34DE vs. -2.62DE and -4.14DE respectively P<0.001). The average size in mild forms is 127.81cm, in moderate 119.75cm and in severe 115.87cm.

In terms of ED weight, mild forms had an average of -0.58DE, moderate forms -1.31DE and severe forms -1.58DE, finding statistically significant differences (P=0.028).

Regarding Waterlow Classification height for age, patients with severe forms presented a mean of 80.16%±1, moderate forms 88.5%±5.1 and mild forms 93.3%±4.5, these differences being statistically significant (P<0.001).

In the Waterlow Classification weight for age, patients with severe forms presented a mean of 112.3%±23, moderate forms 102%±16 and mild forms 104.8%±14 (P=0.47).

Conclusions:

Anthropometry and nutritional parameters differ between different types of OI.

Severe forms present a higher degree of chronic undernourishment compared to mild and moderate forms.

Follow-up of these parameters is important to decrease morbidity associated with the disease.

205 / #540


NUTRITION AND BODY WEIGHT STATUS IN CHILDREN WITH CYSTIC FIBROSIS

X. Roussou1, I. Loukou2, C. Katsagoni3, I. Tokou3, T. Lampidi1, E. Papachristou1, E. Kokkinou1, M. Plyta2, A. Petrocheilou2, M. Moustaki2, M. Yannakoulia1 1School of Health Science & Education, Department Of Nutrition And Dietetics, Athens, Greece, 2Agia Sofia Children’s Hospital, Department Of Cystic Fibrosis, Athens, Greece, 3Agia Sofia Children’s Hospital, Department Of Clinical Nutrition, Athens, Greece


Monitoring of nutritional status is part of the routine care of children with Cystic Fibrosis (CF). The present study aims to explore the associations between dietary intake and weight status in paediatric CF patients.

Methods:

The study included 100 children and adolescents (37% boys, 63% girls; 10.5±3.9years) with CF in Greece. Dietary assessment was based on four 24-hour recalls. The average daily energy and macronutrients intake were estimated using this information. Thinness, overweight and obesity were assessed using Body Mass Index (BMI) measurements and the relevant cut-off points set by Cole et al. Information on pancreatic enzyme replacement therapy was also obtained from medical records.

Results:

Overall, 7.2% of children were thin, 76.3% had normal BMI, and 16.5% were overweight or obese. Seventy-seven percent of children have been following the dietary recommendations for CF [daily energy intake >110 of Estimated Average Requirement (EAR), 39% from carbohydrates, 15% from proteins and 46% from lipids]. Energy intake of children with pancreatic sufficiency was 112% of EAR compared to 146% of EAR in children with pancreatic insufficiency (p=0.002). After adjusting for age, sex, daily energy intake and pancreatic in/sufficiency, the consumption of salty snacks, soft drinks and sweeteners was associated with increased likelihood of being overweight/obese (OR:2.2, 95% CI:0.92-5.4), whereas the consumption of vegetables and potatoes with lower odds (OR:0.06, 95% CI:0.006-0.58).

Conclusions:

Apart from under-nutrition, other forms of malnutrition should be taken into account when evaluating nutrition and growth of CF patients.

206 / #164


ASSOCIATION BETWEEN DIETARY CHANGES AFTER A LARGE NATURAL DISASTER AND GROWTH IN JAPANEASE CHILDREN

Y. Sato1,2, M. Shigihara3, A. Kondo4, R. Suzuki5, C. Suzuki6 1Tohoku University, Tohoku Medical Megabank Organization, Sendai,Miyagi, Japan, 2National Institute of Occupational Safety and Health, Epidemiology Research Group, Kawasaki,Kanagawa, Japan, 3Shichigo Elementary School, Sendai, Miyagi, Japan, 4Shiromaru Elementary School, Sendai, Miyagi, Japan, 5Japan Women’s University, Graduate School Of Human Life Science, Tokyo, Japan, 6Saga Medical School, Saga University, Nursing Department, Saga, Japan


The 2011 Great East Japan Earthquake resulted in dramatic social environment and lifestyle changes in affected areas. It has been suggested that a shortage of necessary nutrients emerged, it might previously satisfied before the disaster, for children’s growth through long-term dietary changes. This study examines the relationship between dietary changes and growth in schoolchildren in the disaster area.

Methods:

We administered a questionnaire survey of schoolchildren’s diet and health on their guardians residing in the northern district in January 2016, where the epicentre of the 2011 earthquake. We used questionnaire data from 381 guardians out of 422 enrolees (cooperation rate: 90.2%). The Rohrer index (weight (kg) / height (m)3 × 10) was used as the growth indicator.

Results:

Almost 21% of guardians had concerns about their children’s food intake after the large disaster. Among them, 43% stopped providing certain food to children or changed their food choices after the disaster. Comparing the Rohrer index mean value and the changed period of children’s diet (three periods: less than half a year, more than half a year to a few years, 4+ years), the index value tended to decrease as the change period lengthened; however, there was no statistically significant difference between the categories.

Conclusions:

Although survey limitations exist, our examination suggested the possibility that long-term dietary changes after natural disasters and continued avoidance of certain foods could disturb children’s healthy physical growth.

207 / #307


THE RELATIONSHIP BETWEEN SHORT STATURE AND PSYCHOSOCIAL PROBLEMS IN PRIMARY SCHOOL-AGED CHILDREN

R. Sekartini medical School Universitas Indonesia, Department Of Child Health, jakarta, Indonesia


Introduction: Short stature is a growth problems that is commonly found in developing countries. In Indonesia, the prevalence of primary school-aged children with short stature reaches 23,6% in 2018. Short stature in children is associated with psychosocial problems that are thought to be related to abuse, stigmatization, and social isolation faced by children. However, previous studies discussing this topic have had mixed results and the amount of studies have not been adequate. Therefore, this study aims to look for the relationship between short stature and psychosocial problems in primary school-aged children.

Methods:

A cross-sectional study design was used in primary school-aged children at SDN 01 Kampung Melayu, Jakarta – Indonesia. The study was conducted by comparing groups of children’s height and screening results for psychosocial problems using the PSC-17 questionnaire, which assesses three subscales of behavioral problems (internalizing, externalizing, and attention).

Results:

The prevalence of short statured children in SDN 01 Kampung Melayu reached 15,28%. The prevalence of children with psychosocial problems is 18,12% and the prevalence of short statured children with psychosocial problems is 22,73%. Analysis of association between short stature and psychosocial problems showed no statistically significant relationship, for general psychosocial problems (p = 0,268), internalization subscale (p = 0,532), externalization (p = 0,400), attention (p = 0,414), and PSC-17 total score (p = 0,614).

Conclusions:

There are no significant relationship was found between short stature and psychosocial problems in primary school-aged children.

208 / #438


NUTRITIONAL STATUS OF ADOLESCENTS IN FIERI OF ALBANIA

D. Selfo, R. Luçi, G. Sinanaj, M. Zahaj Univesity Of Vlora, Nursing Department, Vlore, Albania


The aim of this study is to determine the nutritional status of adolescents in urban and rural schools of Fieri.

Methods:

The study population was divided into two strata- rural and urban based on the type of school. Sample size selected for the study was 2000 with 500 subjects . Height and weight were taken using the standard procedure,stunting and thinness.

Results:

It was found that the mean weight and mean BMI of adolescents in the 13–14 years age group was more in rural areas (36.73 kg and 16.95) than in urban areas (36.49 kg and 16.93). However, mean height was similar for this age group in both urban as well as rural areas. In successive age groups, were more in urban adolescents than in their rural counterparts.Mean height was similar in both the areas except among adolescents of 15–16 years age group, where urban females were taller than rural females approximately by 1 cm. The prevalence of thinness in the rural areas ranged from 23.4 to 30.3% among males as compared to 14.5 to 15.7 %among females. Stunting in urban areas ranged from 6.5 to 15.2 %among males and 7 to 14 among females.Thinness was more prevalent among males than females in urban areas and it ranged from 21.9 to 34.1 %among males and 12.4 to 20.7 %among females.

Conclusions:

The prevalence of stunting and thinness was more in rural than in urban settings for both the sexes .More stress should be laid on planning and implementing nutritional programmes for adolescents

209 / #223


A BODY LENGTH PREDICTION MODEL FOR CHILDREN AGED 12-24 MO BASED ON ARM LENGTH AND ULNA LENGTH: A CASE STUDY IN DEPOK, INDONESIA

A. Setiarini, T. Haerunnisa Faculty of Public Health, Universitas Indonesia, Public Health Nutrition, Depok, Indonesia


Stunting is still a nutritional problem in Indonesia. However, a tool to measure the body length of children aged less than 2 years is still lacking as well as the skills to measure it. Therefore it is necessary to find a measurement that is easy to do and a simple tool. The aim of this study was to develop a body length prediction model using predictors of arm length and ulna length in children aged 12-24 mo.

Methods:

The study design was cross sectional located in Depok, Indonesia with the sample of 81 children aged 12-24 mo. The data collected were body length (BL), arm length (AL), ulna length (UL), using measuring tape, while age (A) and sex (S) using questionnaire. Data were analyzed using linear regression

Results:

The results showed that there was a strong correlation between the age of the child with body length (r = 0.662) and arm length with body length (r = 0.617), and there was a moderate correlation between ulna length and body length (r = 0.364).Body length prediction models obtained in this study were BL=51.086 + [0.571 x AL(cm)]+ [0.559 x A(mo)]-[0.940 x S] and BL=62.338 + [0.433 x UL(cm)]+ [0.697 x A(mo)]-[0.940 x S], for sex 1:boy, 2: girl)Prediction models with predictors of arm length can explain 59% of the variation in body length variables (R2).

Conclusions:

A prediction model using arm length has a higher degree of accuracy than the length of the ulna in this study

210 / #562


INCIDENCE OF LOW WEIGHT AT BIRTH AND STUNTING AT CHILDHOOD: A CASE STUDY OF MALDA DISTRICT, INDIA

R. Sk Jawaharlal Nehru University, Centre For The Study Of Regional Development, New Delhi, India


The government of India has tried to combat malnutrition through several flagship programmes since 1980s. Despite that Global Nutrition Report 2018 addressed that India tops in the number of stunted children, and malnutrition was the leading cause of death in children below five years in each state of India in 2017. Therefore, a cross-sectional study was conducted at a local level of India to know the level of nutritional status and to investigate the risk factors of stunting among pre-school children aged 36-59 months in Malda district.

Methods:

A multi-stage, stratified simple random sample survey was conducted using a structured questionnaire, and 731 samples nested within Anganwadi Centres in 12 PSUs were collected.

Results:

It is found that 40.1% children are stunted, varying substantially across disaggregate groups. For instance, 69.6% children belonging to a tribal community are stunted as compared to 30% children are stunted in general/privileged community. The results of multilevel analysis reveal children were born with low birthweight are 2.2 times (OR=2.22;p<0.001) more likely to be stunted at childhood than their counterparts. Children of bidi workers are also at higher risk of being stunted (OR=1.92;p<0.010). Other important risk factors of stunting are birth interval, duration of breastfeeding, and mother’s level of education. On the other hand, there is a significant variation (14%, SE-0.14) in stunting is observed due to community/neighbourhood effects.

Conclusions:

For improving the child’s nutritional status, special attention needs to be paid for children born with low birthweight and intervention should be taken for mothers who are bidi worker.

211 / #445


PROMOTE THE MEDITERRANEAN DIET: RESULTS OF AN INTERVENTION

B. Sousa School of Sciences and Health Technologies, Universidade Lusófona de Humanidades e Tecnologias, Lisboa, Portugal, Cbios – Research Center For Biosciences And Health Technologies, Lisbon, Portugal


The Mediterranean Diet (MD) has an important role in prevention of the cardiovascular disease, however we know that the eating habits of adolescents are far from a healthier diet and their eating patterns need to be improved. The aim of this study is evaluate the impact of a MD promoter intervention on adherence to this diet in a population of adolescents.

Methods:

The adherence to the MD was evaluated before intervention in a population of adolescents (n=94) through the application of Mediterranean Diet Quality Index for children and adolescents (KIDMED) and classified the adherence as high, intermediate and low. The intervention consisted of food education about MD. One month after the intervention, the adherence to MD was again evaluated in the same population.

Results:

This population consisted of 59,6% (n=56) of girls, ages between 16 and 19 years old, and with a mean age of 17.8 (± 0.9) years. Before intervention, 28.7% had a high adherence to MD, 59.6% had intermediate adherence and 11.7% a low adherence. The average rate of adherence to KIDMED was 6.1(± 2.4), but after the intervention, this rate increased to 7.4(± 2.7) (p<0.05). We also observed that high levels of adherence increased to 51.1% and the low adherence dropped to 7.4% (p<0.05).

Conclusions:

This intervention, in this population, improved the indices of adherence to the MD, which may be a form of prevention of cardiovascular diseases and should be taken into account to improve the eating habits of the adolescents.

212 / #558


ASSOCIATIONS BETWEEN FATTY ACIDS AND BONE MINERALIZATION IN HEALTHY PRESCHOOL CHILDREN.

B. Strandvik1, M. Garemo2, D. Mellström3 1Karolinska Institutet NEO, Dept Of Biosciences And Nutrition, Stockholm, Sweden, 2Zayed University, Dept Of Natural Sciences And Public Health, P.O. Box , Abu Dhabi, United Arab Emirates, 3University of Gotheburg, Dept Ofinternal Medicine And Clinical Nutrition, Institute Of Medicien, Göteborg, Sweden


Background and aims: The bone development during childhood is important for peak bone mass and thereby for bone health in adults. The aim was to investigate relations between bone mass and nutritional intake and to the serum phospholipid concentrations of fatty acids in healthy 4-yrs old.

Methods:

Methods: Ninety-eight children (48 girls), 20% being overweight, were investigated. Anthropometry was measured with stadiometer and dual-energy X-ray absorptiometry (DXA) (Lunar Prodigy equipment). Nutritional intake was estimated from 7 days recording. Plasma phospholipid fatty acids were determined with capillary GC. Statistical methods included multiple regression analyses and confounders.

Results:

Results:. Total energy and carbohydrate intake but not total fat intake correlated to all bone measures. Linoleic acid intake did not differ between the groups, but was positively correlated to bone mineralization in normal weight but not in overweight children. No correlation was found to omega-3 fatty acid intake.

Normal weight children showed strong negative correlation of bone to monounsaturated fatty acids in serum phospholipids but no correlations to linoleic acid. Overweight children showed strong negative correlations between BMD and serum linoleic acid concentrations (r=-0.58, p 0.009), total n6 (r=-61, p 0.03) and ratio n6/n3 (r=-0.64, p 0.003), similar to what was reported in healthy 8-yrs old (Eriksson et al 2009). DHA was positively correlated to BMD in all children (β=0.24. p= 0.02).

Conclusions:

Conclusion: Bone mineralization had strong correlation to fatty acids, with a difference between the associations in normal weight and overweight children, suggesting that metabolism might change during this time of adiposity rebound.

213 / #35


RELATIONSHIP BETWEEN GENDER AND LIGHT MEAL INTAKE BETWEEN MEALS IN PROFESSIONAL MASTER’S NURSING STUDENTS

B. Subashi1, L. Subashi2, K. Idrizi2, G. Simoni2, L. Likaj3, E. Gerxhi4, D. Gerxhi4, M. Meçe4, I. Shuaipi4, J. Mehmeti5 1University "Ismail Qemali" Vlore, Scientific Research Center In Public Health, Vlore, Albania, 2Vlora Regional Hospital, Emergency, Vlore, Albania, 3Vlora Regional Hospital, Surgery, Vlore, Albania, 4Vlora Regional Hospital, General Nurse, Vlore, Albania, 5Hospital of Saranda, Emergency, Vlore, Albania


Malnutrition, in all its forms, is a global problem.

Worldwide, one in three people suffer from some form of malnutrition.

Today, almost 800 million people suffer from chronic undernourishment and more than 2 billion people suffer from micronutrient deficiencies. Another 1.9 billion people are overweight, and 600 million of them are obese. And the prevalence of overweight or obese people is increasing in almost all countries.

A healthy diet helps protect us from malnutrition in all its forms, as well as from noncommunicable diseases, including diabetes, heart disease, strokes and cancer.

Methods:

This is a descriptive correlational study included 27 randomly selected professional master's students in surgical nursing, who completed an online anonymous questionnaire regarding nutricion and the correlation between gender and the dependent variables, during 15-16 June 2019.

Results:

The study showed that: 88% was female, the main age was 23 years old.

47% refer that believe they rarely eat healthy. 48% rarely eat snacks between meals, 45% always follow any diet type, 41% sometimes read food labels to know their composition, 48% never eat slowly and sit down, 45% consume 3 meals/ day. Was found a moderate positive correlation (r=0.36) between gender and light meal intake between meals.

Conclusions:

The findings show that the alimentary habits of nursing students are not always healthy for the most part of them, and also suggests increasing knowledge and promoting healthy behaviors in nursing students as a key element in health education and the promotion of healthy behaviors in the community.

214 / #282


DEVELOPMENT OF EARLY DETECTION TOOLS FOR CHRONIC ENERGY DEFICIENCY FOR ADOLESCENT GIRLS IN YOGYAKARTA, INDONESIA

S. Susetyowati1, E. Huriyati1, S. Helmyati1, P. Samekto1, D. Caturini1, R. Jati Kusuma1, T. Sudargo1, D. Izwardy2, A. Sugihantono2 1Universitas Gadjah Mada, Health Nutrition, Sleman, Indonesia, 2Ministry of Health, Nutrition, Jakarta, Indonesia


Chronic energy deficiency (CED), a condition caused by deficiency of energy and protein intake, is still major health problem especially in Indonesia. According to National health survey, adolescent girl is one vulnerable groups to CED with prevalence reached 36.3%. Thus, early detection of CED is important to prevent the development of CED particularly in adolescent girl population. The aims of this study was to develop a simple, easy and fast method to detect CED for adolescent girl.

Methods:

A total of 448 adolescent girls from 3 different high schools that representing urban and rural areas in Sleman district, Yogyakarta. Schools were selected using cluster random sampling and student that met the inclusion and exclusion criteria were recruited. Upper arm circumference was measured by trained nutritionist and 19 questions for questionnaire development was asked by interview

Results:

There were 127 (28.3%) has upper arm circumference less than 23.5 cm. The questions ‘did you feel fat?’, ‘did you experience change in your clothing size?’, ‘are you on special diet to reduce your body weight?’, ‘did you consume 3-4 servings of vegetables/day?’, ‘have you reduced your portions of food in the last few weeks?’ were most predictive for CED with Area Under Curve of 0.77, 0.61, 0.54, 0.55 and 0.55 respectively.

Conclusions:

Five questions can be used as simple questionnaire for early CED detection in adolescent girls.

215 / #340


NUTRITION LITERACY AMONG SECONDARY SCHOOLCHILDREN AND TEACHERS IN DEPOK, INDONESIA

A. Syafiq, S. Fikawati Faculty of Public Health Universitas Indonesia, Center For Nutrition And Health Studies, Depok, Indonesia


Studies on nutrition literacy in Indonesia is rare despite the importance of understanding nutrition literacy as the basis for further development of nutrition education and intervention. There is a need to assess nutrition literacy not only among the schoolchildren but also among the teachers. This study aims at measure nutrition literacy score among schoolchildren and teachers in selected junior and senior high schools in Depok, Indonesia.

Methods:

A number of 500 schoolchildren and 100 teachers were selected through stratified random sampling technique. Literacy was assessed through structured and standardised questionnaire including questions on functional literacy, interactive literacy, and critical literacy.

Results:

Low score of functional nutrition literacy was found where only 59.8% of total respondents could provide correct answers. Percentage of teachers who could answer correctly was slightly lower than the schoolchildren. In the interactive literacy domain, mean score (based on 5 scale Likert scale where 1 is lowest and 5 is highest) was found to be on average, ranged from 3.0 for seeing nutrition expert and facilities to 3.9 for using various sources of information. Critical literacy data shows that the lowest score is for trust to nutrition information in the media (2.4) and the highest was for expectation for school to provide healthy and nutritious food (4.6).

Conclusions:

Low functional nutrition literacy and medium interactive and critical nutrition literacy in this study reflects lack of nutrition information, education, and communication. This is to be followed up by a massive production and dissemination of nutrition information and messages via various channels.

216 / #331


DEVELOPMENT OF QUESTIONNAIRE FOR ASSESS FOOD BEHAVIOR －FOR JUNIOR HIGH

SCHOOL STUDENTS BELONGING TO SOCCER CLUB－

S. Tanakadate1, C. Watanabe1, S. Ozawa1, N. Omi2 1University of Tsukuba, Graduate School Of Comprehensive Human Sciences, Tsukuba, Japan, 2University of Tsukuba, Faculty Of Health And Sport Sciences, Tsukuba, Japan


To develop a questionnaire using a Transtheoretical Model to accurately and easily assess the eating behavior of athletes belonging to soccer club.

Methods:

We conducted self-filled questionnaire survey on first to third grade junior high school students belonging to the soccer club. The questionnaire consists of three scales on own meal: stage of change (1 item), self-efficacy (6 items), decisional balance (13 items). Reliability and validity of the scale were examined by principal component analysis (PCA), exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Cronbach α coefficient and intra class correlation coefficient (ICC).

Results:

The self-efficacy scales consisted of 6 items, moderate reliability and validity was recognized. Preparation, action maintenance was high self-efficacy score. The decisional balance scale consisted of 13 items of 2 factors, good reliability and validity was recognized. The perception of the pros and the cons were reversed between preparation and action. It was in the precontemplation that the difference between the perception of the pros and the cons was the largest.

Conclusions:

From this, it is the most difficult to change behavior in precontemplation, so it is necessary to pay attention. We confirmed the reliability and validity of the questionnaire developed in this research and suggested the possibility of using this scale.

217 / #478


RELATIONSHIP OF STUNTING WITH THE QUALITY OF LIFE IN CHILDREN WITH CKD AT HASAN SADIKIN GENERAL HOSPITAL BANDUNG

R. Tarigan, F. Sani, A. Widiasta Department of Child Health Medical Faculty,Universitas Padjadjaran,Hasan Sadikin General Hospital, Department Of Child Health Medical Faculty,universitas Padjadjaran,hasan Sadikin General Hospital, Bandung, Indonesia


Introduction: Chronic kidney disease (CKD) affects children's health , one of them was the growth and the development of children. According to the World Health Organization (WHO), Indonesia is the third countries with the highest prevalence of stunting in the Southeast Asian region. There were 52 cases of CKD occured at Hasan Sadikin General Hospital in Bandung in 2018. The aim of this study was to know the relationship of stunting in children with chronic kidney disease at RSUP Dr. Hasan Sadikin Bandung with their quality of life.

Methods:

Method: This is a descriptive-categorical cross sectional study which was conducted in Hasan Sadikin General Hospital Bandung from July – August 2019. The subjects were children (2 – 18 years old) with CKD and their parents, the sample was selected by consecutive sampling. Data collected by measuring the antopometry/from medical records and through PedsQL 4.0 Generic Score Scale questionnaire.

Results:

Results: In this study there were 14 stunting children. Stunting affects the quality of life of children. The lowest total score were 62.68 (based on self-report) and total score based on parent-report were good.

Conclusions:

Conclusion: Large proportion of children patients with CKD in Hasan Sadikin General Hospital Bandung suffering growth failure due to CKD. Stunting impacts various life functions in children therefore affects the quality of life.

219 / #503


A LONGITUDINAL ANALYSIS IN THE CLUSTERING OF CVD RISK FACTORS AMONG ADOLESCENTS IN MALAYSIA: FINDINGS FROM THE MYHEARTS

N. Thangiah1, T. Su Tin2, K. Chinna3, H. Majid4 1Centre for Population Health, Social & Preventive Medicine, Kuala Lumpur, Malaysia, 2Monash University, Jeffery Cheah School Of Medicine And Health Sciences, Selangor, Malaysia, 3Taylor's University, School Of Medicine, Faculty Of Health And Medical Sciences, Selangor, Malaysia, 4University of Malaya, Department Of Social & Preventive Medicine, Kuala Lumpur, Malaysia


Risk factors of cardiovascular diseases (CVD) begin clustering from young. This study aims to investigate the clustering of biological CVD risk factors among adolescents in Malaysia and identify lifestyle parameters discriminating adolescents in high-risk clusters from those who are not.

Methods:

Data is derived from the Malaysian Health and Adolescents Longitudinal Research Team study (MyHeARTs) in which three repeated measurements of adolescents beginning at age 13 and followed at 15 and 17 years old, were taken biennially over a period of 5 years. Measurements of 606 adolescents with complete cases were available from the follow-up cohort. Hierarchical and non-hierarchical (k-means) cluster analyses classified adolescents into high, medium and low-risk clusters each year after combining standardized z-scores of eight risk factors of CVD. Longitudinal logistic regression using generalized estimating equations assessed the chances of being in clustered high-risk groups over time while controlling for gender, ethnicity, locality and family socioeconomic status.

Results:

Throughout the longitudinal study, more than 12% of adolescents remained in high-risk clusters with sizeable adverse transitions. Fat as a percentage of energy and body mass index was positively related to the clustered high risk in adolescents (OR=1.054, p<0.01 and OR=1.515, p<0.001) whereas physical fitness score was inversely related to the clustered high risk over time (OR=0.979, p<0.001).

Conclusions:

Increased fat intake and being physically less fit are associated with a higher likelihood of remaining in high-risk profiles over time. Therefore, these lifestyle parameters should play a fundamental role in preventive measures for CVD among adolescents.

221 / #21


EFFECT OF LACTOBACILLUS REUTERI DSM 17938 IN THE INTENSITY AND FREQUENCY OF FUNCTIONAL ABDOMINAL PAIN (ROME CRITERIA III) IN CHILDREN AGED 4 TO 16 YEARS OLD: A META-ANALYSIS

A. Uy Manila Doctors Hospital, Pediatrics, Ermita, Philippines


In a retrospective review of Pediatric patients who were diagnosed with ROME III defined-Functional Gastrointestinal Disorders, the most common diagnosis was Functional Abdominal Pain (FAP) in 45% (11). Irritable bowel syndrome is the most encountered sub-type of abdominal pain-related functional gastrointestinal disorder. Female gender, psychological disorders, stress and traumatic life events affect prevalence (8).

The treatment for FAP varies from supportive to symptomatic. In a systematic review and meta-analysis, the potential importance of microbial manipulation strategies in the prevention and management of recurrent abdominal pain has been highlighted (9).

This study aims to assess the effect of Lactobacillus reuteri DSM 17938 in the intensity and frequency of functional abdominal pain based on Rome Criteria III in children aged 4 to 16 years old through a meta-analysis of Randomized Control Trials.

Methods:

Electronic databases were searched. Qualified studies were reviewed through Revman 5.3. For continuous variables, the data were expressed as a mean difference (MD) or as a standardized mean difference (SMD) at 95% Confidence Intervals. In case of heterogeneity, random effects model was used.

Results:

Lactobacillus reuteri at 2 x10^8 CFU shows significant reduction in the intensity of pain in 4 weeks. However, overall assessment of frequency of abdominal pain showed no significant difference in 4 weeks.

Conclusions:

Lactobacillus reuteri DSM 17938 can significantly decrease the intensity of Functional Abdominal Pain at 2 x 10^8 CFU in 4 weeks.

222 / #374


PREVALENCE OF OVERWEIGHT AND OBESITY IN 7-YEAR-OLDS IN LATVIA, TRENDS 2008-2018

B. Velika, D. Grinberga, I. Pudule, I. Gavare The Centre for Disease Prevention and Control of Latvia, Department Of Research And Health Statistics, Riga, Latvia


Obesity is one of the leading public health issues and challenges in society today. It is globally accepted as an important modifiable health risk for noncommunicable diseases (NCD). Overweight and obesity represent a significant risk for the development of all five leading NCDs.

Methods:

The study conducted in Latvia used the framework of European Childhood Obesity Surveillance initiative study methodology developed by the WHO Europe. The design was a cross-sectional study. The study has been carried out every two/three years since 2008. In total five rounds of study have been carried out. One stage representative cluster sampling was conducted. Anthropometric measurements were carried out at schools for the cohort of first grade 7.0-7.9 old children. The survey protocol aims to achieve coverage of a minimum 2800 children of each round.

Results:

In 2018 the overall prevalence of overweight and obesity in 7-year-olds was 22.8%, which compared to 2008 – 21.5%, has increased slightly.

Over a ten-year period, the prevalence of 7-year old boys with overweight and obesity remains constant: 23.8% in 2008 and 23.7% in 2018. For girls, this proportion has been increasing gradually since 2008 when the prevalence of girls with overweight and obesity was 18.3% and in 2018 – 21.8%.

Conclusions:

The overall prevalence of overweight and obesity in 7-year-olds has been without significant changes since 2008 in Latvia.

223 / #248


RELATIONSHIP BETWEEN DIETARY INTAKE BALANCE OF JUNIOR HIGH SCHOOL FOOTBALL CLUB STUDENTS AND FOOD BEHAVIOR

C. Watanabe1, S. Tanakadate1, S. Ozawa1, N. Omi2 1University of Tsukuba, Graduate School Of Comprehensive Human Sciences, Tsukuba, Japan, 2University of Tsukuba, Faculty Of Health And Sport Sciences, University Of Tsukuba, Tsukuba, Japan


Evaluate the dietary intake balance for the junior high school students of soccer club using the food group and clarify the relation with the stage of change.

Methods:

We conducted a diet survey and self-filled questionnaire survey on 321 first to third grade junior high school students belonging to the football club team from September to October 2018.256 subjects from which effective responses to the questionnaire were obtained were analyzed. The dietary intake balance consists of five food groups of staple food (rice, bread, noodles), main dishes (meat, fish, eggs, soy products), side dishes (vegetables, seaweed, mushrooms, potato), dairy products, and fruits. Dietary behavior is based on the concept of stage of change in the transtheoretical model. The precontemplation, contemplation, preparation, action, and maintenance were evaluated in 5 stages.

Results:

Among the weeks, the number of times to eat the breakfast with staple food, main dish, side dishes, milk, dairy products, fruit and five dishes groups is the largest in the maintenance period, followed by action. Moreover, the maintenance period was significantly greater than in the contemplation period.

Conclusions:

For the nutritional education imparted to athletes during the growth period, it was suggested to consider the intervention approach for each stage of change.

225 / #407


EVALUATION OF THE EFFECT OF DIFFERENT DOSAGE OF CAFFEINE CONSUMPTION ON THE ADOLESCENT’S BLOOD PRESSURE

N. Yousefirad, M. Taylan Health Sciences/Istanbul Medipol University, Nutrition And Dietetics, Istanbul, Turkey


Coffee, is one of the most widely consumed beverages in the World. Health effects of caffeine in coffee were previously investigated. Caffeine acts as a potential antagonist of adenosine receptors in the nervous system and cause acute elevation in blood pressure. Epidemiological studies have shown that caffeine consumption may have a potential to increase cardiovascular risk by increasing the blood pressure. In this context, this study was conducted to investigate the effect of coffee containing different doses of caffeine on blood pressure in adolescents.

Methods:

A total of 42 subjects, 21 controls and 21 experiments were included in the study. Control and experiment grups called three times. Control group was given caffeine-free and experiment group were given coffee containing 70, 150 and 300 mg caffeine. Systolic and diastolic blood pressures and heart rate were recorded at 0. 30. 60. and 90 minutes.

Results:

According to the study results, 70 mg caffeine caused the significant increase in systolic blood pressure of the experimental group than the control group in 90. minutes (p˂0.05). There was not found significant difference between different dosage caffeine consumption and diyastolic blood pressures between groups. There were significant decrease in heart rate of control group compare to and experiment group recorded in different time units.

Conclusions:

For adolescents, caffeine intake may increase blood pressure and thereby increase the risk of hypertension. Additional research is needed owing to rising rates of adolescent hypertension and coffee consumption.

226 / #258


ATTITUDES OF PARENTS REGARDING NUTRITION IN CHILDREN IN KINDERGARTEN AGE-A QUALITATIVE STUDY

Y. Stramarko, J. Cobo University of Vlore Ismail Qemali, Faculty of Health, Research Center Of Public Health, Vlore, Albania


The history of nutrition and tire regimen in the first few years of a baby's life is very important. Different studies have shown the relationships between nutrition and the malnutrition factor relate to the relationship between parent and pediatrician. The study objective was to evaluate the parent’s knowledge regarding the nutrition of children in the kindergartens period.

Methods:

In order to implement the study, a qualitative research approach was used. The method used in the study is interviewing through a questionnaire. The questionnaire consists of 3 parts and contains 32 questions. The study was conducted in the city of Tirana and the two institutions are located in one of the administrative units, such as number eight.

Results:

The population of our study consists of the parents of two educational institutions where 124 individuals participated. The new generation of parents has created their own education taking into account the care of their child up to pediatrician consultation but also by reading recent literature on the health of the child's plot or their children.

Conclusions:

The importance of good nutrition for pregnant and lactating mothers should be emphasized by health workers. The proper implementation of the diet of sharing and discouraging cultural beliefs and taboos that interfere with the child's nutrition status should be taken into account both by the government and health workers.

227 / #403


THE ASSOCIATIONS OF MOTHER-INFANT FACTORS WITH COGNITIVE PERFORMANCE AMONG MALAYSIAN CHILDREN AGED 2 TO 4 YEARS.

N.H. Mohd Shukri1, N.A.A. Abdul Razak1, W.Y. Gan1, S.I.F. Ismail2, A.M. Ma'Rof3 1Universiti Putra Malaysia, Department Of Nutrition And Dietetics, Faculty Of Medicine And Health Sciences, Serdang, Malaysia, 2Universiti Putra Malaysia, Department Of Psychiatry, Faculty Of Medicine And Health Sciences, Serdang, Malaysia, 3Universiti Putra Malaysia, Department Of Foundations Of Education, Faculty Of Educational Studies, Serdang, Malaysia


Cognitive development is most rapid during the first four years of life, which could be affected by multiple factors. This study aimed to ascertain factors associated with cognitive performance among children aged 2-4 years.

Methods:

Children (n=296) attending government nurseries in Klang Valley, Malaysia were assessed for cognitive performance using the Wechsler Preschool Scale. The children’s mothers were approached to complete questionnaires on sociodemographic, maternal stress, mother-child interaction and child behaviour (i.e. milk feeding, sleep habits and screen time).

Results:

The average cognitive performance of Non-Verbal Index (NVI), Visual-Spatial Index (VSI) and Working-Memory Index (WMI) were 111±17, 106±10 and 113±12 respectively, indicating normal (VSI) to high levels (NVI and WMI). NVI was associated with mother’s and father’s educational levels (r=0.13; p=0.027 and r=0.15; p=0.013 respectively) and mother’s monthly income (r=-0.316; p=0.027). High WMI was associated with early age introducing milk other than breastmilk or formula (r=-0.21; p=0.007). Mother-child interaction, specifically learning materials and academic stimulation were positively associated with VSI (r=0.14; p=0.03 and r=0.16; p=0.016 respectively), whereas physical environment was negatively associated with WMI (r=-0.138; p=0.034). Maternal stress, child sleeping and screen behaviour were not associated with cognitive performance (p>0.05).

Conclusions:

Sociodemographic, milk feeding, and mother-child interaction were significantly associated with cognitive performance. This study highlights the importance of parental factors and child milk-feeding that may influence cognitive performance in young children, which could be a target for future intervention. Long-term follow-ups involving multi-ethnicity samples is recommended for future research.

228 / #415


FOUR-WEEK SUPPLEMENTATION WITH FURIKAKE ULVAMINA MADE OF ALGAE (ULVA SP.) AND TUNA (THUNNINI) ACCELERATED GROWTH BUT NOT COGNITIVE DEVELOPMENT IN MALNOURISHED MICE (ROTTUS NORVEGICUS)

T. Sudargo1, A. Isnansetyo2, I. Puspita2, S. Budiyanti3, R. Muslichah1, T. Aristasari1, S. Putri2, K. Alfionita2, Y. Pranoto1 1Universitas Gadjah Mada, Nutrition And Health, Yogyakarta, Indonesia, 2Universitas Gadjah Mada, Department Of Fisheries, Yogyakarta, Indonesia, 3Universitas Gadjah Mada, Department Of Food Technology, Yogyakarta, Indonesia


Algae (Ulva sp.) and tuna (Thunnini) are edible marine sources of protein, essential amino acids, zinc, and iodine. The combination of both resources may produce a supplementation (Furikake Ulvamina) with nutritional quality to accelerate growth and development in malnourished children. We investigated the effect of Furikake Ulvamina supplementation on growth and cognitive development in malnourished mice.

Methods:

Twenty-five mice aged 4 weeks were randomly allocated into five groups. Subjects in B0, B1, B2, and B3 groups were malnourished and had baseline weight below 70% of the control group (A0). Furikake Ulvamina was made of 60% tuna and 40% algae. Supplementation equal to 10% (B1), 15% (B2), and 20% (B3) was mixed into standard diet for 4 weeks. Cognitive function was measured before and after intervention as time-to-survive during Morris Water Maze test. Weight and length were measured weekly. Statistical analysis was done using Paired T-Test, Independent T-Test, and ANOVA.

Results:

Baseline weight of mice in all malnourished groups was lower than control group (p<0.05) while baseline weight between all malnourished groups was not different (p>0.05). In all groups, weight and length was constantly increasing each week from baseline (p<0.05). The biggest weight increment was found in B2 group (82.64 gram) while B3 group had the biggest length increment (4.98 cm). However, decreased time to survive during Morris Water Maze test was only found in control group (66.8 sec, p<0.05).

Conclusions:

Four-week supplementation with Furikake Ulvamina equal to 15-20% of standard diet may accelerate growth but not cognitive development in malnourished mice.

229 / #509


BODY DISSATISFACTION OF ADOLESCENTS AND MESSAGES SENT BY THEIR PARENTS ABOUT FOOD AND WEIGHT IS HIS ASSOCIATION WITH BODY MASS INDEX

E. Abrahao, M. Campos, F. Garcia, R. Viebig Centro Universitario Sao Camilo, Nutricao, Sao Paulo, Brazil


Family messages, mainly from the parents seem to have an important influence in the teenager’s corporal image satisfaction. Objective: Rate the influence of the messages sent by the parents about the feeding and weigh, in the body dissatisfaction and nutricional status of the teenagers.

Methods:

Transversal study. The sample has been composed by 398 teenagers, from 12 to 16 year old. A standardized questionnaire about socio characteristics and satisfaction with the body image was applied. The instrument “ Perception of the messages that parents send about feeding and weigh” was applied, adapted and translated from the propound instrument by Gross and Nelson (2000). Weigh and heigh to calculate as index of body mass were measured, informated by the OMS.

Results:

Most teens were girls (69.8%), with mother and father economically active (74.6% and 85.4%, respectively). According to the indicator BMI / Age, 52.5% of adolescents were overweight. Only 15.3% were satisfied with their body image and 74.8% of girls want to lose weight, while 47% of boys would like to increase your body silhouette. The average negative messages about weight and diet of the mother and father for teenagers was significantly lower in the group of teenagers satisfied with their body image (p <0.001). Adolescents who received more positive messages from their mothers and fathers found themselves more eutrophic and satisfied with body image (p <0.001).

Conclusions:

To receive more negative messages from parents was significantly associated with body dissatisfaction among adolescents studied. Also receive positive messages appeared to be an important factor healthy BMI.

230 / #628


METABOLIC SYNDROME IN CHILDREN: THE ”SILENT” THREAT

B. Stana Gr T Popa University of Medecine and Pharmacy Iasi ROMANIA, Physiology, Iasi, Romania


Although varying definitions of metabolic syndrome have hindered the development of a consensus for the diagnostic criteria in the pediatric population, its prevalence seems to be increasing. Pathogenesis is not completely understood, main actors being insulin resistance and subsequent inflammation.

To evaluate overweight, obesity, abnormal glucose metabolism and hypertension in a group of dyslipidaemic children, in order to puzzle-up the metabolic syndrome.

Methods:

89 patients with dyslipidaemias were found in a 12-month study period in 2nd Pediatrics Clinic of Iasi, Romania; the mean age was 9.1 years, with higher prevalence in adolescence. Nutritional status, blood glucose and hypertension were assessed.

Results:

Mean age in the study group was 9.1 years, with higher prevalence of dyslipidaemias in adolescence. Risk factors were food mistakes, family dyslipidemias or genetic diseases. Obesity and overweight were found in 35% of cases, liver steatosis and steatohepatitis – 33%, hypertension – 5%. Metabolic syndrome was found in 15% of patients with dyslipidaemias.

Conclusions:

The puzzle of metabolic syndrome in children and adolescents is threateningly completing itself, in parallel with the increasing trends in obesity and dyslipidemia rates. Prevention and management of this condition in children can be accomplished with lifestyle modifications, behavioral and sometimes pharmacological interventions.

232 / #664


LEARNINGS FROM PROJECT ANSH – IMPROVING NUTRITION OF RURAL ADOLESCENTS

J. Arora School Health Annual Report Programme, Non- Governmental Organisation, New Delhi, India


India is home to the largest number of underweight & anaemic adolescents. In this context, School Health Annual Report Programme (SHARP NGO) initiated the Adolescent Nutrition, Sanitation and Health (ANSH) project in 2018, in partnership with GlaxosmithKlien Consumer Health and partner organisation, in four poorest performing aspirational districts of - Bihar, Uttar Pradesh, Madhya Pradesh & Assam, targeting 150,000 adolescents. The objectives are to improve awareness on nutrition and WASH and to reduce by 10% thinness in a core group.

Methods:

An in-depth study into the local adolescent’s nutrition and WASH-related practices and behaviors informed the project strategies. WASH is addressed by facilitating safer drinking water and upgradation of toilets in schools and villages. To improve adolescent’s access to public services to Iron Folic Acid and Take Home Rations, project employed an integrated approach, coordinating between National Adolescent Health Program (called RKSK), Women and Child Development, Sanitation and Education.

Results:

By Nov 2019, the project reached 70,000 adolescents. Cohort of 2,414 adolescents was monitored regularly for a year for Body Mass Index (BMI). At baseline, 60% of adolescents had low BMI (< 18.5); more girls than boys, and more school dropouts were severely underweight (BMI< 16.5). The underweight group were counselled regularly. After a year, BMI among 17% adolescents improved, improvement being more marked among the severely underweight group.

Conclusions:

Employed strategies worked well with adolescents, who are extremely receptive to information. Connecting related government departments helps streamline nutrition schemes. The project model and learnings will be shared after its completion in March 2020.

233 / #670


IMPACT OF MATERNAL MENTAL HEALTH ON RECOVERY OF CHILDREN WITH SEVERE ACUTE MALNUTRITION IN MALAWI: A SECONDARY DATA ANALYSIS

M. Chisala, M. Kerac Malawi Liverpool Wellcome Trust, Peadiatric And Child Health, Blantyre, Malawi


Malnutrition is disproportionally high in Africa where over two-thirds of children are either stunted, wasted and/or underweight. Inappropriate childcare is one of the underlying causes of malnutrition in which maternal mental illness affects this. Common mental disorders(CMD) have consistently remained a cause of disability in females.Children born to mothers with a CMD are 2x likely to be malnourished.Despite evidence that mental problems are prevalent in developing countries, there is little research to assess maternal mental illness and malnutrition.This study explores the potential association between CMD and nutritional status amongst children treated for SAM in Malawi.

Methods:

Secondary analysis of 320 children followed up after admission for SAM in Malawi.184 community-controls were selected for comparison. 450 caregivers were assessed for CMD using the WHO self-reported questionnaire (SRQ20). Socio-demographic and children’s nutrition status data were also collected.

Results:

Mean SRQ-score was 4.9(±4.1).83/450 of the mothers (18%) were at risk of having a CMD (SRQ-score>9). There was no association between SRQ20 and undernutrition after adjusting for confounders. Mothers who had an SRQ-score>9 had 2x increased odds of reporting intimate partner violence (IPV) (1.5-4.4,p-value<0.001) and 4x increased odds of having low social support(1.6-13.9,p-value<0.001). This association remained strong amongst mothers of cases but not amongst controls.

Conclusions:

There was no association between mother's SRQ-score and children’s nutritional status in this population. However, mothers reporting IPV and low social support are at a high risk of reporting depressive/anxiety symptoms and were likely to have malnourished. This emphasizes complex interactions between malnutrition and mental illness and therefore,need for a holistic approach.

234 / #675


THE CLINICAL LINK OF PRESCHOOLERS’ PICKY EATING BEHAVIOR WITH THEIR GROWTH, DEVELOPMENT, NUTRITIONAL STATUS, AND PHYSICAL ACTIVITY IN KURDISTAN REGION-IRAQ

K. Yaqob ZAKHO GENERAL HOSPITAL, Pediatrics, ZAKHO NEW ZAKHO, Iraq


The aim of this study is to assess the prevalence of picky eating among preschoolers and to address the clinical link between eating behavior and growth, physical activity, development

Methods:

Methods: In this study, a structured questionnaire was used to perform a cross-sectional descriptive study of 800 parents of preschoolers aged 2–4 years in Kurdistan/Iraq. Data collected included: demographics, food preferences, eating behavior, body weight, BMI, height, development, physical activity, and records of medical illness. Data from children defined as picky or non-picky eaters responses were analyzed and compared using standard statistical tests according to questionnaire records obtained from participating parents.

Results:

Results: The mean age of the children was 2.85 years; among eight hundreds participants, 620 (77%) were picky eaters. Compared with non-picky eaters 180 (23%), z-score of weight-for-age, height-for-age, and body mass index (BMI)-for-age in picky eaters was 0.90, 0.71, and 0.42 SD lower, respectively. There were significant variations of rates in the weight-for-age, height-for-age, and BMI-for-age percentiles <15, between picky and non-picky eaters (P = 0.04, 0.023, and 0.005, respectively). Certain findings were higher in picky as compared to non picky preschoolers including negative social communication such as afraid of unfamiliar places 65% vs 13.3%, afraid of being lonely 14.6% vs 12.1%, poor physical activity 36.8% vs 17.7%, learning disability 16.2% vs 7%, attention deficit 11.8% vs 4.3%, speech delay 4.6% vs 3.3%, respectively).

Conclusions:

The prevalence of picky eaters in preschool children was high, resulting in significant negative impacts on growth, nutritional status, development, physical activity, and health status.

235 / #683


MAPPING FAMILY RISK FACTORS - BASIS OF EARLY PREVENTIVE INTERVENTIONS IN PEDIATRIC PRACTICE OF FAMILY PHYSICIAN

V. Herdea1, P. Tarciuc1, R. Ghionaru2, L. Comnea3, S. Cioc4, E. Costiug5, C. Pop5, L. Barbacariu6, I. Brinza7, L. Chitanu8, S. Diaconescu9 1UMFST Tg Mures, Family Medicine, Bucuresti, Romania, 2CMI Dr Ghionaru R, Family Medicine, Bucuresti, Romania, 3CMI Dr Comnea L, Family Medicine, Bucuresti, Romania, 4CMI Cioc S, Family Medicine, Bucuresti, Romania, 5UMF Cluj Napoca, Family Medicine, Cluj Napoca, Romania, 6UMF Iasi, Family Medicine, Iasi, Romania, 7CMI Dr Brinza I, Family Medicine, Braila, Romania, 8CMI Chitanu L, Family Medicine, Braila, Romania, 9UMFST Tg Mures, Gastroenterology, Iasi, Romania


Malnutrition is major global health problem: undernutrition, obesity, eating disorders( WHO, 2018). 1 of 4 children 5 to 19 years are obese in Romania (2016)

Aims

Introduction of early preventive interventions in pediatric practice of GP”s, based on family major risk factors (MRF) assessment.

Methods:

We present a prospective observational interventional cohort study, including two groups of children, aged 6-18 years, coming from families struggling with chronic diseases: hypertension (HBP), dyslipidemia, diabetes, obesity. Family medical history was recorded, clinical parameters were recorded: 3 visits over a period of 6 months: Weight, Height, blood pressure (BP) abdominal perimeter (PA), body mass index (BMI). An intrafamilial predictive model (MIP) has been prepared and a schedule of recommendations for the child and family has applied.

Results:

After 6 months we obtained:

- 10% weight loss in children

- Reduction of Systolic BP values averaged- 15 mmHg- girls, 10mmHg- boys

- Daily sports activity - average 60 min

- 30 min every day- spending quality time with family (sport, dinner)

Conclusions:

1. Obesity remains the main common, identified major risk factor (MRF) in the studied patient.

2. MIP allows early identification and evaluation of MRF in childhood with a possible role in the etiology of chronic diseases in adulthood

3. MIP allows development and implementation of a personalized, cost-effective program, based on education for healthy life style.

Future study needed for a larger group of children to allow correlations between MRF and chronical diseases occurrence.

237 / #690


SEVERE MALNUTRITION IN A PATIENT WITH CROHN’S DISEASE

G. Mitea, I. Dijmarescu, D. Pacurar "Grigore Alexandrescu" Emergency Hospital for Children, Paediatrics 3, BUCHAREST, Romania


Crohn’s disease is known for its impact on the nutritional status of the patient, furthermore if the disease is neglected and treatment compliance is low. We aimed to present the difficulties encountered in treating a patient with severe Crohn’s disease and cachexia.

Methods:

We present the case of a 13-year-old, male patient, cachectic, diagnosed with Crohn’s disease.

Results:

The patient was being investigated for weight loss and chronic diarrhea. It was impossible to establish the time of onset due to the fact that the patient originated from a rural area, with low socioeconomic status and symptoms were initially neglected, subsequently interpreted as giardiasis and treated accordingly. At the time of admission he had pale, dry skin, acrocyanosis, frail hair, sever dental dystrophy, adipose tissue globally reduced, rickety chest, and he presented diarrhea. The BMI was 11.4 kg/m2 (< 1st percentile). Laboratory tests showed anemia (hemoglobin 6.9g/dL), sever iron deficiency, thrombocytosis, high inflammatory markers, hypoalbuminemia, hypocalcemia, vitamin D deficiency, oral candidiasis, and high fecal calprotectine. Infection was ruled out. He was started on parenteral nutrition and received red blood cells transfusion. A colonoscopy was performed and biopsies were obtained. The diagnosis of Chron’s disease was set and confirmed based on histopathology. Exclusive enteral nutrition was initiated with low compliance and poor therapeutic response, hence immunosuppressant therapy was started with slow recovery and catch-up growth.

Conclusions:

Nutritional support is an essential part in the management of Crohn’s disease, particularly for patients with a severe forms and low socioeconomic status.

238 / #691


ENTERAL AUTONOMY IN CHILDREN WITH INTESTINAL FAILURE: COMPARISON BETWEEN CLINICAL AND MORPHOLOGICAL FINDINGS

D. Petrov, I. Aver'Ianova, S. Makarov Pirogov Russian National Research Medical University, Pediatric Surgery, Moscow, Russian Federation


The aim of this study is to demostrate the lack of correlation between clinical and morphological presentation of intestinal adaptation and the achievement of enteral autonomy

Methods:

Short bowel syndrome (SBS) and gastrointestinal neuromuscular diseases (GINMDs) are the most frequent causes of chronic intestinal failure (IF) in children. 58 patients with SBS and 44 children with GINMDs aged 1 months to 17 years have been treated at Russian Children's Clinical Hospital. A wide range of non-transplant options is being used: home parenteral nutrition (HPN), autologous intestinal reconstructions (AIR), absorption-enhancing drug therapy (teduglutide). Breast milk and oligomeric nutrient formulas are used for feeding of the children in the first year of life. In some IF patients, we perform night feeding via gastrostomy tube. The introduction of complementary foods begins at 4 months of age which prevents the formation of eating disorders. Evaluation of jejunal biopsies for morphological signs of intestinal adaptation included villi hight, crypt depth and intracellular mitosis.

Results:

Fourteen SBS children remain off PN 32 months after STEP procedures; nineteen children after intestinal reconstractions continue to receive reduced PN 2-4 nighta a week. Teduglutide therapy in 5 SBS patients allowed to reduce in PN by 50% within 12 weeks. 23% patients with GINMDs achieved enteral autonomy. Based on morphological evaluation we have not noted a correlation between described morphological changes and the degree of enteral tolerance.

Conclusions:

So far the assessement of intestinal adaptation has been based mainly on clinical signs. Known morphometric criteria of intestinal adaptation do not directly correlate with enteral autonomy.

241 / #701


ANTHROPOMETRIC, DIETARY AND PSYCHOLOGICAL RISK FACTORS FOR PREVALENCE OF DEPRESSION AND ANXIETY AMONG ADOLESCENTS STUDYING IN PUBLIC SCHOOLS OF DELHI

P. Khanna, B. Aeri INSTITUTE OF HOME ECONOMICS, UNIVERSITY OF DELHI, Food And Nutrition, NEW DELHI, India


Depression is ranked by WHO (2015) as the single largest contributor to global disability, therefore there is a need to investigate the maturation patterns (gender specific) & it’s relationship with risk factors which impact overall health of an adolescent. The present research was designed to study the prevalence & association of depression & anxiety with anthropometric, dietary and psychological risk factors among adolescent boys & girls (aged 13-15 years) studying in public schools of Delhi.

Methods:

546 adolescents participated in this cross-sectional study (selected from public schools in Delhi). For the assessment of depression and anxiety symptoms Child Behavior Checklist (CBCL; administered to the parents) was used. Anthropometric profiles (BMI and body fat), Body Image Perception, Locus of Control and Dietary Intake were also assessed.

Results:

Prevalence of depression was 33.5% and anxiety was 27.47%. Statistically significant associations were found among BMI (underweight and overweight/obesity), body fat %, diets deficient in proteins and micronutrients, excess intake of HFSS (High fat, sugar, salt) foods, poor body image perception and locus of control with depression and anxiety symptoms.

Conclusions:

This study highlight’s the association of mental health with anthropometric, dietary and psychological risk factors among adolescents. It will also serve as a strategic tool for mental health prevention & management policies designed for adolescents and adds to the growing body of research in the area of nutritional psychiatry.

242 / #711


DETERMINATION OF BONE AGE IN A POPULATION OF DIFFERENT SOCIOECONOMIC STATUS

K. Alshamrani Najran Univeristy, Radiological Sciences, Najran, Saudi Arabia


Socioeconomic status is a critical factor affecting children growth which might therefore impacts on skeletal maturity, hence, the reliability of bone age methods has been debated. the aim is to determine the reliability of the Greulich & Pyle (G&P) atlas method in a Saudi population with variations in the socioeconomic status.

Methods:

Bone age from 406 hand radiographs (216 males, 357 left) was determined using the G&P method. Paired sample ttest was performed to assess the difference between mean bone age (BA) and mean chronological age (CA). Socioeconomic status was recorded for each child and its effect was evaluated using the one-way ANOVA test.

Results:

Numbers of children living in a high to average socioeconomic status were 257 (63%) in contrast to 149 living in a low socioeconomic status. There was a statistically significant difference between BA and CA in these two groups when using G&P (mean difference -0.32 ± 1 years, p <0.01). ANOVA test showed that 21.4% of the variation between CA and BA is being accounted for by socioeconomic status. Differences between BA and CA were larger and significant (p<0.01) in females of low socioeconomic status.

Conclusions:

The socioeconomic status seems to influence the reliability of the G&P method in which the G&P underestimation BA compared to CA in those living in low socioeconomic background.

243 / #717


SCREENING OF CHILDREN’S PHYSICAL GROWTH AND DEVELOPMENT WITH CHRONIC KIDNEY DISEASE (CKD).

A. Zavyalova, F. Popov, L. Firsova FEDERAL STATE BUDGETARY EDUCATIONAL INSTITUTION OF HIGHER EDUCATION the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russian Federation, Department Of General Medical Practice, St. Petersburg, Russian Federation


Nutrition in children with CKD changes cardinally and depends on kidney’s tissue damage level. Diet recommendations depend on protein load in correlation with residual kidneys function. There is a correlation between kidney’s tissue damage level and physical growth and development (G&D)

Methods:

Anthropometry (height, weight, body mass index (BMI)) and complex examination were carried out 34 kids (22 boys) from 4 m.o to 17 y.o (average 8.7 y.o) with CKD from C3 to C5 stages with glomerular filtration rate from 10.9 to 59. 7 ml/min, who was receiving treatment in universities' hospital.

Results:

Growth retardation was detected in 47% of children (z-score from -1,24 to -6,99). Spreading by percentile growth corridors in 1- 36%, in 2- 13%, in 3- 10%, in 4- 25%, in 5- 6%, in 6- 6%, in 7- 3%. Severe malnutrition in 52.9% children (z-score from -5,12 to -2). In 1 percentile corridor by weight 50%, in 2– 8,5%, in 3- 8,5%, in 4- 12%. In the sample, 8.8% of children were overweight or obese. BMI deficiency identified had 44% of kids (z-score from -9,38 to -1,24). The distribution by percentile BMI corridors is as follows: in 1- 26%, in 2- 17%, in 3- 15%, in 4- 20%, in 5- 11%, in 6- 3%, in 7- 6%.

Conclusions:

Severe violations in G&D had children of early and preschool age. Assessment of G&D is necessary at all stages of growth. Children with CKD, from the first stages of the disease should receive recommendations for lifestyle changes and dietary. Research continues.

244 / #722


PREVALENCE AND PREDICTORS OF HYPOVITAMINOSIS D IN PRESCHOOL CHILDREN IN ALGERIA

O. Drali, M. Arab, Z. Arrada, Z. Guechi CHU HUSSEIN DEY, Paediatric, HUSSEINDEY, Algeria


It is now established that optimal vitamin D status plays a key role in the constitution of optimal bone mass during childhood and by the same in the prevention of osteoporosis in adulthood.

To evaluate the vitamin D status during the 4 seasons of a pediatric population, to estimate the prevalence of hypovitaminosis D and to identify potential risk factors.

Methods:

A prospective, analytical and cross-sectional study carried out between March 2014 and March 2016 in healthy pre-school children living in an urban environment in the commune of Hussein Dey. 1016 children aged 9 to 72 months were collected. An assessment of dietary intakes was performed, all children underwent clinical examination and blood sampling

Results:

The average age was 36.5 ± 1.8 months. The mean concentration of total OHD for the 4 seasons was 18.6 ± 10.4 ng / ml with an average PTH of 30.9 ± 14.6 μg / ml. The prevalence of hypovitaminosis D follows a statistically significant seasonal variation (p = 0.0001), The risk factors identified by logistic regression are: the automno-winter season, the age less than 24 months, the high BMI, the dark phototype, a duration of sun exposure less than 15 minutes, calcium intake less than 500 mg / day and weekly food intake below 200 IU vitamin D

Conclusions:

These results motivate us to provide more effort for the screening and treatment of hypovitaminosis D as well as updating our vitamin D supplementation schedule

245 / #724


FOOD BEHAVIOR AND NUTRITIONAL STATUS OF ASTHMATIC CHILDREN

O. Drali, Z. Arrada CHU HUSSEIN DEY, Paediatric, HUSSEINDEY, Algeria


Asthma is a common disease whose prevalence is increasing in all countries of the world. Complex disease with high clinical heterogeneity and high phenotypic variability over time.

objectives:To evaluate the feeding behavior of children with asthma and to compare their nutritional status according to their asthma severity

Methods:

This is a prospective, uni-centric, analytical study conducted between February 1 and June 1, 2018 at the Pediatric Pneumology consultation of CHU Hussein Dey of Algiers .48 Children with asthma were included. analyzed, namely: Anthropometric status (Weight, Height, BMI), nutritional context and 24-hour recall (Frequency of consumption of several food categories, Number and types of meals, snacking, energy intake, macronutrient intake and micronutrients), the biological assessment: FNS, eosinophils and allergological assessment

Results:

Of the 48 children interviewed, there are 31 boys and 47 girls with a mean age of 6.25 +/- 2.85. The average BMI is 20.02 ± 3.84 kg / m². Children with intermittent asthma: have a low prevalence of overweight and obesity as well as a low deficiency of antioxidant vitamins and trace elements. Children with persistent asthma have a high prevalence of overweight and obesity as well as a high deficiency in antioxidant vitamins and trace elements

Conclusions:

The adequate dietary and nutritional care of these children by qualified personnel (dieticians and nutritionists) is essential for optimal treatment

246 / #726


NUTRITIONAL STATUS OF CHILDREN WITH CYSTIC FIBROSIS FOLLOWED IN CONSULTATION

O. Drali, Z. Arrada CHU HUSSEIN DEY, Paediatric, HUSSEINDEY, Algeria


Long regarded as a European pathology, cystic fibrosis is well present in our country, even if its exact frequency is not known, it is currently more frequently diagnosed.

objectives

To evaluate the feeding behavior of children with asthma, to compare their nutritional status according to their severity of asthma and to study the link between the severity of asthma and the frequency of consumption of certain foods in these children.

Methods:

We conducted a prospective, cross-sectional, analytical, comparative and uni-centric case-control study involving 10 children (aged 2 to 18 years) with cystic fibrosis and 20 normal children

Results:

The results of our study show that there is a male predominance and a high prevalence of underweight in our patients. We have also found that the frequency of consumption of certain foods (fruits, vegetables, cereals, milk and dairy products. .) was statistically different between the two groups of children (p = 0.05). Moreover, according to the 24-hour recall, a low energy intake in cystic fibrosis children was observed. Lipid, protein and carbohydrate intake were significantly higher in normal children compared to cystic fibrosis children. With regard to the supply of vitamins and trace elements, a decrease in intake of fat soluble vitamins ADEK, zinc and selenium have been observed in the patients of the present study.

Conclusions:

These results reveal the importance of intervening with cystic fibrosis children and implementing information sessions promoting the adaptation of healthy eating habits.

247 / #729


BODY COMPOSITION AND NUTRITION STATUS OF A HOSPITALIZED PATIENT.

A. Zavyalova, I. Zhugel, S. Chuinyshena FEDERAL STATE BUDGETARY EDUCATIONAL INSTITUTION OF HIGHER EDUCATION the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russian Federation, Department Of General Medical Practice, St. Petersburg, Russian Federation


Physical development of children is a marker of adequacy of nutrition. Nutrition status (NS) affects adaptation, severity of pathological processes, rate of recovery, effectiveness of therapy, and terms of hospitalization

Methods:

NS was evaluated at 206 kids. 105 - all hospitalized children in acute reception department during one day working. 101 patients with various eating disorders examined at the office of a nutritionist. Physical development was evaluated by the WHO Anthro program, using percentile tables, and the impedance method. Statistical analysis was performed

Results:

In acute reception department patients identified overweight status in 12% and 31% obese of varying severity. Normal NS was determined in 41% of children. Malnutrition was detected in 16% cases. At nutritionist office examined 101 patients with eating disorders (54 boys), from 2 m.o to 17 y.o (average 8.5 y.o) Malnutrition 30%, severe malnutrition - 6% cases. Obesity had 39% kids. The results of the WHO Antro assessment, the percentile tables and the impedance data were compared. Direct correlation links between the child 's percentile weight corridor, the WHO Antro z-weight scan, and the percentage of deficiency or excess of fat and active cell mass are obtained (p=0.05). The child 's percentile growth corridor and body mass index also correlates with the z-growth scor, fat, and active cell mass percent according to body impedance (p=0.05)

Conclusions:

Deviations of NS from physiological norm are determined by all proposed methods. Screen NS in hospitalized kids is very important. Malnourished patients, so as obese patient may show more serious complications of the underlying disease.

248 / #731


HEIGHT DIRECTLY ASSOCIATED WITH SOCIO-ECONOMICAL AND EDUCATION STATUS OF THEIR PARENTS

A. Pulungan University of Indonesia, Child Health, Jakarta, Indonesia


Humans are able to perceive physical size as a signal of social dominance. The greater influence of perceived taller humans in a negotiation task has been described by Huang et al. Hence, we can expect that growth is not only predictable based on genetics and nutrition but depends on an individual’s social life and their society position, We are interested to study child body height according to their parent income and education from five primary schools in Jakarta, Indonesia

Methods:

Cross-sectional data on height were obtained in 1386 children , aged 6.5 to 12.5 (mean 9,5) years from five primary schools in Jakarta, Indonesia. Statistical analysis with Anova.The Indonesian National Growth Charts were used as references for height.

Results:

Father’s income was divided into 6 groups and significantly influences children height with p value 0,02 (p<0,05). Parents education divided into 9 groups, we analysed the association between father’s education and height with insignificant results, but however mothers education was significant with p value 0,01(p<0,05)

Conclusions:

Height influenced by sosioeconomical status wich seen by fathers income. And Height directly associated with the educational status of the mother, but not directly associated with the educational status of the father

249 / #431

E-Poster Viewing INFANCY 08-27-2020 21:30 - 22:00

GROWTH PATTERN OF INFANTS WITH CMPA - A RETROSPECTIVE OBSERVATIONAL STUDY FROM A TERTIARY CENTRE OF EASTERN INDIA

B. Acharyya, M. Roy, J. Bathia Institute of Child Health, Dept Of Paediatric Gastroenterology, KOLKATA, India


CMPA is increasing in India. Following retrospective study was undertaken to find out the prevalence of growth failure in infants of CMPA at the time of diagnosis and the subsequent catch up growth on treatment.

Methods:

A retrospective analysis of case records of infants diagnosed as CMPA; from March 2018 to July 2019 in a tertiary Paediatric Teaching Institution of Eastern India; was undertaken. The percentiles of weight & height (as per Indian Academy of Paediatrics growth chart), symptoms at presentation and the growth pattern after treatment were recorded for each infant.

Results:

A total of 100 infants were evaluated with 61 (61%) boys. Number of infants weighing below 1st, 3rd and 25thcentile were 13, 23 and 19 respectively (total 55 ie, 55%) though all had a birth weight at or above 25thcentile. Only 2 infants had length below 3rdcentile and 13 infants had a length of between 3rd and 25thcentile (total15%), rest 85% had length at or above 25thcentile. In the growth retarded allergic infants GERD was the commonest presenting symptom in 32(58.2%). 15 babies (28.4%) had recurrent watery diarrhoea, 4(7.2%) had bloody diarrhea and rest 4(7.2%) had colic like screaming episodes. Length was less affected(15%) in CMPA patients compared to weight(55%). On follow up 50 (91%) patients achieved wt and height of 25thcentile within 3 months.

Conclusions:

This is the 1st study of growth pattern of infants with CMPA in India.Growth failure is commonly present in infants at diagnosis with majority achieving catch up growth after treatment.

250 / #238


UNDERSTANDING INFLUENCING FACTORS ON BREASTFEEDING TODAY: A SCOPING REVIEW

G. Almquist-Tangen1, J. Roswall2 1Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Paediatrics, Gothenburg, Sweden, 2Institute of Clinical Sciences, Department Of Pediatrics, Gothenburg, Sweden


Breastfeeding has numerous benefits, for the infant and the mother and is often depicted as the natural and normal mode of infant feeding. Despite an abundance of breastfeeding projects supporting and promoting breastfeeding initiation and duration, breastfeeding still remains low in many of the industrialized countries.

The purpose of this review was to develop a conceptual model to identify modifiable and nonmodifiable influencing factors on breastfeeding and to illustrate how these findings are relevant in developing strategies aimed at supporting breastfeeding.

Methods:

The authors conducted a scoping review to map and analyze available data from literature sources regarding breastfeeding. Literature was retrieved from several databases, including PubMed, CINAHL, MEDLINE, and Google Scholar using the following keyword search terms: breastfeeding, initiation, duration and influencing factors. Studies were limited to English language and published between 2008-2018.

Results:

Six core themes were identified: Sociodemographic, maternal, biological, psychological, infant health and the health care system. Most of the categories were nonmodifiable (sociodemographic factors, unemployment, maternal stress) but significant for the health care staff to be made aware of. Breastfeeding problems (pain) and the shortcomings in the health care system (insufficient support) are issues that are modifiable by health care staff.

Conclusions:

In order to support breastfeeding, health care staff need to identify modifiable maternal needs (pain) and ensure that the mother gets access to appropriate care. In order to promote breastfeeding, the health care system needs to be reviewed and the issue of continuity of care needs to be prioritized.

251 / #259


INFLUENCE OF HUMAN MILK OLIGOSACCHARIDE 2’-FUCOSYLLACTOSE ON ADHESION AND GROWTH OF STREPTOCOCCUS MUTANS

K. Salli1, E. Söderling2, U. Gursoy2, J. Hirvonen1, K. Tiihonen1, H. Anglenius1, J. Maukonen1, A. Ouwehand1 1DuPont Nutrition and Biosciences, Global Health And Nutrition Science, Kantvik, Finland, 2University of Turku, Department Of Periodontology, Turku, Finland


Oral cavity is part of the digestive tract. Human milk oligosaccharides (HMOs) have been intensively studied in relation to gut bacteria, but not in relation to oral pathogens. Nowadays, HMO are also added to infant formula, and it is thus important to understand if they have an impact on the biofilm-related virulence properties of dental caries-associated oral bacteria.

Methods:

Here the effect of an HMO, 2’-fucosyllactose (2’-FL) on growth of Streptococcus mutans was assessed using a Bioscreen automated microbiology growth curve analysis system. Furthermore, it was evaluated how 2’-FL affects both adhesin and exopolysaccharide mediated adhesion properties of three S. mutans strains, reference strains DSM20523, Ingbritt, and a clinical isolate CI2366, using adhesion assay to hydroxyapatite and glass surface, respectively. Xylitol, lactose, glucose and galacto-oligosaccharides (GOS) were used as comparators.

Results:

Neither of three tested S. mutans strains were able to grow using 2’-FL as their sole carbon source. All tested strains grew well with lactose and glucose, whereas with GOS variable growth was observed and with xylitol inhibition of the growth of all three strains. Adhesion to saliva coated S. mutans CI2366 was reduced by 2‘-FL and GOS. Furthermore, exopolysaccharide mediated adhesion of S. mutans DSM20523 was reduced by 2’-FL, lactose and GOS and S. mutans CI2366 by GOS.

Conclusions:

2’-FL did not support the growth of S. mutans, and it did not enhance its adhesion properties but rather selectively decreased adhesion of some S. mutans strains. The results highlight the benefical functions of HMOs in the oral cavity against caries-related oral bacteria.

253 / #430


OPTIMISING NUTRITION AND GROWTH IN PAEDIATRIC PATIENTS WITH INTESTINAL FAILURE ON HOME PARENTERAL NUTRITION

M. Baycheva1, B. Mladenov2, P. Hadzhiyski1, D. Kofinova1, Z. Antonova3, Y. Pahnev3, H. Shivachev3, P. Yaneva1 1University Children’s Hospital “Prof Ivan Mitev”, Medical University, Department Of Gastroenterology And Hepatology, Sofia, Bulgaria, 2Multiprofile Hospital for Active Treatment and Emergency Medicine /MHATEM/ "N. I. Pirogov", Department Of Paediatric Anaesthesiology And Intensive Care, Sofia, Bulgaria, 3Multiprofile Hospital for Active Treatment and Emergency Medicine /MHATEM/ "N. I. Pirogov", Department Of Paediatric Surgery, Sofia, Bulgaria


Intestinal failure (IF) is a complex condition of severe malabsorption caused by short bowel syndrome (SBS), congenital diseases of enterocyte development, and severe motility disorders (total or subtotal aganglionosis or chronic intestinal pseudo-obstruction syndrome). Children with IF require long-term total or partial parenteral nutrition (PN) to preserve nutritional status and prevent complications. When a child depends on long-term PN, home parenteral nutrition (HPN) is the best alternative to prolonged hospital stay, improving the quality of life.

Methods:

We present the first national HPN program for paediatric patients with IF.

Results:

Six patients were managed on HPN for prolonged period, four are still on HPN. Three patients have SBS, one has tufting enteropathy and one has total aganglionosis with severe dysmotility and postoperative SBS. For administration of HPN we place a tunnelled single lumen central venous catheter (CVC) surgically. We use commercial premixed PN solutions with individual adjustments. The regime, monitoring and prevention of complications follow the European HPN guidelines. All patients are being reviewed with growth evaluation, clinical examination, bloods and abdominal ultrasound. Bone health was regularly checked.

Conclusions:

Although PN is a life-saving therapeutic option for children with IF, it is a high-risk therapy with potential acute and long-term complications. The rate of complications can be high, particularly in inexperienced hands. Management of HPN by centralised units with expertise in the investigation of IF rehabilitation and with a multidisciplinary team to support care at home would minimise complications and improve outcome.

254 / #444


NUTRITIONAL CHARACTERISTICS AND GROWTH PARAMETERS IN CHILDREN WITH GASTROINTESTINAL ONSET OF CYSTIC FIBROSIS

M. Baycheva1, G. Petrova2, D. Kofinova1, P. Hadzhiyski1, P. Yaneva1 1University Children’s Hospital “Prof Ivan Mitev”, Medical University, Department Of Gastroenterology And Hepatology, Sofia, Bulgaria, 2University Hospital “Alexandrovska”, Department Of Paediatrics, Sofia, Bulgaria


Gastrointestinal (GI) tract manifestations of cystic fibrosis (CF) are very important especially as an initial disease presentation. It is well defined that the nutritional status is closely linked to pulmonary function and mortality. There are few studies evaluating the prognosis of CF patients comparing cases with mainly GI or respiratory involvement.

Methods:

We present a retrospective study based on database of tertiary centre for CF. We evaluated nutritional and growth parameters of 107 patients according to their initial symptoms.

Results:

67 patients had initially pulmonary manifestation (group one), one patient was diagnosed in utero and 39 had gastrointestinal onset of the disease (group two) with failure to thrive, steatorrhea, meconium ileus and CF related liver disease. The age of initial diagnosis was significantly earlier in group two compared to group one – 2.5 ± 1.2 years vs. 5.93 ± 1.24 (p < 0.05), the gender distribution was the same in both groups. We found that the prevalence of patients with liver cirrhosis was higher in group one – 22% vs. 15% in group two. The body mass index (BMI) was lower in group two – 16.61 ± 2.71 vs. 18.03 ± 0.49 in group one. Despite the poorer nutritional status forced expiratory volume in 1 second (FEV1) was higher in group two – 72.61% ± 33 vs. 66.48% ± 28.7 in group one.

Conclusions:

Despite being diagnosed earlier children in group two show worse BMI results. Early nutritional strategies in these patients would improve outcomes and mortality.

255 / #447


SEVERE VITAMIN D DEFICIENCY WITH MULTIPLE FRACTURES IN AN INFANT WITH SHORT BOWEL SYNDROME

M. Baycheva1, D. Yordanova2, P. Hadzhiyski1, D. Kofinova1, E. Stefanova2, P. Yaneva1 1University Children’s Hospital “Prof Ivan Mitev”, Medical University, Department Of Gastroenterology And Hepatology, Sofia, Bulgaria, 2University Children’s Hospital “Prof Ivan Mitev”, Medical University, Department Of Endocrinology, Sofia, Bulgaria


Short bowel syndrome (SBS) is a major cause of intestinal failure (IF) in infants. Necrotizing enterocolitis remains one of the most common underlying diagnoses leading to SBS and to the inability to maintain adequate enteral nutrition. In SBS there is a compromised bowel absorptive capacity because of a severely reduced mucosal surface resulting in malabsorption, electrolyte disturbances, intestinal bacterial overgrowth, steatorrhea, and weight loss. Vitamin D deficiency is common in patients with IF and SBS, and adequate supplementation is required to prevent further complications.

Methods:

We report a clinical case of severe vitamin D deficiency with multiple fractures in an infant with SBS.

Results:

We present an ex-prem 29 weeks’ male infant with SBS due to necrotizing enterocolitis in the neonatal period. The child was referred to our tertiary paediatric gastroenterology centre at the age of 4 months with symptoms of severe malabsorption, growth failure and bone disease with multiple fractures. He was found to have undetectable vitamin D levels and raised parathyroid hormone, but also other nutritional deficiencies and severe malnutrition. The child was started on total parenteral nutrition, treatment with vitamin D, initially with high doses intramuscularly, other vitamins, and microelements supplementation. Within three months we were able to successfully manage his deficiencies and wean him off parenteral nutrition.

Conclusions:

The prognosis of SBS has improved dramatically. With the appropriate multidisciplinary team care and prevention of complications, transplantation indications are limited. We analysed the lack of appropriate treatment strategies in this complicated case and the late referral to the national specialised centre.

256 / #594


SOCIOECONOMIC POSITION AND INFANT AND YOUNG CHILD SNACKING IN URBAN INFORMAL SETTLEMENTS IN MUMBAI: ANALYSIS OF LONGITUDINAL DATA FROM A BIRTH COHORT STUDY

K. Bhatia1, J. Wells2, D. Osrin1, S. Das3, N. Shah-More3 1UCL Institute for Global Health, Institute For Global Health, London, United Kingdom, 2UCL GOS Institute of Child Health, Population, Policy & Practice Department, London, United Kingdom, 3Society for Nutrition, Education and Health Action, Monitoring And Evaluation, MUMBAI, India


Consumption of sweet and savoury snack foods is increasingly common among young children (6-23 months) in low and middle-income countries. Repeated data on the same individuals are required to understand how strongly consumption is correlated over time, and the influence of socioeconomic position.

We aimed to understand whether consumption of snack foods at any time in the complementary feeding period was influenced by feeding in the previous period as well as background socioeconomic factors.

Methods:

We used data from the SNEHA Centres Infant Nutrition Cohort, a prospective study of 1012 children born in 20 informal settlements in Mumbai, India. Data on children’s diet was measured monthly up to two years. We conducted autoregressive response modelling for repeated measures data in six three-month intervals using random effects models to estimate (1) the odds of consuming snacks if a child had consumed some in the previous period, and (2) the association of socioeconomic characteristics with snacking.

Results:

Consumption in one interval was strongly influenced with consumption in the previous period (OR 2.38; 95%CI 1.8, 3.1). Children of mothers who studied beyond the 6th standard were less likely (aOR 0.65; 95%CI 0.5, 0.9) and those in families with four or more children were more likely (aOR 1.61; 95%CI 1.1, 2.2) to consume snacks regularly.

Conclusions:

Consumption of snack foods among children in urban informal settlements is highly correlated over time, and children in lower socioeconomic groups are more likely to eat snacks habitually.

257 / #520


GROWTH IN INFANTS WITH GALACTOSEMIA BEFORE AND ON THE LACTOSE-FREE DIET

T. Bushueva1, T. Borovik1,2, V. Skvortsova1,3, N. Zvonkova1,2, E. Roslavtseva1 1National Medical Research Center for Children's Health, Department Of Nutrition For Healthy And Sick Child, Moscow, Russian Federation, 2I.M. Sechenov The First Moscow State, Pediatric Department, Moscow, Russian Federation, 3M.V.Vladimirsky Moscow Regional Research Clinical Institute, Neonatology Department, Moscow, Russian Federation


The severity of galactosemia can affect physical development in children. The aim of study was to evaluate the nutritional status of galatcosemic children in different periods of infancy.

Methods:

67 term infants were under observation: 39 with classic galactosemia (1st group) and 28 with compound geterozygosity for Duarte variant (2nd group). Anthropometric data was analyzed at birth, before dietary treatment and at age of 1 year (WHOAnthro 2006 program). Statistical analysis was performed using the package Statistica 6.0 (StatSoft Inc., USA).

Results:

Anthropometric data of newborns at birth did not differ between groups. Before dietary treatment (mean 8 day of life) Z-score BMI/age was ≤-2SD in 31 (80%) infants of 1st group and in 2 (8%) infants of 2nd group (p = 0,000). After 1 year of lactose-free diet Z-score BMI/age was within the normal range in 34 (87.2%) children of 1st group and in 27 (96.4%) children of 2nd group (p = 0.075). Z-score length/age ≤-2SD observed in 4 (10.3%) patients of 1st group, that was significantly higher than in 2nd group (p = 0.002), in which all patient had normal growth parameters.

Conclusions:

Аcute undernutrition has high incidence in classic galactosemia infants without treatment. Lactose-free diet is very effective in nutrition status optimization. However, some children remain stunted.

258 / #435


GROWTH OF INFANTS WITH SHORT BOWEL SYNDROME DURING 1-ST YEAR OF LIFE

A. Chubarova, E. Kostomarova, N. Zshikhareva N.F. Filatov Children's City Hospital of Moscow Healthcare Ministry, Pirogov N.I. Russian National Research Medical University, Chair Of Hospital Pediatrics, Moscow, Russian Federation


The system of home parenteral nutrition has been applied for the first time in Russia by authors 14 years ago. Now with the use of tunneled catheters, aseptic non-touch technique (ANTT), 3-in-one parenteral nutrition, parent schools the growth of children with short bowel syndrome (SBS) has improved. This work is aimed at reevaluation of SBS criteria by measuring growth parameters during the first year of life in children on HPN.

Methods:

79 children who underwent massive bowel resection were included In the open prospective study. The SBS was considered if the left intestine length was less than 20 cm, or if it was not possiblity after 90 days after initial resection to stop PN (n=62), all received HPN till 1 year of life. The other 19 children demonstrated good growth 90 days after resection (control group). The growth parameters were calculated with the use of Eurogrowth program.

Results:

At the age of 1 year in the 1-st group linear growth was normal (mean length z-score -1.31), as well as in 2-nd group (-0.91). But weight and BMI were lower in1-st group (-2.58 against -1.54 and -2.24 against -1.04) consequently. 55% of children in the first group and 29% in 2-nd group had weight for length deficiency.

Conclusions:

90 days cut-off is not an appropriate time to exclude SBS. HPN program allows to archive good linear growth and give the opportunity to reach normal growth in later life. HPN program in SBS children should be corrected to reach more appropriate weight.

259 / #170


ASSOCIATION BETWEEN BREASTFEEDING DURATION AND WEIGHT TRAJECTORY FROM BIRTH TO 5 YEARS AMONG CHILDREN EXPOSED AND UNEXPOSED TO GESTATIONAL DIABETES MELLITUS IN UTERO

C. Dugas1, M. Kearney2, J. Perron2, S. Weisnagel3, I. Marc4, J. Robitaille1 1Laval University, School Of Nutrition, Quebec, Canada, 2Institute of nutrition and functional foods, Nutrition, Quebec, Canada, 3CHU de Québec Research Center, Endocrinology And Nephrology Axis, Quebec, Canada, 4Laval University, Department Of Pediatrics, Quebec, Canada


Breastfeeding plays an important role in health programming and is known to affect growth trajectory in infancy. In order to develop strategies to prevent obesity in children exposed to gestational diabetes mellitus (GDM), the aim of this study was to evaluate the association between breastfeeding duration and weight trajectory in children exposed (GDM+) and unexposed (GDM-) to GDM.

Methods:

A total of 103 GDM+ and 63 GDM- children born between 2003 and 2013 were recruited between 2012 and 2017. Weight at 0, 6, 12 and 18 months, 2, 3, 4 and 5 years were collected from the participant’s health record. Total and exclusive breastfeeding duration were retrospectively collected by the children’s mother. Weight trajectories were compared between groups according to the median duration of breastfeeding using a mixed linear model for repeated measurements among GDM+ and GDM- children.

Results:

Being breastfed <9 months compared to ≥9 months was not associated with weight trajectory of GDM+ and GDM- children (p>0.05). Among GDM+, being exclusively breastfed <5 months, compared to ≥5 months, was associated with lower weight gain between 4 and 5 years independently of gestational age, infant sex and maternal education level (1.86 ± 1.41 and 3.16 ± 1.35 kg, p=0.02).

Conclusions:

Among GDM+ children, exclusive breastfeeding duration was associated with children’s weight only between 4 and 5 years of age. Further investigations should evaluate the impact of breastfeeding on adiposity measurements all through childhood in order to better understand mechanisms leading to obesity in this population.

260 / #288


TIMING OF INTRODUCTION OF COMPLEMENTARY FOODS TO INFANTS AND RISK OF DEVELOPING COELIAC DISEASE: THE ASSESSMENT BY THE EUROPEAN FOOD SAFETY AUTHORITY (EFSA)

A. Titz1, C. Dumas1, F. Morreale1, C. Nielsen1, L. Ciccolallo2, J.-L. Bresson3, M. Fewtrell4, M. Kersting5, H. Przyrembel6, D. Turck7 1European Food Safety Authority (EFSA), Nutrition Unit, PARMA, Italy, 2European Food Safety Authority, Assessment And Methodological Support Unit, Parma, Italy, 3Hôpital Necker-Enfants malades - Université Paris Descartes, Pediatric Gastroenterology, Hepatology And Nutrition (retired), Paris, France, 4UCL Great Ormond Street Institute of Child Health, Childhood Nutrition Research Group, London, United Kingdom, 5Universitätsklinikum der Ruhr-Universität Bochum, Research Institute For Child Nutrition, Bochum, Germany, 6Bundesinstitut für Risikobewertung, Department Of Food Safety (retired), Berlin, Germany, 7University of Lille and Lille University Jeanne de Flandre Children's Hospital, Pediatrics, Lille, France


The European Commission requested EFSA to update its 2009 opinion on the appropriate age range of introduction of complementary foods (CFs). EFSA conducted a systematic review of the effect of age at introduction of CFs on 14 health outcomes, including coeliac disease (CD).

Methods:

EFSA developed an assessment protocol to select studies with groups of infants differing only in the timing of CF introduction. The risk of bias (RoB) was assessed for each study and outcome. Pooled estimates of effects/associations were obtained using random effects meta-analyses combining data from at-risk populations and the general population. EFSA drew conclusions from studies with low/intermediate RoB (Tier 1-2) on the risk of developing CD and graded the confidence in the evidence. Time to disease onset was not assessed.

Results:

The single randomised controlled trial available (Tier 1) did not show an effect of gluten introduction at 4 vs 6 months on the hazard of developing CD up to 3 years of age (high confidence in the evidence). A pooled analysis of four prospective cohorts (Tier 1-2) did not find evidence for an association between gluten introduction at ≤3 or 4 months vs thereafter and the hazard of developing the disease up to 12 years (moderate confidence). There were no concerns with respect to the generalisability of results to infants living in Europe.

Conclusions:

Gluten can be introduced to an infant’s diet when other CFs are introduced as far as the risk of developing CD is concerned.

261 / #555


TIMING OF INTRODUCTION OF COMPLEMENTARY FOODS TO INFANTS AND RISK OF DEVELOPING EGG ALLERGY: THE ASSESSMENT BY THE EUROPEAN FOOD SAFETY AUTHORITY (EFSA)

A. Titz1, C. Dumas1, F. Morreale1, C. Nielsen1, L. Ciccolallo2, J.-L. Bresson3, M. Fewtrell4, M. Kersting5, H. Przyrembel6, D. Turck7 1European Food Safety Authority (EFSA), Nutrition Unit, PARMA, Italy, 2European Food Safety Authority, Assessment And Methodological Support Unit, Parma, Italy, 3Hôpital Necker-Enfants malades - Université Paris Descartes, Pediatric Gastroenterology, Hepatology And Nutrition (retired), Paris, France, 4UCL Great Ormond Street Institute of Child Health, Childhood Nutrition Research Group, London, United Kingdom, 5Universitätsklinikum der Ruhr-Universität Bochum, Research Institute For Child Nutrition, Bochum, Germany, 6Bundesinstitut für Risikobewertung, Department Of Food Safety (retired), Berlin, Germany, 7University of Lille and Lille University Jeanne de Flandre Children's Hospital, Pediatrics, Lille, France


The European Commission requested EFSA to update its 2009 opinion on the appropriate age range of introduction of complementary foods (CFs). EFSA conducted a systematic review of the effect of age at introduction of CFs on 14 health outcomes, including egg allergy (EA).

Methods:

EFSA developed an assessment protocol to select studies with groups of infants differing only in the timing of introduction of egg. The risk of bias (RoB) was assessed for each study and outcome. Pooled estimates were obtained using random effects meta-analyses, for the general population (GP) or the population at risk of allergy (RP). EFSA drew conclusions from studies on EA with low/intermediate RoB (Tier 1-2) and graded the confidence in the evidence.

Results:

From a European randomised controlled trial (RCT) (Tier 1), there was limited evidence, in the GP, that introduction of cooked egg at 3–4 vs 6 months may reduce the risk of developing EA up to 3 years. From a pooled analysis of three Australian RCTs (Tier 1-2), there was evidence, in the RP, that introduction of pasteurised raw egg powder between 4 and 6 months of age may be associated with lower risk of developing EA up to 1 year. Results could not be generalised to the whole population of infants in Europe.

Conclusions:

Introduction of egg at 3-4 vs 6 months may reduce the risk of developing egg allergy (low-moderate level of confidence). Regarding allergy risk, cooked egg can be introduced when other CFs are introduced.

262 / #260


EVALUATION OF THE FREQUENCY OF ANTHROPOMETRIC MEASUREMENTS IN SURGICAL INFANTS

C. Elliott, H. Duggan, A. Iqbal Great Ormond Street Hospital, Nutrition And Dietetics, London, United Kingdom


Regular monitoring of length and occipitofrontal circumference (OFC) as well as weight are essential for effective growth monitoring in infants. The aim of this study was to audit the frequency of these measurements in infants cared for on the surgical ward against hospital standards.

Methods:

Anthropometric measurements of all infants admitted to the surgical ward over a one month period were collected retrospectively using the patient’s electronic record at two separate time points (March and October 2019). After the March audit, nursing staff received theoretical and practical training on growth measurements. The purpose of the October audit was to measure the effectiveness of that training. The data collected at both time points was compared to the hospital guideline (weight three times a week, length weekly and OFC monthly).

Results:

March cycle

11 infants (6 preterm) were admitted. 90% were weighed on admission, and 63% were weighed tri-weekly. No length measurements were recorded. 9% had an OFC measured.

October cycle

The same number of admissions occurred in October, 11 patients (4 preterm). 100% infants were weighed on admission and 80% were weighed tri-weekly. 67% had a length measured during their admission, but none had this repeated weekly. 17% had an OFC measured on admission and 83% had one measured during their stay.

Conclusions:

Frequency of growth measurements improved after training of nursing staff. Auditing frequently can help to identify training needs and feeding the results back to ward staff, reinforcing the importance of growth monitoring.

263 / #521


SEVERE COW'S MILK PROTEIN, NON-IGE MEDIATED FOOD ALLERGY - CASE REPORT

A. Flak-Wancerz, S. Więcek, M. Kałużna-Czyż, U. Grzybowska-Chlebowczyk Medical University of Silesia, Paediatrics, Katowice, Poland


Food allergy is a common disease in infants and children. Food allergy is defined as "a hypersensitivity reaction induced by specific immunologic mechanisms ''. According to current epidemiological studies, almost 5% of adults and 8% of children experience food allergy symptoms. According to sources, the most common allergens causing clinical symptoms of food allergies in children are cow's milk proteins (2-3% children's population), and egg white (2-2.5%). The incidence of severe food allergy in children with allergies is 2-4%.

Methods:

The paper describes five infants with severe non-IgE mediated food allergy diagnosed using elimination diet. Clinical symptoms were varied: in two bleeding from the lower gastrointestinal tract - in one of them Fe deficiency anemia, in two - weak weight gain, in one - only lack of weight gain. The remaining 2 infants (4 and 6 weeks) were admitted to the ward due to severe constipation (1 with suspected Hirschsprung disease) and poor weight gain.

Results:

IgE mediated food allergy, gastrointestinal tract infections, anatomical defects were excluded in all described infants. Amino acid mixtures were used in the treatment, resulting in a rapid improvement in general condition and weight gain. Due to the young age of children and severe course of the disease, no diagnostic provocation was carried out.

Conclusions:

In conclusion the use of an elimination diet in children with severe non-IgE mediated food allergy effectively accelerates weight gain and growth, which affects to health status in adulthood.

264 / #513


QUALITY OF LIFE OF MOTHERS AND COMMITMENT TO BREASTFEEDING

S. Guseva1, A. Aminova2, Z. Gumbatova2 1The First Moscow State Medical University named after I.M. Sechenov ("Sechenov University"), Paediatrics, Moscow, Russian Federation, 2The First Moscow State Medical University named after I.M.Sechenov ("Sechenov University"), Paediatrics, Moscow, Russian Federation


Breastfeeding provides emotional contact between mother and child, involves a sensual dialogue and mother receives not only physiological, but also psychological support, which helps in difficult moments of the child's behavior. The WHO recalls that breastfeeding is the best way to feed babies. In this regard, we set a goal to study the quality of life of nursing mothers and to establish whether adherence to breastfeeding affects the physical and psychological state of a woman.

Methods:

We used the SF-36 questionnaire was conducted in 151 mothers with infants. The age of mothers is 27-32. All respondents were divided into 2 groups - nursing (83) and non-nursing (68).

Results:

It was found that the average income of families of non-feeding women is almost 2 times higher than that of non-feeding. The indicators of physical functioning in the compared groups did not differ. Nursing mothers are less prone to depression. The pain intensity factor in nursing mothers is much lower. The indicators of own health and vitality in the groups did not differ.

Conclusions:

Lactating women are less susceptible to depression, have a more stable emotional state, role-playing and social management of daily activities are not impaired in lactating women, that is, their physical condition and emotional tone do not interfere with her daily work and do not affect social activity. Subjective sensations of the state of health, vitality, and susceptibility of diseases after childbirth were similar and didn't depend on adherence to breastfeeding. It is possibly associated with higher material well-being of non-breastfeeding mothers.

265 / #409


CO-PARENTING AND EMOTIONAL MANAGEMENT IN MEN AND WOMEN AFTER BABY BIRTH

A. Gutierrez-Hervas, I. Sospedra, V. Muñoz-Poveda, A. Oliver-Roig, M. Lozano, M. Richart-Martínez University of Alicante, Nursing Department, San Vicente del Raspeig, Spain


After a baby birth, co-parenting and emotional management are important aspects that involve benefits for both parents and infants in different areas, including food environment and mental health. Currently, there are a lot of people with metabolic and mental illness as obesity and post-partum depressions, anxiety, and stress. We aim to analyse the situation of co-parenting and emotional management in both genders of parents after baby birth.

Methods:

The study was carried out in Spain and included 1721 parents (962 women and 759 men) with their toddler (12-24 months). They completed an on-line questionnaire about co-parenting and emotional management. The variables of interest were measured with the following scales: Parental Sense of Competence (PSOC), Dyadic Adjustment Scale (DAS), Parenting Alliance Inventory (PAI), WEMWBS, Diener Scale, Parental Stress Scale and Fatigue Assessment Scale (FAS). To analyse the results SPSS vs 23.0 statics program was used.

Results:

Both parents have optimal scores in all the different scales. They seem sure about their parental competences and with stress management. However, there is a little difference between genders in PAI where men feel more supported by the women.

Conclusions:

Generally, there are no differences in co-parenting and emotional management between parents, both genders seem to have well emotional manage, but men feel more supported by their partner than women.

266 / #262


SARPHATI DIARIES: A STUDY ON INFANT NUTRITION DURING THE WEANING PERIOD IN FOUR MAIN ETHNIC GROUPS IN AMSTERDAM

J. Hall1, O. Sirkka2, J. Ujcic-Voortman1, J. Seidell2, A. Verhoeff1 1Public Health Service of Amsterdam, Epidemiology, Health Promotion & Care Innovation, Amsterdam, Netherlands, 2Vrije Universiteit, Faculty Of Science, Department Of Health Sciences, Amsterdam, Netherlands


Overweight, including obesity, forms a serious health threat in the Netherlands and worldwide. There are large and largely unexplained differences in early overweight prevalence between ethnic groups. The complementary feeding period is important for developing eating habits and food preferences and may have a significant impact on growth trajectories. With Sarphati Diaries we aim to collect extensive data on dietary intake during weaning in order to 1) understand ethnic differences in dietary intake at 6 and 12 months of age in the diverse population of Amsterdam, including Dutch, Turkish, Moroccan and Surinamese infants and 2) identify indicators that could be used for developing an age specific tool to assess determinants of dietary intake among infants.

Methods:

We aim to recruit 200 mothers with a 3-6 month old infant in Amsterdam. Participants will fill out a questionnaire, covering maternal demographics and infant feeding. At 6 and 12 months mothers will complete a 3-day food diary to assess their child’s dietary intake, with a special focus on food preparation. Interviews will take place to check the filled-out diaries and to collect qualitative information on motivations behind their feeding practices.

Results:

Recruitment of participants has started in September 2019. During the conference, we will present the study design and first results.

Conclusions:

The identification of the main foods, feeding frequency and food preparation during weaning in four main ethnic groups in Amsterdam will help to develop targeted interventions for parents from different socio-cultural groups.

268 / #537


EFFECT OF A NOVEL SUPPLEMENTARY PORRIDGE ON THE NUTRITIONAL STATUS OF INFANTS AND YOUNG CHILDREN DIAGNOSED WITH MODERATE ACUTE MALNUTRITION IN UGANDA

R. Kajjura1, F. Veldman2, S. Kassier2 1University of Kwazulu Natal, Department Of Nutrition And Dietetics, Pietermaritzburg, Uganda, 2University of Kwazulu Natal, Nutrition And Dietetics, Pietermaritzburg, South Africa


Moderate acute malnutrition (MAM) and anaemia is prevalent among infants and young children (IYC) in Uganda. A lack of consensus regarding the most effective strategy for managing MAM among IYC, resulted in comparing the effect of MSBP (an active malt, extruded maize and soy sorghum supplementary porridge developed for the purpose of the study) as intervention, to an extruded maize and soy micronutrient fortified blend (CSB+) as control and current standard care. Outcome measures were anthropometric status and haemoglobin levels.

Methods:

A double blind cluster randomized control trial with eight to ten conveniently sampled consenting mother-IYC pairs per cluster, were randomly assigned to treatment (n=110) or control (n=110) for three months. Weekly anthropometric measurements were taken. Haemoglobin levels were measured at baseline and end line. Mean length-for-age, weight-for-age, length-for-weight, and mean haemoglobin levels of the treatment and control groups were compared using the independent t-test. The z-test was used to compare proportions of the outcome indicators between the treatment and control groups.

Results:

Difference in mean weight-for-age z-scores in the treatment group improved when compared to control (P = 0.01). The change in mean haemoglobin levels was lower in the treatment versus control group (P = 0.01). The proportion of IYC recovering from MAM between treatment and control did not differ significantly (P = 0.055).

Conclusions:

Recovery rates after supplementation with MSBP versus CSB+ resulted in similar weight-for-length and haemoglobin levels. Therefore, MSBP has the potential for being up scaled in the management of IYC with MAM in Uganda.

269 / #209


END USER EXPERIENCE WITH AMINO ACID-BASED FORMULA FOR MANAGEMENT OF FOOD ALLERGIC CONDITIONS

J. Kajzer1, V. Mccann2, J. Agnew3, B. Marriage1 1Abbott Nutrition, Medical & Scientific Affairs, Columbus, United States of America, 2Abbott Nutrition, Market Research, Columbus, United States of America, 3Abbott Nutrition, Marketing, Columbus, United States of America


Hypoallergenic, amino acid-based infant formula is indicated for infants who cannot tolerate intact or hydrolyzed protein. The aim of this study was to better understand the experiences of parents/caregivers of infants consuming an amino acid-based product, including patient diagnosis, symptoms, route of administration, formula acceptance, and symptom resolution.

Methods:

Consumers participating in a program to receive free product were given the option to be contacted for future programs and provided an e-mail address. Surveys were e-mailed to customers who opted-in to being contacted; consent was obtained prior to the start of the survey. Surveys were sent to 1,995 consumers between 2/14/19 – 3/15/19. A descriptive analysis was performed using Qualtrics Customer XM™.

Results:

Two hundred ninety-one responses (11% response rate) were received and 175 were specific to infant formula. Ninety-five percent of infants received the formula orally. Per parent reports, 82% of infants were diagnosed with food allergic conditions; 54% were experiencing multiple symptoms prior to using a specific amino acid-based formula. Eighty seven percent saw improvement after initiating the formula and 94% of parents reported their child’s quality of life was very much or much improved. Ninety-six percent of parents were satisfied or very satisfied with the formula and 98% would recommend the formula to other parents.

Conclusions:

Managing food allergies in young infants can be challenging for parents. Experiences from other parents may be reassuring to families with infants who have been newly diagnosed with food allergies and require an amino acid-based formula.

270 / #39


INFANT CEREAL WITH PROBIOTIC IMPROVES HEALTHY CHILDREN GUT MICROBIOTA ON THE SIMULATOR OF HUMAN INTESTINAL MICROBIAL ECOSSYSTEM (SHIME®)

K. Sivieri1, N. Perina2, F. Freire1, M. Salgaço1, E. Mosquera2, T. Lazarini2 1UNESP, Food And Nutrition, Araraquara, Brazil, 2Nestle Brazil, Medical And Scientific, Sao Paolo, Brazil


Dysbiosis of gut microbiota is a new factor in the development of child metabolic diseases such as obesity and allergies. Thus, prevention of illnesses is proposed to begin in the first 3 years of life, when gut microbiota is being formed. The aim of this work was to evaluate the effect of probiotic infant cereal on children gut microbiota using SHIME®.

Methods:

The effect of infant cereal with probiotic Bifidobacterium animalis subsp. lactis BB-12® on children gut microbiota was evaluated using SHIME®, which simulates human gastrointestinal conditions, from stomach to colon. The ascending colon was inoculated with fecal microbiota from three children (± 2.5 yo). The study protocol included one week of control period, one week of infant cereal treatment, one week of washout and one week of probiotic infant cereal treatment. NH4+, Short chain fatty acids (SCFA) and microbiota composition were determined by selective-ion electrode, GC/MS and 16S-sequencing, respectively.

Results:

Butyric acid was increased 52% (p<0.05) after treatment with probiotic infant cereal. Decrease of NH4+

(p<0.01) production was observed in treatment with both infant cereals. Treatments stimulated an increase (p<0.01) of Lactobacillus spp, specifically L. grasseri and only treatment with probiotic infant cereal stimulates L. kefiri growth. Interestingly, L. grasseri has been associated with the prevention of childhood allergic rhinitis and L. kefiri in obesity prevention.

Conclusions:

Probiotic Infant cereal is able to stimulate growth of L. grasseri and L. kefiri, in a beneficial way, reducing the NH4+ and increasing production of SCFA, especially butyric acid, on SHIME®.

272 / #597


EATING HABITS AND NUTRITIONAL STATUS OF CHILDREN IN THE 1ST GRADE

M. Ângelo, A. Faria, M. Loureiro Coimbra Health School, Dietetics And Nutrition, Coimbra, Portugal


Food plays a key role in all stages of the life cycle, especially in school-aged children, since adequate nutrition is essential so that the correct supply of essential nutrients to the child’s normal development is warranted. Overweight and obesity in school-aged children have been risking to alarming proportions in recent years.

The main goal of this study was to evaluate the eating habits and nutritional status of children in the 1st grade.

Methods:

A questionnaire was sent to parents, consisting of sociodemographic questions (gender, age, parent schooling) and questions about the daily consumption of certain foods by children, as well as other habits related to feeding. Anthropometric data for BMI classification according to the WHO references, was also collected.

Results:

The questionnaire was answered by parents of 38 children. Of these, 50,0% were eutrophic, 26,3% were overweight and 23,7% showed obesity. Most of them presented healthy eating habits overall, but 32 children often consumed sugary products and 29 consumed excess processed foods.

Conclusions:

Taking into account that foods considered unhealthy are often consumed by children and to the detriment of healthy foods, it is necessary to assess the nutritional quality of children’s diet. Emphasis is placed on the importance of parents encouraging the consumption of healthier foods and schools promoting the development of appropriate eating habits to ensure the health and quality of life of children.

273 / #402


INFANT FEEDING STYLES DIFFERENCES BETWEEN PARENT GENDERS

M. Lozano1, I. Sospedra2, M. Richart-Martínez2, A. Gutierrez-Hervas2, A. Oliver-Roig2, V. Muñoz-Poveda1 1University of Alicante, Nursing, San Vicente del Raspeig, Spain, 2University of Alicante, Nursing Department, San Vicente del Raspeig, Spain


From some years ago women are working as much as men but they still being the main responsible for feeding the kids. These gender roles can be reflected in several aspects of parenting, including feeding practices. Feeding styles are characterized by feeding practices determined by exigency and sensitivity. According to that, 4 feeding styles can be defined: democratic (high sensitivity and exigency), authoritative (low sensitivity and high exigency), permissive (high sensitivity and low exigency), and indifferent (low sensitivity and exigency). These feeding styles can be determined by The Toddler Feeding Style Questionnaire (TFSQ). We aim to analyse the relationship between feeding styles and gender roles.

Methods:

The study included 1721 parents (962 women, 759 men) from Spain and their toddlers. They completed a web-based survey including TFSQ and other general questions related to sociodemographic aspects. The results of the questionnaire were analysed by SPSS v23.0 statics program.

Results:

Democratic was the mostly feeding style followed by both parents (57.6% women and 53.6% men). Permissive was the second style followed by women (24.6%) whereas authoritative was the second by men (26.1%).

Conclusions:

Democratic is the main feeding style followed by both parents, which is the more recommendable style according to the literature. Comparing gender roles are observed in the second feeding style, authoritative in men and permissive in women.

274 / #408


WORK CONDITIONS AND FEEDING RESPONSIBILITIES AFTER BABY BIRTH: GENDER ROLE DIFFERENCES

M. Lozano, I. Sospedra, A. Gutierrez-Hervas, V. Muñoz-Poveda, M. Richart-Martínez, A. Oliver-Roig University of Alicante, Nursing, San Vicente del Raspeig, Spain


During years there was a social gender role where women had a main role inside the house looking after the child and cleaning whereas men were working. Some years ago that fact started to change when women started to apply for jobs and spend less hours in the house but currently the typical gender role is still present. The aim was to study the gender roles related to work and child feeding responsibilities.

Methods:

1721 parents (962 women, 759 men) from Spain with a toddler were included in the study. They completed a web-based survey to obtain data about differences in social and baby-feeding aspects between genders. Variables studied included: incorporation of parents into work, type of employment contract before and after birth, current employment situation, and knowledge about their child feeding practices. The results of the on-line questionnaire were analysed by SPSS v23.0 statics program.

Results:

After birth, women have less full-time jobs and more temporary works than men. Besides, more women decide to left the job or reduce their work hours after birth. Women are the main kid feeding responsible. From the point of view of both genders (>60%) women appear to be more involved in children feeding than men.

Conclusions:

Gender roles are still present in work and feeding aspects. Women have worse job conditions after birth (less full-time job, more reduction of working hours even absence) than men and they still have the main role in the kids feeding.

275 / #432


A NOVEL APPROACH TO EVALUATING LINEAR GROWTH FALTERING IN PRE-SCHOOL NEPALESE CHILDREN USING A DERIVED TANNER-WHO GROWTH VELOCITY REFERENCE

S. Manohar1, A. Thorne-Lyman1, E. Colantuoni2, A. Kc1, B. Shrestha2, R. Adhikari3, K. West Jr.1 1Johns Hopkins Bloomberg School of Public Health, International Health, Baltimore, United States of America, 2Nutrition Innovation Lab, Jhu, Kathmandu, Nepal, 3IOM, Community Medicine & Public Health, Kathmandu, Nepal


Attained stunting fails to reveal the timing and extent of growth faltering, for which linear growth velocity (LGV) assessment is preferred. However, no velocity reference exists throughout the preschool years. We propose a novel , sex-age-specific, annualized LGV reference, concatenated from extant references, to evaluate faltering, applied to Nepalese children.

Methods:

Two LGV references were conjoined: WHO Growth Standards (for interval-initiating monthly ages <12 mo) and Tanner Velocity References (for 13-48 mo). Predicted sex-specific median LGVs as a function of age were fit by linear restricted cubic spline regression, LGV z-scores (LGVZ) constructed and growth faltering defined by values <-2. The reference was tested in 6079 <60 mo old children in 21 wards of 7 subdistricts randomly sampled across the plains of Nepal. Anthropometry was measured between May-August annually between 2013- 2016. LGV was annualized and stratified by sex and interval-initiating month of age. Prevalence and risk factors of growth faltering were evaluated for ages < 6, 6-11, 12-23, 24-35, 36-47 and 48-59 months.

Results:

Referent LGV medians followed an expected decreasing trend with age. Growth faltering was common among Nepalese preschoolers, affecting 31.1%, 28.6%, 29.3%, 6.7%, 6.2%, and 6.2% of children in each respective age group. Mean LGVs and % faltering rates were worse for girls during the first 2 years of life. Age-specific risk factors will be reported.

Conclusions:

A novel linear velocity reference, derived from two global references, is illustrated, revealing growth faltering in Nepalese children irrespective of attained height-for-age. This approach can be replicated where population-level longitudinal growth measures are available.

276 / #234


CHALLENGES OF DEVELOPING A HYPOALLERGENIC EXTENSIVELY HYDROLYZED PROTEIN INFANT FORMULA

B. Marriage1, C. Ramirez1, M. Masor2 1Abbott Nutrition, Medical & Scientific Affairs, Columbus, United States of America, 2M&M, Arts And Science, Durango, United States of America


Extensively hydrolyzed protein (EHP) formulas are important treatment options for non-breastfed infants with a variety of conditions including cow’s milk allergy (CMA), colitis, maldigestion and malabsorption.

Specifically, nutritional management of cow’s milk allergy requires the removal of intact protein from the diet; non-breastfed infants must rely on a hypoallergenic infant formula as a sole source of nutrition, utilizing extensively hydrolyzed protein (EHP) or an amino acid-based infant formula. Few recognize the extraordinary amount of work required to successfully manufacture EHP formulas. They must be demonstrably hypoallergenic, support optimal growth, be well-tolerated and available as either a commercially sterile and stable liquid or easily reconstituted powder. This represents a considerable challenge, given the effects of protein hydrolysis on formula stability, mixability and organoleptic properties.

Methods:

Fifty-four reports of clinical studies conducted on a casein-based EHF between 1987 and 2019 were reviewed and categorized into growth, tolerance, metabolic balance or efficacy studies.

Results:

The clinical work demonstrated that the formula supports normal growth in infants, is well tolerated (formula acceptance, stool characteristics, incidence of spitting up and/or emesis) and supports mineral absorption as demonstrated in metabolic balance studies.

Conclusions:

The casein-based EHF was proven to be hypoallergenic and efficacious as the sole source of nutrition for infants with proven CMA or multiple protein allergies. In addition, the formula provides an effective nutrition source for infants or children with chronic malabsorption, cystic fibrosis, protein sensitive colitis, and colic due to protein sensitivity.

277 / #512


NATIONAL PREVALENCE SURVEY FOR DISABILITIES IN EGYPT: ASSESSING ITS EPIDEMIOLOGICAL PATTERN AND RISK FACTORS

A. Metwally National Research Centre, Community Medicine Research Dept, Giza, Egypt


Disability is an interaction between individuals with a health condition, personal and environmental factors. About 15% of the world's population, have some form of disability. This study was a national community-based survey conducted through the fund from the Academy of Scientific Research and Technology to define the magnitude of the problem of disabilities in Egypt in the context of the population of infants at the age group of 2 years till 12 years as well as the identification of its risk factors.

Methods:

This survey was carried out in 8 Governorates representing all geographic regions of Egypt. All children were subjected to the modified checklist for disabilities as a screening tool, suspected children were referred to Maternal and child health facilities of the Ministry of Health (MOH) and National Research Centre clinics for confirmation and to get managed. The actual sample size achieved was 41,558 children out of the 22,022 visited household.

Results:

It was found that 9.7% (4047/41558) of the surveyed children suffered from disabilities; 60.7 % were boys versus 39.6% girls. Speech and comprehension were the most prevalent disabilities. The most common significant risk factors for disabilities were suffering from convulsions (OR = 5.9) followed by cyanosis after birth (OR = 4.8), meningitis (OR = 3.9), preterm pregnancy less than 7 months (OR = 3.14) and low birth weight less than 2.5 kg at birth (OR = 2.92).

Conclusions:

Children with disabilities have the right to greater access to health care services and thereafter will experience their unmet health care needs.

278 / #610


BREASTFEEDING AND DIETARY DIVERSIFICATION OF INFANTS FROM BIRTH TO 12 MONTHS IN LIBREVILLE AND LAMBARÉNÉ (GABON – AFRICA).

S. Minto'O, M. Pemba Messan, E. Kuissi Kamgaing, S.J. Ategbo UNIVERSITE DES SCIENCES DE LA SANTE, Pediatrics, LIBREVILLE, Gabon


World Health Organization recommandation for the duration of exclusive breastfeeding is 6 months. We aimed to evaluate breastfeeding duration, food diversification and weaning of infants from birth to twelve months in Libreville and Lambaréné, and correlated factors.

Methods:

We conducted a cross-sectional, observational study conducted from August to December 2017, in vaccination centres of Libreville and Lambaréné. Including mothers coming to the health centre for vaccination, asked about dietary practices and dietary diversification foods from birth to the day of the interview.

Results:

We included 555 children from the questioning of their mothers, 290 boys for 265 girls. The mean age was 4.2 ± 3.2 months. On average, exclusive breastfeeding duration was <1 month. The mean age of introduction of a formula was 2 ± 1.6 weeks for Libreville and 4 ± 0.3 weeks for Lambaréné (p = 0.004). The mean age of introduction of a food other than milk was 2.2 ± 2.3 months, the specific age of flours 4.9 ± 1.5 months, that of fruits and vegetables was 6 ± 1.4 months , that of the introduction of meat and fish was 6.4 ± 1.3 months. Water was introduced on average at 1.9 months ± 1.7 months.

Conclusions:

Mothers in Gabon have improved dietary diversification practices. Mothers living in semi-rural areas have a duration of exclusive breastfeeding longer than urban mothers.

279 / #20


IRON DEFICIENCY ANEMIA IN ALGERIAN PRESCHOOL CHILDREN IN THE REGION OF DJELFA

A. Mohammed Yehya El Amin Ecole Supérieure Des Sciences de l'Aliment et Des Industries Agro-alimentaires d'Alger, Technologie Alimentaire, Algiers, Algeria


In Algeria, iron deficiency anemia is a major public health problem. A descriptive cross-sectional study was carried out to assess the prevalence of anemia and iron deficiency anemia and to investigate the factors associated with iron deficiency anemia.

Methods:

A total of 368 clinically healthy children aged between 6 months and 5years living in a poor rural area of Algeria were assessed in this study. Biological indicators of iron status were assayed, and those of malnutrition were calculated. Socio-economic and dietary data were also collected.

Results:

The prevalence of iron deficiency anemia was 20.92% (95%CI: 17–25%), accounting for 86.5% of anemia cases. Nutritional components appeared as a potential cause of its occurrence. Binary logistic regression demonstrated that this elevated frequency is significantly correlated with risk factors relating to infancy(<2 years) (OR = 2.68 [95CI%: 1.47–4.97]),late introduction of weaning foods (OR = 2.51 [95%CI:1.29–5.05]), exclusive lactation(OR = 3.22 [95%CI:1.37–7.6]), low educational level of mothers (OR = 3.42 [95% CI: 1.52–7.65]) and gender (boys) (OR = 2.39 [95% CI:1.39–4.39]).

Conclusions:

Anemia and iron deficiency anemia were significant health problems among the studied sample. The improvement of the socio-economic status of mothers and weaning practices should both be included in public health strategies for the control and prevention of iron deficiency anemia in our population.

280 / #412


THE ASSOCIATIONS OF MILK INTAKE AND EARLY INFANT BEHAVIOUR WITH MATERNAL ANXIETY AMONG FIRST-TIME MOTHERS

N.H. Mohd Shukri1,2, J. Wells2, M. Fewtrell2 1Universiti Putra Malaysia, Department Of Nutrition And Dietetics, Faculty Of Medicine And Health Sciences, Serdang, Malaysia, 2UCL GOS Institute of Child Health, Population, Policy & Practice Department, London, United Kingdom


Maternal-infant interactions, either through nursing or behaviour could influence maternal psychological state, or vice-versa. Aims: To ascertain associations of infant milk intake, behaviour and temperament with maternal anxiety.

Methods:

First-time mother-infant dyads (n=64) were followed postnatally during home visits (HVs) at 2(HV1), 6-8(HV2), 12-16(HV3) weeks post-birth. Breast milk intake was measured at HV1 and HV3 using deuterium dilution. The duration of time spent on each breastfeeding session was assessed at HV1-3. Mothers completed a 3-day diary to estimate the duration of infant feeding, crying/distress, awake and sleeping at HV1-2. Infant temperament was assessed at HV3 using Revised-Rothbart’s-Infant-Behaviour. Maternal anxiety was assessed using Beck-Anxiety-Inventory at HV1-3.

Results:

A longer time spent on feeding was associated with higher anxiety score at HV1 (r=0.32,p=0.01). Consistently, breast milk intake at HV3 and an increase in milk intake HV1-3 were associated with anxiety score at all HVs (r-range=0.55-0.64,p<0.01). At HV1, infant distress and awake duration were associated with anxiety (r=0.32,p=0.03 and r=0.39,p=0.02 respectively). Shorter sleep and increased awake duration (HV1-2) were associated with anxiety score at HV3 (r=-0.37,p=0.03 and r=0.4,p=0.02 respectively). Easy temperament (effortful-control) was negatively associated with anxiety score at HV1 (r=-0.38,p=0.02), whereas difficult temperament (negative-affectivity) were positively associated with anxiety scores at HV2-3 (r-range=0.30-0.31,p<0.02).

Conclusions:

Maternal anxiety scores were positively associated with feeding duration, milk intake, infant distress and awake, and negative-affectivity, and negatively associated with infant sleep duration and effortful-control. These mother-infant effects could interact in both ways, hence, highlights the importance of understanding and improving maternal-infant interaction during the early postnatal period, especially among new mothers.

281 / #608


GROWTH RETARDATION AND CHROMOSOMES

S. Mougou-Zerelli, W. Slimani, M. Kamoun Farhat hached university teaching hospital, Human Cytogenetics And Reproductive Biology, Sousse, Tunisia


Various factors affect human growth including genetic, nutritional, environmental and hormonal factors that change at different growth stages: pre-natal life, infancy, childhood and adolescence. Genetic factors represent a prominent place. Consequently, any genetic, chromosomal, gene, or epigenetic abnormality may result in a disruption of intrauterine and / or postnatal growth.

Methods:

In the present work, we screened for the chromosomal abnormalities associated with IUGR and / or PNGR combining conventional cytogenetic and molecular techniques (FISH, array CGH and MLPA) in order to establish genotype-phenotype correlations.

Results:

Through this work we highlight le importance of genetic diagnosis in GR. Indeed, more than half of the series showed chromosomal aberrations. Combining all techniques, we found 23 different chromosomal abnormalities (figure1). Overall, our results allowed us to classify chromosomal abnormalities into two groups. The first group results in antenatal GR abnormalities, namely aneuploidies, triploidy and supernumerary marker chromosomes. The second group is responsible for postnatal GR, including duplications and deletions. These anomalies mainly disturb the hypothalamo-pituitary somatotropic axis by increasing or reducing the number of copies of genes involved at several levels.

Conclusions:

The genetic etiology of IUGR and PNGR are numerous and of varying importance according to the timing and the territory where the genes are expressed. A better knowledge of the regulation of the growth and the intervention phase of each regulatory factor during the development as well as the clinical picture of their possible failure could facilitate the genetic diagnosis and allow a better management in prenatal diagnosis and adequate genetic counseling.

282 / #202


THE MUTUAL INTERACTION BETWEEN TV VIEWING, FREQUENCIES OF EATING AS A FAMILY AND SNACKING, AND WAKE-UP AND SLEEP TIMES OF THE INFANT

N. Soichiro1, M. Niinuma2 1Yasuda Women University, Cildcare, Hiroshima, Japan, 2Yasuda Women Unversity, Child Education, Hiroshima, Japan


This study examines the actual lifestyle habits of infants, including sleeping, going to bed and waking up, and the co-eating situation during breakfast and dinner. Through this, this study aims to examine the optimum lifestyle habits for infants’ mental and physical development.

Methods:

After securing the cooperation of 184 guardians of pre-school children, the children’s bed and waking up times, meals taken, co-eating situation, snacks taken, and TV viewing frequeny were researched. The statistical processing of the obtained data was cross-tabulated between two factors using SPSS 23, and a chi-square test was performed. In this paper, only statistically significant results are detailed.

Results:

This study’s results found that 1) to increase the frequency of eating together as a family during breakfast, the infants should have a lifestyle that predicates early bed and wake-up times, 2) high frequency of skipping breakfast is correlated with a delayed bedtime, 3) a correlation between the frequency of watching TV with eating dinner together and bedtime was found, and 4) an impact of snack frequency on eating breakfast together and bedtime was found.

Conclusions:

It was found that how infants spend their time is mutually affected by the frequency of eating breakfast and dinner as a family, bed and wake-up times, the existence of snacking, and the frequency of TV viewing. Therefore, this study suggests the possibility that, by changing the conditions behind such lifestyle factors, the infants’ lives as a whole will follow more desirable directions, creating a positive impact on both their mental and physical health.

284 / #393


GROWTH OF DOMINANTLY BREASTFED SMALL FOR GESTATIONAL AGE TERM INFANTS IN THE FIRST SIX MONTHS OF LIFE

N. Nurani1, T. Wibowo1, R. Susilowaty2, J. Hastuti3, M. Julia1, M. Weissenbruch4 1Universitas Gadjah Mada/Sardjito General Hospital, Department Of Child Health, Yogyakarta, Indonesia, 2Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Department Of Histology And Cell Biology, Yogyakarta, Indonesia, 3Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Department Of Anthropology, Yogyakarta, Indonesia, 4Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit, Department Of Neonatology, Amsterdam, Netherlands


Compared to their appropriate–for-gestational (AGA) peers, small-for-gestational-age (SGA) infants are at risk for growth deficits. As exclusive breastfeeding is recommended up to 6 months, it is important to understand how breastfed SGA infants grow compared to AGA infants.

Objective: To evaluate growth of breastfed SGA term infants in the first 6 months after birth.

Methods:

Method: We conducted a prospective cohort study of term infants born in Dr. Sardjito Hospital, Yogyakarta, Indonesia. SGA was defined as birthweight less than the 10th percentile according to Fenton criteria. Weight, length, and head circumference (HC) were measured at birth and every month until 6 months of age.

Results:

We followed 39 AGA and 17 SGA term infants. Infants were breastfed up to age 6 months. Mean±SD weight, length and HC at birth of the SGAs were 2244±387g, 45.4±2.9cm and 31.6±1.5cm respectively. They were significantly lower than those of the AGAs: weight 3143±339g; length 49.1±1.8cm and HC 33.9±1.4cm. Afterwards, the SGAs grew in parallel with the AGAs, so at 6th month, mean±SD weight and length of the SGAs were 7020±61g and 64.9±2.7cm, which were significantly lower than those of the AGAs, i.e. 7881±951g and 68.5±3.1cm respectively. However, HC of SGAs grew significantly faster than the AGAs’ (p=0.005). At 6th month, there were no significant differences in HC between the two groups, i.e. 42.6±1.1cm in SGAs vs. 42.9±3.1cm in AGAs.

Conclusions:

In the first 6 months after birth, breastfed SGA term infants only catch up the growth of HC of their AGA peers.

286 / #554


VITAMIN D INTAKE AND GROWTH IN PRESCHOOL CHILDREN

M.R. Otelea1, D. Voican2 1University of Medicine and Pharmacy Carol Davila, Clinic Department 2, Bucharest, Romania, 2SAMAS Association, Nutrition, Bucharest, Romania


Vitamin D is important for children development and parents awareness regarding the vitamin D sources is important to assure the necessary level for a harmonious growth. Vitamin D deficiency was reported in both wasted and obese children, and there is no agreements if vitamin D intake should be different, according to the BMI.

Methods:

A questionnaire survey was conducted in 3 Bucharest kindergarten to assess the sun exposure, the vitamin D intake from foods and supplements. The questionnaire also collected data on height and weight. The BMI was calculated and classification in BMI categories (obese/overweight/normal/wasted/severely wasted) was based on the WHO charts. Data were processed with an SPSS software.

Results:

A total of 160 parents responded to the questionnaire. The average children age was 4,62 years. The majority of the children had normal BMI (73%), 5% were severely wasted, 14% were wasted, 6% were overweight and 2% were obese. On average children stayed outside for 4.33h/day during the summer and 1.9h/day during winter; 90% of them spent on average 8.9 days/year at the seaside. Only 135 children ate fat fish at least once a month (average intake = 360g/month) and 73 children received vitamin D as supplement. For these characteristics No statistical differences between the BMI categories groups (chi test, p >0.05) was found.

Conclusions:

There is no differentiation in vitamin D intake or estimated internal production according to the BMI status. A personalized recommendation of vitamin D for different BMI categories could provide benefit to children growth and development.

287 / #339


PREVENTION OF URINARY TRACT INFECTIONS IN YOUNG CHILDREN THROUGH BREASTFEEDING

R. Chamova1, R. Pancheva1, T. Dimitrova1, D. Bliznakova2 1Medical university of Varna, Bulgaria, Hygiene And Epidemiology, Varna, Bulgaria, 2Medical College, Varna, Bulgaria, Medical College, Varna, Bulgaria


Urinary tract infections (UTIs) are the most common bacterial infections in childhood. Breastfeeding has been repeatedly demonstrated as a protective factor against many infections in young infants, but its potential role in protecting from UTIs has not been well-characterized yet.

To assess the possible protective effect of breastfeeding on the occurance of UTIs in early childhood.

Methods:

We conducted a prospective case–control study between June 2014 - December 2016 in the St Marina University hospital, Varna, Bulgaria, a pediatric unit. A total of 108 children with diagnosed UTI (cases) 0-3 years were eligible for the study. Controls were recruited among infants or children registered for a well child visit. Recruitment took place after the parents and caregivers signed an informed consent for inclusion in the study. A questionnaire regarding breastfeeding and nutritional practices was applied. A diagnostic ultrasound and urinalysis was performed to rule out urinary tract anomalies.

For statistically significant differences a p-value < 0.05 was accepted. SPSS version 17 is used.

Results:

The average age of patients and controls was 17.7 ± 1 months. The mediana of the duration of breastfeeding and exclusive breastfeeding for the cases was 3.5 and 0 months respectively compared to the significantly longer duration for the controls - 6 months and 2 months respectively. UTI was not accompanied by high temperature in breastfed cases compared to non- breastfed cases (p <0.05).

Conclusions:

The duration of breastfeeding and exclusive breastfeeding have a protective effect against the development of urinary tract infections in infants and children in infancy.

289 / #456


COMPLEMENTARY FOODS: IS THE HOME-MADE FOOD STILL A POPULAR CHOICE?

T. Prawitasari, R. Martanti Faculty of Medicine, Universitas Indonesia, Department Of Child Health, Jakarta, Indonesia


There is a trend in our community to use commercial home-made complementary food. This foods were prepared and sold by individual or home industry with or without government registered. Despite food safety issues, it seems the products are very popular. This study aims to describe the choices of middle-low urban family about complementary food and their correlated factors.

Methods:

A cross-sectional survey of 100 mothers of infant 9-12 months infants were conducted in crowed urban area of Jatinegara, East Jakarta, Indonesia

Results:

Among 100 respondents, 54% prefer to have home-made complementary food (HMCF), 28% commercial home-made complementary food (CHMCF) and 10% commercial industry complementary food (CRCF), 8% are mixed. Most of HMCF mothers choose home-made complementary food because of variety of food choices and preference, while those who use commercial home-made and commercial industry think about practicality and the influence of family and friends. We found tendency to use commercial home-made over commercial industry due to their perception about no preservative and natural contents. There is no significant correlation between mother characteristics and choices, except for home ownership and number of family members.

Conclusions:

This survey point out that home-made complementary food is still the popular choice among middle-low mothers from urban area, and a trend of commercial home-made usage due to its convenience and affordability. Therefore, it is essential to educate mothers about good complementary foods to ensure nutrients adequacy and optimal growth of the children.

290 / #265


HUMAN MILK LEVELS OF 2’-FUCOSYLLACTOSE AND 6’-SIALYLLACTOSE ARE NOT IMPACTED BY MATERNAL BMI OR DIABETIC STATUS AND ARE POSITIVELY ASSOCIATED WITH INFANT NEURODEVELOPMENT

E. Oliveros1, M. Martin1, F. Torres-Espínola2, M. Segura2, M. Ramirez1, A. Santos-Fandila1, R. Buck3, R. Rueda1, M. Escudero2, A. Catena4, H. Azaryah2, C. Campoy2 1Abbott Laboratories, R&d, GRANADA, Spain, 2University of Granada, Paediatrics, Granada, Spain, 3Abbott Laboratories, R&d, Columbus, United States of America, 4University of Granada, International Mind, Brain And Behavior Centre (cimcyc)., Granada, Spain


Human milk oligosaccharides are the third most abundant solid component of human milk and are associated with multiple health benefits. Whether or not certain maternal factors influence human milk oligosaccharide concentrations remain unclear.

Methods:

In a pilot study, breast milk samples from overweight, obese, normal weight and gestational diabetic mothers in the PREOBE study were collected at 1 month postpartum. Eighty-two samples were analyzed by UHPLC-MS/MS to determine 2’-fucosyllactose (2’-FL) and 6’-sialyllactose (6’-SL) concentrations. Neurodevelopment of infants from mothers providing breast milk samples was assessed by Bayley III scales at 6 and 18 months of age.

Results:

No significant differences were found in 2’-FL or 6’-SL levels among study groups. A positive association was found between 6´-SL human milk concentration and cognitive and motor scale scores in infants at 18 months of age. An association between 2’-FL concentration and motor score at 6 months of age was found although it was lost when considering Low and High 2’-FL groups separately.

Conclusions:

6’-SL and 2’-FL levels were not influenced by pre-conceptional maternal body mass index or the development of gestational diabetes mellitus. 6’-SL level in breast milk was associated with infant cognitive development although further research is needed.

291 / #206


SEVERE GASTROINTESTINAL PRESENTATION OF COW’S MILK PROTEIN ALLERGY IN INFANTS AND YOUNG CHILDREN

Y. Rashed National Liver Institute, Pediatric Hepatology, Gastroenterology And Nutrition, Shebin El Kom, Egypt


Cow’s milk protein allergy (CMPA) is the most common food allergy in infants and can affect a family’s quality of life. (1) Symptoms tend to develop in the first few months of life and the resolution rates vary according to the type of allergy.

The aim of this study is to study the different clinical presentation of cow milk allergy in infants and young children.

Methods:

All patients were subjected to thorough clinical history, with special interest of family history of atopic disease in parents or siblings, any personal history of early atopic disease, the infant's feeding history and the presenting symptoms and signs, details of previous management, including any medication and the perceived response to any management. Was there any attempt to change the diet and what was the outcome?

Results:

Gastrointestinal manifestations varied from mild symptoms to severe presentations needed pediatric intensive care unit admission (PICU) in one case.

The gastrointestinal presentations were as follow:-

Diarrhea in 13 patients

Constipation with abdominal distention in 11 patients

Failure to thrive in 9 patients

Gastrointestinal reflux in 8 patients

Colitis with bloody diarrhea and abdominal distension in 8 patients

Vomiting in 7 patients

Two patients presented with food protein induced enterocolitis (FPIEC)

Two patients with protein loosing enteropathy.

Conclusions:

There different clinical presentations of CMPA in infants and children, clinical suspicion is verey important step to reach the diagnosis.

292 / #41


PREDICTORS OF EXCLUSIVE BREASTFEEDING PRACTICE IN URBAN KIGALI

D. Rutagumba, J. Hitayezu, E. Kalimba University of Rwanda, Pediatrics And Child Health, KIGALI, Rwanda


Background: Children face many challenges during their early period of life and are prone to have nutritional deficiency disorders and other forms of malnutrition, infectious diseases such as diarrhea and respiratory infections. Exclusive breastfeeding for the first six months of life is one way of fighting against them. In Rwanda the duration of exclusive breastfeeding in urban is shorter than in rural areas.

Aim: This study aimed to evaluate the predictors of exclusive breastfeeding in urban Kigali

Methods:

Methods: A cross-sectional study was done in five health facilities: CHUK, KFH, Muhima DH, Kibagabaga DH and Muhima HC. We targeted mothers of infants aged 6-12 months old. Multivariate logistic regression was used to determine the factors associated with exclusive breastfeeding.

Results:

Results: On total, 221 mothers were included in this study, 55.7% have done exclusive breastfeeding for the first six months of life, and 80.5% have initiated breastfeeding within the first hour of life. Employed mothers (aOR 0.245, 95% C.I 0.16-0.62, p=0.003), feeding EBM (aOR 8.500; 95% C.I .64-27.37; p<0.001), single gestation (aOR 71.635; 95% C.I 6.56-789.95; p<0.001), and planning for exclusive breastfeeding (aOR 4.602; 95% C.I 1.89-11.23; p=0.001), breastfeeding and formula milk (aOR 0.12; 95% C.I 0.03-0.45; p=0.002) have been found to be significantly associated with exclusive breastfeeding.

Conclusions:

Conclusion: Exclusive breastfeeding for the first six months of life is suboptimal in Kigali and there is a need to emphasize on mothers education and advocacy to employers in order to promote exclusive breastfeeding.

293 / #200


MUAC ASSESSMENT AND COMPARISON WITH WEIGHT FOR HEIGHT Z-SCORE IN INFANTS ≤6 MONTHS AS AN INDICATOR OF SEVERE ACUTE MALNUTRITION

S. Zehra1, Z. Kazi2, A. Saleem1 1Aga khan University Hospital Karachi, Paediatrics, Karachi, Pakistan, 2Aga khan university Hospital, Peadiatrics, karachi, Pakistan


Young infants with malnutrition are the most vulnerable to morbidity and mortality. World Health Organization recommends using Mid Upper Arm Circumference (MUAC) for severe acute malnutrition (SAM) above 6 month, however it has not been considered as a reliable measure for ≤6 month SAM, because of lack of data on its inter-observer reliability, measurement in practice and predictive value for recovery or death. The study aims to assess the validity of MUAC measurements in infants ≤6 months of age compared to Weight for Height Z-Score (WHZ-score) and to determine the sensitivity and specificity of MUAC comparing WHZ-score in diagnosing SAM.

Methods:

A cross-sectional study was used to enroll 550 infants ≤6 months of age from three different sites in Karachi, Pakistan. Their anthropometric measurements were taken by experienced community health workers while the data were analyzed using Statistical Package for Social Sciences.

Results:

MUAC cut-off ≤11.5 cm yielded the Youden Index of 0.30 with sensitivity and specificity of 60% and 71% respectively. The total area under Receiver Operating Characteristics curve was 0.69 [95% CI: 0.63, 0.76; P<0.001]. The kappa coefficient showed a fair degree of agreement (0.2 - 0.3) between MUAC and WHZ-score to diagnose SAM.

Conclusions:

The Youden Index implied that a MUAC of ≤11.5 cm can be used as a reliable indicator for diagnosing SAM ≤6 months, while the kappa coefficient showed a fair agreement between MUAC and WHZ-score to diagnose SAM ≤6 month of the study population.

294 / #360


PREVALENCE OF FEACAL ESBL CARRIAGE AMONG INFANTS IN A HOSPITAL AND COMMUNITY SETTING AND ITS ASSOCIATION WITH NUTRITIONAL STATUS.

S. Parkar1, S. Zehra2, Z. Kazi3, A. Hotwani1, A. Saleem3 1Aga Khan University Hospital, Paediatrics, Karachi, Pakistan, 2Aga Khan University Hospital, Karachi, Paediatrics, Karachi, Pakistan, 3Aga khan University Hospital Karachi, Paediatrics, Karachi, Pakistan


Extended spectrum beta lactamases (ESBL) producing Enterobacteriacea presents a public health burden in hospital and community settings among all ages and demographics. Faecal carriage of ESBL carries a potential risk of transmission and infection especially among infants. Therefore, we aim to investigate prevalence of ESBL in stools samples of hospitalized and community infants from the CHAIN cohort and find association of ESBL positive infants with nutritional status.

Aims:

To determine prevalence of ESBL in hospitalized and community infants.

To determine association between ESBL carriage and nutritional status of the infants.

Methods:

Case control study was taken from Childhood Acute Illness and Nutrition Cohort. Cases were acutely ill children admitted in the hospital and controls were from the same community. Nutritional status was assessed by anthropometric measures. This cohort was conducted on 255 children aged 0 to 23 months, admitted in Civil Hospital, Karachi, and 52 community children of the same age. Stool samples were collected at the time of enrollment. Statistical analysis was done using SPSS.

Results:

Overall ESBL carriage is 59%. The prevalence of ESBL carriage is significantly high in hospitalized infants 61.9%, compared to community which is 47%. We found high prevalence of Escherichia coli and KlebsieIlla pneumonia positive ESBL as 72.3% and 62.1% respectively in stool samples. Among severe acute malnourished infants 73.8% were ESBL positive for Escherichia coli and 78.3% were ESBL positive for Klebsiella pneumonia.Chi square analysis determined equal distribution of ESBL carriage rate across all nutritional status.

Conclusions:

Significantly high ESBL rates were seen among hospitalized infants.

295 / #377


SHORT-TERM CALORIC COMPENSATION ABILITY IN INFANTS BELOW 15 MONTHS OLD

C. Schwartz, P. Brugaillères, C. Chabanet, S. Nicklaus, S. Issanchou INRA, Centre Des Sciences Du Goût Et De L'alimentation, Agrosup Dijon, Cnrs, Inra, Univ. Bourgogne Franche-comté, DIJON, France


In infancy, a too rapid weight gain is a risk factor associated with overweight. Growth is linked to the infant’s ability to adjust energy intake depending on the energy density of foods. Evidence regarding the behavioral aspects of appetite control ability in infancy is sparse. The objective was to study the short-term energy adjustment ability of, first, exclusively milk fed infants before the onset of complementary feeding (CF) and, second, of infants at 11 mo and 15 mo.

Methods:

Caloric compensation ability was assessed in infants by adapting a preload paradigm. Before CF, the ‘preload’ was a feed with formula made more or less caloric by concentration/dilution; the subsequent formula feed was registered. For older infants, the preload was a carrot puree made more energetic with vegetable oil offered 25 min before a recorded meal. Ad libitum food intakes after the consumption of the preload were measured.

Results:

A score of caloric compensation ability was calculated for 27 infants at 4.5 mo and for 31 infants at 11 and 15 mo. Before CF, infants adjusted partially their energy intake for the energy of their previous feed. After CF, infants also adjusted partially their energy intake for the energy of the highly energetic puree. This ability decreased from 11 to 15 mo; this decrease was positively correlated with an increase in weight status from 11 to 15 mo and with a higher weight status at 2 years.

Conclusions:

Better understanding the etiology of appetite control ability in the ‘first 1000 days’ is warranted.

296 / #395


KNOWLEDGE, ATTITUDE, AND BEHAVIOR ASSESSMENT OF MOTHERS WITH CHILDREN OF 0-6 YEARS IN DIARRHEA

F.E. Sezer, N. Bıyıklı, M. Garipağaoğlu Istanbul Medipol University, Department Of Nutrition And Dietetics, Istanbul, Turkey


The study was planned and conducted to determine the level of knowledge about diarrhea and nutrition of mothers with children in the 0-6 years old and to investigate their attitudes and behaviors.

Methods:

This study was conducted with 75 mothers of 0-6 years old children in hospitals and schools in Istanbul. Research data were obtained by face to face survey method. The questionnaire included questions about the sociodemographic knowledge of mothers and children, their knowledge, attitudes and behaviors about diarrhea and nutrition. The obtained data were evaluated in SPSS 18.0 statistical program.

Results:

Most of the children had acute diarrhea attacks (79.3%) and the majority of mothers had insufficient knowledge about antibiotic use, travel diarrhea and infectious diarrhea (p<0.05). It was found that mothers continued to give plenty of water and breast milk in diarrhea (88%) but 34.7% continued to give cow milk. In addition, it was found that mothers restrict their children’s normal diets (76%) as they increase diarrhea. In diarrhea, boiled potatoes, yogurt, apples, peaches and bananas are the most common foods. It was determined that mothers did not have information about oral rehydration solutions (ORS) treatment for fluid loss (54.7%).

Conclusions:

Diarrhea factors are possible with sociocultural development, but it is important to teach mothers individually. The level of knowledge of mothers about diarrhea prevention, transmission and treatment methods should be increased. Therefore, nutritional trainings should be done to inform mothers and these trainings should be repeated by health professionals at regular intervals.

297 / #400


ARABIC ADAPTATION OF THE "TODDLER FEEDING STYLE QUESTIONNAIRE (TFSQ)"

I. Sospedra, A. Gutierrez-Hervas, A. Oliver-Roig, H. Es Sadki, M. Richart-Martínez, M.Á. Avecilla University of Alicante, Nursing Department, San Vicente del Raspeig, Spain


“Toddler Feeding Style Questionnaire” (TFSQ) is a Spanish questionnaire that evaluates parental feeding styles. Applying the TFSQ in other collectivities such as the Arab one will allow to study the differences that exist between cultures concerning feeding styles. The objective is to adapt the TFSQ questionnaire to Arabic, according to the International Test Commission’s recommendations (ITC).

Methods:

The adaptation of the TFSQ questionnaire from Spanish to Arabic was made through translation and translation-back, based on the ITC’s recommendations. Besides, to collect information on the level of difficulty and the kind of change in the translation, a qualitative study of cognitive interviews with Arab mothers and fathers was also carried out.

Results:

In the translation step, 78% of the items were adapted with a mean of difficulty between 2 and 5 points and 22% with a mean between 1 and 2. While in the translation-back the 53% of the items were qualified between 1 and 2 points of difficulty and 47% between 3 and 5. In addition, type B1 changes were made in 22% of the translations to be able to use expressions more appropriate to Arabic. In general, the TFSQ questionnaire’s Arabic version was well understood in the cognitive interviews, since there were just three incidences of change of meaning.

Conclusions:

A TFSQ questionnaire’s version in Arabic was obtained, which will allow the use of this scale in the Arab population, in which it will be necessary to develop studies to determine their psychometric characteristics.

298 / #615


IMPORTANCE OF FIRST-YEAR NUTRITION IN PREDICTING LATER NUTRITIONAL DISORDERS

B. Stana1, E. Moraru2, I. Ioniuc2, M. Alexoae2, P. Popovici2, A. Azoicai2 1Gr T Popa University of Medecine and Pharmacy Iasi ROMANIA, Physiology, Iasi, Romania, 2Gr. T. Popa University of Medecine and Pharmacy, Pediatrics, Iasi, Romania


Recent assumptions from literature show a relationship between diet in the first year of life and the subsequent obesity or malnutrition during childhood. Studies suggest importance of appetite programming from this age, when numerous physiological and hormonal factors are regulated, with a subsequent impact on the somatopsychological development of the child.

Retrospective correlations between late childhood nutritional and infectious disorders and 1st year of life specific factors: first year feeding (breastfeeding, formula, complementary), birth weight, prematurity.

Methods:

Three groups of children were compared, each with 42 subjects. The first group (A) was composed of normal weight children, group B of obese children and group C of malnourished children. Subjects were selected retrospectively from the 2nd Pediatric Clinic - Children Emergency Clinical Hospital "Sf. Maria "Iasi between June 2017 - May 2019.

Results:

Most of the obese children came from the urban area, while most of the malnourished were from rural areas. Children breastfed for at least 10 months have had a normal weight later, while the obese and the malnourished have been breastfed for a shorter period of time or not at all. Early, late or incorrect complementary feeding was found as risk factor for later nutritional and infectious disorders. Breastfed children showed later on less comorbidities (infectious, metabolic).

Conclusions:

Breastfeeding proves its subsequent protective role for the child, reflected both in normal nutritional status and less infectious or metabolic comorbidities. Lack of breastfeeding, early or late complementary feeding or innapropriate diets at small age led to nutritional disorders later on in life.

299 / #37


MALNUTRITION IN CHILDREN DUE TO HOSPITALIZATION - A PROSPECTIVE STUDY

F. Kamberi1, J. Celoaliaj1, V. Pulomemoj1, H. Skendo2 1University of Vlore Ismail Qemali, Faculty of Health, Research Center Of Public Health, Vlore, Albania, 2University of Bonn. The Faculty of Mathematics and Natural Sciences,, Institute Of Pharmacy, Bonn, Germany


Malnutrition in children due to hospitalization despite its high frequency and its association with poor clinical outcomes continues to be unidentified and properly evaluated by health staff affecting the patient with associated costs. The aim of the study was to assess the malnutrition of children due to hospitalization and the awareness of nursing staff for more effective management and timely referral.

Methods:

The risk for malnutrition was assessed using the standard questionnaire STRONG kids and nutritional status (height, weight, and body mass index) were assessed at the time of admission and discharge from hospital. One month (April – May 2019) in the pediatric ward of Vlora Regional Hospital, Albania was the study duration and included 53 hospitalized children aged 0-14 years.

Results:

The mean age of children in the study was 5.13 years; SD ± 2.89. Major hospitalization problems were related to the respiratory system. A statistical correlation was found between the small age children and loss of muscle mass and fat mass thickness, p=0.0408. Higher tendency to malnutrition appear children who had metabolic problems. Hospitalized children were not evaluated for nutritional status, there was also evidence of a lack of knowledge of the health staff on malnutrition management.

Conclusions:

The results of the study suggest that all children admitted in hospital should be assessed for the risk of malnutrition as a result of hospitalization. Pediatric nurses should be more attentive to the evaluation, management and timely referral of malnutrition to hospitalized children.

300 / #276


CORRELATIONS BETWEEN COMPLEMENTARY FEEDING PRACTICE, DIETARY INTAKE, AND INFANT’S GROWTH AND DEVELOPMENT: A CROSS SECTIONAL STUDY IN INDONESIA

T. Sudargo1, R. Muslichah1, D. Izwardy2 1Universitas Gadjah Mada, Nutrition And Health, Yogyakarta, Indonesia, 2The Ministry of Health of The Republic of Indonesia, Directorate Of Public Health Nutrition, Jakarta, Indonesia


There is a higher risk of failing to achieve maximum potential development among children <5 years in developing countries. Inevitably, nutrition from complementary feeding (CF) in addition to breastmilk during this stage plays a major role in infant’s growth and development. However, the relationship between CF, dietary intake, and infant’s development remains less studied compared to physical growth albeit more complex. We aimed to investigate the correlation between CF practice, dietary intake, early growth and development of infants.

Methods:

Using a cross-sectional approach, 228 pairs of healthy infant aged 6-9 months and main caretaker resided in suburban area of Kulon Progo participated in this study. All data was collected during home visit. A questionnaire was developed and validated to measure CF practice. Infant’s length and weight were measured using a electronic infant scale. A validated Semi-Quantitative Food Frequency Questionnaire (SQFFQ) was used to collect dietary data. Infant’s development was scored using a standard Vineland Social Maturity Scale (VSMS). Pearson’s correlation test followed by partial correlation test correcting for potential confounders were conducted for the statistical analysis.

Results:

VSMS score was correlated with total energy (R=0.17), protein (R=0.17), fat (R=0.14), and carbohydrate (R=0.14) intakes (p<0.05). After correcting for CF practice, infant’s growth, income, and mother’s education, only energy (R=0.18) and protein (R=0.14) intakes were correlated with VSMS score (p<0.05). Neither infant’s weight nor length was correlated with VSMS score.

Conclusions:

Low intake of total energy and macronutrients, particularly protein, during early period of feeding may delay infant’s development.

301 / #557


USE OF PROBIOTIC IN FUNCTIONAL GASTROINTESTINAL DISORDER AND INFANTILE COLIC

M. Sulakshane Pediatric center Aundh Pune, Pediatric Department, Pune, India


Investigate Pediatrician's knowledge of use of probiotics in infantile colic, reason to advise or and not to advise use of probiotic in treatment of infantile colic and functional gastrointestinal disorder.

Methods:

Pediatrician's filled in survey regarding their perceived knowledge about use of probiotic in infantile colic.

27 questions about work experience,knowledge of probiotic,knowledge of advising or not advising probiotic and current probiotic advising practices.types of probiotic used

Results:

Most Pediatricians advises probiotic in different situations of FGID and different probiotics used for colic and functional gastrointestinal disorder

Conclusions:

Improved knowledge of probiotic is necessary among Pediatricians.

clear indication and definite type for definite usage of probiotic as per indication needs to be highlighted.

302 / #559


TEST AND VALIDATION OF COW’S MILK RELATED ALLERGY SYMPTOMS SCORE IN A POPULATION OF SYMPTOMATIC AND HEALTHY INFANTS

M. Sulakshane1,2 1Pediatric center Aundh Pune, Pediatric Department, Pune, India, 2Pediatric center, Pediatric, Pune, India


The diagnosis of cows milk allergy is challenging in infancy with negative allergy test.Cows milk free diet and extensively hydrolysed formulas are often started in infants with persistent GI symptoms based on clinical severity,Pediatrician attitude and experiences.The lack of specific symptoms may cause overdiagnosis and over treatment.Aim is to asses the accuracy of COMiSS scale in identifying infants who responds to cows milk free diet.

Methods:

Prospective study on all infants referred to our clinic with suspected CMPA and studying improvement of the symptoms after starting CMPA.

Results:

Symptoms improvement in significant number of children started on CMPA diet!COMiSS scale was very helpful and had better correlation with symptoms improved

Conclusions:

COMiSS scale is helpful to identify which infants or children will be benefitted by CMPA diet.

305 / #210


A RARE CAUSE OF FEEDING DISORDER IN AN INFANT

E. Tolstova1, N. Zaytseva2, N. Semenova3, E. Efimova4, E. Radimova4, E. Ionova4, S. Izotova4, O. Zaytseva2 1Moscow State University of Medicie and Dentistry, Pediatrics, Moscow, Russian Federation, 2Moscow State University of Medicie and Dentistry, Pediatrics, Москва, Russian Federation, 3Research Centre of Medical Genetics, Pediatrics, Moscow, Russian Federation, 4St. Vladimir Children Hospital, Pediatrics, Москва, Russian Federation


Feeding disorder is a frequent problem associated with different diseases. We present a clinical case of rare cause of feeding disorder in an infant.

Methods:

The boy was born from 2 normal pregnancy, 2 delivery (3200g, 53cm). Apgar score 7/8. Since the boy was born 54 hereditary diseases were excluded during screening.

Results:

From birth child slept too long, sucked slowly and tired. After the introduction of supplementation with the formula (3 month), colic were noted, then he fed with hydrolized protein formula. At the age of 5 months he was admitted to our hospital. The main complaint was feeding problems. Weight 6.04kg(9p,-1,35z), height 66cm(50p,0z). He had antimongoloid eyes, convergent squint. He was active but quickly tired. We revealed muscular hypotension. Main biochemical tests, KFK, KFK-MB, glucose, lactate, thyroid function were normal. Moderate increase of ammonia was revealed(164μmol/L, norm 80μmol/L). With tandem mass-spectrometry aminoacidopathies, organic aciduria and mitochondrial beta oxidation disorders were excluded. Concentration of adipic (16.04 mM/mcr, norm 0-12), sebacinum (43.55 mM/mcr, norm 0-2), suberinic (273.84 mM/mcr, norm 0-2) acids were increased. These changes were regarded as features of the exchange when feeding mixtures based on hydrolyzed protein. Lysosomal storage diseases were also excluded.The boy had male karyotype 46XY. Prader - Willi syndrome was excluded. Chromosomal microarray analysis revealed microduplication of the short arm region of chromosome 17(17p11.2). Potocki - Lupsky syndrome (OMIM # 610883) was diagnosed.

Conclusions:

Eating disorder may be due to a wide range of causes, including genetic ones. Timely diagnosis helps to properly route the patient and adequate early rehabilitation.

306 / #336


ENERGY AND NUTRIENT DENSE FORMULA IN NUTRITIONAL MANAGEMENT OF SEVERE GROWTH FALTERING: CASE REPORTS FROM INDIA

Z. Ul Kareem1,2, S. Bhatia2, N. Joshi2 1Ankura Hospital for Women & Children, Pediatrics, Hyderabad, India, 2Danone Nutricia India, Medical Affairs, Mumbai, India


In India, malnutrition is a public health concern. 38 percent of children under age five years are stunted, 21 percent are wasted, while 36 percent of children are underweight. Hospital based malnutrition occurs when an underlying medical cause results in suboptimal weight gain in infants. Traditionally, addition of glucose polymer and/or MCTs to regular infant formula, concentrating regular infant formula or using formula meant for children (>2yr of age) was in practice to overcome the energy and nutrient gap in such infants.

Aim is to understand the effectiveness of a new affordable Energy and Nutrient Dense Formula (ENDF) with 1Kcal/ml, 50% higher protein and 14-50% higher micronutrients compared to a regular infant formula to meet the additional requirements.

Methods:

Two infants from Hyderabad city with severe growth faltering and underlying upper airway obstruction were admitted to PICU. Nutritional management involved various approaches to achieve weight and height between 25th to 50th percentile with a view of spontaneous resolution of upper airway obstruction post satisfactory weight gain. ENDF was initiated at 60 ml/3 hours which gradually increased to 160 kcal/kg/day over a period of 1 week.

Results:

Both patients tolerated the formula well without any adverse effects. In a short period of two weeks of hospitalisation, they gained 400g with no episode of reflux or GERD.

Conclusions:

Early administration of ENDF in critically-ill infants is well tolerated, promotes a more adequate nutrient intake, improves energy and nitrogen balance and improves protein anabolism, without any adverse effects.

307 / #186


BIOACCESSIBILITY OF VITAMINS A, D AND E IN WHEY/CASEIN-BASED INFANT FORMULA

K. Walsh1, C. Chitchumroonchokchai2, R. Jimenez-Flores3, M. Failla4 1Mead Johnson Nutrition/RB, Research And Development, Nutrition Science, Evansville, United States of America, 2The Ohio State University, Comprehensive Cancer Center, Columbus, United States of America, 3The Ohio State University, Food Science & Technology, Columbus, United States of America, 4The Ohio State University, Human Nutrition, Columbus, United States of America


Infants are born with immature digestive systems. Digestive capability develops as the infant matures and such development likely affects the bioavailability of dietary lipophiles.

Methods:

Here we investigated the stability and bioaccessibility of fat-soluble vitamins during simulated digestion of whey/casein-based infant formula with or without milk fat globule membrane (MFGM) using a static, two-phase in vitro digestion model. Bioaccessibility refers to the partitioning of low molecular weight lipophilic compounds into bile salt mixed micelles for their delivery to absorptive small intestinal epithelial cells, a required process for the absorption of dietary lipophiles and their digestive metabolites.

Results:

Recoveries of vitamins A, D and E after prandial-like, simulated gastric and small intestinal digestion in infants exceeded 89%. Partitioning of vitamins A, D and E and provitamin A into the mixed micelle fraction during simulated small intestinal digestion was 72%, 75%, 71% and 80%, respectively. Recovery and bioaccessibility of the fat-soluble vitamins was independent of the presence of MFGM in infant formula. Moreover, relative bioaccessibility of the fat-soluble vitamins was significantly (p < 0.05) greater when infant formula was digested using conditions more similar to that in the mature upper gut of infants compared to those in the newborn gut.

Conclusions:

These results suggest that fat-soluble vitamins in whey/casein-based infant formula are stable during the gastric and small intestinal phases of digestion and highly bioaccessible.

309 / #654


COMPLEMENTARY FEEDING PRACTICES IN A ROMANIAN INFANT COHORT

C. Becheanu1, V. Antoci1, I. Tincu2 1”Grigore Alexandrescu” Emergency Children’s Hospital, Gastroenterology, Bucharest, Romania, 2„Dr. Victor Gomoiu” Children’s Clinical Hospital, Gastroenterology, Bucharest, Romania


The period from birth to two years of age is considered to be an important opportunity for promotion of optimal growth and development which are directly dependent on nutrition. This study was aimed to examine practices and mothers’ knowledge about complementary feeding in Romanian 1 year old children.

Methods:

In a population-based prospective cohort study we used face to face questionnaire with the mothers regarding knowledge, attitude, and practices of complementary feeding.

Results:

A total of 382 parents completed the questionnaire, with a response rate equivalent to 85.29%. Breastfeeding for at least 4-6 months was a priority for over 70% of mothers. The results showed that over 50% of patients were weaned correctly according to ESPGHAN criteria. Friends and family are the most important sources for nutrition information mainly for mother in rural regions, low incomes and basic educational level (p<0.05, CI 95%). Living in rural areas, low level of maternal education, decrease family economic level were associated with introducing solids early rather than within the 4–6 month window. Multivariate analyses showed that friends and family used as nutrition information sources are among risk factors for inappropriate complementary feeding practices (p<0.001, CI 95%). There was significant association between delayed complementary feeding and malnutrition of the child at 1 year of age.

Conclusions:

Mothers should receive proper advice on foods, preparation and practice of complementary feeding in order to prevent malnutrition and obesity. Effective implementation of interventions that are known to improve weaning practices is imperative in specifics groups of interest.

310 / #657


INFLUENCES OF GENDER, PHYSICAL GROWTH, AND SOCIOECONOMIC CHARACTERISTICS ON EARLY BRAIN DEVELOPMENT IN CHILDREN FROM UP, INDIA

S. Deoni1, A. Kumar2, V. Kumar2 1Bill & Melinda Gates Foundation, Mnchd&t, Seattle, United States of America, 2CEL, Public Health, Lucknow, India


Children in low and middle income settings (LMICs) often experience multiple forms of adversity (e.g., malnutrition, neglect) that negatively can affect their physical development and cognitive outcomes. This study sought to characterize early neurodevelopmental patterns in children from an LMIC setting (Uttar Pradesh, India) and examine the associations between brain volume and microstructure growth with gender, physical growth, and demographic and socioeconomic characteristics.

Methods:

Longitudinal MRI, anthropometric, and medical history data were acquired at 6-month intervals between the ages of 3 months and 3 years in 176 children from a rural block within Raebareli district of Uttar Pradesh, India. Longitudinal mixed-models were used to reconstruct patterns of brain development and we examined differences in development in children stratified by gender, stunting & weight status, and socioeconomic status; and investigated correlations with common factors, including parental education, income, caste, and access to flush toilet,.

Results:

Across individuals, we found significant associations between brain volume and microstructure with gender, weight-for-age, and maternal education. Early brain growth was significantly associated with child weight-gain but not linear growth. Males had significantly greater brain development than females, even after controlling for physical size. While both stunted and underweight children had significantly smaller brain volumes and disrupted tissue microstructure than non-stunted and normal-weight children, stunted males showed consistently smaller volumes across the age range whilst stunted females appeared to normalize with age.

Conclusions:

The findings provide new insight into factors that affect early neurodevelopmental patterns in LMIC children, highlighting the importance of early nutrition (weight gain), sanitation (access to flush toilets), maternal education, and gender equality.

311 / #665


OPTIMISING LOCALLY MADE READY-TO-USE THERAPEUTIC FOOD (RUTF) FORMULATIONS FOR SIERRA LEONE

A. Bechoff1, F. Dibari2, E. Ferguson3 1Natural Resources Institute, University of Greenwich, Food And Markets, Chatham, United Kingdom, 2World Food Program, Ethiopia, Addis Ababa, Ethiopia, 3London School of Hygiene and Tropical Medicine, Department Of Nutrition And Public Health Intervention Research, London, United Kingdom


Severe acute malnutrition (SAM) is a serious public health problem in Sierra Leone. The government has set a priority to tackle it. Ready-to-use-therapeutic food (RUTF) has been a success over the last twenty years to treat paedriatric SAM. Developing RUTF from locally produced foods is more sustainable and may be cheaper than importing RUTF. Sierra Leone has a diverse agroecological system enabling the production of various commodities that could be used as ingredients. The objectives are to identify combinations of local ingredients that could meet RUTF requirements based on cost, nutritional content, and aflatoxin level.

Methods:

Potential ingredients (n=22) were identified and their cost obtained from the literature and in-country partners. Nutritional composition of ingredients was obtained from INFOODS and USDA databases and aflatoxin level from literature. Linear programming (LP) was applied to identify suitable formulations that meet nutritional and aflatoxin requirements at the minimum cost. Various formulations with animal products or not and with producer and market prices were tested using two methods for calculating omega 3 and 6 fatty acids.

Results:

Due to the aflatoxin constraint, all the formulations obtained by LP contained an animal product (fish, eggs or both) and none of the vegan formulations met the requirements. This is because a major limiting factor was the concentration in omega 3 and also omega 6.

Conclusions:

Options are limited: either 1)dried eggs that are expensive commodities, or 2)dried fish that may not be sensorially acceptable. More research is needed to find suitable local ingredients and develop affordable processing technologies.

312 / #666


EDUCATION OF FAMILY MEMBERS TO SUPPORT WEANING TO SOLIDS AND NUTRITION IN LATER INFANCY IN TERM-BORN INFANTS

S. Ojha1, T. Kwok2, Z. Elfzzani2, J. Dorling3 1University of Nottingham, Division Of Medical Sciences And Graduate Entry Medicine, School Of Medicine, Nottingham, United Kingdom, 2University of Nottingham, Child Health, Obstetrics And Gynaecology, Nottingham, United Kingdom, 3Dalhousie University, Division Of Neonatal-perinatal Medicine, Halifax, Canada


Nutrition education on appropriate weaning/complementary feeding practices could reduce childhood undernutrition and obesity. We assessed the effect of family nutrition educational interventions for weaning on growth in the first two years of life.

Methods:

We searched Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 5), MEDLINE via PubMed (1966 to 26 June 2018), Embase (1980 to 26 June 2018), and CINAHL (1982 to 26 June 2018), clinical trials databases, conference proceedings, and references of retrieved articles. We independently identified eligible RCTs & cluster RCTs examining the effects of nutrition education related to appropriate weaning feeding practices delivered to families of term born infants, performed data extraction and quality assessments using the GRADE approach, resolving differences by discussion.

Results:

Ten trials, recruiting 7661 infants, met the inclusion criteria demonstrating that nutrition education, targeted at improving weaning practices, improved weight and height in the first two years of life. Only one study investigated the effects of nutritional education on long term growth at six years, with no effect seen on change in height, or BMI z score. The meta-analysis of four studies did not demonstrate any effect on exclusive breast feeding rates up to six months.

Conclusions:

This review identified moderate quality evidence that nutrition education delivered to families of term born infants can reduce infantile undernutrition. These small improvements in growth parameters may not be of clinical significance and further long term studies are needed to see if this small early life improvement in growth translates into differences in later life.

313 / #668


THE ASSOCIATION BETWEEN INFANT AND YOUNG CHILD FEEDING INDEX AND THEIR NUTRITIONAL STATUS

P. Thaweekul, P. Silapamongkolkul, P. Srithipsukho Thammasat University, Department Of Pediatrics, Faculty Of Medicine, Pathum-thani, Thailand


An infant and young child feeding index (ICFI) is a proposed single summary index to assess the quality of feeding in infants aged 6-36 months according to the World Health Organization’s recommendation on infant and young child feeding practice. This study aims to demonstrate the association between ICFI and their nutritional status.

Methods:

304 caregivers of the healthy, 6-to-36 month-old infants and young children were asked for their demographic data and feeding practices, using the questionnaires. Anthropometric measurements were done. The associations between ICFI and weigh-for-age Z-score, length-for-age Z-score, weight-for-length Z-score and BMI-for-age Z-score were examined. Thirty participants were randomly selected for the evaluation of the association among the ICFI and energy/nutrients intake, using food frequency questionnaire.

Results:

Mean ICFI was 6.14±1.63. ICFI was lowest in the 6-8-months age group. The breastfed infants had significant higher ICFI as compared to the non-breastfed group. Factors influcing ICFI were infants’age and their milk volume intake. ICFI was negatively associated with WAZ WLZ/WHZ and BAZ (beta=-0.13,p=0.037; beta= -0.17, p=0.01; beta=-0.15, p=0.026, respectively). Breastfeeding was also negatively associated with WAZ, LAZ/HAZ, WLZ/WHZ and BAZ.

Conclusions:

ICFI was associated with infants’ intake of many nutrients. However, the association among ICFI and the nutritional status could not established from our study population. Breastfeeding may obscure some positive effects of appropriate feeding practice, on the other hand, formula milk intake may obscure the negative effects of the inappropriate one on growth and nutritional status.

314 / #693


DO BABY GIRLS HAVE MORE FAT DURING INFANCY? – A LONGITUDINAL BODY COMPOSITION STUDY IN HEALTHY CHILDREN IN COLOMBO SRI LANKA

N. Lucas1, P. Lanerolle2, A. Hills3, P. Wickramasinghe1 1University of Colombo, Paediatrics, Colombo, Sri Lanka, 2University of Colombo, Biochemistry And Molecular Biology, Colombo, Sri Lanka, 3University of Tasmania, Sports Medicine, Tasmania, Australia


Adult males are heavier but have less fat mass percentage (FM%) than females. This difference is evident at birth, childhood and post-puberty. However little is known about body composition changes during the first 2 years of life.

The aim of this paper is to describe the gender difference in body composition in healthy babies from 0-2 years fed according to the Infant And Young Child Feeding (IYCF) Guidelines in Sri Lanka

Methods:

This is an ongoing descriptive longitudinal study from 0-2 years since July 2015. All healthy babies born in the University unit, De Soysa Hospital for Women, Colombo after 37 weeks gestation to >18 years old mothers who agreed to attend monthly follow up until 2 years were included. Ethical clearance was obtained from Faculty of Medicine, University of Colombo. Body composition was assessed at 3,6,9,12,18 and 24 months of age by the deuterium dilution method using saliva which was sampled pre-dose, 2.5 and 3hours post-dose (deuterium=0.15mg/kg) and analysed using Fourier Transform Infrared Spectroscopy (Agilent 4500). Group means were compared using independent samples t-test (SPSS version 25).

Results:

79/169, 59/139, 49/110, 32/72, 15/43,10/26 were girls at 3-6-9-12-18-24mts respectively.Boys were heavier, longer and had higher BMI at all ages. Total Body Water(TBW)%,Fat Free Mass(FFM)% and Fat Free Mass Index(FFMI) were also higher in boys whereas girls had a higher Fat Mass(FM)%, Fat Mass Index(FMI) and FM/FFM at all ages except 18 months.

Conclusions:

Girls have higher levels of body fat between 3-24 months, with the exception of 18 months although boys were heavier and longer at all ages.

315 / #700


GROWTH AND NEURODEVELOPMENT OF CHILDREN EXPOSED VERTICALLY TO ZIKA VIRUS SECOND GESTATIONAL TRIMESTRER OF INFECTION

M.E. Moreira, F. Soares, M.D.B. Baker Meio, S.C. Gomes Junior Fiocruz, Clinical Research Unit, Rio de Janeiro, Brazil


The vertical transmission of Zika Virus is a public health problem and to guarantee a good nutritional status could be important in terms of better outcomes for children's growth and neurodevelopment.

The goal of this study is verify anthropometric measurements one year after birth in infants exposed to Zika Virus second gestational trimestrer of infection.

Methods:

We are conducting a cohort study in zika virus exposed infants that didn´t present microcephaly or others malformations at birth,. In the end of first year of life we performed anthropometric measurements (head circunference, weight and lenght) and calculate diffrences in z-score for each one. To evaluate neurdevelopment we used Bayley III Test.

Results:

We found differences in the lenght measurements when the infection happened in the first trimestrer of gestational age and in weight in the second trimestrer of gestational age. There weren´t no differences in head circunference in the three trimestrers. We also found a language delay in the exposed babies without differences between time of infection.

Time of infection Difference of z-score between birth and end first year of life *

p-value

1st trimester

Weight -0.28 ±1.26 0.12

Lenght -0.49 ± 1.35 0.01

Head circumference -1.21±5.16 0.12

2sd trimester

Weight 0.37±1.16 0.01

Lenght 0.28±1.16 0.05

Head circumference 0.21±1.32 0.20

3rd trimester

Weight 0.23±0.91 0.34

Lenght -0.09±1.43 0.80

Head circumference 0.01±1.08 0.97

*Means ± SD

Conclusions:

The zika virus exposition ould affect the growth and development in the first year of life.

316 / #733


ARE INFANT FEEDING PRACTICES INFLUENCED BY TYPE OF BIRTH?

C. Bujor, R. Stanciu, C. Becheanu Emergency Hospital for Children Grigore Alexandrescu, Pediatric Gastroenterology, Bucharest, Romania


The international recommended method of infant feeding is breastfeeding with proven benefits over infant formula feeding. We examined the association between caesarean delivery and infant feeding practices

Methods:

In this observational retrospective study were included ninety children under five years of age which were born both caesarean and vaginal delivery. The study was conducted over 3 months and was based on a questionnaire that included data on birth mode, the reason for women’s choice of caesarean section, type of nutrition.

Results:

26 (20.29%) of caesarean births have chosen to bottle-feed vs. 8 (13.71%) exclusively breastfeeding, while vaginal birth received in 11 (16.71%) cases a formula feeding was used and 17 (11,29%) babies were exclusively breastfed (p=0.002). 27 (31.91%) of c-sections were breastfed (both mixed and exclusively breastfeeding) vs. 29 (24,09%) vaginal delivery (p=0.035). We divided our group in “under 2 years old” children and “over 2 years old” and we found out that 45 (39.33%) of <2 years children were born by caesarean section vs. 9 (14.67%) of >2 years, and 22 (27,67%) of <2 years children were born via vaginal birth vs. 16 (10.33%) of >2 years group (p=0.006). 23 (45%) of caesarean births were mother’s request vs. 28 (55%) for other reasons.

Conclusions:

Babies born by C-section receive often a formula feeding. Caesarean section rates higher in the last 2 years but despite this increase, due to nutrition information campaigns, mothers choose to breastfeed. In our country, caesarean section is “on-demand” more than a medical recommendation.

317 / #678


MALNUTRITION: CLINICAL AND ETIOLOGICAL MANIFESTATIONS IN INFANTS

T. Chisnoiu, C. Mihai, A. Balasa, A. Panzaru County Emergency Hospital of Constanta, Pediatrics, Constanta, Romania


Being a low to middle income country Romania is still facing serious nutrition health problems in pediatric activity. Poverty, uneducated parents and the lack of medical care are the main reasons that still sustain a high mortality and morbidity induced by malnutrition among infants.Underlining the necessity of parent education regarding nutrition importance especially during childhood.

Methods:

During a 1-year retrospective study (January 1st2014- January 1st2015) we evaluated 120 patients (ages between 1 month – 1 year) admitted in the Pediatric Department of the Clinical County Emergency Hospital of Constanta.A set of mandatory documents were signed before starting the study: Hospital approval, inform consent, inclusion/exclusion criteria, growth charts, anthropometric measurements, anamnesis, clinical and imagistic data, demographic affiliation. We exclude children with underlying conditions that could lead to secondary malnutrition.

Results:

Gender distribution underlined a slight male predisposition (66 male :54 female).Growth-to-age and height-to-age charts revealed that 67cases had mild malnutrition, 44 cases had a moderate form and 9 cases were diagnosed with severe malnutrition (under percentile 3% or more than - 3 SD).Age distribution: 4-6 months- 48 cases, 10-12 months- 36 cases, 7-9 months-22 cases, 1-3 months 14 cases. Main reasons leading to malnutrition: introducing cow’s milk under 1 year (39,71%), introducing solid food before 6 months or inappropriate food according to age: 68%. 3% had a reserved prognosis.

Conclusions:

Mothers education (breastfeeding, water sources, periodical medical evaluation) is the key on preventing infanthood mortality and morbidity induced by nutrition deficits.

318 / #687


MEDICAL NUTRITION THERAPY OF DOWN SYNDROME INFANT WITH UNDERLYING ATRIOVENTRICULAR SEPTAL DEFECT AND CHRONIC LUNG DISEASE: A CASE STUDY

N. Nurliyana, Y. Yao, M.Y. Barakatun-Nisak Universiti Putra Malaysia, Department Of Nutrition And Dietetics, Selangor, Malaysia


Infants with Down Syndrome (DS) quite commonly have difficulties with feeding due to the presence of oral-motor dysfunction. Despite having significant feeding difficulties, multiple issues such as congenital heart disease and chronic lung disease may perpetuate the vicious cycle of under-nutrition. Optimal nutrition is very important to ensure infants with DS growth is not hampered by additional medical conditions.

Methods:

We report a patient of DS, 7months old boy with weight-for-age between 10th to 25th percentiles of DS Growth Standard. Patients were seen by a dietitian for enteral feeding on 27th April 2018, with goals to achieve a weight gain of 15g/day. Therefore, an enteral feeding regime of 110ml term formula with 2.5scoop Caborie + 1.5ml MCT oil, 3Hourly, 8x/day were prescribed to provide 136kcal/kg BW/day.

Results:

During the first follow-up visit on 30th April 2018, patient tolerated with the feeding regime and able to achieve 132kcal/kg BW/day, which subsequently achieved the goals of weight on 25th percentiles (7.06kg) and achieves a weight gain of ~83g/day vs 15g/day as per recommendations. However, during the second follow-up visit, the patient's weight reduced by 0.12kg within 3 days as patient was given a regime that provides only 125g/kg BW/day. Therefore, an extra 0.5scoop of Caborie was added to the previous feeding regime where the regime will provide 130kcal/kg BW/day.

Conclusions:

This case supported the benefit of medical dietary intervention in under-nutrition patients with DS. The use of modular formula together with the standard infant formula as a therapeutic intervention has proven effective in improving anthropometric measurements among infants with DS.

320 / #255

E-Poster Viewing NEONATAL & PREMATURITY 08-27-2020 21:30 - 22:00

MATERNAL EXPOSURE TO HEAVY METALS, CORD BLOOD ONES: IS THERE A RELATION?

E. Abdel Hamid1, L. Sherif1, S. Shaaban2, H. Elnady1, H. Ahmed3 1NRC, Child Health, cairo, Egypt, 2Ain Shams university, medical college, Pediatrics, cairo, Egypt, 3NRC, Hormones Department, cairo, Egypt


In our developing countries, toxic heavy metals are a threatening catastrophe to human health particularly in the vulnerable group of pregnant mothers and their fetuses. Fortunately, the placenta can be a protective barrier to the fetuses.

Aim: to assess the influence of levels of maternal exposure to some heavy metals including lead, cadmium, and arsenic on their neonatal cord blood levels of and to display how the placental barrier acts as a protective defense against the passage of toxic heavy metals from mothers to their fetuses.

Methods:

This is a cross-sectional study was conducted on 100 pregnant mothers at the time of labor and on their newborns. Full history, sociodemographic data and food frequency questionnaire for dietary assessment were all taken. Cadmium, lead, and arsenic levels in both mothers’ and umbilical cord blood were measured using the Inductively Coupled Plasma Mass Spectrometry (ICP-MS).

Results:

All the studied heavy metals concentrations were significantly higher in the maternal blood in comparison to the cord blood, (P < 0.05). There was a significant association between the maternal lead and both fetal levels of lead and arsenic, a negative, but non-significant correlation was found between the maternal blood cadmium levels and each of the fetal cadmium, lead, and arsenic.

Conclusions:

The study findings indicated a weak relation between maternal and fetal blood heavy metals, except for the influence of maternal lead, so it can be assumed that the placental barriers are partially protective against those toxic agents, putting in consideration the influence of their different natures.

321 / #545


NUTRITION AND CONGENITAL CARDIOPATHY: A CASE REPORT

E. Abrahao1, R. Viebig1,2, D. Amaral1, M. Campos1 1Universidade Presbiteriana Makenzie, Nutricao, sao paulo, Brazil, 2Centro Universitario Sao Camilo, Nutricao, Sao Paulo, Brazil


Congenital heart malformations are frequent in foetuses, common in live births and lead to high mortality in the first year of life. Malnutrition is a common phenomenon in children with congenital heart disease, due to increased energy expenditure, so children with heart disease have a high nutritional risk. Objective: The aim of this study was to follow-up a clinical case of congenital heart disease.

Methods:

The study was conducted in a private paediatric hospital in São Paulo, Brazil, for 10 days. The patient was 2 years old and presented congenital heart disease and cow's milk protein allergy. Clinical follow-up was performed through medical records consultation and visits to the patient. Medical prescription data, the evolution of clinical signs, biochemical tests, drugs prescribed were collected. Nutritional status assessment was conducted, and the results were plotted at growth charts (WHO, 2005). Food intake was monitored and nutritional needs were stablished prior nutritional therapy.

Results:

The patient in question had a high nutritional risk assessed by Strong Kids instrument. Weight-for-age and length-for-age were above 3rd centile in the growth charts. Energy supply, at the beginning of the study, was lower than the requirements as well as patient´s food acceptance, fact that was reversed throughout the study. A hydrolysed formula was offered to the child, fractionated in 7 times a day and selenium and zinc were supplemented.

Conclusions:

Diet therapy contributed to improve the patient´s clinical condition, but diet acceptation still needs more attention, especially to reach fibre, micronutrient and vitamin ideal intakes.

323 / #289


USE OF MOVICOL IN PRETERM INFANTS

I. Alvarez1, D. Wackernagel1,2 1Astrid Lindgren's Childrens Hospital, Karolinska university hospital Huddinge, Po Sick Newborn Infant, Neonatology, Huddinge, Sweden, 2Karolinska Institutet, Department Of Clinical Science, Intervention And Technology (clintec), Huddinge, Sweden


Background and aims

Constipation is a common problem in preterm infants, traditionally treated with lactulose at Karolinska university hospital. In recent years the treatment has shifted towards the use of polyethylene glycol (PG). It’s use and safety have not been previously documented in preterm infants. The aim of our study was to describe the use of PG in preterm infants.

Methods:

Methods

Retrospective data were extracted from the patient file system for all infants with GA <37 weeks treated with PG during 2018. Dose, treatment start and duration, gestational age, sex, anthropocentric-parameters and daily total fluid volume were extracted and analyzed.

Results:

Results

Out of 40 identified patients 31 were eligible for analysis. Mean gestational age was 25,8 (range 23,1-33,4). Treatment was started at a mean age of 28,3 days (range 9,5-92,9) at a mean dose of 0,509g/kg/day (range 0,359-2,394). 13 patients were born SGA, 17 were born AGA and 1 patient LGA.

Conclusions:

Conclusions

No correlation between fluid restriction and polyethylene glycol treatment could be found in our cohort. AGA and SGA were equally distributed. No harmful side-effects were found in our group when treated with polyethylene glycol.

324 / #462


EFFECT OF NUTRITION ON GROWTH OF PRETERM NEWBORNS WITH BRONCHOPULMONARY DYSPLASIA

M.D.B. Baker Meio1, B. Milanesi2, A. Martins2, P. Azzara2, S.C. Gomes Junior1, M. Moreira1 1Instituto Fernandes Figueira - Fundação Oswaldo Cruz, Pós-graduação Em Pesquisa Clínica Aplicada, Rio de Janeiro, Brazil, 2Instituto Fernandes Figueira - Fundação Oswaldo Cruz, Neonatology, Rio de Janeiro, Brazil


Bronchopulmonary dysplasia (BPD) may impair growth. This study aimed to evaluate the influence of nutrition on growth of preterm newborns with BPD at term age.

Methods:

Cohort. Inclusion criteria: gestational age <32 weeks. Exclusion criteria: malformations, congenital infections, genetic syndromes. Anthropometric measures were taken at birth, at the end of each first four weeks of life and 40 weeks PMA, and the volume of water, the amount of protein, lipid, carbohydrate and calories received per Kg/day in this period were registered. BPD was defined as the need of oxygen at 36 weeks PMA. We also registered the age of initiation of feeding, of full enteral diet, recovery of birthweight and duration of total parenteral nutrition.

Results:

77 newborns were enrolled, 16 (20.5%) developped BPD. The mean gestational age and birthweight were significantly lower in the BPD group, with a longer time to initiate feedings, to reach full enteral diet and a greater duration of total parenteral nutrition. Both groups received equivalent amounts of protein and carbohydrates during the first four weeks of life; the BPD group received significantly less water and calories on weeks 3 and 4, and lipid at week 4. The weight Z scores were equivalent at the end of each first weeks of life and at term age.

Conclusions:

There was no difference in the growth of newborn with BPD at term age, in spite of the longer duration of parenteral nutrition, the time to reach full diet and of the smaller amounts of calories and lipids in this group.

325 / #475


THE INFLUENCE OF A NUTRITIONAL PROTOCOL ON THE GROWTH OF NEWBORNS WITH BRONCOPULMONARY DYSPLASIA – JAN/2016 TO JUL/2019

M.D.B. Baker Meio1, B. Milanesi2, L. Villela2, P. Azzara2, A. Martins2, S.C. Gomes Junior1, M. Moreira1 1Instituto Fernandes Figueira - Fundação Oswaldo Cruz, Pós-graduação Em Pesquisa Clínica Aplicada, Rio de Janeiro, Brazil, 2Instituto Fernandes Figueira - Fundação Oswaldo Cruz, Neonatology, Rio de Janeiro, Brazil


Nutrition is important for the care of newborns with Bronchopulmonary dysplasia (BPD). We evaluated the influence of a nutrition protocol on the growth of these newborns at 40 weeks PMA from January/2016 to July/2019.

Methods:

Cohort. Inclusion criteria: gestational age <32 weeks. A nutrition protocol was established in the last semester of 2015, with higher amounts of nutrients and earlier initiation of feedings. Anthropometric measures with Z scores were taken at birth, at the end of each first four weeks of life and 40 weeks PMA, and the volume of water, the amount of protein, lipid, carbohydrate and calories received per Kg/day in this period were registered. BPD was defined as the need of oxygen at 36 weeks PMA. The age of initiation of feeding, of full enteral diet, recovery of birthweight and duration of total parenteral nutrition were registered. The nutritional variables and the Z scores were compared between the groups for each year between January 2016 and July 2019.

Results:

Water, protein, carbohydrate, lipids and calories remained relatively stable during these years, with a slight increase of lipids (weeks 3 and 4 in 2017) and a decrease in carbohydrate (week 4 in 2016). The age of initiation of feedings and full enteral diet, and the duration of parenteral nutrition decreased. Both groups showed increasing Z scores (weight, length, HC) but these gains were greater in the BPD group.

Conclusions:

The observation of a protocol improved the nutrition care of preterm newborns and resulted in better growth of newborns with BPD.

326 / #421


HUMAN MILK COMPOSITION AND IMMUNOLOGICAL OUTCOMES: AN UPDATED SYSTEMATIC REVIEW AND META-ANALYSIS

C.-D. Ceapa, D. De Deyn, K. Solak, W. Carpentier, J. Beauprez Inbiose, R&d, Ghent, Belgium


Human milk oligosaccharides (HMOs), the third most abundant component of human milk, have been associated to a variety of immunomodulatory effects in infants. The aim of this meta - analysis is to determine the concentrations and ranges for the 13 most abundant HMOs, representing approximately 90% of the total HMO content of human milk, to determine the effect of factors influencing composition (such as genetics, lactation time, geography, gestation time, analytical methods) and to review the evidence linking HMOs to immune-related outcomes.

Methods:

Studies were sought in bibliographic scientific databases, published from 1999 to 2019. Weighted averages were calculated to give more importance to studies with a higher number of tested samples.

Results:

Eighteen studies involving approximately 5000 samples met the inclusion criteria. Specific changes in HMO concentrations over lactation time and their implications for their use in infant formula are discussed. There were no significant differences based on gestational status (term and preterm) or geographical location (stratified by continents). Individual HMOs have been associated with immune outcomes such as allergy (particularly cow’s milk allergy) and atopic dermatitis, and to metabolic diseases with an immune component such as obesity and diabetes.

Conclusions:

Our meta-analysis identified 18 eligible trials describing the natural composition of HMOs in human milk. Pre-clinical and clinical data suggest that HMO dose is important when aiming for immunological outcomes.

327 / #394


EXTRAUTERINE GROWTH RESTRICTION IN PRETERM INFANTS WITH WEIGHT OF LESS THAN 1500 GRAMS. RISK FACTORS.

M.C. De Nardo, R. Lucchini Policlinico Umberto I, Sapienza Università di Roma, Neonatologia, Patologia E Terapia Intensiva Neonatale, Roma, Italy


Failure to achieve an adequate extrauterine growth, known as “Extrauterine growth restriction” (EUGR), occurs in the majority of extremely preterm infants. EUGR is defined as a growth measurement that is ≤10th percentile of the expected intrauterine growth for the postmenstrual age at the time of discharge. EUGR could affect brain development. Risk factors influencing EUGR include birth weight(BW), gestational age(GA), Respiratory Distress Syndrome(RDS), Oxygen dependence at 36 weeks(BPD), Necrotizing Enterocolitis(NEC), Patent ductus arteriosus(PDA), Retinopathy of prematurity(ROP), intraventricular haemorrhage(IVH), mechanical ventilation, parental or enteral nutrition(NPT, EN).

The aim of the study was to correlate EUGR risk factors to postnatal rate of growth (GV).

Methods:

Neonates with GA of less than 32 weeks and BW of less than 1500 grams, born at Policlinico Umberto I, during a 6-year period, were retrospectively included. Infants with major congenital malformations, hospital stay or death before 24 hours of life were excluded. The GV was expressed by g/kg/day. Risk factors related to EUGR were analysed by t-Student test.

Results:

138 neonates were collected. The percentage of newborns with weight less than 10th percentile increased significantly during hospital stay. The GV was higher in infants with the highest gestational age at birth. Presence of RDS or NEC during hospitalization were statistically significantly associated with EUGR. Newborns fed with NPT showed a GV inversely proportional to NPT duration.

Conclusions:

EUGR is a common event in clinical practice. Among its modifiable risk factors, our study suggests that modulating the way of feeding could be key in reducing the frequency of this condition.

328 / #347


BARRIERS TO HUMAN MILK FORTIFIER USE AFTER DISCHARGE: A QUALITATIVE STUDY

Y. Devaera, A. Rasyada, A. Hendarto Faculty of Medicine Universitas Indonesia, Child Health, Jakarta, Indonesia


Low birth weight infants may need to continue breast milk supplementation after discharged to achieve optimal growth. Human Milk Fortifier (HMF) use in Indonesia is less popular then preterm formula as supplementation to breast milk. Besides economic reasons, we explored the barriers of HMF use at home.

Methods:

Qualitative Study. Semi-structured interviews were conducted in four hospitals in Jakarta and Bekasi from August to September 2019. The data were analyzed using thematic analysis. Subjects were mothers who demonstrated low compliance in giving HMF at home. All of them using bottle when giving the HMF. Sample were recruited consecutively until data saturation was achieved.

Results:

Ten mothers were depth-interviewed with a guided questionnaire. Four themes were identified as contributing the barriers HMF use at home: (i) preparation of HMF use; (ii) administering HMF to infants; (iii) infants’ reaction; (iv) impact to direct breastfeeding. Mothers reported difficulty when mixing HMF and breast milk due to the lumps inside the bottle, longer time needed when giving HMF. Lesser amount of expressed breast milk and infants' preferance to bottle feeding rather then direct breastfeeding also reported. Infants initial refusal, vomits and alteration of stool consistency were amongst infants reaction. Six mothers identified numerous barriers that related to more than one identified theme.

Conclusions:

This study identified important barriers of HMF use at home in Jakarta and Bekasi, finding that participants consistently reported multifaceted. Future research should examine whether HMF use at home with no artificial teats will increase growth and successful breastfeeding.

329 / #263


DETAILED METEGENOMIC ANALYSIS OF HUMAN MILK BIFIDOBACTERIA CONTENT: COMPARISON BETWEEN NORMAL DELIVERY VS. CAESEREAN SECTION AND FOREMILK VS. HINDMILK SAMPLES

M. Dinleyici1, V. Perez-Brocal2, Y. Vandenplas3, A. Moya2, E. Dinleyici4 1Eskisehir Osmangazi University Faculty of Medicine, Department Of Social Pediatrics, Eskisehir, Turkey, 2Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO-Public Health), Department Of Genomics And Health, Valenica, Spain, 3UZ Brussel- Vrije Unversiteit Brussel, Department Of Pediatrics, Brussel, Belgium, 4Eskisehir Osmangazi University Faculty of Medicine, Department Of Pediatrics, Eskisehir, Turkey


Although Bifidobacteriaare not one of the dominant bacteria in human milk (HM), Bifidobacteria content and strains have been shown to have positive effects on the infant’s intestinal microbiota composition. In this study, the Bifidobacterium content of foremilk and hindmilk HM (exclusively breastfed) at the species level was evaluated

Methods:

Among exclusively breast-fed mothers, we enrolled 10 mothers who had normal spontaneous vaginal deliveries (NS) group, 10 mothers who had cesarean deliveries (CS; all elective, and non-received intrapartum antibiotics) group. HM samples were taken at the beginning (foremilk), 10th and 20thminutes (hindmilk) of breastfeeding episode. Bifidobacteriumspecies were defined by detailed metagenomic analysis.

Results:

22 different Bifidobacterium species were identified, remaining defined as Bifidobacterium_uc. In the foremilk samples, 10 different species were detected in CS while 15 different species were found in NS group. In the NS group, B.longumand B.brevewere the most common in the foremilk and 10thminutes samples, while B. brevewas the most common in the hindmilk samples. B.brevewas found to be most common in the foremilk of CS group, followed by B.longumand B. bifidumrespectively. B.brevewas also the most common in the 10thminute and hindmilk samples.

Conclusions:

Although there were some differences in the Bifidobacteriacontent of human milk according to delivery mode, the predominant species were B breve and B.longum. In this study, we showed that Bifidobacteria content changes during a single breastfeeding session, with differences between foremilk and hindmilk. There are still unclassified Bifidobacteriumstrains in HM, need further analysis.

330 / #244


PDA LIGATION EFFECT IN STORMY NEONATAL COURSE WITH PERFORATED GUT IN EXTREME LOW BIRTH WEIGHT BABIES ... AN UPDATE ..! (A CLINICAL CASE REVIEW PRESENTATION)

A. Hawal1, S. El Deib2 1Amina Hospital, Pediatrics & Neonatology, Ajman, United Arab Emirates, 2NMC Royal Hospital, Pediatrics & Neonatology, Abu Dhabi, United Arab Emirates


Our Study is a clinical case review that aims to state the evidence-based effect of surgical PDA ligation on the stormy neonatal course with perforated gut in extreme very low birth weight neonates&the strategies guidelines for choosing the preferable & best management for such cases.

Methods:

The study is a clinical case review of a male Preterm(+28 wks),EVLBW(690grams)who was delivered&transferred to NICU because of Prematurity,EVLBW,sever IUGR,RDS&need for respiratory support.Baby presented with large PDA with huge volume overload which medically faild to close,then baby shortly undergo a stormy course of multisystem complications of NEC,multiple sites perforated GUT,periventricular leukomalacia,bacterial&fungal neonatal sepsis,metabolic acidosis,abnormal heamatological&coagulation profile.Baby was deteriorated clinically,So,Abdominal exploration surgery with intestinal resections&end–end anastomosis was done urgently&surgical PDA ligation done,after that baby was improved significantly&early feedings was started&gradually increased up to full feedings with a sginficant clinical improvement in baby's condition.

Results:

The Study stated the evidence-based effect of the surgical PDA ligation on the stormy neonatal course with perforated gut & multisystem complications in extreme very low birth weight neonates&the strategies guidelines for choosing the preferrable&best management for such cases as the surgical PDA ligation is the preferrable choice in the management of PDA with big volume overload in EVLBW neonates with multiple complicated course than the medical management with a significant clinical,laboratory&radiological improvement of such cases.

Conclusions:

1)Prematurity is the single greatest risk factor for multisystem complications&avoidance of premature birth is the best way to prevent such problems.2)The role of surgical PDA ligation&its preference than medical management with its significant effect on stormy neonatal course.

332 / #161


NECROTISING ENTEROCOLITIS IN A PRETERM INFANT NEWBORN&ROLE OF FEEDING.....AN UPDATE

S. El Deib NMC ROYAL HOSPITAL, Neonatology, ABU DAHBI, United Arab Emirates


It’s a clinical case presentation of a male Preterm infant Newborn (+31 wks) who was delivered in our hospital & transferred to our NICU because of Prematurity, VLBW & need to respiratory support. Baby shortly undergo Necrotizing Enterocolitis (NEC) on 5th day of life shortly after start of expressed milk feeding.

Methods:

Baby shortly undergo Necrotizing Enterocolitis (NEC) on 5th day of life shortly after start of expressed milk feeding …! Which was early detected by use of Near Infrared Abdominal spectroscopy (NIRS).

Results:

The Study stated the evidence-based Feeding Strategies guidelines for necrotizing enterocolitis (NEC) among very low birth weight infants & Role of trophic feedings, Probiotics, Prebiotics & micronutrients in Prophylaxis, Prevention & Management of NEC.

Conclusions:

1) -Prematurity is the single greatest risk factor for NEC & avoidance of premature birth is the best way to prevent NEC. 2)-The role of feeding in the pathogenesis of NEC is uncertain, but it seems prudent to use breast milk (when available) and advance feedings slowly and cautiously. 3)-NEC is one of the leading causes of mortality, and the most common reason for emergent GI surgery in newborns. 4)-A better understanding of the pathophysiology will offer new and innovative therapeutic approaches, and future studies should be focused on the roles of the epithelial barrier, innate immunity, and microbiota in this disorder. 5)-Bioinformatics modeling is a new emerging strategy aimed at understanding the dynamics of various inflammatory markers and their application in early diagnosis and treatment.

333 / #47


ASSOCIATION BETWEEN MODE OF DELIVERY AND BREASTFEEDING PRACTICES IN EGYPT: A POPULATION-BASED STUDY

N. Fadl1, Z. Haile2 1High Institute of Public Health, Alexandria University, Department Of Family Health, Alexandria, Egypt, 2Heritage College of Osteopathic Medicine,Ohio University, Department Of Social Medicine, Ohio, United States of America


The rise in cesarean deliveries constitutes a major public health concern in low- and middle-income countries. Evidence on the influence of cesarean delivery on breastfeeding practices in low- and middle-income countries is currently lacking. The aim of current study was to examine the association between mode of delivery and breastfeeding initiation and prelacteal feeding practices in a nationally representative sample of Egyptian women.

Methods:

A cross-sectional study was performed on 3773 women from the 2014 Egypt Demographic and Health Survey. The outcomes of interest were timing of breastfeeding initiation and prelacteal feeding practices. Descriptive statistics and multivariable regression models were performed.

Results:

Results: Overall, 25.1% of mothers initiated breastfeeding within 1 hour after birth and 63.5% practiced prelacteal feeding within 3 days after birth. Mothers who had cesarean delivery had higher odds of delayed breastfeeding initiation (AOR: 2.25; 95% CI, 1.84-2.74) and were more likely to engage in prelacteal feeding (AOR: 1.44; 95% CI, 1.19-1.74). Moreover, the relationship between cesarean delivery and delayed breastfeeding initiation varied by parity with stronger association among multiparous (AOR: 2.57; 95% CI, 2.04-3.24) compared to primiparous mothers (AOR: 1.52; 95% CI, 1.03-2.25).

Conclusions:

Conclusion: Cesarean delivery significantly increased the likelihood of delayed breastfeeding initiation and increased prelacteal feeding practices. Breastfeeding support and guidance should target women considering cesarean delivery.

334 / #373


PARENTERAL NUTRITION FEATURES IN NEONATAL INTENSIVE CARE UNIT.

I. Gonzalez, C. Fraile, T. Betancor, C.L. Diaz, F.J. Merino, M. Vera, A. Ferrer Hospital Universitario Nuestra Señora de Candelaria, Pharmacy, Santa Cruz de Tenerife, Spain


To analyze total parenteral nutrition (TPN) use in neonatal critical care unit (NCCU) of a third level hospital and make a comparison with recommendations of ESPEN guidelines on pediatric parenteral nutrition 2018 (EGPPN).

Methods:

A prospective observational study of TPN characteristics was performed, as well as serum values of patients admitted to the NCCU, who received TPN between August-October 2019.

TPN duration, total volume, glucose, lipids, protein, sodium, potassium, magnesium, calcium, phosphorus, chloride and acetate amounts data were recorded.

Results:

A total of 11 patients were included, 63.6% male, who started TPN from the first day of life. Average time with TPN was 5.64 days. Between start and end of TPN average weight difference was 36 grams/day.

In 90.9% of cases, TPN was suspended due to oral dietary tolerance.

72.7% of patients received co-administration of TPN and enteral nutrition (EN), of which 63.5% started EN before 7 days with parenteral nutrition.

Average amounts included in TPN were: glucose 10.7 g/kg/day, lipids 2.8 g/kg/day, amino acids 3.2 g/kg/day, sodium 3.4 mEq/kg/day, potassium 1.8 mEq/kg/day, calcium 1.9 mEq/kg/day, phosphate 1.53 mmol/kg/day, magnesium 0.26 mEq/kg/day, chloride 1.4 g/kg/day and acetate 1 mEq/kg/day.

Conclusions:

TPN prescriptions follow EGPPN recommendations, except for calcium, phosphate, and magnesium which fall below recommended amounts levels, the last one due to treatment for preeclampsia mothers.

335 / #543


RETROSPECTIVE STUDY ON THE ANTIBIOTIC USE IN NEONATAL ICU OF MURATSAN UHC, YEREVAN, RA – JANUARY TO JUNE 2017

M. Grigoryan1, S. Brutyan2, G. Beglaryan3, M. Sargsyan4, S. Zadoyan5, S. Adamyan5, S. Arakelyan6, M. Melkonyan1, L. Martirosyan2, H. Kalanteryan4, B. Baveyan7, V. Asoyan2, H. Apresyan2 1Yerevan State Medical University after Mkhitar Heratsi, Internal Medicine, Yerevan, Armenia, 2Yerevan State Medical University after Mkhitar Heratsi, Infectious Diseases, Yerevan, Armenia, 3Yerevan State Medical University after Mkhitar Heratsi, Plastic, Reconstructive And Aesthetic Surgery, Yerevan, Armenia, 4Yerevan State Medical University after Mkhitar Heratsi, Intensive Care Medicine, Yerevan, Armenia, 5Yerevan State Medical University after Mkhitar Heratsi, Radiology, Yerevan, Armenia, 6Yerevan State Medical University after Mkhitar Heratsi, Neurology, Yerevan, Armenia, 7Muratsan University Hospital Complex, Pediatrics, Yerevan, Armenia


Antibiotic resistance is rising to dangerously high levels in all parts of the world. Considerable portion of antibiotic use lacks clear warrant; in some NICUs, antibiotics are overused. Our aim to show the most frequent antibiotics administered in NICU of Muratsan UHC and subsequently to avoid the huge burden of antibiotic resistance.

Methods:

We retrospectively reviewed the case records of randomized selected patients admitted to NICU of Muratsan hospital, from January 1 – June 1, 2017. Patients with recovery were included (lethal outcome was exclusion criteria). Information obtained included patient diagnoses; antibiotics used for treatment.

Results:

Of 133 patients, 131 received antibiotic treatment, of which 39(29.8%) were treated with only one antibiotic, 45(34.4%) with 2 antibiotics and 43(32.8%) – 3 antibiotics. Totally, 13 different antibiotics were used in 266 courses of treatment. The most common antibiotics used in this period were gentamycin – 69(25.9%), penicillin – 55(20.7%), moxifloxacin – 35(13.2%). Complete list is shown in table.

Penicillin+gentamycin combination was given to 37(28.2%) neonates. In most cases (120) antibiotics were administered for treatment of respiratory tract disorders (congenital and community-acquired pneumonias, RDS, bronchitis etc.) and sepsis. Alas, there were no data about etiology of infectious diseases such as pneumonia or sepsis.

Conclusions:

It is a necessity to use our arsenal of antibiotics carefully. Greater than half of patients received treatment with 2 and more antibiotics without identifying infectious agent and its susceptibility to antimicrobial drugs.

Identifying of infectious agent and implementation of guidelines can prevent deleterious effects of antibacterial resistance.

336 / #179


NECROTIZING ENTEROCOLITIS IN A PRETERM INFANT NEWBORN & ROLE OF FEEDING …. AN UPDATE ! ( A CLINICAL CASE REPORT PRESENTATION ).

A. Hawal Amina Hospital, Pediatrics & Neonatology, Ajman, United Arab Emirates


Our Study is a clinical case review that aims to state the evidence-based Feeding Strategies guidelines for Necrotising Enterocolitis(NEC)among VLBW infants&Role of trophic feedings,Probiotics,Prebiotics&micronutrients in Prophylaxis,Prevention&Management of NEC.

Methods:

The study is a clinical case review of a male Preterm infant(+31 wks)who was delivered&transferred to NICU because of Prematurity,VLBW&need for respiratory support.Baby shortly undergo NEC on 5th. day after start of EBM feeding!which was early detected by use of Near Infrared Abdominal spectroscopy(NIRS).Baby was deteriorated clinically in a couple of hours&undergo intestinal perforation with peritonitis.So,Abdominal exploration surgery with intestinal resection&end–end anastomosis was done urgently.Baby improved&early feedings was started&gradually increased up to full feedings with use of Human Milk Fortifier,probiotics&prebiotics.

Results:

The Study stated the evidence-based Feeding Strategies guidelines for necrotizing enterocolitis(NEC)among very low birth weight infants&Role of trophic feedings,Probiotics,Prebiotics&micronutrients in Prophylaxis,Prevention&Management of NEC.

Conclusions:

1)Prematurity is the single greatest risk factor for NEC&avoidance of premature birth is the best way to prevent NEC.2)The role of feeding in the pathogenesis of NEC is uncertain,but it seems prudent to use breast milk(when available)and advance feedings slowly and cautiously.3)NEC is one of the leading causes of mortality&the most common reason for emergent GI surgery in newborns.4)NEC remains a major unsolved medical challenge,for which no specific therapy exists, and its pathogenesis remains controversial.5)A better understanding of the pathophysiology will offer new and innovative therapeutic approaches&future studies should be focused on the roles of the epithelial barrier,innate immunity,and microbiota in this disorder.6)Bioinformatics modeling is a new emerging strategy aimed at understanding the dynamics of various inflammatory markers&their application in early diagnosis&treatment.

337 / #291


THE PREVALENCE OF FEEDING INTOLERANCE IN ETHIOPIAN VERSUS OTHER ETHNIC ORIGIN NEWBORNS HOSPETILAIZED IN THE NEONATAL INTENSIVE CARE UNIT

C. Hershkovich-Shporen, L. Hofi, A. Khodjaev, O. Flidel Rimon Kaplan Medical Center, Neonatology, Rehovot, Israel


Background: Feeding intolerance (FI), defined as the inability to digest enteral feedings associated with increased gastric residuals, abdominal distension and or emesis is frequently encountered in newborns admitted to the intensive care unit (NICU) and might lead to disruption in the feeding plan.

Aims: To evaluate whether FI is more prevalent in Ethiopian origin newborns (EON) versus other ethnic origin newborns (OEON).

Methods:

A retrospective case control study based on medical records of newborns admitted to Kaplan Medical Center (KMC) between 2014 to 2016. The study group included 50 EON and the control group 100 OEON.

Results:

We found that the EON group had significantly higher prevalence (34%) of FI compared with OEON group (15%), (p=0.007). Breast milk based feeding was more prevalent in the EON group. There was no difference in the prevalence of Necrotizing enterocolitis, intestinal perforation or cow's milk allergy between the two groups.

OEON with FI had higher prevalence of other neonatal co-morbidities and respiratory support compared to OEON without FI. This association was not found in the EON group.

There was no statistical difference between the two groups in the demographic, anthropometric parameters or neonatal co morbidities

Conclusions:

FI was more prevalent in EON versus OEON group. We speculate that the difference might be associated with an intrinsic factor in the EON group, such as lactose intolerance or difference in the microbiome. More studies are needed to confirm that data.

338 / #534


SEASONALITY IN BIRTH SIZE AND ASSOCIATIONS WITH DIETARY DIVERSITY AMONG PREGNANT WOMEN IN RURAL MALAWI

K. Hjertholm, P.O. Iversen, G. Holmboe-Ottesen, I. Mdala, P. Kamudoni University of Oslo, Department Of Nutrition, Oslo, Norway


In rural Malawi, pregnant women are prone to inadequate dietary intakes and thus at increased risk of delivering small infants. Seasonality affects the availability of foods and thus possibly also birth size. However this association has not been clarified. Here we investigated the seasonality in birth size and the potential association with dietary diversity score (DDS) as a proxy for dietary intake. We also examined the Minimum Dietary Diversity for Women indicator (MDD-W) as a predictor for birth size.

Methods:

Dietary intakes of 330 pregnant women residing in the Malawian Mangochi District were assessed between gestational weeks 28-35 across two agricultural seasons (pre-harvest and post-harvest seasons). Dietary data was collected using 24-h recalls, and the 10-food group DDS indicator proposed by the FAO/USAID 2016 was used. Neonatal anthropometry was collected shortly after birth. Pearson's correlations and regression analyses were applied to investigate relationships between diet and birth outcomes.

Results:

Neonatal size was larger in the pre-harvest season (p<0.05), with the largest difference seen in birth weight (116.2 grams), followed birth length (1.4 cm) and head circumference (0.6 cm). There were no significant associations between DDS and birth outcomes in the two seasons. Achieving MDD-W was negatively associated with abdominal circumference in the pre-harvest season (β= -1.1, 95% CI: -1.9, -0.2 cm). No other associations between MDD-W and birth outcomes were statistically significant.

Conclusions:

We found no associations between DDS and birth outcomes in this low-resource setting. MDD-W negatively predicted abdominal circumference in the pre-harvest season.

339 / #474


AGGRESSIVE NUTRITIONAL GUIDELINES IN INDONESIAN NATIONAL REFERRAL HOSPITAL: THE RISK OF EXTRAUTERINE GROWTH RESTRICTION (EUGR) IN VERY PRETERM INFANTS

W. Iskandar, R. Rohsiswatmo, K. Yuliarti Cipto Mangunkusumo Hospital, Department Of Child Health, Jakarta, Indonesia


Aggressive nutrition was indicated for very preterm (< 32 weeks) or very low birth weight (<1,500 grams) infants. In 2016, an adapted feeding guideline was developed to prevent neonatal malnutrition. We aimed to evaluate its implementation on EUGR in very preterm infants.

Methods:

This prospective cohort study was conducted in a national referral hospital since July 2018 until June 2019. Subjects were live-born infants with gestational age <32 weeks irrespective of birth weight. Infants with inborn errors of metabolism, genetic abnormalities, and major congenital malformation were excluded. Weekly anthropometric data and complications (NEC, hypertriglyceridemia, cholestasis, and refeeding syndrome) were recorded. EUGR was defined as weight at discharge less than 10th percentile of Fenton 2013 chart.

Results:

Among 97 subjects, the survival rate at discharge was 38.1% and mean length of stay was 39.7 (19.5) days. Median time to start enteral feeding, reach full enteral feeding, and duration of total parenteral nutrition were 4, 9, and 5 days, respectively. Mean weight gain was 19.1 g/kgBW/day. EUGR incidence was 43.2% with median survival of 39 (33-44) days. SGA infants had shorter median survival (28 VS 36 days, log rank test, p value = 0.255). NEC incidence was 13.4% (medical 76.9% and surgical 23.1%) and the incidence of hypertriglyceridemia, cholestasis, hypokalemia, hypophosphatemia, and hypomagnesemia in the first week of life were 4.1%, 6.2%, 8.2%, 30.9%, and 5.2%, respectively.

Conclusions:

Our adapted aggressive nutrition guideline may reduce the incidence of EUGR with lower incidence of complications except hypophosphatemia. Micronutrients should be administered in parenteral nutrition.

340 / #385


SMALL-FOR-GESTATIONAL AGE (SGA) INFANTS FOR HEAD CIRCUMFERENCE AT BIRTH AND THEIR EFFECT ON HEAD CIRCUMFERENCE AT SCHOOL AGE AND COGNITION

D. Ivanovic1, Y. Orellana1, B. Leyton1, V. Arancibia2, A. Almagià3, R. Valenzuela4, C. Barrera4, C. Larraín5, C. Silva5, F. Zamorano5, P. Billeke5, C. Villa1 1University of Chile, Institute Of Nutrition And Food Technology Dr. Fernando Monckeberg Barros (inta), Human Nutrition Area, Nutrition And Neurological Sciences, Santiago, Chile, Santiago, Chile, 2World Bank. Washington, United States., Consultant Specialist In Education, Washington, United States of America, 3Pontifical Catholic University of Valparaíso, Laboratory of Physical Anthropology and Human Anatomy, Valparaíso, Chile, Laboratory Of Physical Anthropology And Human Anatomy, Valparaíso, Chile, Valparaíso, Chile, 4University of Chile, Faculty Of Medicine, Department Of Nutrition, Santiago, Chile, Santiago, Chile, 5Universidad del Desarrollo, Facultad De Medicina-clínica Alemana Radiology Department, Santiago, Chile


The aim of this study was to assess the long-term effect of to be born SGA for head circumference (HC) on HC at school age and their association with cognition.

Methods:

From a representative, proportional and stratified sample of 1,353 school-age children, of both sexes, enrolled in the 5th grade of elementary school and in the 1st grade of high school in the Metropolitan Region of Chile in 2010, their HC at birth (n = 169) was classified as small (SGA), appropriate (AGA) and large-for-gestational age (LGE) according to Alarcón y Pittaluga Tables. HC at school age was compared with the tables of Nellhaus and was expressed as HC-for-age Z score (Z-HC). Scholastic achievement (SA) was assessed by means of the 2009 Quality Education Measurement System (SIMCE) and IA, by the Raven Progressive Matrices test. Data were analyzed using non-parametric statistic and correlation from the SAS software.

Results:

HC at birth was positively and significantly correlated with Z-HC at school age (p< 0.0001). SGA children for HC exhibited, in the long-term, significantly lower Z-HC at school age than their AGA and LGA peers (p <.0001). Z-HC at school age and not HC at birth was positively and significantly correlated with 2009 SIMCE outcomes for language, mathematics and natural sciences (p< 0.0001), and IA (p< 0.0001).

Conclusions:

These findings confirm that SGA children for HC have in the long term significantly lower Z-HC and indirectly, lower SA and IA. These results can be useful for health and educational planning.

Grants FONDECYT 1100431, 1150524 and 1201079.

342 / #261


FEEDING AND GROWTH OUTCOMES IN LATE AND MODERATE PRETERM INFANTS. A PREVIEW OF THE FLAMINGO COHORT

A. Kakaroukas1, M. Abrahamse-Berkeveld2, N. Embleton1, R. Van Elburg3 1Royal Victoria Infirmary/Newcastle Hospitals Foundation Trust, Neonatal Intensive Care Unit, Newcastle upon Tyne, United Kingdom, 2Danone Nutricia Research, -, Utrecht, Netherlands, 3University of Amsterdam, Medicine, Early Life Nutrition, Amsterdam, Netherlands


Longitudinal data on growth and feeding practices of late and moderate preterm infants is scarce. This is the primary aim of our prospective, observational cohort study.

Methods:

The cohort will collect information from up to 250 infants born between 32+0 – 36+6 weeks gestation, with birthweight between 1.25-3.0 kg. During 6 visits in the first 2 years of age anthropometry, body composition using dual X-ray absorptiometry, feeding behaviour and gut microbiota samples will be collected.

Results:

Available feeding data from 62 infants (29 boys and 33 girls) until 3 months corrected age shows that the the rate of breastfeeding fell from 41.9% at hospital discharge to 24.2% at 3 months corrected age for exclusive breastfeeding and from 67.74% to 33.87% respectively for any breastfeeding. Duration of any breastfeeding was 77 days and 71 days, whereas duration of exclusive breastfeeding was 60 days and 43 days for moderate and late preterm infants respectively. Weight gain between term equivalent age and 3 months corrected age was 28.0 g/day and 29.3 g/day for exclusively breastfed (n=14) and formula fed infants (n=28) respectively.

Conclusions:

The preliminary results indicate that the rate of breastfeeding in this population at discharge and 3 months corrected age is suboptimal. Although moderate preterm infants remain in hospital for longer being provided with breastfeeding support, the duration of any breastfeeding between the two groups is not apparently different. The FLAMINGO study can provide valuable insights in growth and feeding characteristics for this population.

343 / #455


A TAILORED-FOOD-BASED NUTRITION-EDUCATION AND COUNSELLING INTERVENTION OFFERED DURING PREGNANCY TO IMPROVE BIRTH SIZE AND DIETARY INTAKE: A CLUSTER RANDOMIZED CONTROLLED TRIAL IN RURAL MALAWI

P. Kamudoni1, G. Holmboe-Ottesen1, L. Katenga-Kaunda1, K. Maleta2, S. Taoloka1, M. Mphande1, I. Mdala1, A. Munthali3, M. Tharrey4, Z. Shi5, E. Ferguson6, P.O. Iversen7,8 1University of Oslo, Department Of Community Medicine, Oslo, Norway, 2University of Malawi, College Of Medicine, Blantyre, Malawi, 3University of Malawi, Centre For Social Research, Zomba, Malawi, 4Agro Paris Tech, Agro Paris Tech, Paris, France, 5University of Adelaide, Faculty Of Health Sciences, Adelaide, Australia, 6London School of Hygiene and Tropical Medicine, Department Of Nutrition And Public Health Intervention Research, London, United Kingdom, 7University of Oslo, Department Of Nutrition, Oslo, Norway, 8Division of Human Nutrition, Stellenbosch University, Matieland, South Africa


Low birth weight infants have an increased risk of death in the neonatal period. Malawi has a high incidence of low birth weight, 12%. Maternal malnutrition during pregnancy is a major risk factor for low birth weight. We tested the hypothesis that nutrition education and counselling during pregnancy can improve dietary intakes and birth weight.

Methods:

We conducted a cluster randomized controlled trial in Nankumba, Mangochi district, Malawi. Twenty clusters with buffer zones were randomized into either intervention or control group. The intervention group was offered tailored-community-based-nutrition-counselling informed by dietary intake assessments conducted prior to the trial. Pregnant women between their 9th and 16th gestational week were recruited and followed until delivery. The trial is registered with clinicaltrials.gov; ID: NCT03136393.

Results:

Ninety-three out of 161 women in the intervention- and 94 out of 150 women in the control group completed the trial. Mean (SD) birth weight was 3015 (456) g in the intervention group and 2966 (480) g among the controls, representing an adjusted mean difference of 47g (95% CI: -95.3 to 190, p=0.517). Mean (SD) length of gestation was 40 (8.8) weeks in the intervention group and 38.9 (2.7) weeks in the controls, with an adjusted mean difference of 1.5 weeks (95%CI: -0.4 to 3, p=0.113). Women in the intervention group had significantly higher intake of pulses, nuts, dairy, dark greens and oils.

Conclusions:

In poor communities in Malawi, pregnant women receiving community-based nutrition-education showed a trend for better birth outcomes and improved dietary patterns.

344 / #318


CALCIDIOL, INTERLEUKIN-1Β AND INTERLEUKIN-6 LEVEL IN CHILDREN BORN FROM MOTHERS WITH CARBOHYDRATE METABOLISM DISORDERS

N. Verisokina1, V. Kuryaninova1, L. Klimov1, I. Zakharova2, R. Atanesyan1, L. Alaverdyan1 1Stavropol State Medical University, Pediatrics, Stavropol, Russian Federation, 2Russian Medical Academy Continuing Postgraduate Study, Pediatrics, Moscow, Russian Federation


to analyze the level of VD, IL-1β, IL-6 in the blood serum of newborns born from mothers with impaired carbohydrate metabolism

Methods:

laboratory examination 97 newborns was conducted: 26(30.6%) women with type 1 diabetes mellitus, 17(20.0%) women with gestational diabetes mellitus, 18( 21.2%) mothers with GDM which developed on the background of obesity preceding the onset of pregnancy. The control group consisted 36(28.2%) newborns

Results:

in the group of newborns born from mothers with type I diabetes, 20(76.9%) babies were born full-term, 6(23.1%) premature babies, heavy weight (birth weight more 4000 grams) was noted 7(26.9%). In women GDM 14(82.4%) newborns born full-term, 3(17.6%) premature infants, 9(52.9%) born large. In the group of children whose mothers had a combination of GDMobesity, 17(89.5%) born full-term, 2(10.5%) premature, 6(31.6%) large. Indicators of the control group: VD 14.0[8.2–22.1]ng/ml, IL-1β 5.4[1.8–27.7]pg/ml, IL-6 18.2[5.1-54.3]pg/ml. In children born from mothers with type I diabetes, the level VD 5.9 [4.0–8.4]ng/ml (p<0.01), IL-1β 49.6 [10.8–89.6]pg/ml (p<0.001), IL-6 60.5 [38.5–231.3]pg/ml (p<0.001) vs. the control group. Newborns born from mothers with GDS had lower VD level 6.1[4.1–9.6]ng/ml (p<0.01), indicators of IL-1β, IL -6 were significantly greater than in children from mothers without endocrine pathology 41.3[18.9–85.5]pg/ml (p<0.01), 89.4 [30.2–114.7]pg/ml (p<0.01). The level VD in children from mothers with GDM on the background of obesity 9.5 [4.0–20.5]ng/ml (p>0.05), IL-1β 16.6 [12.4–29.2]pg/ml (p<0.001), IL-6 82.4 [60.5–90.1]pg/ml (p<0.05) vs. control group

Conclusions:

Children born from mothers with impaired carbohydrate metabolism on the background of endocrine pathology had lower levels of VD, significantly higher levels of pro-inflammatory cytokines IL-1β, IL-6

346 / #433


EXTRA UTERINE GROWTH RESTRICTION IN VERY LOW BIRTH WEIGHT PRETERM INFANTS: GROWTH RECOVERY BY TWO YEARS OF CORRECTED AGE AND NEURODEVELOPMENT

L. Lucaccioni, M. Arrigoni, M. Pugliese, E. Della Casa, L. Bedetti, N. Bertoncelli, F. Ferrari, A. Berardi, L. Iughetti University of Modena and Reggio Emilia, Department Of Medical And Surgical Sciences Of The Mother, Children And Adults., Modena, Italy


Extra Uterine Growth Restriction (EUGR) is a comorbidity in very low birth weight (VLBW). Aim of the study was to assess how postnatal early growth patterns may affect later growth and neurodevelopment.

Methods:

Retrospective single-centre study of 547 infants (255M) born VLBW between 2005 and 2015. Each participant underwent: a) assessments of weight (W), length (L) and head circumference (HC) at birth, at discharge and at 2 years; b) Evaluation of Fidgety movements (F) at three months; c) Neurodevelopmental assessment at 2 years through the Griffith Mental Development Scales.

Results:

Growth percentiles at discharge were significantly lower than at birth (L:p<0.01; W:p<0.01; HC:p< 0.01). Longitudinal data showed a significant growth restriction between birth(AGA for W:73%; AGA for L:73.2%) and discharge(AGA for W:36%; AGA for L:31.2%). Gestational age, duration of hospitalisation, bronchopulmonary dysplasia and intra ventricular haemorrhage were found to be independent predictive factors for EUGR at discharge. At 2 years, SGA at discharge but not at birth, showed significantly lower stature compared to the AGA ones (p:0.04). The percentage of SGA at discharge was influenced by nutritional intakes of proteins and lipids during the recovery. Significant correlation was found between F and L(p:0.04; r:0.12) and HC at discharge(p<0.02; r:0.2), but not at birth. W and L at discharge, but not at birth, were significantly related to worse locomotor outcome at two years (respectively, p:0.03, r:0.14; p:0.01, r:0.18).

Conclusions:

VLBW growth measurements at discharge, but not at birth, are related to poorer growth and neurodevelopment at later ages, especially in children who become SGA.

347 / #268


THE MICROBIOLOGICAL SAFETY OF MATERNAL AND DONOR MILK: ESTIMATION OF HUMAN MILK BANK TECHNOLOGY IN RUSSIA

O. Lukoyanova1, T. Borovik1,2, T. Potekhina3,4, A. Lazareva1,3, O. Kryzhanovskaya3, G. Yatsyk5 1National Medical Research Center for Children's Health, Nutrition Department, Moscow, Russian Federation, 2I.M. Sechenov The First Moscow State, Pediatric Department, Moscow, Russian Federation, 3National Medical Research Center for Children's Health, Nutrition Department, moscow, Russian Federation, 4National Medical Research Center for Children's Health, Neonatology Department, Moscow, Russian Federation, 5National Medical Research Center for Children's Health, Neonatology Department, moscow, Russian Federation


The aim was to estimate the effect of storage duration at varying temperature ranges, the pattern of microbial isolates and the quantity of colony-forming units (CFU) in expressed maternal and donor breast milk.

Methods:

Eight hundred forty breast milk samples were obtained from 120 mothers. Fresh milk samples were cultured for bacteria immediately after collection, after stored in a room temperature for 3 hours (+23°C), after refrigerator storage for 24 hours (+4°C) and for 1 months (-18°C). Donor milk samples were assessed immediately after pasteurization and then after their refrigerator storage (-18°C) for 1 and 3 months.

The species identification of the microorganisms obtained was carried out on a MALDI-TOF-MS Biotyper MicroFlex mass spectrometer and in a VITEK canalizer.

Results:

In freshly expressed milk samples of 66% of women the microbial non-pathogens of skin flora were detected, There was no growth of microorganisms in stored breast milk after 3 hours (+23°C), 24 hours (+4°C) and 1 months (-18°C). The decrease the bacterial count and S.epidermidis growth during milk storage for 24 hours (+4°C) and a decrease S.epidermis growth in breast milk after 1 months storage (-18°C) were found (p = 0.033). After Holder pasteurization, a statistically significant decrease the bacterial count occurs. The absence of growth the bacterial count during donor milk storage at -18°C for 1 and 3 months is shown.

Conclusions:

Expressed breast milk can be given safely to infants within storage during 3 h (+23°C), 24 hours (+4°C) and 1 months (-18°C). Pasteurization makes the milk almost sterile.

348 / #420


THE USE OF NEONATAL TSH AS A CRITERION OF IODINE DEFICIENCY IN THE REGION

O. Makarova, L. Suplotova Tyumen State Medical University, Endocrinology Course Of The Department Of Therapy, Tyumen, Russian Federation


Iodine deficiency is relevant due to the high prevalence and negative impact on health.

The aim is to evaluate the criterion of neonatal hyperthyrotropinemia to assess the severity of iodine deficiency in the region.

Methods:

We analyzed the results of biomedical monitoring since 1994 (the frequency of goiter in schoolchildren and the median of ioduria). Also we analyzed parameters of neonatal thyroid-stimulating hormone (TSH), determined by screening for congenital hypothyroidism for the period from 1997 to 2017. The study of neonatal TSH was performed by two-way fluorometric immuno ferment assay using the reagents "Delphia neonatal TSH", DELFIA (WALLAC, Finland).

Results:

The iodine deficiency prevention program in Tyumen region was started in 1997. The level of neonatal hyperthyrotropinemia more 5 mU/l decreased from 44.7% in 1995 to 3.9% in 2017 (p =0.001), which generally characterizes the region as a territory with a mild iodine deficiency. In addition, the level of neonatal TSH more 20 mU/l decreased from 2.4% in 1994 to 0.26% in 2017 (p=0,001).

Is established statistically significant high-positive connection (r = 0.94, p less 0.05) between neonatal hyperthyrotropinemia more 5 mU/l and the frequency of goiter among prepubertal children.

Conclusions:

Thus, the criterion of neonatal hyperthyrotropinemia more 5 mU/l can be consideredused both to evaluate the severity of ID in the region, and as a criterion for preventive programs monitoring in endemic areas, as an inexpensive, effective and mass indicator.

351 / #302


EFFECTS OF INTRAUTERINE EXPOSURE OF ADVANCED GLYCATION END-PRODUCTS ON FOETAL NEURONAL CELLS IN A DIABETIC MOTHER

A. Nakamura1, H. Okami2, M. Shimizu3, Y. Tokunaga1, S. Ooi1, Y. Sasaki4, R. Kawaharada3 1Jissen Women’s University, Department Of Food And Health Sciences, Hino, Japan, 2Tunoda Hospital, Department Of Nutrition, Gunma, Japan, 3Takasaki University of Health and Welfare, Department Of Health And Nutrition, Takasaki, Japan, 4Washington University School of Medicine, Department Of Genetics, St. Louis, United States of America


The incidence of Alzheimer-type dementia is higher in patients with diabetes. Excessive glycation of neuronal proteins by hyperglycaemia, which results in the formation of advanced glycation end-products (AGEs), is considered a risk factor for Alzheimer-type dementia. Intrauterine hyperglycaemia during pregnancy has various effects on foetal development. Therefore, we examined the effect of excessive glycation in foetal neuronal cells by intrauterine hyperglycaemic environment on foetal brain development.

Methods:

We analysed the AGEs and Akt signalling of neuronal cells in the infants of diabetic mother (IDM) rat with anti-phospho-Akt antibody and anti-AGEs antibody by western blotting. Additionally, we examined the effects of high glucose culture medium on the rat PC12 cells. Apoptosis of rat PC-12 cells was detected by assessing the caspase activity with anti-caspase 3 antibody.

Results:

In the brains of IDMs, AGEs were 1.3 times higher than that in controls, whereas Akt phosphorylation was 0.78 times lower. The AGEs of PC-12 cells cultured in high-glucose medium was 3.3 times higher and Akt phosphorylation was 0.59 times lower than that in cells cultured in low-glucose medium. Furthermore, high glucose medium enhanced rat PC12 cell apoptosis.

Conclusions:

We have shown that the intrauterine hyperglycaemia promotes excessive protein glycation in neonatal neuronal cells and may be more likely to degenerate neuronal protein, and possibly linked to increased long-term risk of Alzheimer's disease. Furthermore, we would like to clarify the detailed cell signaling of neuronal cell death induced by AGEs.

352 / #349


IRON-FOLATE SUPPLEMENTATION COVERAGE AMONG PREGNANT WOMEN IN FEDERAL CAPITAL TERRITORY, ABUJA NIGERIA

C. Okoro1, A. Maduforo2 1Nutrition Section, Federal Capital Territory Primary Health Care Board, Abuja, Nigeria, Nutrition, Abuja, Nigeria, 2University of Nigeria Nsukka, Department Of Nutrition And Dietetics, Nsukka, Nigeria


Pregnant women in the Federal Capital Territory (FCT) Nigeria receive iron and folic acid supplements routinely in the health facilities during antenatal. However, these supplements are mainly given to pregnant women during the biannual maternal newborn and child health week (MNCHW). However, there are women that receive these supplements but do not adhere with the intake, while some avoid it completely. Some of them do not know the reasons for the supplements as well. This study determined iron-folate supplementation coverage in FCT, the knowledge of the women and the benefits of the supplements.

Methods:

Cross-sectional survey design was employed. Cluster random sampling technique was used to sample 30 households in 30 communities (5 communities in each area council) in the six Area council of FCT. A total of 849 respondents was sampled. A validated questionnaire was used to elicit information from the respondents. The date was analysed using descriptive statistics (frequencies and percentage).

Results:

The result of the survey showed that 91.4% of the respondents received iron and folate supplements, while 6.6% did not receive. The site majority (56%) received their supplements was at Primary Health Centre. This study also showed the 251 respondents out of 849 did not know the benefits of iron-folate supplementations, only 73 (8.6%) knew that it could prevent birth defects and just 5.8% (49) knew that it could reduce death.

Conclusions:

There is high coverage of iron-folate supplements in FCT, PHCs are the major supplementation site but the knowledge on the various benefits of these supplements are low.

353 / #178


FACTORS ASSOCIATED WITH BREASTFEEDING VLBW INFANTS AT NICU DISCHARGE - A BRAZILIAN EXPERIENCE

M. Oliveira, D. Volkmer Hospital Moinhos de Vento, Neonatology, Porto Alegre, Brazil


Human milk is the preferred feeding for preterm infants. Very low birth weight infants face many challenges to achieve breastfeeding at hospital discharge, especially during long lengths of stay. The aim of this study is to address which factors are associated with breastfeeding rates (exclusive or with formula) at discharge for very low birth weight infants, in a private tertiary level Neonatal Intensive Care Unit (NICU) in southern Brazil.

Methods:

A prospective cohort of infants with VLBW and/or less than 30 weeks gestational age, who survived to NICU discharge and had no contraindication to mother’s own milk (MOM) was conducted. All maternal and infant demographic and medical data were prospectively collected by two independent neonatologists, following definitions of the Vermont-Oxford Network database.

Results:

Of 343 infants included, 93% were breastfed at discharge, of which 16% were receiving exclusive MOM and 77% mixed feeding (MOM and formula). Breastfeeding was associated with being born singleton, with gestational age ≥ 28 weeks, higher birth weight and not presenting sepsis or bronchopulmonary dysplasia (BPD) during NICU stay. These infants also had shorter lengths of stay and lower weight at discharge. Multiple regression was not possible because of the small number of babies not receiving MOM (6,5%).

Conclusions:

Despite their clinical characteristics, most VLBW were being breastfed at discharge. Special strategies should be developed to babies with lower birth weight and gestational age, twins, and those who develop DBP and sepsis during NICU stay. Mothers at risk can be identified for more successful interventions for improving breastfeeding.

354 / #501


GROWTH OUTCOMES IN MODERATE AND LATE PRETERMS DURING HOSPITAL STAY AND THE FIRST YEAR OF LIFE AFTER DISCHARGE. EXPERIENCE IN A TERCIARY HOSPITAL.

M.T. Pastor-Fajardo1, B. Calero Cerqueira1, V. Bosch-Giménez2, M. Cidrás Pidre1, J. Pastor-Rosado3 1Hospital Clínico Universitario Virgen de La Arrixaca, Paediatrics, Murcia, Spain, 2Universidad de Murcia, Paediatrics, Murcia, Spain, 3Hospital General Universitario de Elche, Paediatrics, Elche, Spain


During the first year of life, poor growth or rapid weight gain have a great impact on the future development of moderate-late premature infants. The aim is to study growth outcomes of moderate-late preterms admitted in a neonatal unit in a tertiary centre during their hospital stay and the first year of life after discharge.

Methods:

Retrospective study of 85 premature infants born between 32+0 and 36+6 weeks of gestational age (GA) without any medical or surgical complications admitted to our neonatal unit during 2018. Growth outcomes (weight and length) were analysed during hospital stay and after discharge at 2, 4, 6 and 11 months. We used Intergrowth-21st and WHO reference values. Catch-down was defined as ΔZ-score weight <-0,67SD and catch-up as ΔZ-score weight >+0,67DS.

Results:

GA at birth was 33±1,2 weeks and birth weight 2050±400g. There were significant differences between moderate and late preterms during hospital stay, which disappeared after discharge. During the first two weeks of admission, growth velocity was 9,09 g/Kg/d, below growth velocity goal, and there were 23% infants with catch-down, despite receiving an adequate energy intake. After discharge, half of the infants had achieved catch-up at 2 months, quantity that remained over time up until 11 months.

Conclusions:

Our results show that the most critical period in this preterms growth takes place during the first two weeks of life. After discharge, growth rates notably improve.

355 / #428


IMPACT OF HUMAN MILK ON CARE AND LENGTH OF STAY IN VERY LOW BIRTH WEIGHT INFANTS

M. Perrone1, D. Mallardi1, C. Tabasso1, P. Piemontese1, N. Liotto1, C. Menis1,2, P. Roggero1,2, F. Mosca1,2 1Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Milan, Italy, 2University of Milan, Department Of Clinical Sciences And Community Health, Milan, Italy


Human milk is mainly beneficial for preterm infants. When own mother milk is not available or insufficient, donor human milk should be used. The aim of this study was to evaluate the impact of any human milk (fresh mother milk/donor human milk) on care and length of stay in very low birth weight (VLBW) infants.

Methods:

284 VLBW infants born consecutively at author’s Institution from April 2016 to April 2019 were enrolled. For each infant, we calculated intakes and the percentage of any human milk. Time to achieve full enteral feeding (FEF), duration of parenteral nutrition (PN) and length of hospital stay (HS) were obtained from the computed medical charts. A linear regression was conducted to evaluate the association of the percentage of any human milk (any-HM) with FEF, PN and HS.

Results:

The basic characteristics of 231 out of 284 infants study were analyzed. Birth weight 1173.93±262.47 g, GA 30.06±2.47 weeks, PN 24.41±14.63 days, HS 62.35±32.16 days. For each 10% of any-HM, we found a reduction of the time to achieve FEF (-1.2 days, -177.87 cumulative days, p<0.0001), duration of PN(-0.71days, -164.01 cumulative days, p=0.015), length of HS (-1.97days,-455.07 cumulative days, p<0.0001).

Conclusions:

The amount of any-HM influences positively the course of hospitalization. The improvement of care in these vulnerable infants may provide reduction of hospital costs and evidence for additional lactation support in NICUs.

356 / #564


NEONATAL DEATHS IN INDIA: DOES POSTNATAL CARE MATTER?

D. Phukan International Institute for population Sciences, Department Of Public Health And Mortality Studies, MUMBAI, India


Globally, more than four million infant deaths occurred within the first year of life. In India, 2.7 million deaths, or roughly 45% of all under-five deaths, occur during the neonatal period. Of these, almost 1 million neonatal deaths occur on the day of birth, and close to 2 million dies in the first week of life. The apprehension of the present study is to analyze the impact of postnatal care on neonatal deaths among the developing states of India.

Methods:

For the underlined study, information on 85,146 live births was analyzed using unit data of the District Level Household & Facility Survey (DLHS-4). Cox Proportional Hazards model was performed to analyze the association between postnatal care and neonatal mortality.

Results:

The findings suggest that more than two-thirds (70%) of infant deaths occur within the first month of life and it is clear that the rate of decrement in IMR is higher than that of NNM and PNM. Moreover, rural have shown a greater decline in NMR than in urban areas. There exists a substantial variation in neonatal deaths across regions. The cox estimate suggests the hazard decreased by half fold for neonatal mortality among newborns who had received post-natal check-up as compared to those who had not received a post-natal check-up.

Conclusions:

While postnatal care is one of the components of the continuum of delivery care and it is very much important to focus on that component to reduce the variation among states and to achieve the Sustainable Development Goals.

357 / #592


PREVENTING NEONATAL MORTALITY IN INDIA: THE ROLE OF CONSISTENT UTILIZATION OF MATERNAL HEALTH CARE SERVICES

D. Phukan International Institute for population Sciences, Department Of Public Health And Mortality Studies, MUMBAI, India


Academic discourse laid evidence on the impact of continuity of maternal health care and maternal delivery and child health outcomes. This paper examines the impact of consistent utilization of maternal health care programs on neonatal deaths in India.

Methods:

Binary Logistic Regression Model has been performed to analyze the respective objective by using India Human Development Survey-II (IHDS-II), 2011-12 dataset.

Results:

Binary Logistic Regression suggests that if a mother consistently received 100 or more IFA tablets, two or more TT injections and her babies received postnatal care then the neonates were 46 percent (OR 0.54; 95% CI 0.33,0.88) less likely to die than those mothers who have not received all the above mention services consistently. The risk of neonatal mortality decrements by half fold (OR 0.50; 95% CI 0.37,0.66) among new-born who had received post-natal check-up; compared to those who had not received a post-natal check-up.

Conclusions:

So, the present study indorses to efforts should be made to strengthen and consistently use the maternal health care delivery system. Findings shall strengthen policymakers in fulfilling Indians committed to achieving Sustainable development goals in reduce neonatal mortality.

358 / #218


COMPARISON BETWEEN CALF AND MID-UPPER ARM CIRCUMFERENCE AS SURROGATE OF BIRTHWEIGHT

W.K.Y. Putra, K. Kusharisupeni, I. Fajarini Faculty of Public Health, Universitas Indonesia, Public Health Nutrition, Depok, West Java, Indonesia


The high proportion of unmeasured birth weight as well as its improper documentation has been a problem in developing countries, including Indonesia. In 2017, a total of 9.9% labours weren’t assisted by health personnel and 43.4% of newborns did not have proper birth records. This condition increases the possibility of undetected low birth weight (LBW) cases. Therefore, this study aimed to determine a surrogate measurement of birth weight which able to detect LBW.

Methods:

The study used cross sectional approach to analyse birth records from a maternity clinic. A total of 100 records met the inclusion criteria such as has complete record of birth weight, calf circumference and mid-upper arm circumference (MUAC) which were measured within the first 24 hours of birth. The data was analysed using correlation test, area under curve (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and likelihood ratio.

Results:

The result showed that calf circumference and MUAC were significantly correlated with birth weight (p <0.001) with r value 0.529 and 0.674 respectively. At cut-off value 10.62 cm, calf circumference had AUC 0.90, sensitivity 66.7%, specificity 97.9%, PPV 8.2%, NPV 98.2%., likelihood ratio (+) 31.7 and likelihood ratio (-) 0.03.

Conclusions:

Calf circumference had better performance as surrogate measurement of birth weight to detect LBW compared to MUAC.

359 / #613


INCREASED RISK FOR HYPERTRIGLYCERIDEMIA IN SMALL FOR GESTATIONAL AGE PRETERM INFANTS

S. Rabinowicz1, O. Levkovitz2, T. Strauss2 1Safra Children's Hospital, Deparetment Of Pediatrics A, Tel Hashomer, Israel, 2Safra Children's Hospital, Department Of Neonatology, Tel Hashomer, Israel


Lipid emulsions are a source of energy and an essential component of cell membranes and the central nervous system. As such, they are part of routine care of preterm infants. Small-for-gestational-age (SGA) preterm infants may have abnormal metabolism, and be at increased risk for future metabolic syndrome. Our aims were to evaluate whether SGA infants are at increased risk for hypertriglyceridemia during treatment with lipid emulsions compared to similarly treated appropriate-for-gestational-age (AGA) preterm infants, and to investigate the association between hypertriglyceridemia and short-term neonatal morbidities

Methods:

This retrospective analysis of infants born ≤34 weeks’ gestation was performed at a single medical center in 2013-2016. SGA infants were matched to AGA infants based on GA. All of these preterm infants were treated by parenteral nutrition. Plasma triglyceride (TG) concentration was routinely measured around the 4th day of life, and TG levels >250 mg/dL were considered high

Results:

Each group included 71 infants. Hypertriglyceridemia was documented among 22.5% of the small for gestational age infants vs. 5.6% of the appropriate for gestational age infants (p = 0.007). Mean triglyceride levels were 194.4±192.3 mg/dL and 99.9±82.8 mg/dL, respectively (p < 0.001). Small for gestational age was predictive of hypertriglyceridemia (OR = 8.71; 95% CI 2.1-36.2). No significant association was found between triglyceride levels and morbidities in multivariate analysis.

Conclusions:

Small for gestational age preterm infants are at higher risk for hypertriglyceridemia. Tailored nutritional strategies may be required.

360 / #457


EXCLUSIVELY HUMAN MILK-BASED NUTRITION FOR EXTREMELY LOW BIRTH WEIGHT NEWBORNS- SINGLE -CENTER DATA

V. Samedi1, W. Bingham2, S. Daspal1, K. Kalaniti1, N. Mugarab-Samedi3 1Royal University Hospital, Pediatrics, CALGARY, Canada, 2Royal University Hospital, Pediatrics, Saskatoon, Canada, 3University OF Calgary, Library, CALGARY, Canada


A successful outcome of prematurity strongly depends on nutrition, especially for extremely low birth weight (ELBW) newborns. Appropriate (quantitative and qualitative) dietary intake could prevent growth failure and support a better auxological and neurodevelopmental outcome. Human milk (HM) alone may not be sufficient for optimal growth, and bovine-based fortifiers (BBF) were traditionally used for preterm babies in the NICU to supplement deficits in calories, proteins, and minerals.

Methods:

Chart reviews were conducted in 15 infants on HM-HMF aiming to evaluate feeding tolerance and linear growth. Feeding tolerance was assessed by calculating the total days NPO, duration of TPN use and the number of abdominal X-rays for suspected NEC. To measure linear growth we used Fenton charts for length and head circumference (percentile and Z-score) at 32 and 36 weeks of corrected gestational age. Collected data were compared with similar values from a cohort of 15 infants of similar gestation who received BBF in the past (retrospective data).

Results: HM-HMF (n=15) BBF (n=15) Plevel

GAwk , mean(SD) 26.1(1.9) 26.4(1.2) P=0.6092

BWg, mean(SD) 766.8(121.7) 819 (136.2) P=0.2778

NPOdays 3.4 (2.7) 12.4 (3.9) P=0.0001

TPNdays 15.5 (4.03) 20.2 (5.8) P=0.0155

AXR 4.4 (1.89) 8.8 (1.3) P=0.0001

Conclusions:

Our observations showed that not only growth rate but also linear growth is improving in the infants on HM-HMF. These infants were more successful in achieving full feeds and required fewer abdominal X-rays for suspected feeding intolerance. All 15 infants who received HM-HMF had significantly less days of prolonged TPN and days of NPO compared to their historical cohort.

362 / #316


INDICATORS OF VITAMIN D AND PRO-INFLAMMATORY CYTOKINES IN NEWBORNS WITH DIABETIC FETOPATHY

N. Verisokina1, V. Kuryaninova1, L. Klimov1, I. Zakharova2, L. Alaverdyan1, T. Zeleznyakova1, M. Petrosyan1 1Stavropol State Medical University, Pediatrics, Stavropol, Russian Federation, 2Russian Medical Academy Continuing Postgraduate Study, Pediatrics, Moscow, Russian Federation


to analyze the status of vitamin (VD) and pro-inflammatory cytokines (PiC) IL-1β, IL-6 in the blood serum of newborns with DF.

Methods:

during the 3 of life, a laboratory examination of 68 newborns was performed, 32(47.1%) of the children were born from mothers with endocrine disorders and had clinical signs of DF, 36(52.9%) of the newborns were included in the control group

Results:

in the group with DF, 19(59.4%) children were born from women type 1 diabetes mellitus, 7(21.9%) women gestational diabetes mellitus (GDM), 6(18, 7%) mothers GDM on the background of obesity; 29(90.6%) babies were born full-term, 3 (9.4%) were premature babies. The body weight of newborns with DF 4050 [3445–4380]gr, which is significantly higher than in the control group 3350 [3060–3785]gr (p <0.001). In children with DF, the level VD 7.0 [4.4–10.1]ng/ml, in the control group 14.0 [8.2–22, 1]ng/ml (p <0.01), while the level of PiC was significantly higher than in the control group IL-1β 46.1 [13.9–86.6]pg/ml vs. 5.4 [1.8–27.7]pg/ml (p <0.01), IL-6 77.5 [33.6–218.2]pg/ml, 18.2 [5.1–54, 3]pg/ml (p <0.01), respectively. Severe vitamin D deficiency (calcidiol level less than 10ng/ml) in the DF and control groups was found in 24(75%), 13(36.1%) newborns, deficiency (10-20ng/ml) 3(9.4%), 12(33.3%), insufficiency 2(6.3%), 7(19.4%), normal levels 3 (9.4%), 4 (11.1%).

Conclusions:

Newborns with DF had significantly lower levels of VD and significantly higher levels of IL-1β and IL-6, which can be an unfavorable predictor of the course of infectious and inflammatory diseases in the neonatal period, and which requires targeted postnatal hypovitaminosis D prophylaxis

363 / #361


INFLUENCE OF SELECTED HORMONES LEVELS ON THE ONTOGENETIC DEVELOPMENT OF CHILDREN

Z. Chęcińska-Maciejewska1, M. Warchoł1, M. Wojciechowska2, H. Krauss3 1Poznan University of Medical Sciences, Department Of Physiology, Poznań, Poland, 2Poznan University of Medical Sciences, Department Of Mother And Child Health), Poznań, Poland, 3the President Stanisław Wojciechowski State University of Applied Sciences in Kalisz, Department Of Medicina, Kalisz, Poland


There is much ongoing research to clarify the mechanisms controlling intrauterine human development. The results of several studies suggest that growth hormone (GH), insulin-like growth factors (IGF) and insulin affect the growth and development of the fetus and also synthesis and secretion of hormones that regulate appetite, i.e. leptin and ghrelin. The aim of this study was to evaluate the concentration of GH, IGFBP3, IGF-1, insulin, ghrelin, and leptin in cord blood and to determine the relationship between the concentrations of these hormones and parameters of the infants with too low and too high birth weight.

Methods:

The study included 52 healthy newborns with low and high birth weight (19 infants with birth weight <2500g and 33 with weight >4000g). Concentrations of GH, IGFBP3, IGF-1, insulin, ghrelin, and leptin in cord serum were measured, by the ELISA method.

Results:

In neonates with birth weight less than 2500g, a positive correlation (rs=0,80; p=0,01) between birth weight and leptin levels in cord blood was demonstrated. There was a positive correlation (rs=0.82, p=0.01) between head circumference and ghrelin level in cord blood. Insulin levels correlated positively (r=0.95, p=0.04) with the chest circumference. Abdominal circumference correlated negatively (rs=-0.69, p=0.03) with the concentration of growth hormone, and no other correlations were observed. The statistically significant negative correlation (rs=-0.76, p=0.02) of arm circumference with GH was investigated.

Conclusions:

Newborn babies with low birth weight were characterized by intensified secretion of GH and reduced concentration of leptin. Head circumference in this group showed negative correlations with ghrelin levels.

364 / #495


EPIDEMIOLOGICAL ANALYSIS OF PATIENTS IN NICU OF MURATSAN UHC DURING JANUARY-JUNE 2017, YEREVAN, RA *** ABSTRACT WITHDRAWN AT AUTHOR REQUEST**

S. Zadoyan1, L. Martirosyan2, S. Adamyan1, S. Arakelyan3, M. Melkonyan4, G. Beglaryan5, M. Grigoryan4, M. Sargsyan6, B. Baveyan7, V. Asoyan2, H. Apresyan2 1Yerevan State Medical University after Mkhitar Heratsi, Radiology, Yerevan, Armenia, 2Yerevan State Medical University after Mkhitar Heratsi, Infectious Diseases, Yerevan, Armenia, 3Yerevan State Medical University after Mkhitar Heratsi, Neurology, Yerevan, Armenia, 4Yerevan State Medical University after Mkhitar Heratsi, Internal Medicine, Yerevan, Armenia, 5Yerevan State Medical University after Mkhitar Heratsi, Plastic, Reconstructive And Aesthetic Surgery, Yerevan, Armenia, 6Yerevan State Medical University after Mkhitar Heratsi, Intensive Care Medicine, Yerevan, Armenia, 7Muratsan University Hospital Complex, Pediatrics, Yerevan, Armenia


Newborns who need intensive medical care are put in a neonatal intensive care unit (NICU). The NICU has advanced technology and trained healthcare professionals to give special care. The NICU of Muratsan University Hospital is Republican Centre and founded in 1997. Our purpose is to analyze the main characteristic of hospitalized neonates during 01.01.2017-01.01.2017.

Methods:

A randomized retrospective study included 133 medical charts. Exclusion criteria was cases with lethal outcome.

Results:

During aforementioned period 300patients were admitted from which 33 patients died. Out of 133 patients 77(57.9%) was male and 56(42.1%) was female. The mean hospital stay was 15.7days(min-1, max-64). The vast majority of patients (91%) discharged with recovery and other 9% was transferred to other clinics. The distribution by provinces: Gegharkunik-22, Kotayk-20, Ararat-17, Lori-13, Syunik-10, Tavush-10, Aragatsotn-9, Armavir-4, Shirak-3, Vayots Dzor-3. There were 71(53.3%) patients from cities, 22(31%) of them from capital city Yerevan and others(46.7%) from villages. The most frequent diagnosis was pneumonia (87cases), further ones were bronchiolitis(14) and hemolytic disease of the newborn(7). We didn’t find any information in medical charts about vaccination for HBV and TB which should be done according National Vaccination Program.

Conclusions:

We concluded that male-to-female ratio of morbidity was 1.4:1. The highest numbers of patients were from Yerevan(22 per 1.01milion population), and Gegharkunik(22 per 235000) which is explained by

presence of NICUs adjacent to the Maternity Homes in Yerevan and absence of specialized centers in Gegharkunik. The deficiency of neonatologists is a rising problem in Armenia.

365 / #611


THE CONSEQUENCES IN DIFFERENT TYPES OF FEEDING FOR THE PREMATURES

G. Zaharie1, L. Blaga1, M. Hasmasanu1, T. Zaharie2, T. Drugan3, F. Zaharie1, M. Vintan4, M. Matyas1 1UNIVERSITY of MEDICINE and PHARMACY "IULIU HATIEGANU", Neonatology, CLUJ-NAPOCA, Romania, 2Regional Institut Of Gastro-Enterology and Hepathology, Pathology, CLUJ-NAPOCA, Romania, 3UNIVERSITY of MEDICINE and PHARMACY '' IULIU HATIEGANU", Biostatistics, CLUJ-NAPOCA, Romania, 4UNIVERSITY of MEDICINE and PHARMACY '' IULIU HATIEGANU", Neurology And Paediatric Neurology, CLUJ-NAPOCA, Romania


High risk newborns are often much smaller than healthy infants when are discharged from hospital. Different types of feeding can influence growth rates and improve development.The aims of the study were to evaluate the catch–up rate and some biological parameters of the nutritional status such as: hemoglobine, iron, calcium, phosphor, magnesium, protein at differents ages : 1-2-4-6 months in different types of nutrition - breastmilk, special formula for premature , started formula.

Methods:

A retrospective study was performed in a III rd level unit between 2015–2017 in the County Hospital of Cluj, Romania on 383 infants in the follow-up program: 465 records. We divided into 3 categories:group I-VG ≤32, group II-VG 32-36 and group III-VG ≥36 weeks of gestation. Each evaluation consisted of: weight, CBC, calcium, iron, magnesium, protein, Blood Urea Nitrogen (BUN) levels.Informed consent was obtained.

Results:

Growth rate up to 6 months wasn‘t influenced by the type of feeding (p= 0.319).Hemoglobine at 2 months is statistically higher in formula fed group:11.77±2.07g vs premature formula fed group:10.848 ±1,7556g(p=0.008).Is a significant decrease of Fe levels with age in the breastfed ones,r = -0.89. Ca-emia was codependent to types of feeding (p=0.003). Protein in ≤32 weeks is influenced by the type of feeding p=0.024.Phosphatemia influenced by the type of feeding in group II(p=0.043).

Conclusions:

Weight gain at premature <= 32 SS isn't influenced by the type of feeding up to 6 months.The level of protein in group I is influenced by the type of feeding Fe drops with age in breastfedgroup

366 / #44


RISK OF FEEDING INTOLERANCE AMONG NEWBORNS ADMITTED TO A MATERNITY HOSPITAL IN AN URBAN POOR SETTING.

T. Zerfu APHRC, Mcw, Nairobi, Ethiopia


Evidence on burden and factors associated with feeding intolerance (FI) among new-borns is hardly available in resource limited settings. We aimed to determine the incidence and predictors of FI among hospitalised new-borns in maternity hospital serving the urban poor.

Methods:

We enrolled and followed 123 eligible neonates at the New Born Unit (NBU) of Pumwani Maternity Hospital, Kenya. Data were analysed using STATA-15 statistical software. Potential predictors from maternal, child and feeding characteristics were fitted using modified Poisson regression model

Results:

The incidence rate for FI was 13.6%. Neonates with normal birth weight and improving Apgar score had a 76% and 85% (RR, 0.24 and 0.15; C.I: 0.09-0.63 and 0.04, 0.51) less risk of experiencing FI compared to low birth weight (LBW) and deteriorating/stagnant Apgar score, respectively. Conversely, babies who were hospitalised for five or more days and without kangaroo mother care (KMC) experienced double to triple (RR, 2.06 and 2.75; C.I:1.26 -7.44 and 1.06 – 7.15) elevated risk of FI compared to new-borns with a shorter hospitalisation and KMC services.

Conclusions:

Incidence of feeding intolerance was high and predicted by new-born’s birth weight, Apgar score, duration of hospitalisation and KMC services.

368 / #326


CORRELATION OF MATERNAL SERUM TOCOPHEROL LEVELS AND PLACENTAL WEIGHT WITH INFANT GROWTH OUTCOMES

P. Evans1, C. Hanson2, M. Thompson1, M. Van Ormer1, M. Thoene1, M. Enmeier1, A. Freeman1, A. Morozov1, J. Furtado3, A. Anderson-Berry1 1University of Nebraska Medical Center, Pediatrics, Omaha, United States of America, 2University of Nebraska Medical Center, Medical Nutrition Education, Omaha, United States of America, 3Harvard School of Public Health, Nutrition, Boston, United States of America


Vitamin E exists in three isoforms, each having different health roles: alpha (α)-tocopherol is anti-inflammatory, gamma (γ)-tocopherol is proinflammatory, little known about delta (δ)-tocopherol. As inflammation may affect placental function, the aim of this study is to examine relationships between maternal serum tocopherol levels and placental weight with infant growth outcomes.

Methods:

An IRB-approved study enrolled mother-infant dyads (n=342) at time of delivery (Omaha, NE, USA) for collection of birth data, placental weight, and maternal blood. High-performance liquid chromatography analyzed serum tocopherol levels. Fenton growth percentiles for birth weight, length, and head circumference were divided into groups: 1) top 20th%, 2) 20-80th%, 3) bottom 20th%. Nonparametric correlation testing compared nutrient levels with placental weight. Kruskal-Wallis and Mann-Whitney U test compared placental weight with growth groups. P-value <0.05 was significant.

Results:

Mean birth outcomes: 38 1/7 weeks gestation, weight 2922 grams, head circumference 33 centimeters (cm), length 47 cm, placental weight 473 grams. Placental weight approached significance in correlation with maternal serum α-tocopherol levels only (r=0.163, p=0.063). There was a significant difference in placental weights between growth percentile groups for weight (p<0.001), length (p=0.009), and head circumference (p=0.006). Placental weight in group 1 vs. 2 and group 2 vs. 3 was significantly higher across all anthropometric measurements.

Conclusions:

Maternal α-tocopherol level may have perinatal implications related to placental weight. Placental weight significantly impacts anthropometric growth percentiles for infants at birth. More research is needed to specifically identify how individual tocopherol isoforms impact perinatal health.

369 / #698


FEEDING PATHWAY TO IMPROVE WAZ FOR NEONATES FOLLOWING CARDIAC SURGERY

B. Medoff Cooper1, A.J. Lisanti2, M. Sovoca2, S. Irving2, M. Mascarenhas3, W. Gaynor2, A. Costarino2 1The Children's Hospital of Philadelphia, Research Institute, Philadelphia, United States of America, 2The Children's Hospital of Philadelphia, Cardiac Center, Philadelphia, United States of America, 3The Children's Hospial of Philadelphia, Gastroenterology, philadelphia, United States of America


Background and Aims: Growth failure is common in infants requiring neonatal cardiac surgery for congenital heart disease (CHD). This study evaluated patient outcomes before, during and after implementation of a feeding pathway was introduced in th CICU.

Methods:

A retrospective cohort study examined all infants hospitalized for neonatal cardiac surgery over ten years from 2009 through the end of 2018 (n=997). Infants were included if they were ≥37 weeks gestation, ≥2 kg birth weight, and underwent cardiac surgery for CHD ≤30 days of age. . Using the best linear unbiased predictions (BLUP) in the mixed effects model, WAZ change over HLOS was estimated before and after 2013 with adjustment of patient characteristics including gender, race, HLOS, and Clancy category.

Results:

Change in WAZ over HLOS in 2013-2018 was significantly higher than those in 2009-2012 (β(SE)=0.16 (0.02), p<.001) after controlling for gender, race, hospital length of stay, and Clancy category, indicating that infants experienced decreased WAZ loss over HLOS after 2013, potentially due to pathway implementation. Significant differences in WAZ loss over HLOS was found between infants with single ventricle CHD (β(SE)=0.26 (0.04), p<.001) and those with two ventricle CHD (β(SE)=0.04 (0.02), p=0.04).

Conclusions:

These data suggest an organized approach for nutrition therapy through a standardized pathway improves growth outcomes prior to hospital discharge for infants with single and two ventricles who require neonatal cardiac surgery. The findings from this study provide additional evidence to the growing body of research supporting the use of nutrition pathways to guide the clinical care.

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FACTORS ASSOCIATED WITH BREASTFEEDING PRETERM INFANTS, ACCORDING TO BRAZILIAN MOTHERS' PERCEPTION

M. Oliveira, M.K. Schierholt, A. Hennemann, B. Uhry Federal University of Health Sciences of Porto Alegre, Paediatrics, Porto Alegre, RS, Brazil


Human milk is the first choice to feed preterm infants. Mothers face many challenges to maintain breastfeeding during the NICU stay. Support from staff is an important factor to achieve this goal. The aim of this research was to investigate preterm mothers' perception of breastfeeding support during the hospital stay and their association with breastfeeding at the NICU and at discharge.

Methods:

A cross-sectional study was conducted, including mothers of preterm (<37 weeks) infants who followed a prematurity Brazilian blog and agreed to answer a questionnaire online. Factors associated with breastfeeding during NICU and at discharge were described. Multivariable analysis was performed.

Results:

Of 479 questionnaires answered, 360 (74.2%) were born < 32 weeks gestational age, 372 (76.7%) were breastfed during the NICU stay and 362 (74.6%) were being breastfed at discharge. Being breastfed during NICU stay was associated with being born in a private hospital, higher gestational age, birth weight, and mothers' education. Multivariable analysis showed that receiving staff support doubled the chance of being breastfed during the NICU stay (PR=1.98; CI 95% 1.39-2.81; p<0.001). Receiving breastfeeding support during NICU stay was the only factor associated with breastfeeding at discharge (p<0.001).

Conclusions:

Mothers must feel supported by NICU staff to maintain breastfeeding until discharge. Factors associated with breastfeeding success must be known by each NICU, so a personalized, patient-centered support program can be developed.

372 / #727


HIGH INCIDENCE OF EXTRAUTERINE GROWTH RESTRICTION AT DISCHARGE DESPITE ADEQUATE WEIGHT GAIN AMONG VERY LOW BIRTH WEIGHT (VLBW) SURVIVORS

W. Iskandar, R. Rohsiswatmo, K. Yuliarti Faculty of Medicine Universitas Indonesia/Cipto Mangunkusumo Hospital, Department Of Child Health, Jakarta, Indonesia


An adapted aggressive nutritional care was developed for very low birth weight (<1,500 grams) infants with target weight gain of minimum 15 g/kg/day. We aimed to evaluate the incidence of extrauterine growth restriction (EUGR) at discharge among VLBW survivors.

Methods:

A prospective cohort study was conducted in a national referral hospital since July 2018 until June 2019. Subjects were live-born infants with birth weight <1,500 grams irrespective of gestational age. Infants with inborn errors of metabolism, genetic abnormalities, and major congenital malformation were excluded. Weekly anthropometric data and complications were recorded. EUGR was defined as weight at discharge less than 10th percentile of Fenton 2013 chart.

Results:

Among 94 very low birth weight (VLBW) infants, 29 (30.9%) were small-for-gestational-age (SGA). The survival rate at discharge was 37.2%, while the number decreased to merely 5.1% among extremely low birth weight (ELBW) infants. The median length of stay was 40 (21 to 89) days until discharge. Median time to start enteral feeding, reach full enteral feeding, and duration of total parenteral nutrition were 2, 10, and 7 days, respectively. Mean weight gain was 16.7 (SD 4.84) g/kg/day, while EUGR incidence was 66%.

Conclusions:

The aggressive nutrition guideline achieved higher than target weight gain at discharge among VLBW survivors. However, we found high incidence of EUGR, which means targeting weight gain at discharge is not enough to prevent EUGR. This might be due to high proportion of SGA infants, which have been affected by medical problems in utero or postponed delivery.

373 / #728


BIOCHEMICAL COMPLICATIONS FOLLOWING AGGRESSIVE NUTRITIONAL CARE AMONG VERY PRETERM OR VERY LOW BIRTH WEIGHT INFANTS: A REPORT FROM A NATIONAL REFERRAL HOSPITAL

W. Iskandar, R. Rohsiswatmo, K. Yuliarti Faculty of Medicine Universitas Indonesia/Cipto Mangunkusumo Hospital, Department Of Child Health, Jakarta, Indonesia


We developed an aggressive nutritional care guideline for very preterm (<32 weeks) or very low birth weight/VLBW (<1,500 grams) infants to achieve adequate extrauterine growth. The objective is to evaluate the biochemical complications.

Methods:

A prospective cohort study was conducted in a national referral hospital since July 2018 until June 2019. Subjects were live-born, very preterm or VLBW infants. Infants with inborn errors of metabolism, genetic abnormalities, and major congenital malformation were excluded. Biochemical complications were measured in the first week, consisting of cholestasis (direct bilirubin >1 mg/dL), hypertriglyceridemia (>250 mg/dL), hypokalemia (<3.5 mmol/L), hypophosphatemia (<4 mg/dL), and hypomagnesemia (<1.8 mg/dL).

Results:

Biochemical complications were measured in 3-7 days of life. Hypophosphatemia was the most common (37/60), followed by hypertriglyceridemia (5/36), hypokalemia (8/67), cholestasis (7/75), and hypomagnesemia (5/61). Hypophosphatemia was more common in extremely-preterm (10/13), extremely-low-birth-weight (20/40), and small-for-gestational-age (15/17) infants. Parenteral phosphate maintenance (1-2 mmol/kg/day) was administered in only 8 of 37 infants, while receiving parenteral protein with mean dose 3.3 (SD 0.71) g/kg/day. All hypertriglyceridemia patients had worsening neonatal sepsis during measurement. Bilirubin was not routinely measured unless clinically jaundice. Only one patient had hypokalemia, hypophosphatemia, and hypomagnesemia, with poor clinical condition during measurement (septic shock).

Conclusions:

Hypophosphatemia was the most common complication found in very preterm or very low birth weight infants. Parenteral nutrition, especially protein, should be administered along with parenteral phosphate maintenance. Aggressive nutrition may induce refeeding syndrome in high risk infants, therefore routine monitor of biochemical profile was required.

374 / #730


A SYSTEMATIC REVIEW ON ASSESSING WHOLE BODY ADIPOSITY IN PRETERM INFANTS IN EARLY LIFE

D. Yumani1, D. De Jongh2, H. Ket3, H. Lafeber1, M. Van Weissenbruch1 1Amsterdam UMC - location VU University Medical Center, Pediatrics, Amsterdam, Netherlands, 2VU University, Faculty Of Science, Amsterdam, Netherlands, 3VU University, Medical Library, Amsterdam, Netherlands


Context: Despite the increased risk of long term adverse cardiometabolic outcomes after preterm birth, there are no guidelines on which methods should be used to assess adiposity in preterm infants.

Objective: To give guidance to the application of methods to assess adiposity in preterm infants.

Methods:

Data sources: PubMed, Embase.com, Wiley/Cochrane Library, and Google Scholar (inception - 2018).

Study selection: Publications in peer-reviewed journals which reported on the predictive value or validity of adiposity assessments in preterm infants, up to 6 months corrected age, were eligible.

Data extraction: Sample size, gestational age at birth and time of assessment, country, and results were extracted.

Results:

Results: Eighteen out of 1930 identified records were included. Body proportionality measures, skinfold thickness and bioelectrical were found to be a poor representation of adiposity. Air displacement plethysmography (ADP) was validated in 24 infants and agreed well with whole body adiposity as measured by isotope dilution. Dual-energy x-ray absorptiometry (DXA) and isotope dilution have only been validated in animal studies. One MRI study of 15 infants showed promising results.

Limitations: Validation studies were conducted in a small number of infants with a wide range of gestational ages and varying postnatal ages at the time of assessment

Conclusions:

Conclusions: ADP, DXA and isotope dilution seem accurate in preterms, but it remains unclear whether one of these methods is superior. There is a need for larger cross-sectional studies comparing reference

methods at different time points, as well as longitudinal studies investigating the accuracy of the use of the instruments over time.

375 / #732


IMPACT OF A NUTRITION SUPPORT TEAM IN A TERTIARY NEONATAL UNIT

L. Hill, F. Dhilip, C. Forster, L. Mcdowall Leeds Children's Hospital, Neonatology, Leeds, United Kingdom


Recent consensus from both BAPM & ESPGHAN recommends a multidisciplinary team approach to nutrition in preterm and growth restricted neonates. There are both financial and workforce constraints to delivering such a service, and there is no current data demonstrating the impact such a team can have. We present the outcomes from a tertiary surgical neonatal unit following the implementation of a Nutritional Support Team. The team consisted of a neonatal consultant and dietician along with a pharmacist who performed weekly ward rounds supplemented by ward education for medical and nursing staff.

Methods:

Growth rates were collected prospectively for all babies seen by the NST in the 12 months following setting up the service, along with numbers of Catheter Related Blood Stream Infection (CRBSI) and inborn NEC rates. Time to full feeds, days receiving parenteral nutrition (PN) and length of stay were also compared pre and post establishing the NST.

Results:

Growth rates for preterm infants increased by 165% - rates for babies born before 30 weeks increased from 8 to 13g/kg/day. Numbers of babies dropping two or more centiles fell from 46% to 25%. Length of stay, time to full feeds and days receiving PN were all reduced, as were CRBSI rates which fell from 2.85 to 0.91 per 1000 line days.

Conclusions:

This service review demonstrates considerable improvements in both nutritional and infective outcomes after the introduction of a Nutritional Support Team in a tertiary neonatal unit.

477 / #122


ASSOCIATION BETWEEN MATERNAL FATTY ACID STATUS AND HUMAN MILK FATTY ACIDS IN A COHORT OF WOMEN FROM 7 EUROPEAN COUNTRIES

M. Fleith1, F. Giuffrida2, T.M. Samuel1, I. Masserey-Elmelegy2, P. Fontannaz2, C. Cruz-Hernandez2, C.A. De Castro3, I. Al Jashi4, T. Rakza5, M. Domellöf6 1Nestlé Research, Institute Of Health Science, Vers-chez-les-Blanc Lausanne, Switzerland, 2Nestlé Research, Institute Of Food Safety And Analytical Science, Lausanne, Switzerland, 3Nestlé Research, Institute Of Health Science, Singapore, Singapore, 4Titu Maiorescu University, Faculty Of Medicine, Bucharest, Romania, 5CHU, Hôpital Jeanne De Flandre, Lille, France, 6Umeå University, Clinical Science, Pediatrics, Umeå, Sweden


Human milk (HM) is considered as ideal food for infants. HM composition is influenced by several factors, like mother’s diet and body stores. For evaluating the influence of mother’s FA status on milk FA composition, the correlation between FA content in HM and in maternal plasma, erythrocytes and adipose tissue was investigated.

Methods:

Women from 7 European countries provided milk samples over 4 months of lactation. Venous blood and adipose tissue were sampled at delivery. Total lipid FA of plasma, erythrocytes, adipose tissue and milk [colostrum (days 1-3), transitional milk (days 14-17) and mature milk] were analyzed. Correlations between FA content in milk and tissues were calculated.

Results:

Positive correlations were observed between human and adipose tissue for polyunsaturated FA (PUFA), palmitic, stearic, oleic, linoleic (LA), alpha-linolenic (ALA), arachidonic (ARA), eicosapentaenoic (EPA), and docosahexaenoic (DHA). The strongest correlations were for ALA, DHA, LA and palmitic (rho>0.65 and p<0.005). Between HM and plasma FA, the strongest correlations were found for PUFA, LA, ARA, ALA and DHA (rho>0.55 and p<0.005). Oleic acid and total monounsaturated FA (MUFA) were also correlated. No correlation was observed between erythrocytes and milk FA.

Conclusions:

Adipose tissue rather than erythrocytes may serve as reservoir of PUFA and LCPUFA for human milk. Plasma also supplies PUFA and LC-PUFA to the mother for lactation. Both adipose and plasma PUFA are reflection of dietary intake, supporting the need of providing PUFA and LCPUFA during pregnancy and lactation to ensure right provision to infant and mother.

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